Characterization of Doctor of Pharmacy and Prepharmacy Students' Knowledge, Stigma, and Risk Perceptions Toward Persons Living With HIV/AIDS at a Hispanic-Serving Institution.

OBJECTIVE: To assess the knowledge, stigma, and risk perceptions toward people living with HIV/AIDS in Doctor of Pharmacy and prepharmacy students at a Hispanic-serving institution situated on the United States-Mexico border. METHODS: A cross-sectional survey was administered to prepharmacy and Doctor of Pharmacy students to assess HIV background and knowledge, stigma, and risk perceptions using a self-completed electronic questionnaire. The χ2 and correlational analyses were conducted. RESULTS: Performance on the knowledge assessment was significantly correlated with increases in professional year. Although frequencies of negative stigma were overall low, there were 3 key populations that demonstrated higher rates of negative stigma: people who inject drugs, those who partake in high-risk sexual behavior, and sex workers. Although professional year was associated with knowledge and one's willingness to share food with someone living with HIV/AIDS, professional year was not associated with 8 other risk perception variables. CONCLUSION: The identification of stigma among already stigmatized populations supports the need for targeted educational interventions, especially at Hispanic-serving institutions with colleges and schools of pharmacy. Additional research should be conducted to explore the generalizability of these results and measure the impact of cultural beliefs and practices on stigma and risk perceptions across institutions with predominantly Hispanic/Latinx students.

Implementation of pharmacist-led services for sexual and gender minorities: A multisite descriptive report.

PURPOSE: This paper compares and contrasts the implementation of pharmacist-led services for 3 different sexual and gender minority populations across California, Mississippi, and Florida. SUMMARY: Implementation of pharmacist-led services tailored to sexual and gender minorities may be a potential mechanism to address health disparities in these populations. Clinical pharmacists have the potential to provide care with cultural humility and improve health outcomes by optimizing medication regimens, reducing adverse drug events, enhancing medication acquisition, and improving medication adherence. CONCLUSION: The services provided by clinical pharmacists varied across sites and included management of gender-affirming hormone therapy, HIV antiretroviral medication adherence programming, primary care and chronic disease state management, and involvement in care related to mental health, psychiatry, and substance use as well as sexual health. Various legislative and regulatory barriers and differences in scope of practice for pharmacists were also identified. This paper advocates for the expansion of pharmacy-led services and the adoption of a culturally humble approach to patient care.

An exploratory mixed-methods evaluation of continuing education opportunities related to the care of sexual and gender minority patients from ACPE-accredited providers.

PURPOSE: The objective of this analysis was to describe trends in continuing education opportunities for pharmacy professionals across the US related to the care of sexual and gender minority (SGM) patients. METHODS: Continuing education programs offered by Accreditation Council for Pharmacy Education (ACPE)-accredited providers from 2012 through 2022 were identified by searching the ACPE database for titles containing SGM terminology. Data including ACPE provider classification, activity type, format, audience, ACPE topic designator, interprofessional accreditation, contact hours, and learning objectives were collected. Content analysis was used to categorize activities. RESULTS: Following removal of duplicates and non-SGM-focused programming, 726 programs were identified. The most commonly observed program characteristics included a live format (67.6%, n = 491), a pharmacist audience (77.1%, n = 560), knowledge-based activities (90.8%, n = 656), a college or school of pharmacy provider (21.6%, n = 157), an ACPE topic of pharmacy administration (50.6%, n = 367), and a focus on pharmacy rather than interprofessional audiences (87.1%, n = 632). The median program length was 1 hour (interquartile range, 1-1.25 hours). The qualitative analysis identified programs focused on topics of gender-affirming care (pharmacotherapy) (32.1%, n = 233), general SGM (26.7%, n = 194), gender-affirming care (nonpharmacotherapy), sexually transmitted infections (7.2%, n = 52), and health disparities (3.9%, n = 28). CONCLUSION: Advancement has occurred in the number of available continuing pharmacy education programs focused on the care of SGM patients. Further information regarding specific content and effectiveness of continuing education is necessary to determine strategies to better prepare pharmacy professionals to care for this growing patient population.

The Impact of Moving Beyond Intersection to Integration of LGBTQIA+ Identities on Professional Identity Affirmation.

There have been active calls within pharmacy education literature for the profession to work toward dismantling systemic oppression by elevating the voices of commonly underrepresented and marginalized communities, including the lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual(LGBTQIA+) community. There has also been a simultaneously growing interest in understanding how the intersection of one's personal identity with one's professional identity may help to foster greater affirmation within the profession. However, what has not been explored is how intersecting personal and professional identities may enhance the strength of one's LGBTQIA+ identity and therefore result in creating cultures of affirmation in addition to meaningful participation in professional advocacy. We link our lived experiences to a theoretical perspective through the minority stress model to demonstrate how distal and proximal stresses may affect pharmacy professionals' ability to fully integrate their professional and personal identities. Additionally, we call on the academy to strategically address gaps in LGBTQIA+ knowledge, equity, and professional development through research, shifts in culture, and education.

Born This Way: Integrating LGBTQIA+ Identities as Pharmacy Practitioners.

Progression through the profession of pharmacy is filled with many milestones that can contribute to feelings of stress, rejection, and isolation. For Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual+(LGBTQIA+) students and practitioners, these feelings can be compounded by similar issues experienced by their sexual orientation or gender identity. Historically, LGBTQIA+ students, new practitioners, and seasoned professionals alike have lacked visible role models for how to intersect personal and professional identity in the pharmacy profession. In this paper, the authors describe experiences of intersecting personal queer identities with professional pharmacy identities; exploring barriers to integration and developing solutions to overcome these barriers. The authors also share how the formation of a collective of LGBTQIA+ practitioners and educators has led to a unified voice to advocate for the advancement of LGBTQIA+ healthcare in pharmacy education and practice. This manuscript will provide readers with a guide to navigate and address issues with the integration of personal and professional identity to lead to practice that validates personal identity as important, valuable, and affirmed.

Optimizing ceftaroline dosing in critically ill patients undergoing continuous renal replacement therapy.

BACKGROUND AND OBJECTIVES: Currently, no dosing information exists for ceftaroline fosamil in patients undergoing continuous renal replacement therapy (CRRT). The objectives of this study are to characterize the pharmacokinetics of ceftaroline in critically ill patients undergoing CRRT modalities and to derive individualized dosing recommendations. METHODS: This pharmacokinetic study aimed to enroll critically ill patients receiving ceftaroline fosamil and any CRRT modality from adult intensive care units. Selection of the specific CRRT modality and dosing regimen was based on clinical discretion. Pre-filter, post-filter, and ultrafiltrate samples were obtained before the administration of the fourth dose, after the completion of the infusion, and up to five additional time points post-infusion. Plasma concentrations were measured using a validated ultra-high performance liquid chromatography assay. Individual pharmacokinetic parameters were calculated using non-compartmental analysis. RESULTS: Four patients were enrolled to investigate the need for dosing adjustments. The average sieving coefficient for ceftaroline was 0.81 ± 0.1, indicating high filter efficiency. The average volume of distribution was 41.8 L (0.48 L/kg) and is within the previously reported range in patients with normal renal function. Non-renal clearance accounted for more than 50% of the total clearance observed in patients. The observed pharmacokinetic profiles suggest that the pharmacodynamic target for 2-log10  CFU reduction from baseline (%fT >1 mg/L of 50%) was met for each patient. Due to the impact of CRRT and non-renal clearance, dosing recommendations were derived for different ranges of effluent flow rates and adjusted body weights. For a patient with an adjusted body weight of 70 kg and receiving CRRT at an effluent flow rate of 3 L/h, a ceftaroline fosamil dosing regimen of 400 mg every 12 h is proposed. CONCLUSION: Ceftaroline is cleared extensively in critically ill patients receiving CRRT and may impact pharmacodynamic target achievement. Dose adjustments should be based on the intensity of the CRRT regimen, patient weight, and the clinical status of the patient.

Addressing and Inspiring Vaccine Confidence in Black, Indigenous, and People of Color During the Coronavirus Disease 2019 Pandemic.

During the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than white Americans, and, now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines.