Identification of Social Determinants of Education Among Pharmacy Students: Results From a Single-Institution Survey.

OBJECTIVE: To identify social determinants of education (SDOE) among pharmacy students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. METHODS: An original 28-item survey was developed and disseminated to first through fourth year students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences during the spring 2023 semester. The survey evaluated student demographics, educational performance, and SDOE in 6 categories: physical health, psychosocial health, economic stability, self-motivation, social environment/community, and physical environment/community. RESULTS: A total of 133 students responded to the survey. Over half of the respondents acknowledged difficulties completing errands or self-care tasks owing to their physical, mental, or emotional health. Over half of respondents also reported concerns about covering expenses at the end of the month. Respondents also reported eating less because of financial restraints (20.0%), worrying about housing (22.9%), feeling unsafe in their neighborhood (29.0%), and feeling lonely or isolated (63.4%). In the secondary analysis, the respondents who had concerns with covering expenses, affording food, or losing housing had significantly lower academic performance. CONCLUSION: This study identified several SDOE among pharmacy students at our institution, suggesting that students at even the highest levels of education may be subject to disparities. The identification of SDOE provides insight into barriers that are potentially hidden but are highly likely to impact student engagement and success. Efforts toward reducing disparities and promoting equitable opportunities for students are necessary to ensure continued growth and diversification of the pharmacy profession.

Collagenous Colitis with Escitalopram Use: A Case Report and Literature Review.

We present the case of a 42-year-old female whose escitalopram use potentially contributed to a diagnosis of collagenous colitis. The patient presented with significant watery, nonbloody diarrhea, abdominal cramping and pain, and weight loss. Established risk factors of microscopic colitis in this patient include a history of smoking and female gender. The patient underwent a colonoscopy, which confirmed histological changes consistent with collagenous colitis. Prescribed therapy included oral budesonide and omeprazole, continued for eight and twelve weeks, respectively. Escitalopram was continued, with a discussion regarding changing to an alternative therapy. Based on the patient's history of escitalopram use, this case suggests a relationship between escitalopram and microscopic colitis. Though case reports of patients diagnosed with microscopic colitis after antidepressant use are published, this case appears to be the only report of collagenous colitis without macroscopic complications following escitalopram use. This case adds further support in that antidepressants may contribute to microscopic colitis. Despite an undefined frequency of association, healthcare providers who prescribe antidepressants should be cognizant of the theorized association and understand risk factors, screening, and treatment approaches.

Patient Perception and Impact of Home Test Kits on Health Care Utilization for Urinary Tract Infection.

Urinary tract infection (UTI) is a common reason for emergency department (ED) utilization that could potentially be treated by a primary care provider (PCP). This study assessed patient perceived value of a home UTI test kit plus educational materials and its impact on ED utilization for a UTI symptom episode. Women aged 18-75 years with Medicaid insurance and a history of 1-3 uncomplicated UTIs in the past year were prospectively identified and randomized to the intervention, intervention plus (intervention plus a patient portal message before its delivery), or standard of care group. A telephone survey was conducted 3-5 months after the mailing. Site of care for each UTI symptom episode was measured 12 months before and 6 months after the intervention. Test kit packages were mailed to 266 intervention individuals, and 150 responded to the telephone survey. Utilization outcomes were compared between a combined intervention group and a control group. Approximately one-third of the intervention patients experienced UTI symptoms within 5 months, and 73% used the test kit. Of those who experienced UTI symptoms, 58% contacted their PCP to seek care and 96% reported that the test kit was helpful. ED utilization was not significantly different in the intervention groups before and after the intervention, nor between the intervention and control groups postintervention. A home UTI test kit plus educational materials mailed to patients with a history of uncomplicated UTI was deemed helpful but did not have a measurable impact on ED utilization.