The Significance of Taking Antiretroviral Medications for African-Born People Living with HIV and Residing in Minnesota.

Thanks to the development of antiretroviral (ART) medications, HIV is now a chronic and manageable disease. This study aimed to (1) capture the experiences of African-born persons living with HIV and taking antiretroviral treatment, and (2) explore the impact of social and cultural factors on their decisions to follow the prescribed treatment. For this study, a qualitative approach was used. The participants were recruited via fliers, then screened for inclusion and exclusion criteria. Recruitment of the participants continued until data saturation occurred. The interview guide was developed based on the extensive literature and recommendations from the clinical team. In-person narrative interviews were conducted with 14 participants-African-born persons living with HIV and residing in Minnesota. Thematic Analysis revealed three emergent themes: "To exist I have to take the medicine"; barriers and facilitators in taking ART medications; and the power of spirituality and prayers. The findings of this study paint a picture of African-born persons living with HIV, and their experiences with ART medications. This study not only presents the participants' medication experiences and their significance, but also tells their stories of how God and prayers play a significant role in helping them to get through the difficult moments of their lives.

"Stigma and HIV Are Like Brother and Sister!": The Experience of African-Born Persons Living with HIV in the US.

Minnesota has seen an increase in the number of immigrants from Africa, notably in the mid-1990s, making up around 2% of Minnesota's total population. This population also faces many impediments that cause important difficulties not only for HIV prevention but also for treatment and care options. The objectives of this study were to capture the experiences of Persons Living with HIV (PLWH) in Minnesota (US) and to elicit their stories about their diagnosis news and what management strategies they use for coping with the stigma associated with the disease. Participants were recruited via fliers in pharmacies, clinics, and HIV service centers located in Minnesota. Recruitment continued until thematic saturation was obtained. Fourteen subjects participated in audio-recorded, semi-structured interviews that were transcribed verbatim into written text. The transcriptions were analyzed using Thematic Analysis. Three themes emerged from the data. Theme 1: Cruel News: "HIV-Oooooo! I wish I was dead", Theme 2: This is My Secret! and Theme 3: "Stigma and HIV are brother and sister". The results demonstrate that stigma is an ever-present problem in African-born PLWH living in the US. Participants perceived the stigma associated with HIV status to affect their lives and culture at individual, familial, and societal levels.

Using Theater as an Educational Tool for Understanding Medication Experiences from the Patient Perspective.

Objective. To develop a play depicting patients' medication experiences and evaluate its usefulness as an educational tool for improving health care professionals' understanding of medication experiences from the patient perspective. Methods. An award-winning playwright was recruited to write the script, which was based on 2,178 written comments submitted by respondents to a national consumer survey on patients' medication experience and pharmacist roles. The resulting play, Go Ask Alice, was presented during November 2016 in two Minnesota cities. Attendees were asked to complete a survey before and after the performance and to provide their email address if interested in completing a three-month follow-up survey. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively. Results. A total of 225 people viewed the performances, with 161 completing both the pre- and post-intervention surveys and 58 providing feedback three months later. Two themes emerged in the follow-up survey: the play illuminated barriers that patients face when seeking health care services, as well as the major hindrances and other contributors to patients' medication experiences. Conclusion. Theatrical performance can be an effective educational tool for understanding medication experiences from the patient perspective.

Narrative experiences of interactions with pharmacists among African-born persons living with HIV: "It's mostly business."

BACKGROUND: African-born persons constitute 1% of the total Minnesota population, yet 24% of new HIV infections occurred in this population in 2016. Furthermore, 32% of the African born persons living with HIV [PLWH] did not check their CD4 counts or viral load in 2018. Little is known of the role of pharmacists in antiretroviral (ARV) management in the PLWH of African origin. OBJECTIVE: This study aimed to describe the experiences of African-born PLWH in their interactions with pharmacists and perceptions of pharmacists' roles in fostering adherence to ARV therapy. METHODS: A qualitative approach was used for this study. Recruitment via fliers for in-person interviews with African-born PLWH in Minnesota continued until saturation was achieved. Narrative Interviews with 14 participants lasting up to 2 h were conducted over five months. All interviews were audio recorded and transcribed verbatim by a professional transcription service. Conventional Content Analysis was used to analyze the data. RESULTS: Three themes emerged from analyzed data "Interaction with the pharmacists," "Revealing the diagnosis to a pharmacist," and "Lack of disclosure of HIV status to a pharmacist." CONCLUSIONS: The participants referred to the interaction with pharmacists as a "business" or "transactional interaction." To better understand the interaction between pharmacists and PLWH of African-born, future studies could benefit from interviewing pharmacists from different practice settings.

An Opportunity for Pharmacists to Help Improve Coordination and Continuity of Patient Health Care.

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, 2178 were specifically about medicines, pharmacists or health and were relevant and usable for this study. Thematic analysis, content analysis, and computer-based text mining were used for identifying themes and coding comments. The findings showed that 66% of the comments about medication use and 82% about the health care system were negative. Regarding pharmacists, 73% of the comments were positive with many commenting about the value of the pharmacist for overcoming fears and for filling current gaps in their healthcare. We propose that these comments might be signals that pharmacists could help improve coordination and continuity for peoples' healthcare and could help guide the development of new service offerings.

Partners in Public Health: Public Health Collaborations With Schools of Pharmacy, 2015.

To collect data on public health collaborations with schools of pharmacy, we sent a short electronic survey to accredited and preaccredited pharmacy programs in 2015. We categorized public health collaborations as working or partnering with local and/or state public health departments, local and/or state public health organizations, academic schools or programs of public health, and other public health collaborations. Of 134 schools, 65 responded (49% response rate). Forty-six (71%) responding institutions indicated collaborations with local and/or state public health departments, 34 (52%) with schools or programs of public health, and 24 (37%) with local and/or state public health organizations. Common themes of collaborations included educational programs, community outreach, research, and teaching in areas such as tobacco control, emergency preparedness, chronic disease, drug abuse, immunizations, and medication therapy management. Interdisciplinary public health collaborations with schools of pharmacy provide additional resources for ensuring the health of communities and expose student pharmacists to opportunities to use their training and abilities to affect public health. Examples of these partnerships may stimulate additional ideas for possible collaborations between public health organizations and schools of pharmacy.

Pharmacists' and patients' roles in the pharmacist-patient relationship: are pharmacists and patients reading from the same relationship script?

BACKGROUND: Pharmacists' professional roles have maturated to include provision of information, education, and pharmaceutical care services. These changes have resulted in a focus on collaborative pharmacist-patient professional relationships, in which pharmacists and patients both have roles and responsibilities. OBJECTIVE: The study purpose was to investigate pharmacists' and patients' views of selected pharmacist and patient roles in the pharmacist-patient professional relationship, using principles of role theory. Pharmacist and patient role dimensions studied included (1) "information sharing,"(2) "responsible behavior," and (3) "interpersonal communication." "Creating a patient-centered relationship" and "active communication related to health care" were additional pharmacist and patient role dimensions studied, respectively. METHODS: Data were collected via mailed questionnaires from national random samples of 500 patients aged 18 years and older and 500 pharmacists. Internal consistency reliability was estimated for pharmacist and patient role dimensions using Cronbach's coefficient alpha and bivariate correlation analysis. Student's t test was used to compare pharmacists' and patients' views of role dimensions (alpha level of significance=.05). Descriptive statistics were used to characterize the pharmacist and patient samples. RESULTS: The adjusted response rates for the pharmacist and patient groups were 34.9% (173/496) and 40.8% (196/480), respectively. Pharmacist and patient role dimensions exhibited adequate reliability coefficients. Results showed that pharmacists and patients have similar views regarding pharmacists' "information sharing" roles in the relationship, but for the most part, patients agree less about pharmacists' "responsible behavior," "creating a patient-centered relationship," and "interpersonal communication" roles. Regarding patient roles in the relationship, pharmacists and patients have different views about patients' "information sharing," "responsible behavior," "interpersonal communication," and "active communication related to health care" roles. Results suggest that pharmacists more strongly agree that these are patient roles in the relationship than patients do. CONCLUSIONS: If pharmacists and patients agree on relationship roles, the functionality and outcomes of this relationship will be optimized. Future research is needed to monitor trends in pharmacists' and patients' views of their relationship roles and to develop strategies as needed to ensure that pharmacists and patients are following the same relationship script.

Provision of risk management and risk assessment information: the role of the pharmacist.

BACKGROUND: There exists a need to conceptualize and understand the roles that pharmacists serve to help convince others such as patients, prescribers, and payers to value their contributions and to plan for the roles they could serve in the future within the health care system. OBJECTIVE: The purpose of this study was to (1) describe and track differences in pharmacists' and patients' views about the pharmacist's and physician's role in medication risk management and risk assessment in 1995, 1998, 2001, and 2004, and (2) describe associations between selected demographic variables and reported opinions about the pharmacist's role using data from 2004. METHODS: Brushwood's Risk Management/Risk Assessment Framework was used as a conceptual guide for developing 2 risk management and 2 risk assessment scenarios. For each scenario, study participants were asked to select the level of responsibility shared by physicians and pharmacists in addressing the drug therapy problem. Data were collected in 1995, 1998, 2001, and 2004 using random samples of pharmacists and patients as study subjects. Descriptive statistics and logistic regression analysis were used for analyzing the data. RESULTS: The results showed that pharmacists view their role as providing risk management information to patients and may view this role as adding value to patient care above and beyond a level that can be provided by a physician alone. In 2004, pharmacists started to view the risk assessment scenarios as being more their responsibility as well. Patients, on the other hand, consistently viewed their physician as having primary responsibility for their health care in all of the scenarios we studied. CONCLUSIONS: Pharmacists view their role as one that adds unique value to a patient's health through their provision of medication risk management and some types of risk assessment. However, patients do not yet view the pharmacist as the primary provider of either medication risk management or risk assessment information.