Comparison of dietary supplement product knowledge and confidence between pharmacists and health food store employees.

OBJECTIVES: To determine pharmacists' and health food store employees' knowledge about the safety and efficacy of common, nonvitamin, nonmineral dietary supplements in a retail setting and confidence in discussing, recommending, and acquiring knowledge about complementary and alternative medicine (CAM). DESIGN: Cross-sectional survey. SETTING: Central and western New York in May and June 2012. MAIN OUTCOME MEASURES: Knowledge and confidence survey scores based on true/false and Likert scale responses. RESULTS: Pharmacists' mean knowledge score was significantly higher than that of health food store employees (8.42 vs. 6.15 items of 15 total knowledge questions). Adjusting for differences in experience, education, occupation, and confidence, knowledge scores were significantly higher for pharmacists and those with a higher total confidence score. Pharmacists were significantly less confident about the safety and efficacy of CAM comparatively (13 vs. 16 items of 20 total questions). CONCLUSION: Pharmacists scored significantly higher than health food store employees on a survey assessing knowledge of dietary supplements' safety and efficacy. Despite the significant difference, scores were unacceptably low for pharmacists, highlighting a knowledge deficit in subject matter.

Information literacy skills retention over the first professional year of pharmacy school.

The authors aimed to determine if first-professional-year pharmacy students retain library literature search skills throughout the school year. Students (n = 61 consented) were given an identical seven-item quiz on basic library search skills prior to library instruction in the fall semester and at the end of the spring semester. There was no significant difference between median scores on the two quizzes, nor were any significant differences noted in subgroup analyses. Search competency may be retained to a higher degree if library instruction is moved later in the pharmacy curriculum when literature search skills are used more often.

Bedbugs: a primer for the health-system pharmacist.

PURPOSE: The history and life cycle of bedbugs, the identification and supportive treatment of bedbug bites, and the eradication and prevention of bedbug infestations are reviewed. SUMMARY: Cimex lectularius, known commonly as the bedbug, is a growing problem in the United States. While the bedbug population declined between the 1950s and the late 20th century, recent increases in international travel and immigration, the banning of dichlorodiphenyltrichloroethane, and insecticide resistance have caused a resurgence of bedbug infestations. Infestations can be identified based on clinical presentation and situational indicators such as housing location and the presence of bedbug fecal smears and nests. Chronic infestation can lead to nervousness, anxiety, and insomnia arising from the inability to identify and eradicate the problem. Scratching at the bite site can lead to a secondary bacterial infection. Because bedbugs continue to bite until the infestation is eradicated, treatment is not accomplished by one strategy alone. A team effort by different health care professionals is necessary. Because bedbugs are hardy insects, eradication can be a daunting task. Proper eradication plans should be in place at all health care facilities, and bedbug infestations should be reported to the state public health department to support the tracking and management of bedbugs. CONCLUSION: Bedbug infestations are prevalent in locations with high occupant turnover, including hospitals and health systems. Bedbug bites can cause secondary infections and lead to discomfort and anxiety in affected individuals. Pharmacists should work with other health care providers to provide affected patients with supportive treatment and ensure appropriate eradication of the infestation.

Impact of electronic device use in class on pharmacy students' academic performance.

OBJECTIVES: To evaluate and assess the impact of pharmacy students' electronic device (e-device) use during a lecture-based pharmacotherapeutics sequence. METHODS: A validated survey instrument to assess e-device use was e-mailed to 238 second- (P2) and third-year (P3) pharmacy students. Grades were reviewed retrospectively and correlated with e-device use to determine its impact on academic performance. RESULTS: Of 140 responding students (59% response rate), 106 reported using e-devices during class for course-related (91.5%) and non-course-related (81.1%) activities. When P2 and P3 students were combined, e-device use was not associated with academic performance (p = 0.70). Academic performance was not impacted among P3 students (p = 0.86), but P2 students performed better academically if they refrained from using e-devices during class (mean grade = 88.5% vs. 83.3%; p=0.019). CONCLUSIONS: The impact of e-device use on overall academic performance was negligible. Use of e-devices by students enrolled in their first pharmacotherapeutics course may negatively impact academics.

Antimicrobial stewardship: a matter of process or outcome?

The risk of antimicrobial resistance and superinfection is increasing alongside rates of hospital-acquired infection. Imprudent antibiotic use combined with few novel antimicrobials can speed resistance. Antimicrobial stewardship programs (ASPs) advocate for judicious use of available antimicrobials to preserve their usefulness. Decreased antibiotic expenditures was the backbone of early justification for ASPs, but the function of these programs has evolved into measuring the quality and appropriateness of antimicrobial use. Proper evaluation of an ASP helps to inform which methods work best for a particular institution and can help to define best practices at a more global level. Study design and duration limitations, however, can make it difficult to measure the impact of these programs. Process measures have been validated and can evaluate quality of care; however, they do not adequately describe the clinical impact of these programs at the patient level. Outcome measures also have limitations; they are not a direct measure of quality of care. Therefore, both process and outcome measures need to be defined and assessed when evaluating an ASP to confirm that goals of the intervention are attained and clinical objectives are met. Most available well-designed studies judging the effectiveness of ASPs use process measures alone. Adding improvements in clinical outcomes to process measures would theoretically attract the attention of a broader audience and provide additional support to expand current ASPs and develop novel ASPs.

Hypertension in diverse populations: a New York State Medicaid clinical guidance document.

The New York State Medicaid Prescriber Education Program (PEP) is a partnership between the Department of Health and state academic institutions that provides prescribers with an evidence-based, noncommercial source of the latest objective information about pharmaceuticals. This article, detailing treatment of uncomplicated hypertension in diverse populations, represents one of the first large-scale PEP initiatives. The main risk factors for hypertension are age and obesity. Disparities in hypertension risk and outcomes among diverse populations are now believed to be more a function of personal habits, socioeconomic status and psychosocial factors rather than race, ethnicity, or genetics. Blood pressure is controllable in most patients, and all patients should be treated according to best practices. Lifestyle modification, especially diet and exercise, should be encouraged, but most patients will require more than one antihypertensive medication to control blood pressure. Combination therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker plus thiazide-type diuretic or dihydropyridine calcium channel blocker is largely universal in efficacy. Improved provider-patient partnership and communication is important to blood pressure lowering success, and cultural sensitivity should be taken into account where applicable.