Opioid-Associated Emergencies: A Review of Their Management and the Utility of Naloxone.

Although pain is most effectively treated through a multimodal approach, opioids remain a mainstay of treatment for chronic pain despite their considerable adverse effect profile and associated risks. Through modulation of the µ-opioid receptors, opioids can cause respiratory depression, which may result in death if not treated. When used in conjunction with other sedative substances, the risk of respiratory depression is potentiated. If an opioid emergency is suspected, responders should activate the emergency response system as outlined by the American Heart Association. Prompt and appropriate naloxone administration is vital to appropriate emergency care. As a preventative measure, naloxone should be recommended to individuals who are at higher risk of an opioid overdose. Naloxone is available at most pharmacies, can be billed through an individual's insurance, and is now available over the counter without a prescription.

Impact of Prematriculation Course Withdrawals on First Year Pharmacy School Success.

OBJECTIVE: Determine the impact of prematriculation course withdrawals on first year pharmacy school (P1) success, defined as on-time progression to the second (P2) year without remediation. METHODS: A retrospective review of students matriculating to a four-year private institution from 2018 to 2021 was conducted. Potential predictors of P1 year success including age, sex, highest degree achieved, prematriculation grade point average (GPA), and course withdrawals were collected. RESULTS: Bivariate analysis indicates that age, cumulative GPA, science GPA, and prematriculation course withdrawals were significantly different between students who were successful vs unsuccessful in the first year of pharmacy school. Out of 220 students analyzed, 40.9% (n = 90) were unsuccessful in the first year. Of those 90 P1 students, 52% did not progress to the P2 year, and 48% progressed but required course remediation. Multivariate analysis demonstrated that independent predictors of P1 success included cumulative GPA and having less than two prematriculation course withdrawals. In addition, the number of prematriculation course withdrawals, cumulative GPA, and having a bachelor's degree or higher were independent predictors of P1 GPA. CONCLUSION: Prematriculation course withdrawal was an independent predictor of both P1 success and P1 GPA. Students with less than two prematriculation course withdrawals were more likely to be successful during the first year of pharmacy school. College of pharmacy admission committees may consider prematriculation course withdrawal frequency when making admission decisions or to identify students that may need additional academic support during the first year of pharmacy school.

Frequency of Course Remediation and the Effect on North American Pharmacist Licensure Examination Pass Rates.

Objective. Remediation is a tool that allows students to correct an academic deficiency after earning an unsatisfactory grade. There is a lack of data on remediation processes and their impact on future academic performance. This study aimed to evaluate the impact of remediation frequency on North American Pharmacist Licensure Examination (NAPLEX) performance.Methods. The primary analysis was the relationship between the NAPLEX first-time pass rate and the frequency of course remediations (no remediations, one remediation, and two or more remediations). Additional analyses included the correlation between the NAPLEX scaled score and the number of course remediations and characteristics of the course remediated.Results. A total of 116 students with NAPLEX data were included for analysis. Compared to students who never remediated, NAPLEX first-time pass rates were similar among those who remediated only one course; however, students who remediated two or more courses had significantly lower NAPLEX pass rates. Remediation in courses mapped to Pharmacy Curriculum Outcomes Assessment (PCOA) area 4.0 (clinical sciences), and courses with mixed PCOA content areas were negatively correlated with NAPLEX scaled scores. A significant negative correlation existed between remediation in students' second or third years in pharmacy school and the NAPLEX scaled score, but this correlation was not significant for students in their first year.Conclusion. Multiple course remediations are negatively correlated with NAPLEX scaled scores and a reduced first-time NAPLEX pass rate, but a single course remediation has no effect. Institutions should aim to evaluate their current remediation practices and assess whether additional support should be provided to students with multiple course remediations.

Methods and Barriers to Communication Between Pharmacists During Transitions of Care.

Background: Effective communication between pharmacists across healthcare settings is essential to facilitate transitions of care (TOC) and improve patient outcomes. Objective: To explore pharmacists' communication methods and preferences and identify barriers to communication during TOC. Methods: A survey was distributed to a convenience sample of pharmacists in California, Connecticut, Illinois, Massachusetts, New Jersey, and Texas. The survey collected information on pharmacists' demographics, practice settings, and clinical services, and their methods, preferences, and barriers to communication during TOC. Results: A total of 308 responses were included in the analysis. The majority of pharmacists practiced in inpatient pharmacy (39.3%) followed by outpatient community pharmacy (23.4%). About 57.8% of pharmacists reported involvement in TOC services. Among respondents, most reported electronic health record (EHR) as their primary method of communication to receive (66.2%) and send (55.5%) information to perform TOC services. Additionally, EHR was reported as the preferred method of communication to receive (75.4%) and send (75.5%) information during TOC. The primary reasons pharmacists reported not utilizing patient health information were lack of information (38.4%), incorrect information (36.7%), delay in receiving information (36.7%), and lack of time (34.5%). Barriers to providing TOC services included poor communication during handoffs (44.2%) and difficulty obtaining needed patient medical information (43.9%). Conclusion: This study identified methods and barriers to communication between pharmacists during TOC across healthcare settings. This provides an opportunity for future research to develop interventions to improve communication between pharmacists at different practice settings.

Nonsteroidal Anti-Inflammatory Drugs: Updates on Dosage Formulations and Adverse Effects.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used medications due to their prescription and nonprescription availability, various dosage formulations, and therapeutic efficacy. Although NSAIDs have many known benefits, their effects on gastrointestinal, cardiovascular, bone, and renal physiology limit their widespread and long-term use. This article provides an update on dosage formulations, product availability, and pertinent adverse effects and warnings regarding the use of NSAIDs, with an emphasis on nonaspirin NSAIDs.

Impact of a communication technique training on rates of naloxone dispensing.

OBJECTIVES: The primary objective of this study was to measure the impact of a communication technique training (CTT) using a scenario-based active learning approach for community pharmacists on the dispensing rates of naloxone, in patients receiving opioid prescriptions. The secondary objective of the study was to characterize pharmacists and pharmacy-related factors that may affect the dispensing rates of naloxone. DESIGN: Multisite prospective pre- and postintervention study in the Western and Southern regions of Chicago from February 2019 to May 2019. Data were collected 3 months preintervention and 3 months postintervention. The dispensing rates of naloxone were compared with pre- and post-training, and potential variables affecting naloxone dispensing rates, such as demographic and workflow factors, were analyzed. SETTING AND PARTICIPANTS: Pharmacists employed at urban and suburban community pharmacy grocery chain (Jewel-Osco, Albertsons Companies) in the Chicago region. OUTCOME MEASURES: The primary outcome was the dispensing rate of naloxone by pharmacists participating in the study. Additionally, workflow variables associated with naloxone dispensing such as pharmacists' demographic data, time of the day that naloxone was dispensed, and hours of operation for the study locations were evaluated. RESULTS: A total of 21 pharmacists at 6 unique pharmacies participated in the CTT. Of those participating, 61.9% were women, 38.1% were men, 28.6% of pharmacists had 2 to 5 years of work experience, 23.8% had 6 to 10 years of work experience, 4.8% had 11 to 15 years of work experience, and 42.9% had more than 15 years of work experience. A statistically significant increase in naloxone dispensing rates was identified 3 months postintervention (6 units vs. 24 units; P = 0.004). There were no statistically significant differences seen in the workflow variables associated with naloxone dispensing. CONCLUSION: The CTT, an active learning approach for community pharmacists, was an effective reminder tool to aid pharmacists in initiating conversations about naloxone.

Completeness, accuracy, and readability of Wikipedia as a reference for patient medication information.

OBJECTIVES: This study determined the completeness, accuracy, and reading level of Wikipedia patient drug information compared with the corresponding United States product insert medication guides. METHODS: From the Top 200 Drugs of 2012, the top 33 medications with medication guides were analyzed. Medication guides and Wikipedia pages were downloaded on a single date to ensure continuity of Wikipedia content. To quantify the completeness and accuracy of the Wikipedia medication information, a scoring system was adapted from previously published work and compared with the 7 core domains of medication guides. RESULTS: Wikipedia did not provide patient information that was as complete or accurate as the information within the medication guides: 14.73 out of 42 (SD 5.75). Wikipedia medication pages were written at a significantly higher reading level compared with medication guides (Flesch reading ease score 52.93 vs. 33.24 [P <0.001]; Flesch-Kincaid grade level 10.26 vs. 6.86 [P <0.001]). CONCLUSION: Wikipedia medication pages include incomplete and inaccurate patient information compared with the corresponding product medication guides. Wikipedia patient drug information was also written at reading levels above that of medication guides and substantially above the average United States consumer health literacy level. As the public use of Wikipedia increases, the need for educating patients about the quality of information on Wikipedia and the availability of adequate patient education resources is ever more important to minimize inaccuracies and incomplete information sharing.

Development and Implementation of an Advising Program's Meet-and-Greet Session.

OBJECTIVE: To describe the implementation and perceptions of an advising program's meet-and-greet session on student/faculty interactions. DESIGN: Student advisees and faculty advisors attended a meet-and-greet program designed to facilitate introductions. Two online surveys evaluating program perceptions were electronically distributed to participants. ASSESSMENT: Twenty-eight advisors and 226 students attended; 17 faculty members and 42% (n=95) of students completed the survey. Advisors and advisees found the program valuable (100%, 85%) and recommended holding it again (100%, 93%), respectively. Most advisors agreed that the event improved success in meeting advisees while reducing time needed to schedule and meet with advisees. Students felt more comfortable contacting advisors after participating, with 83% agreeing it was more convenient than scheduling separate meeting times. CONCLUSION: An advising meet-and-greet program facilitated initial advisee/advisor meetings while reducing self-reported faculty time/resources. This activity could be implemented by other institutions seeking to promote student advising relationships.