Pilot Evaluation of Generation Rx Ambassadors Virtual Training to Prepare Students for Medication Safety Outreach.

Objective. To describe the creation of a virtual training program (Generation Rx Ambassadors) and evaluate a pilot offering's impact on knowledge and perceived abilities in delivering medication safety outreach through the Generation Rx program.Methods. Generation Rx (GenRx) is a prevention education program used by student pharmacists to teach safe medication practices in the community. An asynchronous virtual course, called Generation Rx Ambassadors (Ambassadors), was developed to train facilitators on best practices for GenRx delivery. The training was piloted in a mixed student cohort and evaluated using a preprogram/postprogram survey assessing participants' objective knowledge gains and self-perceived abilities to appropriately deliver GenRx education.Results. Fifty-two health sciences undergraduate and graduate students as well as Doctor of Pharmacy (PharmD) students completed the pilot offering of Ambassadors. Regardless of degree status or discipline, participants demonstrated significant knowledge gains for all outcomes except defining medication misuse behaviors (for which there was initial strong mastery). Prior to Ambassadors training, many participants indicated a perceived ability to effectively deliver GenRx education; however, corresponding objective knowledge assessment did not support this belief. Training through the Ambassadors program appropriately aligned participants' perceived abilities with actual content knowledge for most program learning outcomes.Conclusion. These pilot findings suggest that Ambassadors is an effective training tool on best practices for GenRx delivery. More generally, this work reiterates a need to formally train student pharmacists ahead of community outreach activities, particularly in the prevention education arena. Future evaluation will focus on replicating this study with an expanded cohort size and assessing participants' ability to deliver GenRx education in community-based settings.

Community Health Center 340B Program: A Qualitative Study of the Experiences of Patients with Diabetes.

Background: The 340B Drug Pricing Program provides discounted drug prices to safety-net entities which help stretch scarce resources to expand comprehensive services and treat more vulnerable patients. The program has received criticism questioning whether the original intentions are being accomplished. Objective: This qualitative study aimed to understand lived experiences of patients accessing high-cost injectable diabetes medication(s) through a 340B Prescription Cash Discount Program (PCDP) provided at a community health center. Methods: This qualitative study utilized semi-structured individual interviews. We invited patients ≥18 years old with diabetes for >1 year who utilized the 340B PCDP to fill an injectable diabetes medication at least twice between 3/1/2020-3/1/2021 to participate. Trained personnel interviewed ten participants in 11/2021-2/2022 and completed thematic analysis of the transcribed interviews. Results: Themes included 340B feedback, benefits of 340B, consequences of being without 340B, community pharmacy experience, and use of other services. Participants deemed the 340B program as a "lifesaver." Perceived benefits of the program included improved diabetes control and savings that made their prescriptions more affordable. Consequences of being without the program include that medication was too expensive to take as prescribed and rationing/skipping doses. Participants were pleased with the accessibility of the network of contract pharmacies and described benefiting from services supported by 340B savings. Conclusions: Recent criticisms question whether the 340B program accomplishes its original intentions of stretching scarce federal resources to help safety-net entities expand services and treat more patients. This study provides insight into the personal impact of the 340B program on underserved patients with chronic disease accessing high-cost medication(s). Findings highlight crucial strengths of the program from the patient perspective, which policymakers and other stakeholders should consider to provide support for the continuation of these services.

HealthCare educational differences in pain management, adverse childhood experiences and their relationship to substance use disorder education.

BACKGROUND: In order to assist the State of Ohio in the United States in addressing the opioid epidemic, the Ohio Attorney General appointed experts in a variety of academic disciplines to the Scientific Committee on Opioid Prevention and Education (SCOPE). The focus of SCOPE is the application of scientific principles in the development of prevention and educational strategies for reducing substance use disorder (SUD). One area of focus for SCOPE was SUD education of healthcare professionals. The objective of the present was to identify the content and extent to which future healthcare professionals are trained in pain management, SUD, and adverse childhood experiences (ACEs). METHODS: In December of 2019, a survey was distributed to 49 healthcare professional schools in Ohio that included the following disciplines: medicine, pharmacy, advanced practice registered nurse (APRN), physician assistant, dentistry, and optometry. The survey included four domains: initial screening of patients, training in SUD, training in care for patients at high risk for SUD, and education in evaluating patients for ACEs. Descriptive statistics were calculated. RESULTS: Thirty one of the forty-nine schools completed the survey. Most disciplines indicated that some form of basic training in the principles of SUD were taught in their core curriculum. The training on ethical issues surrounding SUD were not as widely covered (range 0-62.5%). Medicine, APRN, physician assistant, and pharmacy schools had a "moderate" to "great" extent of pharmacologic therapy curriculum integration. Other pain management strategies were "somewhat" to "moderately" integrated. There were variations seen in training on risk of medication misuse based on various contributors to health. At least 67.7% of medicine, APRN, physician assistant, and pharmacy programs included motivational interviewing training. The extent to which schools integrated education regarding ACEs into their curriculum varied from 0 to 66.7%. CONCLUSIONS: The study finding suggests a need for a unified, consistent, and expanded training requirement in the foundations of pain management, SUD, and ACEs in professional healthcare education.