Establishing the role of the pharmacist in mental health: Implementing Mental Health First Aid into the doctor of pharmacy core curriculum.

INTRODUCTION: The objective of this study was to assess the impact of implementing Mental Health First Aid (MHFA) training in a doctor of pharmacy (PharmD) curriculum on student pharmacists' knowledge, attitudes, self-efficacy, and empathy towards people with mental health conditions and/or crises. METHODS: Participants were third-year PharmD students enrolled in Patient Care Experience, a required communication and ethics course. A survey was administered pre- and post-intervention (i.e. MHFA training). Student pharmacist self-efficacy in assisting someone developing a mental health condition or in crisis was evaluated using confidence measures from the MHFA action plan. Knowledge was measured using Mental Health Knowledge Statements. Attitudes were assessed with the Index of Attitudes Towards Mental Illness, and stigma was evaluated using the Social Distancing Scale. Empathy was measured with the Kiersma-Chen Empathy Scale. RESULTS: Both pre- and post-intervention surveys were completed by 97 of 135 participants (71.9% response rate). MHFA training resulted in significantly increased self-efficacy and empathy. There were no significant differences in knowledge, attitudes, and stigma. CONCLUSIONS: MHFA training was associated with increases in student pharmacist empathy and self-efficacy in providing support to individuals with mental health crises.

Assessment of mental health needs and barriers to care in students enrolled in doctor of pharmacy and pharmaceutical sciences programs.

INTRODUCTION: The purpose of this study is to identify doctor of pharmacy and pharmaceutical sciences students' perceived barriers to mental health care and interest in mental health interventions and to assess student attitudes and perceptions of mental illness. METHODS: A mixed-methods survey was given to 706 students participating in a doctor of pharmacy and pharmaceutical sciences curricula to assess students' perceived barriers to care, interest in mental health resources and interventions within their curricula, attitudes towards seeking treatment, and perceived stigma. The last section included free text responses in which students expressed additional comments unacknowledged by previous sections. Quantitative data was analyzed using descriptive statistics, and free text responses were analyzed using thematic coding. RESULTS: From February to March 2018, 256 responses were received out of 706 students with a response rate of 36%. The most cited barriers to seeking mental health treatment were lack of time, lack of finances, and stigma-related concerns (25%, 13%, and 11%, respectively) with the most desired interventions being the implementation of an onsite counselor and wellness space. A majority of participants (88%) believe professional help for mental illness is effective; however, 63% cited they were negatively impacted by internal stigma. Common themes addressed in the free text responses reinforced these ideas and included additional responses regarding the impact of school culture. CONCLUSION: Students within a doctor of pharmacy and pharmaceutical sciences program experience non-stigma and stigma-related barriers to seeking mental health treatment.

A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans.

BACKGROUND: Our aim was to review the published literature evaluating treatment approaches for chronic heart failure (HF), notably as it relates to African American patients. METHOD: We undertook a comprehensive database search (1986-2017) of PubMed, EMBASE, and Ovid/MEDLINE utilizing terms 'African American', 'black', 'chronic heart failure', 'heart failure', 'medication', 'chronic therapy', and 'clinical trials'. Additional notable studies were obtained from ClinicalTrials.gov . Studies published in English that examine treatment modalities of chronic HF in African American and non-African American patients were included. RESULTS: Examples of current gaps worthy of investigation include whether to maximize thiazides and calcium-channel blockers prior to adding renin-angiotensin system (RAS) inhibitors or beta blockers in HF with preserved ejection fraction; whether hydralazine/isosorbide dinitrate (ISDN) should be initiated during earlier HF stages; whether to prioritize hydralazine/ISDN over other agents such as RAS inhibitors; varying response of African Americans to different agents within drug classes; and the role of mineralocorticoid receptor antagonists. CONCLUSION: Further studies are needed in order for consensus guidelines to clarify how best to treat this population.