Efficacy of an over-the-counter intervention follow-up program in community pharmacies.

OBJECTIVE: To evaluate whether patient adherence to appropriate self-care advice from a pharmacist or professional year 4 (PY4) advanced pharmacy practice experience (APPE) student provides satisfactory symptom relief. SETTING: Two community pharmacies in the same chain in Massachusetts from mid-December 2009 to June 2010. PRACTICE DESCRIPTION: Pharmacists and PY4 APPE students offered a follow-up phone call to patients who were seeking or had accepted the offer for self-care advice for themselves or others for whom they are primary caregivers. PRACTICE INNOVATION: Patients were provided detailed counseling documented on an over-the-counter (OTC) intervention document, administered a point-of-care survey, offered a follow-up phone call(s), and then administered a follow-up survey. MAIN OUTCOME MEASURES: Patient demographics, point-of-care survey assessing current use and perceived benefit from a pharmacist's consultation, intervention document assessing potential medication-related problems, and follow-up telephone survey assessing patient adherence to advice, symptom relief, and satisfaction with the service. RESULTS: Of the 207 patients offered a follow-up phone call, 83 accepted. Of these, 54 completed one call and 9 completed two calls. Of those who completed one phone call and claimed complete adherence to advice provided, 38 (82.6%) experienced great symptom relief. Three patients followed advice only partially and experienced the same level of improvement. More than 75% of patients classified the follow-up as "very helpful," felt that it led to greater symptom improvement, and would like to see this service offered all of the time. CONCLUSION: Pharmacist intervention in OTC therapy is widely accepted and can lead to improved patient outcomes.

An open trial of in-home CBT for depressed mothers in home visitation.

Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

Maternal Depression in Home Visitation: A Systematic Review.

Depression is prevalent in new mothers and has been shown to have profound negative impacts on parenting, maternal life course, and child development. High rates of maternal depression have been found in home visitation, a widely disseminated prevention approach for high risk mothers and their children. This paper reviews the emerging literature on the prevalence, impact, and treatment of depression in the context of home visitation. Findings are synthesized and methodological and design limitations are considered in interpretation of results. Promising approaches to addressing maternal depression and supporting home visitors in working with this clinical population are described. Recommendations for research and practice are offered that build upon the strong foundation of current efforts in this area.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for genotyping of human platelet-specific antigens.

BACKGROUND: Genotyping of single-nucleotide polymorphisms (SNPs) using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an emerging technique, where finally tools for end users have become available to design primers and analyze SNPs of their own interest. This study investigated the potential of this technique in platelet (PLT) genotyping and developed a validated method for genotyping of clinical relevant human PLT antigens (HPAs). STUDY DESIGN AND METHODS: A multiplex assay using MALDI-TOF MS to analyze six HPA loci (HPA-1, HPA-2, HPA-3, HPA-4, HPA-5, and HPA-15) simultaneously in a single reaction was applied for the genotyping of 100 DNA samples from a cohort of plateletpheresis donors and a patient population (n = 20) enriched for rare alleles. The genotyping results using MALDI-TOF MS were validated by the comparison with the results from typing by polymerase chain reaction with sequence-specific primers and conventional DNA sequencing. RESULTS: Both homozygous and heterozygous genotypes of HPA-1 to -5 and -15 of the 120 individuals were easily identified by a six-plexed assay on MALDI-TOF MS. The three approaches achieved a 100 percent concordance for the genotyping results of the six HPA loci. CONCLUSION: Compared to conventional methods, the MALDI-TOF MS showed several advantages, such as a high velocity, the ability to perform multiplexed assays in a single reaction, and automated high-throughput analysis of samples. This enables cost-efficient large-scale PLT genotyping for clinical applications.