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Pharmacist-prescribed hormonal contraception (HC) is supported by a majority of pharmacists and pharmacy students; however, few studies have evaluated perceptions of non-community pharmacists, or differences in geographic areas. The primary objective of this study is to assess differences between community and non-community pharmacists in perceptions of pharmacist-prescribing HC in Georgia, a state that does not currently permit this practice. Secondary objectives include assessment of community pharmacist interest in prescribing HC, and differences in perceptions between pharmacists in metropolitan and nonmetropolitan areas. A survey was emailed in early 2022 to 2592 Georgia pharmacists, with Likert questions assessing interest, perceptions, comfort, and perceived barriers regarding pharmacist-prescribed HC. Chi square testing identified differences between groups. The completed survey response rate was 11.8%. Regardless of practice site, a majority agreed that pharmacists are well trained to prescribe HC (community 61.8% vs. non-community 68.1%, p = 0.25) and provision of HC services is within pharmacists' scope (community 73.6% vs. non-community 74.2%, p = 0.90). Overall, metropolitan and nonmetropolitan community pharmacist perceptions were similar; however, more metropolitan pharmacists believed pharmacists are well trained to prescribe HC (66.7% vs. 48.7%, p = 0.049) and that it is within their scope of practice (78.1% vs. 61.5%, p = 0.045). In summary, the majority of pharmacists, regardless of practice type, believe that pharmacists are prepared to prescribe HC and that it is a part of pharmacists' professional scope of practice. [ABSTRACT FROM AUTHOR]

Approximately 250 million children across the world are not acquiring basic reading and math skills, even though about 50% of them have spent at least 4 years in school. Educational policies on Early grade literacy (EGL) in the Latin America and the Caribbean (LAC) region have long suffered from a disjuncture between school practice and research. This review examines the effectiveness and fidelity of implementation of various programs implemented in the LAC region that aim to improve EGL outcomes, including teacher training, school feeding, computer-aided instruction, nutrition, and technology-in-education. This Campbell systematic review summarizes findings from 107 studies to inform policy for EGL in the LAC region.

Recent advances in molecular analyses of ovarian cancer have revealed a wealth of promising tumour‐specific biomarkers, including protein, DNA mutations and methylation; however, reliably detecting such alterations at satisfactorily high sensitivity and specificity through low‐cost methods remains challenging, especially in early‐stage diseases. Here we present PapDREAM, a new approach that enables detection of rare, ovarian‐cancer‐specific aberrations of DNA methylation from routinely‐collected cervical Pap specimens. The PapDREAM approach employs a microfluidic platform that performs highly parallelized digital high‐resolution melt to analyze locus‐specific DNA methylation patterns on a molecule‐by‐molecule basis at or near single CpG‐site resolution at a fraction (< 1/10th) of the cost of next‐generation sequencing techniques. We demonstrate the feasibility of the platform by assessing intermolecular heterogeneity of DNA methylation in a panel of methylation biomarker loci using DNA derived from Pap specimens obtained from a cohort of 43 women, including 18 cases with ovarian cancer and 25 cancer‐free controls. PapDREAM leverages systematic multidimensional bioinformatic analyses of locus‐specific methylation heterogeneity to improve upon Pap‐specimen‐based detection of ovarian cancer, demonstrating a clinical sensitivity of 50% at 99% specificity in detecting ovarian cancer cases with an area under the receiver operator curve of 0.90. We then establish a logistic regression model that could be used to identify high‐risk patients for subsequent clinical follow‐up and monitoring. The results of this study support the utility of PapDREAM as a simple, low‐cost screening method with the potential to integrate with existing clinical workflows for early detection of ovarian cancer. Key points: We present a microfluidic platform for detection and analysis of rare, heterogeneously methylated DNA within Pap specimens towards detection of ovarian cancer.The platform achieves high sensitivity (fractions <0.00005%) at a suitably low cost (∼$25) for routine screening applications.Furthermore, it provides molecule‐by‐molecule quantitative analysis to facilitate further study on the effect of heterogeneous methylation on cancer development. [ABSTRACT FROM AUTHOR]

Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316 882 women with surgical treatment for ectopic pregnancy and 3 168 820 age- and index-date-matched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] = 0.0060 to 0.0079) and 0.0089 (95% CI = 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P  < .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI = 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR = 0.73, 95% CI = 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Collaborative drug therapy management (CDTM) allows pharmacists to assess patients, administer medications, manage and adjust medication regimens, and order laboratory tests within a defined protocol. Pharmacist CDTM may aid in preventative care and chronic condition management. Objectives: The primary objectives were to identify CDTM services provided by pharmacists in the state of Georgia, examine factors associated with the provision of CDTM services, and identify barriers and facilitators to CDTM service provision. The secondary objective was to assess differences in CDTM practice between pharmacists who completed a Registered Pharmacist (R.Ph.)/Doctor of Pharmacy (Pharm.D.), postgraduate year one (PGY1), or postgraduate year two (PGY2) residency. Methods: Using the Dilman method, this cross‐sectional study invited all 134 CDTM‐licensed pharmacists in Georgia to complete a 30‐min electronic survey. Data included demographics, training, services offered, disease states managed, and perceptions regarding CDTM implementation. Descriptive statistics, Welchs analysis of variance (ANOVA), and chi‐square were conducted using SPSS v28. Results: A total of 36 (26.9%) pharmacists completed the survey. Participants offered a median of three CDTM services. A majority offered medication therapy management (86.1%) and chronic care management (66.7%). A majority offered services for diabetes (58.3%), hyperlipidemia (55.6%), and hypertension (55.6%). There were differences in the mean ranked number of CDTM services offered between R.Ph./Pharm.D. and PGY2 groups (−11.667, p = 0.019), and the mean ranked number of disease states covered between R.Ph./Pharm.D. and PGY1 (−10.990, p = 0.029) and R.Ph./Pharm.D. and PGY2 (−12.640, p = 0.010, adjusted p‐value) groups. Reported CDTM facilitators were job requirements, expanding patient care, job satisfaction/personal advancement, and expanding professional practice. Reported challenges were continuing education, clinical/interprofessional concerns, administration issues with the board of pharmacy or individual practice site, and regulations differing from other states. Conclusion: Of those with CDTM licensure, a majority offer medication therapy management and chronic care management services covering diabetes, hypertension, and hyperlipidemia. Postgraduate training may help prepare pharmacists to engage in CDTM services. [ABSTRACT FROM AUTHOR]

PURPOSE: We previously implemented paper-based screening for health-related social resource needs (HRSN) in our gynecologic oncology clinic and found that 36% of patients who completed the screening reported HRSN. We identified two primary deficiencies with our process. First, only 52% of patients completed the screening. Second, 37% of patients with needs failed to indicate if they desired resource referral or not. Therefore, we conducted a quality improvement project to integrate screening and referral processes into the electronic medical record (EMR) and routine clinic workflow to achieve at least 90% screening compliance and 90% elicited referral preference. METHODS: A multidisciplinary team consisting of physicians, a health outcomes researcher, a computer programmer, project assistants, and the staff of a partner community organization designed and implemented an intervention that screened for HRSN online via the EMR patient platform or in person during visits. The primary outcome was the percentage of eligible patients who completed the HRSN screening (ie, reach). Outcomes were reviewed weekly, and feedback was provided to stakeholders monthly. Iterative changes were incorporated into five successive Plan-Do-Study-Act (PDSA) cycles completed from January 2021 to March 2023. RESULTS: Screening compliance increased from the baseline of 52% (paper-based) to 97% in PDSA 4. Completion via the online patient portal increased from 17% in prelaunch to 49% in PDSA 4. Of patients who reported needs, 100% had a documented referral preference. CONCLUSION: Compared with paper-based screening, an EMR-integrated HRSN screening and referral system significantly improved reach to patients at a gynecologic oncology clinic. Implementation efforts to expand to other ambulatory clinic settings are in process. [ABSTRACT FROM AUTHOR]

The American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkit has been used by colleges and schools of pharmacy as a guide for curricular development and revisions since its inaugural publication in 2009. The toolkit was last revised and updated by the 2019 Publications Committee. The 2023 ACCP Publications Committee was charged with reviewing the 2019 Update to the ACCP Pharmacotherapy Didactic Curriculum Toolkit to determine any necessary revisions/updates. The committee revised tier classifications, shifting the focus of the 2023 toolkit to content within the Pharm.D. curriculum. Multiple literature sources were reviewed to assess conditions for inclusion in the 2023 toolkit, and external feedback was solicited from various practice disciplines. All topics were voted on by a simple majority rule during virtual meetings or by electronic votes. There are a total of 231 topics in the 2023 toolkit, a decrease of 77 (23.2%) from the 2019 edition. Topics in each tier are as follows: 68 as tier 1 (29%), 111 as tier 2 (48%), and 52 as tier 3 (23%). Although some topics were removed completely, others were combined with other line items or revised, which may further minimize curricular overload. Similar to the 2016 and 2019 toolkits, many tier 2 topics remain in the 2023 toolkit, emphasizing the continued need for additional training through postgraduate residencies or fellowships (or "on‐the‐job" equivalent experiences), board certifications, and various certificate training programs. The 2023 ACCP Pharmacotherapy Didactic Curriculum Toolkit is designed to assist individual faculty and colleges and schools of pharmacy with curricular development and revisions. It will continue to be reviewed every 3 years to identify needed revisions on the basis of the pharmacist's evolving role, advances in therapeutics and pharmacy practice, and changes to accreditation standards and recognized professional competencies. [ABSTRACT FROM AUTHOR]

Postgraduate pharmacy residencies are essential in preparing graduates for pharmacy careers. Residencies are highly competitive and despite efforts to increase the number of residency programs in the United States, the demand still outweighs the supply. Attaining a residency interview is a critical step in securing a residency position. The objective of this scoping review is to describe the published literature on factors associated with attaining a pharmacy residency interview. The updated Arksey and O'Malley scoping review framework was followed for this scoping review. The review is reported according to The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Protocols and Scoping Reviews (PRISMA‐ScR). The search strategy contained a combination of medical subject headings (MeSH) and keywords from a review of article title and abstracts. The inclusion and exclusion criteria were created a priori. English language studies describing pharmacy residency interview, selection, rubrics, and descriptive, quantitative, or qualitative data were included. Title and abstracts were independently reviewed, followed by independent full‐text reviews. Covidence©, an online systematic review platform, was used in the screening, review, and selection process. Thirteen studies assessing factors associated with a residency interview met inclusion criteria. The majority of these studies (n = 7) analyzed data from residency program director (RPD) surveys. Most of these studies found that RPDs highly value letters of recommendation when evaluating a candidate's application. Three studies analyzed retrospective data. Several studies focused on letters of recommendation. The studies described letters of recommendation, letters of intent, grade point average, and leadership experience as factors associated with attaining a residency interview. Most studies had limitations in generalizability, study design, and heterogeneous data. [ABSTRACT FROM AUTHOR]

A rising percentage of patients are electing medication abortion over procedural abortion for increased safety and privacy. Access to medication abortion is essential healthcare, but many Americans face unsurmountable barriers when pursuing this option. This has been in large part due to unnecessary restrictions imposed by the United States Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS) for mifepristone, used in combination with misoprostol for medication abortion. Moreover, many states have imposed additional restrictions on abortion, further impeding access to care. Since its original approval in 2000, mifepristone can only be prescribed by certified prescribers. Until recently, mifepristone could only be dispensed by certified prescribers, whereby more accessible community and mail‐order pharmacies were prohibited from dispensing mifepristone. During the Coronavirus disease 2019 public health emergency, there was a temporary allowance for certified prescribers to utilize mail or mail‐order pharmacies to deliver medications to patients. In January 2023, the FDA approved modifications to the mifepristone REMS to allow certified pharmacies to dispense the medication. Given the established safety and effectiveness of mifepristone, the evidence supports its distribution via pharmacies and leveraging pharmacists to expand medication abortion access. Pharmacists are one of the most widely accessible healthcare providers and their responsibility centers on patient and medication safety and improving health outcomes. This article, an opinion of the American College of Clinical Pharmacy Women's Health Practice and Research Network, adds the voice of members of the pharmacy profession to the collective efforts to ensure access to medication abortion, including pharmacist dispensing of mifepristone. We encourage pharmacists to embrace this fresh opportunity to provide medication abortion care in their communities. [ABSTRACT FROM AUTHOR]