Public Health and Pharmacy Partnerships in Opioid Harm Reduction: Responding to Community Needs.

BACKGROUND: Minnesota pharmacists were encouraged to utilize legislation allowing them to dispense naloxone, an opioid overdose reversal drug, without prescription. Unfortunately, this legislation has not been utilized widely resulting in preventable death. OBJECTIVES: This study sought to determine how a partnership between public health and academic pharmacy could facilitate community pharmacists' naloxone dispensing. METHODS: Pharmacy and public health professionals collaborated in two counties to identify ways to support naloxone dispensing. Community pharmacies in these areas were provided with multidisciplinary support in naloxone and naloxone protocol education; dispensing measures were tracked before and throughout the study. RESULTS: Through partnerships between public health and pharmacy, naloxone dispensing measures increased. In-person visits with a public health or pharmacy advocate were associated with increased protocol uptake, dispensing, and naloxone stocking. CONCLUSIONS: Support from public health professionals and pharmacists in partnership shows great promise in increasing naloxone protocols and dispensing in a community pharmacy setting.

Integrating pharmacogenetic testing via medication therapy management in an outpatient family medicine clinic.

Introduction: Pharmacogenetic (PGx) implementation has lagged behind the development of drug/gene pair guidelines. Materials & methods: This was a prospective study assessing the integration of PGx through medication therapy management in an outpatient clinic. Variables collected included patient diagnosis, current medications, failed or discontinued medications, PGx results/recommendations, turnaround time and pre/post clinical ratings. Results: A total of 91 participants completed study procedures with an average enrollment of approximately one consult per week. Participants were referred for testing primarily for guidance for current and future medications. The average number of recommendations per participant was 0.93. Conclusion: Integrating PGx testing into medication therapy management is feasible with PGx results available in under a week resulting in clinical recommendations in over half of patients tested.

Hormones and temporal components of speech: sex differences and effects of menstrual cyclicity on speech.

Voice onset time (VOT) is a salient acoustic parameter of speech which signals the 'voiced' and 'voiceless' status of plosives in English (e.g. the initial sound in 'bat' versus the initial sound in 'pat'). As a micro-temporal acoustic parameter, VOT may be sensitive to changes in hormones which may affect the neuromuscular systems involved in speech production. This study adopted a novel approach by investigating the effects of menstrual cycle phase and sex on VOT. VOT data representing the six plosives of English (/p b t d k g/) were examined for seven women (age 20-23 years) at two phases of the menstrual cycle (day 18-25: high estrogen and progesterone; day 2-5: low estrogen and progesterone). Results indicated that menstrual cycle phase had a significant interaction with the identity of the plosive (F (5,30) = 5.869, P < 0.002). Menstrual cycle phase also had significant effects on the contrasts between cognate voiced and voiceless plosives (F (1,6) = 11.444, P < 0.02); samples from the high hormone phase displayed an enhanced voiced/voiceless contrast. Subsequently, VOT data samples from the two phases of the menstrual cycle were compared with those from five men in order to explore sex differences at different phases of the menstrual cycle. Low hormone phase samples displayed no significant sex differences for either VOT values (F (1,10) = 2.085, P > 0.05), or the contrast between voiced and voiceless cognates (F (1,10) = 0.407, P > 0.05). In contrast, the high hormone phase VOT samples displayed significant plosive by sex interactions (F (5,50) = 4.442, P < 0.005). In addition, significant sex differences were found for the contrasts between cognate voiced and voiceless plosives (F (1,10) = 5.019, P < 0.05); the women displayed a more marked voiced/voiceless contrast. The findings suggest that ovarian hormones play some role in shaping some temporal components of speech.