Maternal response to high-risk obstetric telemedicine consults when perinatal prognosis is poor.

This is a qualitative descriptive study evaluating the maternal response after the woman has learned her pregnancy has a poor prognosis via telemedicine rather than in a traditional, face-to-face, consultation method. In general, telemedicine was positively viewed by the participants; however, the experience may be markedly improved by implementing several simple changes in the overall consultative process.

Emergency contraception counseling: an opportunity for pharmacists.

OBJECTIVE: To determine the impact of pharmacist counseling on patients' knowledge of emergency contraception (EC). DESIGN: Single-group, repeated-measures analysis. SETTING: Academic medical center women's clinic in Little Rock, AR, between January and July 2010. PARTICIPANTS: 116 women 18 years or older. INTERVENTION: 10-minute education session provided by a pharmacist or trained student pharmacist. MAIN OUTCOME MEASURES: Change in participants' test scores (range 0 [lowest possible] to 13 [highest possible]) at three assessment periods (pretest, posttest, and follow-up) using 12 knowledge questions. RESULTS: 116 participants with a mean (±SD) age of 25 ± 5.9 years participated in this study. Mean knowledge scores were 5.3 ± 4.1 for the pretest and 10.7 ± 1.4 for the posttest (P < 0.001). The least-squares mean EC knowledge test score (adjusted for demographics) was 5.86 at pretest, 10.75 at posttest, and 10.75 at follow-up. A nonsignificant small change in scores from posttest to follow-up was detected after the Tukey-Kramer adjustment. A higher education level was associated with higher knowledge scores in this population. CONCLUSION: Brief pharmacist-driven counseling sessions provided in a clinic setting are feasible and have a positive impact on immediate EC knowledge and long-term knowledge retention.

Depression and diabetes: Establishing the pharmacist's role in detecting comorbidity in pregnant women.

OBJECTIVES: To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression. SETTING: Little Rock, AR, between June and August 2007. PRACTICE DESCRIPTION: At a women's health clinic providing obstetrical services to local and statewide patients, the clinical pharmacist functions as a diabetes educator, provides treatment recommendations for the OB/GYN medical residents, and precepts fourth-year student pharmacists. PRACTICE INNOVATION: The pharmacist and student pharmacists screened patients with diabetes for depression using the Beck Depression Inventory, 2nd ed. (BDI-II). MAIN OUTCOME MEASURES: Patient demographics, including obstetrical history, type of diabetes, depression history, and current treatments. RESULTS: 50 patients were screened in this pilot study. Of participants, 42% reported scores that indicated clinical depression. Among patients with clinical depression, only 19% were receiving treatment for depression. Obstetrical history (number of pregnancies) showed a positive correlation with the BDI-II total scores (P = 0.0078). CONCLUSION: This population had a high prevalence of depressive symptoms, but very few women were receiving treatment for depression. Depression screenings should be integrated into routine prenatal care, offering adequate treatment when needed. This study implies that pharmacists can assist with screening for depression in diabetes and thus ensure that at-risk patients receive the attention needed to better manage their illnesses.

Through with the flu: how free family and caregiver immunization protects sick neonates.

Newborns represent the pediatric population most at risk for influenza-related morbidity and mortality, especially premature newborns and those with chronic disease. Compounding this problem is the fact that influenza immunizations are ineffective until 6 months of age. This article describes a successful program that follows the "cocoon" theory of immunization. Free influenza vaccines were given in the nursery to all family members, caregivers, and others living in the homes of discharged infants. Planning and implementation steps are described, along with lessons learned during implementation. The response to the program exceeded expectations, with 185 contacts immunized. Future plans include the expansion of the current program to include the H1N1 influenza vaccine and the Tdap vaccine. The described vaccination effort encourages and substantiates the benefits of cocoon immunization in other nurseries across the nation.