Patient navigation for perinatal substance use disorder treatment: A systematic review.

BACKGROUND: Substance use during the perinatal period (i.e., pregnancy through the first year postpartum) can pose significant maternal and infant health risks. However, access to lifesaving medications and standard care remains low for perinatal persons who use substances. This lack of substance use disorder treatment access stems from fragmented services, stigma, and social determinants of health-related barriers that could be addressed using patient navigators. This systematic review describes patient navigation models of care for perinatal people who use substances and associated outcomes. METHODS: We conducted a structured search of peer-reviewed, US-focused, English- or Spanish-language articles from 2000 to 2023 focused on 1) patient navigation, 2) prenatal and postpartum care, and 3) substance use treatment programs using PubMed, Scopus, PsycINFO, and CINAHL databases. RESULTS: After meeting eligibility criteria, 17 studies were included in this review. The majority (n=8) described outpatient patient navigation programs, with notable hospital (n=4) and residential (n=3) programs. Patient navigation was associated with reduced maternal substance use, increased receipt of services, and improved maternal and neonatal health. Findings were mixed for engagement in substance use disorder treatment and child custody outcomes. Programs that co-located care, engaged patients across the perinatal period, and worked to build trust and communication with family members and service providers were particularly successful. CONCLUSION: Patient navigation may be a promising strategy for improving maternal and infant health outcomes among perinatal persons who use substances. More experimental research is needed to test the effect of patient navigation programs for perinatal persons who use substances compared to other models of care.

A systematic review of the associations between protective behavioral strategies and heavy alcohol consumption and consequences among young adults.

OBJECTIVE: We systematically reviewed the literature to assess the association between use of alcohol protective behavioral strategies (PBS) and young adult heavy drinking and alcohol-related consequences. METHOD: We followed the preferred reporting items for systematic review and meta-analysis guidelines to select and review research studies that were comprised of a sample of young adults ages 18-26, included PBS derived from one of 10 validated scales as an independent variable, measured heavy alcohol use or alcohol consequences as the dependent variable, and tested the direct association between the two. Studies were gathered via PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo, and Global Health. All identified study records underwent a two-step screening process and risk of bias assessment. RESULTS: Data were extracted from 94 studies that met inclusion criteria; 16 studies (17%) examined associations with heavy alcohol use and 91 studies (97%) tested effects of PBS on alcohol consequences. All studies that measured a total effect of PBS use (summations across all strategies) found significant negative associations with heavy alcohol use and 91% were negatively associated with alcohol consequences. Most studies that examined subscales of PBS found at least one significant, negative relation with heavy alcohol use (73%) and alcohol-related consequences (78%), though effects varied across type of subscale (e.g., manner of drinking). CONCLUSIONS: Our results support the use of PBS to address heavy alcohol consumption and related harms among young adults. Opportunities for refinement of current PBS in preventive interventions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Individualized interventions and precision health: Lessons learned from a systematic review and implications for analytics-driven geriatric research.

Older adults are characterized by profound clinical heterogeneity. When designing and delivering interventions, there exist multiple approaches to account for heterogeneity. We present the results of a systematic review of data-driven, personalized interventions in older adults, which serves as a use case to distinguish the conceptual and methodologic differences between individualized intervention delivery and precision health-derived interventions. We define individualized interventions as those where all participants received the same parent intervention, modified on a case-by-case basis and using an evidence-based protocol, supplemented by clinical judgment as appropriate, while precision health-derived interventions are those that tailor care to individuals whereby the strategy for how to tailor care was determined through data-driven, precision health analytics. We discuss how their integration may offer new opportunities for analytics-based geriatric medicine that accommodates individual heterogeneity but allows for more flexible and resource-efficient population-level scaling.

Intraocular Pressure and Medication Burden With Cataract Surgery Alone, or Cataract Surgery Combined With Trabecular Bypass or Goniotomy.

PRCIS: When compared with cataract surgery in glaucoma patients, trabecular micro-bypass and goniotomy resulted in a large decrease in the incidence of intraocular pressure (IOP) spikes, a modest effect on IOP, and a minimal effect on medication burden. PURPOSE: To compare changes in IOP and ocular hypotensive medications in 3 surgical cohorts: cataract surgery, cataract surgery with trabecular micro-bypass (cataract/trabecular), and cataract surgery with goniotomy (cataract/goniotomy). MATERIALS AND METHODS: We included 138 eyes diagnosed with open-angle glaucoma: (1) 84 eyes with cataract surgery alone, (2) 25 eyes with cataract/trabecular surgery, and (3) 29 eyes with cataract/goniotomy surgery. We compared the groups for postoperative IOP and the number of ocular hypotensive medications. We adjusted for preoperative IOP, and preoperative and postoperative number of ocular hypotensive medications. We defined an IOP spike as IOP ≥21 mm Hg and 10 mm Hg higher than preoperative on postoperative day 1. RESULTS: All 3 surgeries showed a decrease in IOP (P≤0.004) and medication burden (P≤0.001) at 3 and 6 months postoperatively when compared with their own preoperative baselines. When compared with cataract surgery alone, cataract/trabecular and cataract/goniotomy had similar IOP lowering at 1 month postoperatively, and variable results at 3 and 6 months. The change in ocular hypotensive medications was not statistically different between the surgical groups at any postoperative visit. Cataract/trabecular and cataract/goniotomy decreased IOP on postoperative day 1, and had relative risk reduction of ~70% for IOP spikes (P≤0.001 for both). CONCLUSION: Trabecular micro-bypass and goniotomy when added to cataract surgery resulted in a large decrease in IOP spikes, a modest effect on IOP, and a minimal effect on medication burden when compared with cataract surgery alone in glaucoma patients.

Use of journal clubs and book clubs in pharmacy education: A scoping review.

BACKGROUND: Journal clubs and book clubs are educational activities used in health sciences education to teach evidence-based decision-making, critical thinking, and appraisal skills, and build trainee understanding about important professional issues. The main objective of this scoping review was to identify and synthesize all research studies on journal or book clubs for pharmacy learners. A secondary objective was to identify gaps in the literature where future research would be beneficial to pharmacy educators and learners. METHODS: A comprehensive literature search was run across five databases. Studies were screened using a two stage, blinded, independent screening process. RESULTS: Forty-two studies met all inclusion criteria; 86% reported on journal clubs and 14% on book clubs. Of the journal club studies, 50% were in didactic courses, 33% in experiential education, and 17% were co-curricular initiatives. Of the six book club studies, 67% were within didactic courses and 33% were co-curricular initiatives, including the only interprofessional education study. Most journal clubs were used to teach evidence-based practice, drug literature evaluation, or biostatistics. Book clubs were more focused on soft skills or topics students were less likely to encounter in the core curriculum. IMPLICATIONS: Future research on journal clubs and book clubs in pharmacy education should continue to assess student learning outcomes and abilities. Specifically, future studies should move beyond evaluating student perceptions of journal clubs to investigate effectiveness for topics other than drug literature evaluation or evidence-based practice, and the impact of journal clubs and book clubs on interprofessional knowledge, communication, and team dynamics.

Video killed the multiple-choice quiz: capturing pharmacy students' literature searching skills using a screencast video assignment.

BACKGROUND: In a flipped, required first-year drug information course, students were taught the systematic approach to answering drug information questions, commonly utilized resources, and literature searching. As co-coordinator, a librarian taught three weeks of the course focused on mobile applications, development of literature searching skills, and practicing in PubMed. Course assignments were redesigned in 2019 based on assessment best practices and replaced weekly multiple-choice quizzes used in prior iterations of the course. CASE PRESENTATION: Following two weeks of literature searching instruction, students were assigned a drug information question that would serve as the impetus for the search they conducted. Students (n=66) had one week to practice and record a screencast video of their search in PubMed. Students narrated their video with an explanation of the actions being performed and were assessed using a twenty-point rubric created by the course coordinator and librarian. The librarian also created general feedback videos for each question by recording screencasts while performing the literature searches and clarifying troublesome aspects for students. The librarian spent about twenty-four hours grading and six hours writing scripts, recording, and editing feedback videos. CONCLUSION: Most students performed well on the assignment and few experienced technical difficulties. Instructors will use this assignment and feedback method in the future. Screencast videos proved an innovative way to assess student knowledge and to provide feedback on literature searching assignments. This method is transferrable to any medical education setting and could be used across all health professions to improve information literacy skills.

Motivating Students to Engage in Preparation for Flipped Classrooms by Using Embedded Quizzes in Pre-class Videos.

BACKGROUND: The success of flipped classrooms is dependent upon students' preparation prior to class, the lack of which is the most common challenge associated with this teaching methodology. To mitigate this limitation, it is important to develop and assess methods of engaging learners during pre-class activities. OBJECTIVE: To determine if quiz delivery method (embedded throughout versus after pre-class videos) affects students' knowledge retention, grades, and video viewing behavior. METHODS: Participating students were randomized to take quizzes, either during pre-class videos via Panopto™ (EQV) or after pre-class videos in the traditional manner via Moodle™ (TMM). Outcomes assessed included students' knowledge retention, scores on pre- and post-class quizzes, and pre-class video viewing behavior (total views and minutes viewed per student) during a three-week period. Having experienced both quizzing modalities during the semester, the perceptions from students in the EQV group were surveyed. RESULTS: Baseline assessment results of both groups (n = 27 per group) were comparable with a median score of 33% (IQR: 17, 50) in both groups. Performance was also similar on knowledge retention [TMM: 67% (50, 83) vs. EQV: 83% (50, 83)], pre-class quiz scores [TMM: 90% (87, 97) vs. EQV: 93% (90, 95)], and post-class quiz scores [TMM: 93% (80, 100) vs. EQV: 87% (80, 100)], while students in the EQV group had more total views [10 (8, 12)] vs. [5 (2, 11)] and minutes viewed [71 (36, 108) vs. 35 (15, 81)]. Results from the perception survey administered to students in the EQV group (74.1% response rate) indicated a preference for embedded quizzes overall (58%) and for class preparation (75%) when compared with post-video quizzes. CONCLUSION: Students' knowledge retention and performance were similar in both EQV and TMM groups, though students in the EQV group were more engaged with videos and most of them preferred this quiz delivery. Using embedded quizzes for formative rather than summative assessment might be an appropriate mechanism to encourage students' viewing of pre-class videos and their preparation for flipped classes.

Novel Eye Drop Delivery Aid Improves Outcomes and Satisfaction.

PURPOSE: To compare a nose-pivoted drop delivery device (NPDD) with traditional eye drop delivery in glaucoma subjects. DESIGN: Repeated-measures case series. PARTICIPANTS: Fifty glaucoma subjects (100 eyes) who reported difficulty self-administering eye drops. METHODS: We compared eye drop delivery using a NPDD against traditional delivery techniques at baseline (baseline traditional) and after standardized teaching (post-teaching traditional). Subjects used a 1-to-10 scale (10 being easiest) to rate the ease of delivery with each technique and completed a satisfaction survey. Two graders used digital video to independently review eye drop delivery and recorded: (1) accurate placement: the eye drop reached the ocular surface; (2) no contact: no bottle tip contact against the ocular or periocular surface; and (3)number of eye drops dispensed. We defined primary success as accurate placement and no contact; secondary success as primary success with only 1 drop dispensed. MAIN OUTCOME MEASURES: We used logistic-transformed generalized estimating equation (GEE) regression to compare technique satisfaction, accuracy, no contact, and primary and secondary success. Number of drops dispensed was compared using a Cox model. RESULTS: Forty-seven of 50 subjects (94%) preferred the NPDD over traditional eye drop delivery. The mean score for ease of use was higher for the NPDD (8.9 ± 1.1) than baseline traditional (6.7 ± 2.1; P < 0.001) and post-teaching traditional (7.0 ± 2.0; P < 0.001). Forty-nine of 50 (98%) subjects thought the NPDD was comfortable to use and would recommend the device. The eye drop reached the ocular surface in a similar percentage of subjects (>90%) with each method. The bottle tip contacted fewer eyes with the NPDD (10 eyes) than baseline traditional (33 eyes; P < 0.001) and post-teaching traditional (25 eyes; P = 0.009). The number of drops dispensed was lower with the NPDD (1.7 ± 1.2) than baseline traditional (2.2 ± 1.6; P = 0.017) and post-teaching traditional (2.4 ± 1.8; P = 0.006). The NPDD increased primary and secondary success of eye drop delivery (86% and 54%, respectively) compared to baseline traditional (66% [P = 0.001] and 28% [P < 0.001]) and post-teaching traditional (70% [P = 0.005] and 40% [P = 0.018]). CONCLUSIONS: Eye drop users preferred the NPDD over traditional eye drop delivery. The NPDD improved eye drop delivery success, reduced bottle tip contact, and decreased the number of eye drops wasted.

Utilization of a Librarian in a Pharmacy Laboratory Course.

This report describes utilization of a librarian in a pharmacy laboratory course over two academic years. Library instruction evolved from a simple drug information review session to case-based, hands-on instruction, collaboratively taught with pharmacy faculty. Additionally, LibChat, an online chat service, was piloted in the pharmacy laboratory course so the librarian could be available to students at their point-of-need. Development of the drug information review sessions across both years, student utilization of LibChat, lessons learned, and ideas for improvement for future iterations of the course are described.

Incorporation of a mock drug information telephone call exercise in a health-systems pharmacy laboratory.

BACKGROUND AND PURPOSE: Hospital pharmacists routinely receive and answer drug information questions via telephone while performing order verification. This report describes the development, implementation, and evaluation of a mock learning experience for student performance of these tasks in a health-systems pharmacy laboratory course. EDUCATIONAL ACTIVITY AND SETTING: An active learning skills-based exercise involving students receiving and answering a standardized drug information question via telephone during an order verification activity, referred to as a cold-call exercise, was developed and implemented. Data collected included student grades on a baseline assessment, the cold call exercise, order verification exercises, and student perceptions from a voluntary post-exercise survey. Student performance on the cold-call exercise was further evaluated via individual sections of the cold-call rubric. Data were summarized using descriptive statistics. Thematic analysis of student opinion and an estimate of faculty time were also executed. FINDINGS: Student grades on the cold call and order verification exercises were 86.14% and 88.8%, respectively. Students often failed to ask category-specific questions because they did not categorize the ultimate question appropriately. Students found the activity organized and applicable. Time dedicated to creation was extensive, but execution and grading were reasonable. SUMMARY: Students performed well on the drug information exercise as well as the order verification component. Students and faculty enjoyed the experience, and students found the exercise relevant and challenging. This exercise could be implemented into any pharmacy curriculum in order to prepare students using authentic learning experiences.

Gamification of a Mobile Applications Lecture in a Pharmacy Course.

This report describes a librarian's development of an interactive and competitive trivia game using Poll Everywhere, an audience response system software. The trivia game was implemented during a live lecture session on drug information mobile applications taught to first-year pharmacy students. To add a fun and engaging reference for students, the librarian decided to model the game after HQ, a free trivia gaming app. Development of the session, student response, changes to future iterations, and lessons learned by the librarian are described.