Prioritizing financial knowledge and skills within the doctor of pharmacy curriculum.

INTRODUCTION: Over the past decade, pharmacy school tuition and the subsequent amount of student debt has risen significantly. Additionally, the debt-to-income ratio for pharmacy school graduates increases, making it extremely important to manage personal finance during pharmacy school and beyond. To assess a personal finance elective's effect on students' financial literacy and confidence, a course evaluation study was pursued at Northeast Ohio Medical University (NEOMED). METHODS: NEOMED's College of Pharmacy graduating Classes of 2018 through 2021 completed a voluntary, anonymous survey to determine the need and interest for a finance elective in the curriculum. Survey results were grouped by enrollment in the personal finance elective course (i.e. students enrolled and students not enrolled). Students self-identified the category describing their knowledge and confidence in financial decision-making using Likert-style scales. RESULTS: Of the 106 students who responded, 57 (54%) were not enrolled and 49 (46%) were enrolled in the personal finance elective course. Students in the elective reported significantly higher financial literacy and financial decision-making confidence in many areas, including budgeting, loans, debt, investing, and retirement planning. Ninety-seven percent of study participants determined that a personal finance elective should be made available to students. CONCLUSIONS: Students' financial knowledge and confidence can be positively impacted by a personal finance course. With the increasing student-loan-debt and expected 3% decline in the 10-year job outlook for pharmacist workforce positions, it is essential to provide future pharmacists with financial resources to make sound financial decisions impacting their careers and lives.

Prevalence, predictors and trends of opioid prescribing for lower back pain in United States emergency departments.

WHAT IS KNOWN AND OBJECTIVE: Current evidence-based guidelines for the treatment of acute low back pain (ALBP) recommend the use of opioid medications only after failure of nonpharmacological therapy, non-steroidal anti-inflammatory drugs and skeletal muscle relaxants and after thorough evaluation of risks and benefits. Despite this recommendation and the state of the opioid epidemic in the United States (US), opioids remain a common drug of choice for ALBP in the emergency department (ED). The purpose of this study was to quantify the prevalence and identify predictors of opioid prescribing for acute lower back pain (ALBP) in emergency departments (EDs) in the United States. METHODS: This was a national, cross-sectional study of the National Hospital Ambulatory Care Survey from 2013-2016. ED visits for patients aged ≥18 years treated for ALBP were included. Patients presenting with specified reasons that an opioid may be indicated were excluded. The primary endpoint was frequency of opioids prescribed. A multivariate logistic regression model identified patient- and provider-level predictors of opioid use. RESULTS AND DISCUSSION: This analysis included 2260 visits for ALBP. Opioids were prescribed in 32.3% of visits. Positive predictors of opioid prescribing were pain score of 7-10 (OR 1.85; 95% CI 1.26-2.70), and patients seen in the Southern (OR 2.53; 95% CI 1.47-4.36) or Western US (OR 2.10; 95% CI 1.19-3.70). Opioids were prescribed less often to patients who received a NSAID or acetaminophen (OR 0.38; 95% CI 0.28-0.52 and OR 0.03; 95% CI 0.01-0.10, respectively). WHAT IS NEW AND CONCLUSION: Opioid prescribing rates for ALBP remain high and the predictors identified demonstrate that this prescribing pattern is not uniformly distributed across the patient and provider characteristics studied.