The Impact of a Culturally Meaningful Storytelling Intervention on Stigma and Attitudes About Mental Health Treatment.

ABSTRACT: The fear of being devalued or discriminated against is a salient deterrent to seeking mental health care, especially in communities of color where racial stigma also impacts mental health and perceptions of service utilization. To address this issue, our research team partnered with This Is My Brave Inc to develop and evaluate a virtual storytelling intervention to highlight and amplify the voices of Black and Brown Americans living with mental illness and/or addiction. We utilized a pretest-posttest survey design administered electronically to viewers of the series ( n = 100 Black, indigenous, people of color and n = 144 non-Hispanic White). Results indicated that postintervention, scores on public stigma and perceived discrimination measures were significantly reduced. We identified significant interaction effects, such that Black, indigenous, people of color viewers showed a greater rate of improvement on outcomes. This study provides strong preliminary evidence of the impact of a culturally meaningful virtual approach to addressing stigma and improving attitudes about mental health treatment.

Alzheimer disease and the evolving treatment landscape.

Alzheimer disease (AD) is an irreversible, progressive neurodegenerative disorder that destroys memory and the ability to think, slowly over time. AD is the leading type of dementia, accounting for 60% to 80% of cases, and the sixth leading cause of death in the United States. AD, which can range from mild to severe, is thought to occur secondary to the aggregation and accumulation of ß-amyloid peptides, abnormal phosphorylation of tau protein, and neuroinflammation. Current treatment options vary depending on the severity of AD, and emerging treatment options continue to arise. Managed care organizations are in an excellent position to implement viable patient care ecosystems to support patients and caregivers in decreasing AD progression and its consequences. Vigilance in identifying AD and providing early treatment is crucial to improving patient outcomes and burden of disease on patients, caregivers, and health systems.

An Artistic Active-Learning Approach to Teaching a Substance Use Disorder Elective Course.

Objective. To incorporate an artistic, multimedia approach to teaching within a substance use disorder (SUD) elective course to intellectually, visually, physically, and emotionally engage Doctor of Pharmacy (PharmD) students in learning and applying clinical and legal SUD topics. Methods. Faculty members created a two credit-hour SUD elective course that required students to engage in visual, linguistic, and performing art forms, including acting, screenwriting, choreography, dancing, artwork, writing movie reviews, writing book reports, writing journal reflections, create-your-own-adventure storytelling, speech writing, examination writing, policy writing, and creative thinking in an escape room gaming environment to learn about SUD and related topics. Results. Student learning and perception of the activities was evaluated using faculty-created analytic rubrics, pre- and post-intervention tests, student feedback, and student responses on standard course evaluations. Students performed well on the graded assignments. Pre- and post-intervention tests administered for the escape room activity demonstrated an increase in scores from 56.7% to 94.9%. Student feedback and course evaluations revealed student engagement with subject material and enthusiasm for creative applications, critical thinking, and collaborative aspects of the activities. Conclusion. The PharmD students consistently rated the interactive class format highly on course evaluations and reported having the perception of simultaneously learning and having fun. Pharmacy instructors are encouraged to incorporate creative projects and activities in courses to enhance student learning experiences and increase student motivation to engage with the material, their classmates, and other professionals.

Active-learning Strategies for Legal Topics and Substance Abuse in a Pharmacy Curriculum.

Objective. To implement active-learning strategies to engage students in learning, applying, and teaching legal and substance abuse topics. Design. Medication Safety course student groups created films on a National Patient Safety Goal (NPSG) using a movie genre and presented them in film festival format. Pharmacogenomics course student groups taught ethical, legal, and social implications (ELSI) topics through presentation of short stories about comic book characters with genetic mutations. Students in the Drugs of Abuse course composed and performed dances depicting the mechanism of action of a drug in an in-class rave dance format. Assessment. Course evaluations revealed student engagement with subject material and enjoyment of the creative applications, critical thinking, and collaborative aspects of the activities. Students performed well on examination questions and graded assignments. Conclusion. These active-learning strategies facilitated students' abilities to learn, apply, and teach material in medication safety, pharmacogenomics, and substance abuse courses.

Identifying biomarkers of dementia prevalent among amnestic mild cognitively impaired ethnic female patients.

BACKGROUND: There is a need to investigate biomarkers that are indicative of the progression of dementia in ethnic patient populations. The disparity of information in these populations has been the focus of many clinical and academic centers, including ours, to contribute to a higher success rate in clinical trials. In this study, we have investigated plasma biomarkers in amnestic mild cognitively impaired (aMCI) female patient cohorts in the context of ethnicity and cognitive status. METHOD: A panel of 12 biomarkers involved in the progression of brain pathology, inflammation, and cardiovascular disorders were investigated in female cohorts of African American, Hispanic, and White aMCI patients. Both biochemical and algorithmic analyses were applied to correlate biomarker levels measured during the early stages of the disease for each ethnicity. RESULTS: We report elevated plasma Aß40, Aß42, YKL-40, and cystatin C levels in the Hispanic cohort at early aMCI status. In addition, elevated plasma Aß40 levels were associated with the aMCI status in both White and African American patient cohorts by the decision tree algorithm. Eotaxin-1 levels, as determined by the decision tree algorithm and biochemically measured total tau levels, were associated with the aMCI status in the African American cohort. CONCLUSIONS: Overall, our data displayed novel differences in the plasma biomarkers of the aMCI female cohorts where the plasma levels of several biomarkers distinguished between each ethnicity at an early aMCI stage. Identification of these plasma biomarkers encourages new areas of investigation among aMCI ethnic populations, including larger patient cohorts and longitudinal study designs.

Psychiatric services: a platform for MTM.

Deinstitutionalization in the 1960s shifted the care of the mentally ill from state-funded institutions to community settings. Unfortunately, funding to support the treatment needs of this population has continued to be minimized, and countless individuals have not received much needed care. This has resulted in a large increase in mentally ill patients surfacing in jails, homeless shelters, and emergency departments. Subsequently, the federal government has begun to prioritize funding to address the mental health needs of our communities. Pharmacists are in a unique position to influence treatment outcomes for patients with mental illnesses, and the current state of health reform provides avenues for the pharmacist to become an essential part of the health care delivery team in numerous ambulatory care clinical settings. The challenges with adherence, medical and psychiatric comorbidities, polypharmacy with psychotropics, potential for life-threatening adverse effects, and the ever-present need for patient education are but a few reasons why pharmacists can be utilized to provide Medication Therapy Management services for these patients.

Pharmacogenomics in psychiatry: implications for practice.

Psychotropic medications are used for numerous psychiatric and neurologic disorders, and are associated with in some cases life-threatening adverse effects, high acquisition costs, stringent monitoring requirements, and potential interactions with other medications. Because of the risks of adverse effects and need for adherence, risk mitigation strategies are being implemented to protect consumers. An understanding of receptor activities, cytochrome P450 2D6 and 2C19 metabolism, overlapping pharmacology, and polymorphic biomarkers for the dopamine 2 D2 receptor gene (DRD2) and dopamine 3 D3 receptor gene (DRD3), serotonin 2A and 2C receptor genes (5HTR2A and 5HTR2C), and human leukocyte antigen (HLA) variants creates opportunities for the integration of pharmacogenomics, and can assist in the application of personalized medicine in this arena. In this review, we discuss the current impression of pharmacogenomic principles pertaining to select psychotropics, with attention given to the atypical antipsychotics, due to their wide use across a broad spectrum of psychiatric disorders (e.g. bipolar disorder, depression, schizophrenia). Patents involving aripiprazole, clozapine, olanzapine, and risperidone will be discussed.