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Purpose Stress may negatively influence the health and academic performance of healthcare professional students and correlates with stress and burnout as a healthcare professional. This study measured student pharmacist well-being and compared the well-being of first- through third-year student pharmacists. Methods In fall 2019, the investigators administered an online survey to first- through third-year student pharmacists to assess student pharmacist well-being. Items included the World Health Organization-5 Well-being Index (WHO-5) and demographic variables. Descriptive and inferential statistical analyses were performed. Descriptive statistics were used to measure well-being, and a Kruskal-Wallis H test was used to determine whether there were differences between professional years. Results Approximately 64.8% of student pharmacists (n = 248 of 383) completed the survey. Overall, 66.1% of respondents were female (n = 164) and 31% of respondents were Caucasian (n =77), while 31% (n =77) were African American; the majority ranged in age from 24 to 29 years. There was not a statistically significant difference in WHO-5 score between the different classes (P = 0.183), with an average WHO-5 score out of 100 of 38.2 for first-year students, 41.2 for second-year students, and 41.04 for third-year students, showing poor well-being for students in all 3 professional years. Conclusion Because of emergent evidence of increased stress and negative outcomes in university students, it is imperative that pharmacy programs expand their efforts in assessment of student pharmacist well-being. While this research manuscript revealed poor well-being in all 3 professional years, it did not identify a statistically significant difference in WHO-5 score between classes. Individualized well-being interventions in all professional years may help students improve their well-being. [ABSTRACT FROM AUTHOR]

The World Health Organization estimates that 347 million people worldwide have diabetes, making it a chronic disease of epidemic proportions. (1) In 2010, the Centers for Disease Control and Prevention [...]

Poor self-care is prevalent in patients with heart failure and adversely affects heart failure symptoms, hospitalization, and mortality. Adherence rates to different types of self-care vary in patients with heart failure. The purpose of this study was to examine factors associated with medication adherence, dietary sodium adherence, and symptom management in patients with heart failure. Data were collected using questionnaires, Medication Electronic Monitoring System, and 24-hour urine sodium output (N = 94). In logistic regression analysis, social support, education level, and race were associated with medication adherence (p =.002). Gender, race, perceived control, and depressive symptoms were associated with dietary sodium adherence (p =.030). Gender, education level, and depressive symptoms were associated with symptom management (p =.006). Different factors were associated with each type of self-care. Thus, clinicians need to manage each type of self-care by considering factors associated with it. [ABSTRACT FROM AUTHOR]

Introduction: Mobile applications (apps) may improve adherence and disease state‐related outcomes in patients with uncontrolled chronic diseases, including hypertension. Objective: The purpose of this study was to determine the effectiveness of using a pharmacist‐designed app to improve blood pressure (BP) and promote adherence to antihypertensive medications. Methods: This study was a prospective, multicenter, randomized controlled trial. Patients were randomized to an intervention or control group for 3 months. The intervention was a pharmacist‐designed mobile app. Antihypertensive medication refill history was assessed 3 months before, during study, and 3 months after study completion. Continuous outcome measures investigated were systolic/diastolic BP and medication refill history using the cumulative medication gap (CMG). Statistical analysis comparing median difference in BPs and CMGs between groups was conducted using Theil‐Sen Siegel regression. Results: The propensity score adjusted population consisted of 78 patients (n = 39 for both groups). No significant difference was observed in the conditional median difference in CMG between groups at the 3‐month follow‐up visit (−0.06 [P =.70]). No significant difference was observed in the conditional median difference in systolic and diastolic BP between groups at the 3‐month follow‐up visit (−2.00 [P =.07] and −1.00 mmHg [P =.39] systolic and diastolic, respectively). Upon subgroup analysis, those nonadherent at baseline in the intention to treat population experienced a significant improvement in outcomes (−0.06 P =.03] and −12.00 mmHg [P =.002] CMG and systolic BP, respectively). Conclusion: A pharmacist‐designed mobile app did not result in improved medication adherence or BP control, but may be beneficial in patients with hypertension who struggle with medication adherence. [ABSTRACT FROM AUTHOR]

Background: Medication adherence can be affected by many factors, including health literacy. The purpose of this study is to determine (1) if a relationship exists between health literacy and self-reported or objectively measured medication adherence and (2) which aspect or aspects of medication nonadherence are most associated with health literacy. Subjects and Methods: This is a multicenter, cross-sectional survey study of adult patients with type 2 diabetes mellitus (T2DM), taking one or more antidiabetes medication for ≥6 months with a hemoglobin A1c (HbA1c) measure on record. Data collected included patient demographics (age, gender, race, language, highest level of education, injectable diabetes medication use, last HbA1c, and diabetes medication refill history) and two survey instruments (the Morisky eight-item Medication Adherence Scale [MMAS-8] and the short-form Test of Functional Health Literacy in Adults [s-TOFHLA]). Descriptive statistics and bivariate correlations were assessed, along with linear and logistic regression. Results: One hundred ninety-two patients with an average HbA1c level of 8.1% were included. Of these subjects, 32.8% had limited health literacy as measured by the s-TOFHLA, 58.9% had low adherence as measured by MMAS-8, and 65.1% were nonadherent based on cumulative medication gap (CMG) analysis. Age was associated with s-TOFHLA (-0.411; P<0.01) and MMAS-8 (0.157; P<0.05) scores. HbA1c was associated with MMAS-8 (-0.209; P<0.01) and CMG (0.152; P<0.05) scores. There was no significant association between s-TOFHLA and MMAS-8 or CMG. However, s-TOFHLA was positively related to MMAS-8 question 8, assessing difficulty remembering to take medications ( P=0.017). Conclusions: Health literacy level is not associated with self-reported or objectively measured medication adherence in underserved patients with T2DM. Lower health literacy scores are associated with a patient experiencing difficulty remembering to take medications. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to characterize and quantify the types of interventions made by an ambulatory care pharmacy team (ACPT), evaluate the financial impact of such interventions, and create a cost template for the interventions using the health system's intervention documentation system. Summary We conducted a retrospective, single-center cohort study covering the period from July 1, 2018, to June 30, 2020. Eligible participants included patients aged 18 years or older who had an appointment at the ambulatory care clinic and received a pharmacy consult. Most patients were uninsured. Data collected included intervention types, specific interventions, the economic impact per intervention, the average cost avoidance per intervention, the total economic impact, and the total cost avoidance. The ACPT documented a total of 1,334 interventions during the 2-year study period. The 4 major categories of interventions included patient counseling, drug utilization review, medication therapy management, and drug information. Each category was further subdivided into subcategories, for a total of 18 distinct subcategories. The economic impact per intervention was approximately $30. The average cost avoidance was estimated to be $357.62 per intervention, with a total economic impact of $40,020 and cost avoidance of $477,065 for the study period. Conclusion Pharmacist interventions resulted in a significant amount of economic impact and cost avoidance for the health system. Using the data from the study, we created a cost estimate to indicate the value of each ambulatory care intervention by using the health system's intervention documentation system. [ABSTRACT FROM AUTHOR]

Objective: To review the efficacy and safety of liraglutide 3.0 mg for weight loss., Data Source: A literature search was performed using PubMed and MEDLINE from 2000 to 2016. The following key terms were used alone or in combination: glucagon-like peptide-1 agonist, liraglutide, obesity, overweight, and weight loss. Additional supporting literature was identified utilizing the reference lists of the preceding articles., Study Selection: Analyzed studies were published in English and investigated use of liraglutide and its impact on weight loss., Data Extraction: Clinical studies with a primary focus of liraglutide use in weight loss were included in this review. Author consensus determined final study inclusion., Data Synthesis: Management of obesity centers on behavior modification that includes diet and exercise; however, pharmacologic therapy may be used. Several studies have indicated that GLP-1 receptor agonists promote weight loss in patients with type 2 diabetes mellitus (T2DM). The efficacy of liraglutide 3.0 mg as a weight-loss agent in patients with and without T2DM was established in three SCALE™ clinical trials. Liraglutide 3.0 mg was generally well tolerated during clinical trials. Common adverse events were typically related to the gastrointestinal system (i.e., nausea, vomiting)., Conclusion: Based on available evidence, liraglutide 3.0 mg appears to be a safe and effective addition to the pharmacologic armamentarium available for chronic weight management in the general population. However, there are limited data within the geriatric population. Clinicians should consider liraglutide's cost, route of administration, and concomitant drug therapy when deciding which patients are appropriate candidates for liraglutide therapy., Abbreviations: AE = Adverse events, AHA/ACC/TOS = American Heart Association/American College of Cardiology/ The Obesity Society, BMI = Body mass index, CV = Cardiovascular, FDA = Food and Drug Administration, GI = Gastrointestinal, GLP-1 = Glucagon-like peptide-1, HbA1c = Hemoglobin A1c, Kcal = Kilocalorie, LCD = Low-calorie diet, MTC = Medullary thyroid carcinoma, NHLBI = National Heart Lung and Blood Institute, NNH = Number needed to harm, PYE = Patient years of exposure, REMS = Risk Evaluation and Mitigation Strategy, SCALE™ = Satiety and Clinical Adiposity - Liraglutide Evidence in Non-diabetic and Diabetic individuals, T2DM = Type 2 diabetes mellitus.