Birth Control Use and Access Including Pharmacist-Prescribed Contraception Services during COVID-19

The COVID-19 pandemic influenced health care with effects on contraception access emerging. The study objectives were to analyze pandemic impacts on birth control (BC) use and access; and evaluate perceptions of pharmacist-prescribed BC. A 50-item survey was distributed by 31 Michigan community pharmacies to women aged 18-45 over a three-month period. The survey link was also posted on two websites. 147 surveys were analyzed. Respondents were 29 ± 7.9 years old, primarily white (77%) and straight (81%). Fifty-eight percent of respondents used prescription BC, mostly to prevent pregnancy (84%) with oral pills (76%) being the most common formulation. Some BC users (25%) were worried about BC access and 27% had difficulty taking BC regularly. Half of the respondents (50%) would likely use pharmacist-prescribed BC if available, with advantages being more convenient than visiting a doctor's office (71%) and easier access (69%). The major concern about pharmacist-prescribed BC was women not receiving PAP smears and screenings (61%). Respondents reported high confidence (72%) in pharmacist-prescribed BC and believe it would help prevent unintended pregnancies (69%). Some respondents experienced altered BC use and access. Half of the respondents supported pharmacist-prescribed BC. Pharmacist-prescribed BC could help solve pandemic-related access problems.

Self-Assessment of Cultural Competence and Social Determinants of Health within a First-Year Required Pharmacy Course

As social determinants of health (SDOH) and health disparities are integrated with cultural competence in healthcare education, tools assessing multiple topics are needed. The Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) survey is validated in student pharmacists and includes SDOH. The research objective was to determine if the SAPLCC survey can quantify cultural competence and SDOH course learning. First-year student pharmacists (N = 87) completed the SAPLCC survey anonymously before and after a social and administrative sciences course. The survey had 75 items with 1–4 Likert scales (4 high, total 300 points). All items were summed for the total score. Each item was assigned to a domain and factor. Factors were assigned to domains. The baseline total score was 190 ± 29 points, increasing by 63 ± 33 points post-course. All domains (i.e., knowledge, skills, attitudes, encounters, abilities, awareness), 13 of 14 factors, and total scores statistically increased. The SAPLCC tool captured student pharmacists’ self-reported changes in cultural competence and SDOH.

Attitudes of Michigan Female College Students About Pharmacists Prescribing Birth Control in a Community Pharmacy

In the United States, the overall unintended pregnancy rate is about 45%. Women between 20–24 years old account for 59% of the unintended pregnancies. Continuous birth control use is related to decreasing unintended pregnancies. Therefore, we assessed female college students’ opinions about pharmacists prescribing birth control in a community pharmacy using an intersectionality framework. A survey with 49 items about provider attributes, pharmacy services use and evaluation, advantages and barriers of pharmacists prescribing birth control, sexual and reproductive history, and demographics was distributed by survey link and QR code. Recruitment was done by investigators and students (snowballing technique) via emails, social media posts, and direct student contact. Respondents (n = 859) were 23.0 ± 4.9 years old, 83% white, 64% healthcare students, 32% student pharmacists, 69% sexually active, 68% with at least one episode of unprotected intercourse within a year, and 29% never using condoms. Forty-six percent of students were extremely likely and 26% moderately likely to get birth control from a pharmacist because it would be easier to adhere to birth control, could prevent unintended pregnancies, would be more convenient, and require less time. Concerns included the lack of Pap screenings and prescriptions written for the wrong birth control. Within most student characteristics or attitudes assessed, at least 70% of the students would use this service. Based on student opinions, female college students would use pharmacists prescribing birth control services.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

Drug-induced osteoporosis in the older adult

The elderly population is at risk for polypharmacy and, therefore, also at risk for drug-induced osteoporosis (DIOP). Epidemiologic studies provide valuable information about medications that may place patients at risk for DIOP. While glucocorticoids are the most common cause of DIOP, the use of several other therapeutic agents can place patients at risk for significant bone loss and fracture. These medications include, but are not limited to, aromatase inhibitors, gonadotropin-releasing hormone agonists, thyroid replacement therapy, antiepileptics, antidepressants, antipsychotics, lithium, gastric acid lowering agents, thiazolidinediones, loop diuretics, heparins and warfarin, vitamin A and cyclosporine. This article provides information about their mechanism of action, studies that have evaluated these agents in DIOP and prevention and treatment strategies.