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Ko J, Carlos J, Nguyen Y. Exploring LGBTQ+ cultural competency and DEI in continuing education: A cross-sectional review of U.S. pharmacy legislation. J Am Pharm Assoc (2003) 2024; 64:540-546. [PMID: 38272310 DOI: 10.1016/j.japh.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, or other sexual orientations or gender identities (LGBTQ+) cultural competency training is offered in pharmacy curricula to variable extents. State legislation directly dictates pharmacist training through continuing pharmacy education (CPE) requirements. OBJECTIVES This study aimed to identify the U.S. states and the District of Columbia (D.C.) that require CPE or training on topics related to LGBTQ+ cultural competency or topics related to diversity, equity, and inclusion (DEI) in general. In addition, this study quantified and compared each state's CPE hours required for each renewal period. METHODS This cross-sectional study retrospectively examined pharmacy legislation on CPE requirements for each of the 50 U.S. states and D.C. Only state legislation that was signed into law and related to pharmacy practice was included. Official websites for each board of pharmacy were identified to locate lawbooks, laws, rules, regulations, and statutes specific to pharmacy practice. Search terms included "lgbt," "lgbtq," "cultural," "cultural competency," "equity," "health equity," "implicit," and "implicit bias." Two study investigators independently collected data from March 2023 to April 2023. Data were re-reviewed for accuracy in January 2024. Discrepancies were resolved through discussion until a consensus was reached. The total number of required CPE hours, years for each pharmacist license renewal, required LGBTQ+ cultural competency CPE hours, and required DEI-focused CPE hours were described using descriptive statistics. RESULTS A total of 44 of 51 states and D.C. required 30 CPE hours for each 2-year renewal cycle or 15 CPE hours for each 1-year renewal cycle. California and D.C. had LGBTQ+ cultural competency CPE requirements of 1 CPE hour or 2 CPE hours per cycle, respectively. Five additional states, Illinois, Maryland, Michigan, Oregon, and Washington, required training or CPE on topics related to DEI as a whole. CONCLUSION Few U.S. states require CPE on LGBTQ+ cultural competency. This study highlights the need for standardized pharmacist training in LGBTQ+ health care.
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Willson MN, Frazier CC, McKeirnan KC. Training Student Pharmacists in Microaggressions and Gender Inclusive Communication. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100676. [PMID: 38360189 DOI: 10.1016/j.ajpe.2024.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The objectives of this study were to describe the implementation of a microaggression and gender inclusive communication (MGIC) module in a required course in a Doctor of Pharmacy curriculum; and to evaluate the impact on student pharmacist knowledge, comfort, and confidence using gender inclusive communication and addressing microaggressions. METHODS Students participated in MGIC module, which included training on microaggressions, and terminology related to gender. The module implementation was evaluated through a pre and post training knowledge assessment and survey of student confidence, comfort, and perceived importance of gender inclusive care. Additional evaluation included qualitative review of the graphics depicting the terminology and rephrasing statement with a microaggression to inclusive language. Survey responses were analyzed using Mann-Whitney U test and knowledge responses were analyzed using the Fisher exact test in SPSS. RESULTS A total of 106 students completed the module, 105 completed presurvey and knowledge assessment, and 92 completed the postsurvey and knowledge assessment. Results demonstrated a statistically significant increase from pre to post on the comfort and importance domain questions. A statistically significant increase in the student confidence was seen on all questions except for 2. The pre and postknowledge assessment results on all questions showed improvement from pre to post, although not all changes were statistically significant. CONCLUSION The MGIC module was effective in increasing to evaluate the impact on student pharmacist knowledge, comfort, and confidence using gender inclusive communication and addressing microaggressions. Reflections echoed the value and need for this training.
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Affiliation(s)
- Megan N Willson
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA.
| | - Cheyenne C Frazier
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Kimberly C McKeirnan
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
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Perez V, Lahrman R, Kissel J, Vaughn T, Li J, Hall LE. Evaluation of gender-affirming care experiences of transgender and gender diverse patients within a LGBTQ+ community pharmacy. J Am Pharm Assoc (2003) 2024; 64:253-259.e2. [PMID: 37940094 DOI: 10.1016/j.japh.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Transgender and gender diverse (TGD) populations require personalized care. Lived experiences and needs TGD populations express, compounded by limited care access, negatively shape health care involvement. Manifestations from these barriers may present as health care avoidance, identity concealment, or preventive care hinderance. Community pharmacies remain engagement points for TGD patients, but gender diverse services remain limited. What remains unknown is how TGD pharmacy perceptions and behaviors are influenced with gender-affirming care (GAC) accessibility. OBJECTIVES The primary objective is to assess how TGD patient perceptions and behaviors toward community pharmacy experiences are affected through a lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+) community-based health system. METHODS A cross-sectional, multisite, reflective survey was conducted at 4 LGBTQ+ community pharmacies in central and southwest Ohio. Nine 5-point Likert-item questions and one ordinal question were used to analyze perception and behavior. Participants responded for LGBTQ+ and external pharmacy experiences respectively. Data were analyzed through descriptive methods, paired Student's t test, and Fisher's exact test or c2 test where appropriate. RESULTS In total, 267 surveys were completed with 96 TGD submissions qualifying for analysis. Perceptions toward pharmacy experience saw statistically significant differences among all evaluations of perception. Behavioral assessment demonstrated statistically significant improvements in pharmacy outreach except for seeking medications from outside sources. Respondents indicated more involvement with the LGBTQ+ pharmacies versus external pharmacies in discussing medications (96.9% vs. 60.4%), care plans (64.6% vs. 41.6%), disclosure of pronouns or gender (97.9% vs. 43.8%), and feeling needs were understood (96.8% vs. 51%). CONCLUSION Inclusive community pharmacies may positively affect pharmacy perceptions and behaviors of TGD patients. These findings call attention to barriers in the provision of care for TGD patients while highlighting the change community pharmacies can have when providing these services. Community pharmacies should be encouraged to incorporate inclusive environments to improve TGD patient care involvement and access.
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Mercer J, Bandy S, Tang H, Wenger B, Ryan L, Lee G, Lipscomb J. Gender-affirming pharmacotherapy and additional health considerations: A contemporary review. J Am Pharm Assoc (2003) 2023; 63:1669-1676.e1. [PMID: 37619851 DOI: 10.1016/j.japh.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Transgender and gender-diverse (TGD) individuals in the United States face health care disparities compounded with discrimination and limited access to necessary medical services. Gender-affirming interventions have been shown to mitigate gender dysphoria and psychiatric comorbidities, yet United States legislation limiting such interventions has increased. As medication experts, pharmacists can facilitate access to care and appropriate use of gender-affirming hormone therapy (GAHT) and educate other health care providers on best practices for caring for TGD individuals in a variety of settings. OBJECTIVES To provide pharmacists with a contemporary review of GAHT and associated medication-related concerns. METHODS We searched PubMed for articles published until December 2022. MeSH terms such as transgender, transsexual, gender diverse, gender variant, or gender nonconforming in combination with phrases like gender-affirming care, treatment, pharmacotherapy, or hormone therapy were used to capture desired articles. RESULTS Feminizing hormone therapy (FHT), such as estrogen and antiandrogen agents, increases female secondary sex characteristics while suppressing male secondary sex characteristics. Masculinizing hormone therapy (MHT) achieves male secondary sex characteristics and minimizes female secondary sex characteristics using testosterone. For both FHT and MHT, the choice of therapy and formulation ultimately involves the patient's treatment goals, preferences, and tolerability. GAHT has additional health considerations pertaining to renal drug dosing, fertility, cardiovascular, and cancer risks. Pharmacists may provide crucial guidance and education to both patients and health care providers regarding risks associated with GAHT. CONCLUSION Many pharmacists feel unprepared to help provide, manage, and optimize GAHT. For many TGD individuals, GAHT is medically necessary and a life-saving treatment. Therefore, pharmacists should be provided tools to close knowledge gaps and improve their ability to care for these patients. By offering a thorough updated overview of GAHT, pharmacists can gain confidence to provide appropriate care for this increasingly visible population.
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Courtney J, Aragon KG, Douglas M, Malhotra A. A Resource Compendium for Embedding LGBTQIA+ Patient Care in the Professional Identity of Community Pharmacists. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100127. [PMID: 37852690 DOI: 10.1016/j.ajpe.2023.100127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/08/2023] [Accepted: 04/18/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Cultural, clinical, social, and legally competent patient care for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) patients is currently scarcely incorporated in pharmacy curricula. Furthermore, clinical, legal, and socio-cultural training that prepares pharmacists on the job to provide LGBTQIA+ competent patient care is scant. Here, our objectives were to (1) systematically review the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify trends in community pharmacists' professional identity development related to the provision of competent LGBTQIA+ patient care, and (2) create a reference guide for community pharmacists for self-directed learning. The literature search focused on 4 professional identity domains common to most pharmacists: academic and clinical competence, cultural sensitivity, knowledge of state and federal laws, and continuing professional development. FINDINGS A total of 207 articles were identified, with 93 retrieved, of which 26 articles were included in the final analysis based on title and abstract and other inclusion criteria. SUMMARY Overall, our search identified that the LGBTQIA+ health professions literature focused on the following themes: guidance for appropriate drug selection and therapy, creation of cultural sensitivity training curricula, community pharmacists' perceptions of their ability to provide LGBTQIA+ care, health system interventions, and Allyship education for advancing LGBTQIA+ care, the need for enhanced training of pharmacists for understanding the federal and state laws and requirements while providing care, and the need for a resource compendium to help community pharmacists access self-directed learning information, for which we have created a self-help resource guide for pharmacists in these 4 professional pharmacist identity domains.
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Affiliation(s)
- Jennifer Courtney
- California Northstate University College of Pharmacy, Elk Gove, CA, USA
| | | | - Monica Douglas
- University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Ashim Malhotra
- California Northstate University College of Pharmacy, Elk Gove, CA, USA.
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Perry A, DiPietro Mager N. Ohio community pharmacists' provision of inclusive care for transgender and gender-diverse patients. J Am Pharm Assoc (2003) 2023; 63:1211-1216. [PMID: 37207708 DOI: 10.1016/j.japh.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Community pharmacists have potential challenges to overcome to care for transgender and gender-diverse patients properly. The American Pharmacists Association and Human Rights Campaign released a resource guide in March 2021 with best practices for gender-affirming care, yet there are no reports of community pharmacists' awareness or implementation of the guide. OBJECTIVES This study's primary objective was to assess community pharmacists' awareness of the guide. Secondary objectives were to determine whether their current practices align with the guide's recommendations and whether they are interested to learn more information. METHODS An anonymous, institutional review board-approved survey developed from the guide's framework was e-mailed to 700 randomly selected Ohio community pharmacists. As an incentive, respondents could select a charitable organization to receive a donation. RESULTS Of the 688 pharmacists receiving the survey, 83 completed it (12%). Only 10% were aware of the guide. A range in self-reported ability to define key terms was found, from 95% for "transgender" to 14% for "intersectionality." Among the guide's suggested practices, collection of preferred names (61%) and consideration of transgender, gender-diverse, or nonheterosexual patients in their staff training (54%) were most often reported. Fewer than 50% reported pharmacy software with key gender-related data management capabilities. Most respondents indicated an interest in learning more about components of the guide, but gaps remained. CONCLUSION There is a need to raise awareness of the guide and to provide foundational knowledge, skills, and tools to ensure culturally competent care for transgender and gender-diverse patients and improve health equity.
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Chaudhary S, Ray R, Glass BD. “I don't know much about providing pharmaceutical care to people who are transgender”: A qualitative study of experiences and attitudes of pharmacists. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100254. [PMID: 37095891 PMCID: PMC10121476 DOI: 10.1016/j.rcsop.2023.100254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Background Globally, with the increased visibility, the number of transgender people accessing healthcare services has risen in the last decade. Although pharmacists are required to provide equitable and respectful care to all patients, their experiences interacting with trans and gender-diverse (TGD) people and attitudes towards the provision of care are largely unknown. Objectives This study aimed to determine the experiences and attitudes of pharmacists providing care to TGD people in Queensland, Australia. Methods Within a transformative paradigm, this study used semi-structured interviews conducted in person, over the phone, or through the Zoom app. Data were transcribed and analyzed by applying the constructs of the Theoretical Framework of Accessibility (TFA). Results A total of 20 participants were interviewed. Analysis revealed all seven constructs across interview data, with affective attitude and self-efficacy being the most frequently coded constructs, followed by burden and perceived effectiveness. The least coded constructs included ethicality, intervention coherence, and opportunity cost. Pharmacists had positive attitudes towards providing care and interacting professionally with TGD people. Prime challenges in delivering care were being unaware of inclusive language and terminology, difficulty building trusted relationships, privacy and confidentiality at the pharmacy, inability to locate appropriate resources, and lack of training in TGD health. Pharmacists felt rewarded when they established rapport and created safe spaces. However, they requested communication training and education to improve their confidence in delivering care to TGD people. Conclusion Pharmacists demonstrated a clear need for further education on gender-affirming therapies and training in communication with TGD people. Including TGD care in pharmacy curricula and continuous professional development activities is seen as an essential step towards pharmacists improving health outcomes for TGD people.
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Christopherson L, McLaren K, Schramm L, Holinaty C, Ruddy G, Boughner E, Clay A, McCarron M, Clark M. Assessment of Knowledge, Comfort, and Skills Working with Transgender Clients of Saskatchewan Family Physicians, Family Medicine Residents, and Nurse Practitioners. Transgend Health 2022; 7:468-472. [PMID: 36644488 PMCID: PMC9829118 DOI: 10.1089/trgh.2020.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
People who are transgender and gender diverse (TGD) report suboptimal care from health care providers. A cross-sectional survey was codesigned with community partners to assess the knowledge, comfort, and skills of family physicians, family medicine residents, and nurse practitioners working with TGD patients in Saskatchewan. It was administered from August to October 2019. Of 188 participants, 30% and 96% were comfortable providing transition-related and non-transition-related medical care to patients who are TGD, respectively. Interest in further training in providing transition-related medical care and cultural safety was high. No significant differences between provider groups were observed. Based on our results, provincial training initiatives will be undertaken.
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Affiliation(s)
- Lisette Christopherson
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Krishia McLaren
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Lori Schramm
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan and Saskatchewan Health Authority, Saskatchewan, Canada
| | - Carla Holinaty
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan and Saskatchewan Health Authority, Saskatchewan, Canada
| | - Ginger Ruddy
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan and Saskatchewan Health Authority, Saskatchewan, Canada
| | | | - Adam Clay
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | | | - Megan Clark
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan and Saskatchewan Health Authority, Saskatchewan, Canada
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Melin K. The need for a prepared and committed profession. J Am Pharm Assoc (2003) 2022. [DOI: 10.1016/j.japh.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Llayton C, Wagner TD, Anderson AN, Crawford AN, Donohoe KL, Matulewicz AT, Caldas LM. Introducing LGBTQIA+ Patient Care to Pharmacy Students Through Laboratory-Based Exercises. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8569. [PMID: 34697011 PMCID: PMC10159440 DOI: 10.5688/ajpe8569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/27/2021] [Indexed: 05/06/2023]
Abstract
Objective. To assess the impact of novel skills-based laboratory exercises on first-, second-, and third-year pharmacy students' confidence and knowledge regarding care for people identifying as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other (LGBTQIA+).Methods. An LGBTQIA+ lecture discussing pronouns, common terminology, health disparities, health screenings, and gender-affirming hormone therapy was presented to students. During laboratory sessions, students applied lecture topics via a learning level-specific activity. Students completed a pre- and post-activity survey assessing their knowledge, confidence, and activity experience.Results. Seventy-nine students (N=348) completed both the pre- and post-activity survey. Students' overall increase in knowledge scores was significant, with improvement in four out of six questions among each cohort. A significant increase was seen in students understanding of the role of the pharmacist, their confidence in caring for LGBTQIA+ patients, and their comfort with using appropriate terminology. Most students (92%) agreed or strongly agreed that learning about LGBTQIA+ patient care was a positive experience, while 74% agreed that additional education on LGBTQIA+ patients is needed within their pharmacy curriculum.Conclusion. After a brief skills-based laboratory course, students' knowledge and confidence in caring for LGBTQIA+ patients improved; however, students agreed that more exposure was necessary. Future studies will follow students as they progress through the curriculum to determine the impact of exposure to LGBTQIA+ content across all three didactic years.
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Affiliation(s)
- Chelsey Llayton
- University of Charleston School of Pharmacy, Charleston, West Virginia
| | - Tyler D Wagner
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Apryl N Anderson
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Alexis N Crawford
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Krista L Donohoe
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | | | - Lauren M Caldas
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
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Melton TC, Johnson WT, Tipton B, Aragon KG, Daniels CC, Renfro CP. Improving Pharmacy Students' Clinical Knowledge on Providing Care for Patients Belonging to the LGBTQ+ Community. PHARMACY 2022; 10:pharmacy10040070. [PMID: 35893708 PMCID: PMC9326589 DOI: 10.3390/pharmacy10040070] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 02/01/2023] Open
Abstract
A 12-question survey instrument was developed, pilot-tested, and administered to 191 pharmacy students in their first professional year after engaging in a learning activity focusing on topics across five categories with clinical relevance to providing care to the LGBTQ+ community. A paired student t-test was performed on survey tool pre-test and post-test survey responses, with p < 0.05 considered significant. A total of 183 usable pre-test and post-test survey responses were received. Statistically significant differences between the pre-test and post-test correct responses were observed for scenarios involving proper pronoun use, hormone therapy (HT) counseling, immunization best practices, and communication hesitancy. The greatest knowledge change was reported in the categories of immunization best practices (48.9%), HT counseling (33.6%), and pronoun use (22.8%). Active learning assignments are effective teaching strategies to promote clinical knowledge in providing inclusive and culturally competent care to LGBTQ+ patients. Clinical topic areas including proper pronoun use, HT counseling, immunization best practices, privacy, risk awareness, and communication hesitancy are effective curricula additions for pharmacy colleges to advance inclusive curricula concerning providing care to the LGBTQ+ community.
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Affiliation(s)
- Tyler C. Melton
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
- Correspondence:
| | - William T. Johnson
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
| | - Brittany Tipton
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
| | - Kelsea G. Aragon
- College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA;
| | | | - Chelsea Phillips Renfro
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN 38103, USA; (W.T.J.III); (B.T.); (C.P.R.)
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Langdon E, Kavanagh P, Bushell M. Exploring pharmacists' understanding and experience of providing LGBTI healthcare. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 6:100134. [PMID: 35909715 PMCID: PMC9335930 DOI: 10.1016/j.rcsop.2022.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/03/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Lesbian, gay, bisexual, transgender and intersex (LGBTI) people experience health and wellness challenges additional to and separate from those of the wider population. Extant research has identified that LGBTI patients support education for healthcare providers to improve their access to appropriate care. Community pharmacists have a role in providing appropriate care to LGBTI patients. Aims This study explores the experiences of Australian community pharmacists in providing LGBTI healthcare. Methods Ten pharmacists were interviewed using a semi-structured interview guide and the major themes were identified using Braun and Clark's thematic analysis. Results Analysis revealed a demand for professional education in several areas of LGBTI healthcare, especially gender-affirming hormone replacement therapy and safe communication with this group. Barriers to privacy and confidentiality were revealed, including time constraints, Covid-19 social distancing requirements, and the lack of appropriate consultation rooms. Further there is a need to engage LGBTI patients through greater inclusive advertising. Conclusions While there is some improvement, more must be done to promote inclusive pharmacy care for LGBTI people. This study demonstrates a demand from Australian pharmacists for increased professional education on LGBTI related healthcare.
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Affiliation(s)
- Elizabeth Langdon
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, Australia
| | - Phillip Kavanagh
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Canberra, Australia
| | - Mary Bushell
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, Australia
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Napolitano F. Implementation and analysis of a LGBTQ cultural competency module on pharmacy student knowledge. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:266-275. [PMID: 35307084 DOI: 10.1016/j.cptl.2022.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 12/08/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study describes the implementation and assessment of a cultural competency module on caring for patients who identify as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). The module was delivered to first professional year pharmacy students, and focused on student knowledge and application of LGBTQ-specific definitions, inclusive language, and health disparities. METHODS A mixed-methods design captured data to assess the effect of a LGBTQ module on student knowledge and confidence. For the pre- and post-assessment, descriptive statistics were calculated and mean differences were compared using the paired sample t-test. The number of correct choices for multiple-select questions were compared using the Pearson chi-square test. Post-laboratory (lab) reflections were analyzed via percentages of agreement for Likert-scale questions and thematic analysis of free-response questions. RESULTS Average pre- and post-assessment scores (n = 74 students) were 47.84% and 53.51% (P = .02). Sub-analysis of the multiple-select questions indicated statistically significant improvement in student performance on health disparities and culturally-competent communication (P values < .05). Likert-scale questions from 71 student's post-lab reflections indicated agreement of improved knowledge of health disparities (95.77%) and LGBTQ terminology (92.96%). Agreement in student's confidence using inclusive language and competent communication improved from 64.79% pre- to 95.67% post-module. Reflection themes included respect, inclusivity, awareness, and avoiding assumptions. CONCLUSIONS The module slightly improved student knowledge via assessment performance; however, student-reported knowledge and confidence regarding LGBTQ competency significantly improved. This module can be utilized by schools of pharmacy as a model educational activity on LGBTQ cultural competency with lab-based application.
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Affiliation(s)
- Francesca Napolitano
- Concordia University Wisconsin School of Pharmacy, 12800 N Lake Shore Drive, PH216, Mequon, WI 53097, United States.
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14
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Frazier CC, Nguyen TL, Gates BJ, McKeirnan KC. Teaching transgender patient care to student pharmacists. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1611-1618. [PMID: 34895670 DOI: 10.1016/j.cptl.2021.09.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/23/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study describes content on transgender care taught in a doctor of pharmacy (PharmD) course and evaluates students' confidence and knowledge of providing care for transgender people. It also examines what pharmacy students want to learn about providing care to transgender people. METHODS Three hours of transgender patient care content was integrated into a pharmacy course that focused on therapeutics of special populations. Students completed an electronic survey before and after the class sessions to identify changes in their confidence in caring for transgender patients. The pre-class survey inquired about what the students were hoping to learn. The post-class survey asked students what was missing from this session that they would have liked to learn. Knowledge regarding transgender care was assessed through a multiple-choice examination. RESULTS Students reported interest in improving communication skills, learning terminology/vocabulary preferred by transgender people, and understanding population-specific challenges faced by transgender patients. Students reported they would have liked additional information about the transition, being transgender, and local resources available. Student confidence in asking about patient pronouns and counseling on effects of medications for gender transition were both significantly increased from the pre-class survey to post-class survey. Students demonstrated proficiency toward the learning objectives, with a 92.4% average on the examination questions on transgender care. CONCLUSIONS Student pharmacists are interested in learning skills to provide care to transgender patients. A learning session on transgender patient care integrated into a PharmD curriculum increased student knowledge and confidence in caring for transgender patients.
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Affiliation(s)
- Cheyenne C Frazier
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E Spokane Falls Blvd, Spokane, WA 99202, United States.
| | - Tricia L Nguyen
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E Spokane Falls Blvd, Spokane, WA 99202, United States.
| | - Brian J Gates
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E Spokane Falls Blvd, Spokane, WA 99202, United States.
| | - Kimberly C McKeirnan
- Washington State University College of Pharmacy and Pharmaceutical Sciences, 412 E Spokane Falls Blvd, Spokane, WA 99202, United States.
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Bear MD, Mukherjee SM, Goldsmith CAW. Transgender health education for pharmacy students and its effect on student knowledge and attitudes. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1351-1357. [PMID: 34521531 DOI: 10.1016/j.cptl.2021.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/28/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Increased student pharmacist education on health issues and concerns of the underserved Lesbian, gay, bisexual, transgender, and queer (LGBTQ) population is needed. We incorporated pharmacy-specific, transgender-focused education into the curriculum and sought to identify whether pharmacy students' knowledge and attitudes towards LGBTQ individuals were affected by: (1) required online module or in-class lecture and (2) student demographics. Educational activity and setting: Pharmacy student attitudes and perceptions towards transgender individuals and the LGBTQ population were assessed before and after online (video) and in-person education using a modification of the Attitudes towards Lesbian Gay Bisexual Transgender Patients Scale. Wilcoxon test for non-parametric paired data was used to test for statistically significant changes between the pre- and post-education surveys, while two-way analysis of variance was used to analyze correlations between student demographics and responses. FINDINGS Changes in students' knowledge and attitudes were observed after exposure to either online or in-person education. Increases in students' perceived competence to provide care to patients identifying as LGBTQ were associated with both teaching methods. Significant demographic associations were seen with specific attitudes; female students and students who knew a transgender person were more likely to strongly disagree that discussing sexual behavior with LGBTQ patients is challenging. SUMMARY Delivery of transgender-focused education produced observable changes in student pharmacist perceptions and attitudes towards working with the LGBTQ patient population. Demographic characteristics, such as being female or knowing a transgender individual, positively correlated with student pharmacists' feeling more comfortable discussing sexual behavior with LGBTQ persons.
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Affiliation(s)
- Michael D Bear
- Pharmacy Practice, MCPHS University, School of Pharmacy-Worcester/Manchester, 40 Foster Street, Worcester, MA 01698, United States.
| | - S Mimi Mukherjee
- Pharmacy Practice, MCPHS University, School of Pharmacy-Worcester/Manchester, 40 Foster Street, Worcester, MA 01698, United States.
| | - Carroll-Ann W Goldsmith
- Pharmaceutical Sciences, MCPHS University, School of Pharmacy-Worcester/Manchester, 1260 Elm Street, Manchester, NH 03101, United States.
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16
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Newsome CC, Gilmer A. Strategies to Bring Transgender and Non-binary Health Care into Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8283. [PMID: 34283728 PMCID: PMC8174614 DOI: 10.5688/ajpe8283] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/30/2020] [Indexed: 05/22/2023]
Abstract
Research has shown an increase in the number of people in the United States identifying as transgender and non-binary (TNB) . Many pharmacy schools and colleges do not offer any instruction specific to students interacting with and caring for TNB people, and practicing pharmacists have reported a lack of confidence in managing TNB patients. Regardless of the practice setting they choose, there is an increased likelihood that pharmacy graduates will serve TNB patients. Pharmacy schools that include TNB-specific education in their Doctor of Pharmacy curriculum will equip graduates with the necessary knowledge and skills to support this vulnerable population. The purpose of this commentary is to suggest methods for incorporating TNB-related material into pharmacy curricula and to provide resources for developing content.
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Affiliation(s)
- Cheyenne C Newsome
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, Washington
| | - Alexander Gilmer
- University of California, San Francisco Medical Center, San Francisco, California
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17
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Nowaskie DZ, Patel AU. LGBT cultural competency, patient exposure, and curricular education among student pharmacists. J Am Pharm Assoc (2003) 2021; 61:462-469.e3. [PMID: 33715973 DOI: 10.1016/j.japh.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Pharmacists are positioned in unique and important roles in health care in their ability to care for the lesbian, gay, bisexual, and transgender (LGBT) population. For example, pharmacists are a highly prevalent, accessible provider type, and informal surveys have shown that LGBT patients may be more comfortable asking their pharmacists sensitive medication questions rather than their primary provider. OBJECTIVES To demonstrate gaps in LGBT cultural competency among student pharmacists and propose specific recommendations on the number of LGBT patient exposures and educational hours that can significantly improve LGBT cultural competency. METHODS Student pharmacists (N = 275) at 3 universities in the United States completed a survey comprising demographics, experiential variables (i.e., number of LGBT patients and LGBT hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores were stratified by 1-point increments, and experiential variable means were computed per each stratification to characterize the mean LGBT patients and hours of student pharmacists with higher scores and those with lower scores. RESULTS Student pharmacists reported low numbers of annual LGBT patients (Mean = 3.82, SD = 9.54), annual LGBT curricular hours (Mean = 0.55, SD = 0.95), and annual LGBT extracurricular hours (Mean = 2.50, SD = 15.42). They reported very high attitudinal awareness (Mean = 6.19, SD = 1.02), moderate knowledge (Mean = 5.00, SD = 1.25), and low clinical preparedness (Mean = 3.26, SD = 1.33). Student pharmacists who cared for 25 or more LGBT patients and received 10 or more LGBT total hours reported significantly higher preparedness, knowledge, and overall cultural competency. CONCLUSION Student pharmacists have shortcomings in LGBT cultural competency and limited LGBT patient exposure and education. To improve LGBT cultural competency, pharmacy schools and accrediting bodies should consider ensuring that student pharmacists receive at least a total of 25 LGBT patient contacts and 10 LGBT formal education hours across their pharmacy education.
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Chaudhary S, Ray R, Glass B. Pharmacists' role in transgender healthcare: A scoping review. Res Social Adm Pharm 2021; 17:1553-1561. [PMID: 33436315 DOI: 10.1016/j.sapharm.2020.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/19/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Transgender patients have unique healthcare needs, providing pharmacists with the opportunity to play an important role in transgender care through addressing the healthcare disparities observed in this patient group. OBJECTIVE This scoping review aimed to explore the role of pharmacists in transgender healthcare. METHODS Six databases were searched from inception: Emcare, Informit, MEDLINE (Ovid), PubMed, Scopus, and Web of Science. The first author performed screening and data extraction in consensus with co-authors. Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was utilised to report this review. Themes related to the role of pharmacists in transgender healthcare were identified. RESULTS A total of 356 studies were identified; however, only 15 studies, all from the USA met the selection criteria and were included in this review. Study types included empirical research, practice reports and opinion pieces such as commentaries, editorials, and reports. Pharmacists were found to practise in two different care settings: community and interdisciplinary clinics, performing various roles in transgender healthcare, including patient education and counselling, management of cross-sex hormonal therapy, patient advocacy and provision of preventative care. They were also responsible for the provision of culturally sensitive care in an inclusive and welcoming environment. Although pharmacists considered their role important, they lacked confidence in their knowledge to provide appropriate care to this patient group. CONCLUSION This review has highlighted that there is a need for education in transgender care for both pharmacists and pharmacy students, so that they are both confident and comfortable to play a meaningful role in transgender care. Pharmacists' involvement in addressing the health disparities experienced will contribute to improving the overall health outcomes for this group.
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Affiliation(s)
- Swapna Chaudhary
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia
| | - Beverley Glass
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia
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Rosa-Vega J, Carlo E, Rodríguez-Ochoa A, Hernández-Agosto J, Santiago Quiñones D, Cabrera-Candelaria D, Rodríguez-Díaz CE, Melin K. Educational intervention to improve pharmacist knowledge to provide care for transgender patients. Pharm Pract (Granada) 2020; 18:2061. [PMID: 33343770 PMCID: PMC7739511 DOI: 10.18549/pharmpract.2020.4.2061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/06/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Most pharmacists have not received formal training or education in the
provision of care for transgender patients. Nonetheless, pharmacists have
the potential to be valuable partners in the care of transgender patients,
and a continuing education course might be valuable in addressing this
knowledge gap. Objective: The aim of this study was to examine the impact of a three-hour continuing
education course in improving the knowledge of pharmacists to provide
pharmaceutical care for transgender patients. Methods: A quasi-experimental, one-group pre-test/post-test study design was used to
measure the impact of a three-hour continuing pharmacy education course on
the knowledge of pharmacists on transgender care. The course was divided
into three units: (1) Transgender Patient Care Introduction, (2) General
Health Issues of Transgender Patients, and (3) Gender Affirming Hormone
Therapy. A total of 68 pharmacists participated in the study, of which 54
completed both the pre- and post-test. An ANOVA was used to compare
differences in knowledge in the group before and after the educational
intervention. Results: The majority of the participating pharmacists were cisgender, heterosexual
women who had not received any formal training related to transgender care.
Participants demonstrated the largest increase in execution score in the
third unit, with a percent improvement of 25.22% (pre-test
45.06%, post-test 70.28%; p<0.001). The average total
execution score was 52.15% in the pre-test and 72.89%
(p< 0.001) in the post-test. Conclusions: Pharmacists benefited from a three-hour continuing education course with an
increase in knowledge regarding transgender patient care and hormone therapy
for gender affirmation. As this study only evaluated the effect in short
term memory, further studies are needed to assess long term impact of the
continuing education course on transgender care knowledge.
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Affiliation(s)
| | - Edgar Carlo
- PharmD. School of Pharmacy, University of Puerto Rico. San Juan, (Puerto Rico).
| | | | - Jonathan Hernández-Agosto
- EdD. Associate Professor, Director of Curriculum and Institutional Effectiveness. School of Pharmacy, University of Puerto Rico. San Juan, (Puerto Rico).
| | - Darlene Santiago Quiñones
- PhD, MS. Associate Professor. School of Pharmacy, University of Puerto Rico. San Juan, (Puerto Rico).
| | | | - Carlos E Rodríguez-Díaz
- PhD, MPHE, MCHES. Associate Professor, Director Community-Oriented Primary Care Program. Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Washington, DC (United States).
| | - Kyle Melin
- PharmD, MSc, BCPS. Associate Professor. School of Pharmacy, University of Puerto Rico. San Juan, (Puerto Rico).
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Hernández-Agosto J, Melin K, Rosa-Vega J, Carlo-Frontera E, Rodríguez-Ochoa A, Santiago-Quiñones D. The Development of a Knowledge Test on Transgender Patients' Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197192. [PMID: 33019588 PMCID: PMC7579190 DOI: 10.3390/ijerph17197192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/01/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022]
Abstract
The objective of this study was to develop an assessment instrument to measure the effects of a continuing education intervention on 3 domains in pharmacists’ knowledge needed to provide pharmaceutical care for transgender patients: (1) foundations of gender-affirming care, (2) health disparities and the specific needs of transgender patients, and (3) hormone treatments for transgender patients. Multiple-choice questions were developed, and an initial item bank of 47 items was drafted. Item bank revision was conducted by content matter experts, while feedback from 8 practicing pharmacists was provided for face validity and further insights. A preliminary test, containing 42 items was administered to 64 pharmacists before and after a three-hour continuing education intervention. Cronbach’s alpha coefficient yielded a value of 0.65 as a pre-test and 0.77 as a post-test. Items were less difficult to answer by participants after taking the three-hour continuing education, showing better discrimination among high and low performers in the instrument administration as post-test, as well as better correlation when comparing participants’ performance in the overall score against item-level performance. Psychometric evidence supports further instrument examination, which can improve this tool to measure gains in pharmacists’ knowledge related to the care of transgender patients.
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Affiliation(s)
- Jonathan Hernández-Agosto
- Curriculum and Institutional Effectiveness Evaluation Division, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA
- Correspondence: ; Tel.: +1-(787)-758-2525 (ext. 5420)
| | - Kyle Melin
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA; (K.M.); (J.R.-V.); (E.C.-F.); (A.R.-O.)
| | - Jurynelliz Rosa-Vega
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA; (K.M.); (J.R.-V.); (E.C.-F.); (A.R.-O.)
| | - Edgar Carlo-Frontera
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA; (K.M.); (J.R.-V.); (E.C.-F.); (A.R.-O.)
| | - Andrés Rodríguez-Ochoa
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA; (K.M.); (J.R.-V.); (E.C.-F.); (A.R.-O.)
| | - Darlene Santiago-Quiñones
- Department of Pharmacutical Sciences, School of Pharmacy, University of Puerto Rico, San Juan, PR 00936, USA;
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21
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Tran MT, Swank SD, Oliver AS, Lipscomb JS. Pharmacists perceptions and preparedness regarding gender-affirming hormone therapy. J Am Pharm Assoc (2003) 2020; 61:e30-e34. [PMID: 32972851 DOI: 10.1016/j.japh.2020.08.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/23/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND As the transgender and gender non-conforming (TGNC) population in the United States continues to grow, there is a need for health care providers who are competent in managing gender-affirming therapy (GAT) for these individuals. OBJECTIVES The purpose of this study was to assess practicing pharmacists' readiness to care for transgender and gender nonconforming (TGNC) patients and to compare the perceptions between pharmacists who have received formal education about gender-affirming therapy (GAT) and those who have not received such training. METHODS This was a cross-sectional study that was conducted online over 4 weeks (January 2019-February 2019). A survey was distributed to pharmacists in the United States. Distribution of the survey was conducted through professional pharmacy social media groups. Respondents were asked to anonymously rate their perceived preparedness to care for a TGNC patient and to disclose any formal GAT training they had received during pharmacy school or through continuing pharmacy education. Responses were further stratified on the basis of self-reported completion of GAT education taken after pharmacy school. The responses of those who had received GAT training were compared with the responses of those who had not received GAT training. RESULTS The results of this survey indicated that few pharmacists felt prepared to care for TGNC patients. Furthermore, few pharmacists report receiving formal education over GAT during pharmacy school or postgraduation. Approximately 41% and 40% of respondents, respectively, reported that they did not feel prepared to make recommendations to other health care providers on GAT and counsel TGNC patients about GAT regimens. However, the self-reported GAT-trained pharmacists showed a significantly increased level of perceived preparedness in caring for TGNC patients when compared with pharmacists who did not receive such education. CONCLUSION Increased accessibility to GAT education for pharmacists may be associated with a significant growth in pharmacists' perceived ability to provide care for and interact with transgender patients.
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Gauly J, Atherton H, Kimani PK, Ross J. Utilisation of pharmacy-based sexual and reproductive health services: a quantitative retrospective study. Sex Transm Infect 2020; 97:126-133. [PMID: 32817275 PMCID: PMC7892391 DOI: 10.1136/sextrans-2020-054488] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the utilisation of pharmacy-based sexual and reproductive health services (SRHS) in order to optimise delivery and identify barriers to access. METHODS The health provider Umbrella offers six SRHS from over 120 pharmacies in Birmingham (England). In this retrospective study, data collected between August 2015 and August 2018 were used to analyse uptake, user characteristics and attendance patterns according to day of the week. RESULTS A total of 60 498 requests for a pharmacy service were included in the analysis. Emergency contraception (50.4%), condoms (33.1%) and STI self-sampling kits (9.6%) accounted for more than 90% of all requests. A lower uptake of services was observed for the contraceptive injection (0.6%), oral contraception (5.4%) and chlamydia treatment (1.0%). Services were most likely to be requested by those self-identifying as female (85.6%), and those aged 16-24 years (53.8%). Based on available ethnicity data (n=54 668), most requests for a service were made by White/White British individuals (43.4%) and Asian/Asian British people (23.1%). The largest number of services were delivered on Mondays (20.9%) and the lowest on Sundays (5.0%). A high proportion of requests for services on Saturdays (57.0%), Sundays (67.6%) and Mondays (54.4%) were made by females presenting for emergency contraception. CONCLUSION The evaluation of healthcare utilisation is important to help refine and optimise the delivery of services. However, information relating to pharmacy-based SRHS is scarce and often limited to a single type of service provision. Overall, a wide range of pharmacy-based services were accessed by a diverse range of people, suggesting that pharmacies are a suitable provider of many SRHS. However, the routinely collected data analysed in the study had several limitations restricting the analysis. Sexual health providers should ensure they collect data which are as comprehensive as is possible in order to help understand the utilisation of services.
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Affiliation(s)
- Julia Gauly
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Helen Atherton
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter K Kimani
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jonathan Ross
- Whittall Street Clinic, University Hospital Birmingham, Birmingham, UK
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Llayton CK, Caldas LM. Strategies for inclusion of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) education throughout pharmacy school curricula. Pharm Pract (Granada) 2020; 18:1862. [PMID: 32206144 PMCID: PMC7075428 DOI: 10.18549/pharmpract.2020.1.1862] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others (LGBTQIA+) patients face stigma and barriers to health care, including a lack of health care professionals' knowledge and confidence in treating this patient population. Pharmacists are in prime position to decrease this health disparity. United States pharmacy schools have limited LGBTQIA+ content, continuing the concern of recent graduates without knowledge and confidence. This commentary discusses potential barriers to introducing LGBTQIA+ content into school of pharmacy curricula and presents five strategies currently in use by nursing, medical, and pharmacy schools. Schools of Pharmacy should consider proactive incorporation of this content to graduate practitioners able to provide quality care to LGBTQIA+ patients.
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Affiliation(s)
- Chelsey K Llayton
- PharmD. School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Lauren M Caldas
- PharmD, BCACP. School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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24
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Leach C, Seung H, Layson-Wolf C. Student pharmacists' perceptions of transgender health management. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:1254-1258. [PMID: 31836150 DOI: 10.1016/j.cptl.2019.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 06/09/2019] [Accepted: 09/07/2019] [Indexed: 05/14/2023]
Abstract
INTRODUCTION To measure the general perceptions and attitudes of pharmacy students toward transgender patients and health and evaluate students' level of support for receiving education in transgender healthcare. METHODS This study was a cross-sectional survey delivered online to approximately 60 s-year pharmacy students enrolled in a required pharmacotherapy course at the University of Maryland School of Pharmacy. Students received a survey link, with five questions for completion prior to the "Gender Transition Therapeutics" lecture and a separate link with 11 questions for completion post-lecture. Responses were anonymous with no identifiers collected and multiple-choice, using Likert-scale questions aimed at gathering respondents' perceptions of managing transgender patients and support for receiving additional education in transgender healthcare. RESULTS Survey results indicated that students' cultural competency and confidence in managing transgender patients increased after lecture, and that they support integrating transgender health into pharmacy education. Significant findings include: 67% of students lacked confidence in their ability to treat transgender patients prior to the lecture while only 20% of students reported this lack after the lecture. 51% of students reported being aware of barriers-to-care experienced by the transgender population compared to 92% of students after the lecture. After the lecture, 87% agree pharmacists need more education in transgender health, and 74% support integrating this education into pharmacy curricula. CONCLUSIONS Students' confidence in managing transgender health increases after didactic education, and overall, students support integrating transgender health education into pharmacy school curricula.
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Affiliation(s)
- Caitlin Leach
- Department of Women's & Gender Studies, University of Maryland, College Park, United States of America.
| | - Hyunuk Seung
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, United States of America.
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Allison MK, Marshall SA, Archie DS, Neher T, Stewart G, Anders ME, Stewart MK. Community-Engaged Development, Implementation, and Evaluation of an Interprofessional Education Workshop on Gender-Affirming Care. Transgend Health 2019; 4:280-286. [PMID: 31656857 PMCID: PMC6814076 DOI: 10.1089/trgh.2019.0036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Transgender/nonbinary (trans/NB) patients face stigma in health care settings. Health care professionals' training on trans/NB issues has historically been lacking. Interprofessional education (IPE) provides an opportunity to improve knowledge and attitudes across health care professions. The purpose of this study was to: (a) describe the development and implementation of an IPE workshop on gender-affirming care through a trans/NB community-academic partnership and (b) examine the impact of the workshop on student knowledge and attitudes. Methods: The workshop included a slide presentation on basic terminology and concepts, video clips of trans/NB patient-provider interactions, facilitated discussions of affirming practices, and a trans/NB panel. Nonparametric statistical analysis of pre- and post-survey data from 58 workshop participants measured changes in student knowledge and attitudes. Findings: Students demonstrated statistically significant improvements in knowledge (t=-12.72; p<0.01) and interpersonal comfort (t=-2.06; p<0.05) as well as sex and gender beliefs (t=-3.06; p<0.05) on subscales from the Transgender Attitudes & Beliefs Scale. The results demonstrated no differences on the human value subscale (t=-0.69; p=0.49) or on health care professional questions (t=-1.23; p=0.23). Conclusions: A community-academic partnership developed and implemented this brief interactive educational intervention, which can improve both knowledge and attitudes about trans/NB individuals' health among health professional students.
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Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - S. Alexandra Marshall
- Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Taylor Neher
- Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Gray Stewart
- Arkansas Transgender Equality Coalition, Little Rock, Arkansas
| | - Michael E. Anders
- Division of Academic Affairs, Office of Educational Development, University of Arkansas for Medical Sciences, Little Rock, AR
| | - M. Kathryn Stewart
- Department of Health Policy & Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Knockel LE, Ray ME, Miller ML. Incorporating LGBTQ health into the curriculum: Assessment of student pharmacists' knowledge and comfort level in caring for transgender patients. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:928-935. [PMID: 31570131 DOI: 10.1016/j.cptl.2019.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND PURPOSE This study aimed to measure the effects of instruction regarding transgender health in second-year student pharmacists and provide qualitative insight regarding their impressions of the educational experience. EDUCATIONAL ACTIVITY AND SETTING Students completed a pre- and post-survey assessing knowledge regarding transgender therapeutics, the pharmacist's role, level of comfort providing care, and impression of exposure to the topic. McNemar's test and paired t-tests compared respondent data before and after the activity. The post-survey evaluated the learning activity, with an opportunity to leave open comments that were then analyzed using content analysis. FINDINGS Eighty-five of 107 (79.4%) students completed both surveys and were included in the analysis. Transgender therapeutics knowledge, participant understanding of pharmacist's role, comfort level, and assessment of adequateness of exposure improved significantly (p < 0.001). A majority (82.4%) affirmed that more than one exposure to issues regarding care of transgender patients is needed in the curriculum. Fifty-five open comments offered by 23 students were coded and categorized into two overall themes with four and two subthemes, respectively. Strengths of the activity were topic importance, exposure appreciation, presentation style, and knowledge foundation. Opportunities for improvement included providing more information and different types of information. SUMMARY The activity increased student pharmacists' knowledge regarding transgender therapeutics, the pharmacist's role, and comfort level in caring for this patient population. Respondents found the content valuable and desired more. Colleges of pharmacy should consider increasing exposure to specific patient populations, such as transgender patients, to prepare students for practice.
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Affiliation(s)
- Laura E Knockel
- University of Iowa College of Pharmacy, 115 S Grand Avenue, Room 222, Iowa City, IA 52242, United States.
| | - Mary Elizabeth Ray
- University of Iowa College of Pharmacy, 115 S Grand Avenue, Room 318, Iowa City, IA 52242, United States.
| | - Michelle L Miller
- University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United States.
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27
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Eckstein MA, Newsome CC, Borrego ME, Burnett A, Wittstrom K, Conklin JR. A cross-sectional survey evaluating transgender-related care education in United States pharmacy school curricula. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:782-792. [PMID: 31227193 DOI: 10.1016/j.cptl.2019.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/04/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The objectives of this study are to evaluate the extent of transgender-related care in current pharmacy school curricula, identify where transgender-related care is covered in the curriculum, describe how the content is delivered to pharmacy students, and review how student knowledge of transgender-related care is evaluated. METHODS This cross-sectional study utilized an online survey of curricular contacts of 142 pharmacy schools in the United States. Survey questions regarding transgender-related care were presented as multiple choice, ranking, and free-response. The survey inquired about transgender-related care information taught, teaching methods, hours of education, and student assessment. RESULTS Of the 66 schools that responded to the survey, 53% indicated that transgender-related education is a topic that is currently addressed somewhere within the curriculum. Twenty-two pharmacy schools incorporate this topic into the didactic curriculum, two into the experiential curriculum, and 10 into both didactic and experiential. Transgender-related care is only taught in the required curriculum of 41.2% of schools that responded to the survey. CONCLUSION Transgender-related care education is taught to variable degrees throughout US doctor of pharmacy programs. This study should serve as a call to action to incorporate this necessary transgender-related care education and training into pharmacy curricula to effectively reduce health disparities among this population that is increasingly seeking care.
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Affiliation(s)
- Megan A Eckstein
- University of New Mexico Hospitals, 2211 Lomas Blvd NE, Albuquerque, NM 87106, United States.
| | - Cheyenne C Newsome
- Washington State University College of Pharmacy and Pharmaceutical Sciences, PO Box 1495, Spokane, WA 99210-1495, United States.
| | - Matthew E Borrego
- University of New Mexico College of Pharmacy, 1 University of New Mexico, MSC 09 5360, Albuquerque, NM 87131, United States.
| | - Allison Burnett
- University of New Mexico Hospitals, 2211 Lomas Blvd NE, Albuquerque, NM 87106, United States.
| | - Kristina Wittstrom
- University of New Mexico College of Pharmacy, 1 University of New Mexico, MSC 09 5360, Albuquerque, NM 87131, United States.
| | - Jessica R Conklin
- University of New Mexico College of Pharmacy, 1 University of New Mexico, MSC 09 5360, Albuquerque, NM 87131, United States.
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Aragon KG, Conklin J, Lenell A, Rhodes LA, Marciniak MW. Examining community-based pharmacist perceptions on the care of transgender patients. J Am Pharm Assoc (2003) 2019; 59:S62-S66. [PMID: 31203014 DOI: 10.1016/j.japh.2019.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether community-based pharmacists in North Carolina have the personal confidence, comfort level, and resources needed to care appropriately for and interact with transgender patients. METHODS Using the North Carolina Board of Pharmacy database, a link to a 25-item questionnaire was e-mailed to all actively licensed community pharmacists in North Carolina. Survey items included pharmacist demographics, prior or current education on transgender health care, comfort regarding care provision for transgender patients, and the ability to care for transgender patients at the practice site. Questionnaire items were developed in collaboration with a pharmacist who actively participates in the care of transgender patients. The questionnaire was pilot-tested among a convenience sample of student pharmacists and pharmacists for feedback on validity and question structure. The survey was open for 30 days with a reminder sent on day 15. Upon survey completion, participants had the option to be entered into a drawing to receive a gift card incentive. RESULTS In total, 342 surveys were completed of 4784 surveys distributed, yielding a 7.1% response rate. Three percent of survey respondents reported receiving education on treating transgender patients during their respective pharmacy school curricula, and 12% of respondents sought other forms of transgender education (i.e., continuing education). Seventy-one percent of respondents viewed the role of the pharmacist as important in the care of transgender patients. Sixty-six percent of respondents were comfortable welcoming transgender patients into their practice sites, and 36% were comfortable asking for pronouns. CONCLUSION Survey participants reported a lack of formal or postgraduate education, which describes a need for accessible education on transgender care. North Carolina community-based pharmacists believe that it is within their role as pharmacists to provide gender-affirming care, but they may need additional training to feel comfortable in providing this care.
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Melin K, Hilera-Botet CR, Vega-Vélez D, Salgado-Crespo VM, Santiago D, Hernández-Agosto J, Muñoz-Burgos A, Cajigas Z, Martínez-Vélez JJ, Rodríguez-Díaz CE. Readiness to provide pharmaceutical care to transgender patients: Perspectives from pharmacists and transgender individuals. J Am Pharm Assoc (2003) 2019; 59:651-659. [PMID: 31153824 DOI: 10.1016/j.japh.2019.04.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objectives of this study were (1) to assess pharmacist readiness to provide pharmaceutical care for transgender patients through measuring both pharmacists' knowledge and attitudes towards transgender patients, (2) to assess transgender patients' perception of pharmacist readiness to provide them pharmaceutical care through measuring both pharmacists' knowledge and attitudes toward them, and (3) to compare pharmacist readiness to provide pharmaceutical care for transgender patients and patient perception of this readiness. DESIGN The study used a descriptive, cross-sectional design. The pharmacist's readiness and the transgender patient's perception of their readiness, defined as a combination of knowledge and attitude, were evaluated. Two separate, validated questionnaires with dichotomous, multiple choice, and open-ended questions were used to measure both constructs among both populations. SETTING Community-based research. PARTICIPANTS Pharmacists practicing in Puerto Rico were provided the questionnaire by e-mail or in person. Transgender participants in Puerto Rico were recruited through health clinics and community partners and were surveyed in person. The analysis included responses from 96 pharmacists and 31 transgender participants. RESULTS The majority of the pharmacists' knowledge scores (90%) were found in the low (0-5) and moderate (6-10) ranges, with a mean score of 7.23 out of a total possible score of 16 (SD ±2.36). For the attitude construct, most of the scores (81%) were found in the high (18-26) range, with a mean score of 19.63 out of a total possible score of 26 (SD ±3.65). For both constructs, transgender patient perceptions echoed the results of the pharmacists, indicating several perceived knowledge deficits in combination with mostly positive attitudes. CONCLUSION The majority of pharmacists demonstrated positive attitudes toward caring for transgender patients, and transgender patients also perceived these positive attitudes from pharmacists. However, the measured and perceived knowledge deficits observed in this study suggest the need for educational interventions to improve pharmacist readiness to provide care for transgender patients.
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Abstract
Pharmacists are increasingly part of a multifaceted team providing health care to members of the often marginalized transgender (TG) community. Some pharmacists, however, may feel unprepared to care for and interact with TG individuals. By providing comprehensive, respectful, and gender-affirming support, improving physical pharmacy environments with policies and procedures, pharmacists can be trustworthy providers for TG patients. This review focuses primarily on the health issues of TG persons and the pharmacist's role in promoting health, identifying barriers to health care, and providing health care resources for TG persons. The evolution of psychiatric diagnostic criteria, access to health care, and inclusion of TG, lesbian, gay, and bisexual topics in the educational curriculum are presented. Cultural competency and diversity training that addresses gender identity and sexual orientation issues should be important interdisciplinary and interprofessional activities for all health care professional education programs. Pharmacists play a key role in the health care needs of TG persons that include appropriate laboratory monitoring, complex pharmacotherapeutic challenges, and providing unbiased gender-affirming interactions. The pharmacy's physical environment, staff training, and policies and procedures can offer unique services to TG persons.
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Affiliation(s)
- Jan S Redfern
- Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, Texas.,Redfern Strategic Medical Communications, Inc., Springtown, Texas
| | - Michael W Jann
- Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Fort Worth, Texas
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Lewis NJW, Batra P, Misiolek BA, Rockafellow S, Tupper C. Transgender/gender nonconforming adults’ worries and coping actions related to discrimination: Relevance to pharmacist care. Am J Health Syst Pharm 2019; 76:512-520. [DOI: 10.1093/ajhp/zxz023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nancy J W Lewis
- Department of Pharmacy Practice,University of Michigan College of Pharmacy, Ann Arbor, MI
- Transcend the Binary, Ferndale, MI
| | - Peter Batra
- Institute of Social Research, University of Michigan, Ann Arbor, MI
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Marshall SA, Allison MK, Stewart MK, Thompson ND, Archie DS. Highest Priority Health and Health Care Concerns of Transgender and Nonbinary Individuals in a Southern State. Transgend Health 2018; 3:190-200. [PMID: 30581992 PMCID: PMC6301431 DOI: 10.1089/trgh.2018.0003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Transgender (trans) and nonbinary (NB) individuals experience a number of health and health care disparities when compared with cisgender individuals. While this has been reflected in nationwide surveys of trans/NB people in the United States, few studies capture the unique experiences of trans people living in the South, and fewer studies have collected qualitative data directly from trans/NB people. The purpose of this trans/NB-led initiative was to engage the trans/NB community in a southern state in defining their most pressing health and health care concerns and comparing those results with those reported by their cisgender allies, as well as national samples of trans individuals. Methods: Participants (n=125), who were trans/NB individuals (77%) and their cisgender allies (23%) living in a southern state, completed a survey with open-ended response options and/or participated in trans-led summits. Results: The top three health and health care concerns identified by participants, both trans/NB and cisgender allies, were insurance coverage for transition-related care, access to and availability of transition-related care, and education of health care providers about trans patients and issues. Conclusions: The top concerns from trans/NB participants and cisgender allies reflect health and health care issues frequently reported by the trans/NB community nationwide. Having qualitative data from trans/NB individuals and their allies living in the South enhances our understanding of these commonly reported concerns. Future research, education, and health care practice initiatives should focus on the concerns identified by the trans/NB community.
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Affiliation(s)
- Sarah Alexandra Marshall
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mary Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mary Kathryn Stewart
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Noel D Thompson
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Dani S Archie
- Arkansas Transgender Equality Coalition, Little Rock, Arkansas
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Addition of Care for Transgender-Related Patient Care into Doctorate of Pharmacy Curriculum: Implementation and Preliminary Evaluation. PHARMACY 2018; 6:pharmacy6040107. [PMID: 30274311 PMCID: PMC6306811 DOI: 10.3390/pharmacy6040107] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 11/17/2022] Open
Abstract
The number of transgender and gender-diverse patients seeking medical care in the United States is increasing. For many of these patients, pharmacotherapy is a part of their gender-affirming transition. Effective instructional methods and resources for teaching pharmacy students about this patient population’s social considerations and medical treatments is lacking. Three hours of educational material on caring for transgender patients was added to a third-year course in a four-year Doctorate of Pharmacy program in the United States. The content included cultural, empathy, and medical considerations. Students in the course were given a survey to assess their perception of each instructional method’s effectiveness and self-assess their confidence in providing competent gender-affirming care to transgender people before and after the learning session. The survey response rate was 36% (54/152). Students’ self-assessed confidence to provide competent care to people who are transgender increased significantly. Before the learning session, the median confidence level was 4/10 (Interquartile range (IQR) 3–6), after the class session, the median confidence increased to 7/10 (IQR 6–8, p < 0.01). Students rated the pre-class video, jeopardy game, and patient panel as most helpful to improving their skills. The addition of transgender-related patient care material into the Doctorate of Pharmacy curriculum significantly increased the students’ confidence to provide competent care to people who are transgender.
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Wilkening GL. The current status of transgender health education in doctor of pharmacy curricula in North America. Ment Health Clin 2018; 7:168-171. [PMID: 29955518 PMCID: PMC6007525 DOI: 10.9740/mhc.2017.07.168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Doctor of pharmacy programs across the country strive to prepare culturally competent pharmacy professionals who are trained to provide compassionate and evidence-based care to a variety of patients. Within the Accreditation Council for Pharmacy Education 2016 Standards and Key Elements for the Doctor of Pharmacy Degree, pharmacy schools are charged with the task of developing professionals who can identify and diminish health care disparities. Transgender persons represent one of the most underrepresented and underserved communities within the modern health care system, yet very little information is available for training future pharmacists to care for the transgender community. A literature search using the MeSH terms transgender persons or trans-sexualism and pharmacy education was conducted, and it revealed 1 article published by Parkhill and colleagues in the American Journal of Pharmacy Education. A Google® search of the phrase “transgender education in pharmacy school” was conducted and produced 1 additional published article as well as an online transgender education program launched in November 2016. The following commentary outlines the current literature and practices that involve integration of transgender health education into pharmacy schools in North America and a discussion on areas for future study.
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Affiliation(s)
- G Lucy Wilkening
- Assistant Professor, Department of Pharmacy Practice, University of the Incarnate Word, Feik School of Pharmacy, San Antonio, Texas,
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Radix AE. Pharmacists' role in provision of transgender healthcare. Am J Health Syst Pharm 2018; 74:103-104. [PMID: 28122749 DOI: 10.2146/ajhp160939] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Asa E Radix
- Callen-Lorde Community Health CenterNew York,
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Maxwell E, Salch S, Boliko M, Anakwe-Charles G. Discrepancies in Lesbian, Gay, Bisexual, and Transgender Patient Care and How Pharmacists Can Support an Evolved Practice. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:6181. [PMID: 29109564 PMCID: PMC5663655 DOI: 10.5688/ajpe8176181] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 06/14/2017] [Indexed: 05/27/2023]
Abstract
We live in an increasingly multicultural society with people from different ethnicities and beliefs. In recent years, we have witnessed a growing group of people who identify as having diverse sexual orientations and gender identities. Members of the lesbian, gay, bisexual, and transgender (LGBT) community have historically been marginalized by the health care industry. The disproportionate prevalence of LGBT health concerns and cultural prejudices may be overlooked by many practitioners. As pharmacists, we are in an optimal position to affect meaningful changes in how we treat, counsel, and interact with all our patients, including with those whose sexual orientation or gender identity differ from ours. It is important for student and practicing pharmacists alike to receive adequate education and training that identifies the role of a pharmacist in LGBT health and fosters culturally competent and equitable patient care. Clinical and cultural competence should be reflective of inclusive pharmacy programs that embrace and incorporate LGBT health. The objectives of this commentary are to identify the role of a pharmacist in LGBT health, recognize specific concerns with mental and sexual health, describe gender-transitioning pharmacotherapy, and discuss the current stance of LGBT health in pharmacy education.
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Affiliation(s)
- Erin Maxwell
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Stephanie Salch
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Monique Boliko
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina
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