Abstract
Understanding public health concepts through a photo project after Hurricane María
Georgina Silva-Suarez, PhD1, Silvia Rabionet, EdD2 and Alexandra Vázquez, PharmD (c)3
(1)Nova Southeastern University, San Juan, PR, Puerto Rico, (2)Nova Southeastern University; University of Puerto Rico, Fort Lauderdale, FL, (3)Nova Southeastern University, San Juan, Puerto Rico
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: A traumatic event can have a powerful impact in the classroom. NSU-Puerto Rico Campus PharmD students went through category 4 Hurricane-María in September 2017. They had to complete their academic semester at the same time as facing many challenges like fulfilling their basic needs.
Methods: A public health photo project was used to teach public health concepts such as social determinants of health, vulnerable populations, health promotion and disease prevention, and epidemiology. The main objective of this project was to give the students an opportunity to learn about public health using their own experiences with Hurricane María. Also, it served as an opportunity for them to reflect about the importance of pharmacy during an emergency and provided them an opportunity to vent.
Results: Through their photos, PharmD students were able to effectively identify public health issues like the use of contaminated water, problems with infrastructure, lack of shelter, lack of access to health care and shortage in medication, among others. The majority of them were able to portray in their photos the importance of the pharmacy field during an emergency. Despite the hardship the students were enduring, they were able to transcend beyond the adversity showing a positive approach to life.
Conclusion: Their experiences with Hurricane-María and their voiced experiences reflect an in-depth understanding of public health concepts and an uplifting message despite adversity. In addition, after their experiences with Hurricane María, the students showed a broader perspective of the role of the pharmacy during a public health emergency.
Public health or related education
Abstract
Pharmacists: An overlooked resource in contraception provision for Zika preparedness
Natalie DiPietro Mager, PharmD, PhD, MPH1 and Sally Rafie, PharmD, BCPS2
(1)Ohio Northern University Raabe College of Pharmacy, Ada, OH, (2)UC San Diego Health, San Diego, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Access to contraception in the context of the Zika virus is critically important. An additional but overlooked strategy to increase access to contraception in the United States (U.S.) is through pharmacist prescribing, wherein patients receive contraceptive supplies directly from a community pharmacy. This greatly increases access to prescription-only contraceptives (pills, patch, ring, injection) while maintaining product coverage for insured patients. Pharmacists are well-qualified to assess patient eligibility for contraceptive methods following review of patient-reported medical history and measuring blood pressure. While one-third to one-half of U.S. residents do not have a medical home, the average resident lives within 5 miles of a community pharmacy. Additionally, pharmacies are often available and accessible for vulnerable, hard-to-reach populations. Pharmacies have expanded hours of operation on evenings and weekends, are visited frequently, and allow for a single visit for the clinical visit and contraceptive supplies. Prescriptive authority can be granted at the state level through legislation expanding pharmacist scope of practice to allow for directly providing hormonal contraception to women through statewide protocols. Further, some states allow pharmacists to prescribe emergency contraception (through collaborative practice or statewide protocols), which has important implications for access and reimbursement for these pills. More states should adopt legislation to increase access to contraception; legislation and protocols should be evidence-based, include all contraceptive methods that are safe when self-administered or administered by a pharmacist, and exclude age and duration restrictions. To protect more women from unintended pregnancy, pharmacists should be fully engaged and enabled to provide much-needed contraceptive services.
Chronic disease management and prevention Clinical medicine applied in public health Other professions or practice related to public health Protection of the public in relation to communicable diseases including prevention or control
Abstract
Antiretroviral therapy and lipodystrophy: Life experiences of perinatally HIV infected youth in Puerto Rico
Yarelis Alvarado Reyes, Pharm.D., BCPS, BCCCP1, Georgina Silva-Suarez, PhD2, Silvia Rabionet, EdD3 and Carmen Zorrilla, MD4
(1)Nova Southeastern University College of Pharmacy, San Juan, PR, (2)University of Puerto Rico, Medical Sciences Campus, Maternal Infant Study Center, San Juan, PR, Puerto Rico, (3)Nova Southeastern University; University of Puerto Rico, Fort Lauderdale, FL, (4)University of Puerto Rico, Medical Sciences Campus, San Juan, PR
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background:
Older antiretroviral regimens provided life-saving alternatives for perinatally HIV infected (PHIV-I) patients but their use has been highly associated with lipodystrophy. We aimed to assess the effects of lipodystrophy among PHIV-I youth.
Methods:
A qualitative study of PHIV-I youth in Puerto Rico was conducted. Their experiences as youth living with HIV were explored. Qualitative Interpretative Phenomenology Analysis was used to assess patient responses. Patients describing lipodystrophy during their in-depth interview were included in this analysis.
Results:
A total of 20 in depth interviews were conducted of which four patients described lipodystrophy. All four patients were female, with ages ranging from 20-29 years old. Of these, two did not complete high school and one reported being in a relationship. Among their experiences with lipodystrophy the following phases were identified: life-experience, inquiry, knowledge, and outcome. Patients described their experience with lipodystrophy as very significant which resulted in diminished self-esteem, dislike in their own appearance, and bullying. These effects brought them to question their providers about the cause. In all cases, physicians explained lipodystrophy after patient questioning. All were offered to switch medications and one was referred for corrective treatment. Two patients received cheek implants which they referred significantly changed their lives.
Conclusion:
For PHIV-I youth in Puerto Rico, dealing with lipodystrophy was very difficult. Providers failed to educate patients on this side-effect of their HIV regimen. Although the risk of lipodystrophy has decreased with new medications, antiretroviral education should be integrated into the post-disclosure care of perinatally infected youth.
Assessment of individual and community needs for health education Chronic disease management and prevention
Abstract
Improving immunization rates through community pharmacies: An Economic Evaluation
Nizar K. Wehbi, MD, MPH, MBA, Rajvi Wani, PhD (Candidate), Donald Klepser, Ph.D., M.B.A and Ali Khan, MD, MPH
University of Nebraska Medical Center, Omaha, NE
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Objectives: To improve immunization (influenza, pneumococcal, pertussis, and herpes zoster) rates for adult patients in Iowa and Nebraska, and estimate the healthcare cost savings realized through increased vaccinations.
Methods: A bidirectional link platform - ImmsLink - was installed in 159 participating Hy-Vee pharmacies in Nebraska and Iowa. The technology platform allows single sign on and connects the pharmacies' technology platform to both states’ immunization registries. It also provides personalized on-screen recommendations of a patient’s immunization needs to prompt a discussion of patient’s immunization needs other than influenza vaccination. Cost savings based on decrease in the burden of disease were adjusted for inflation for 2017. Total averted cost due to increased vaccination was estimated.
Results: Compared with the previous year, there were 53,822 more influenza vaccines administered, 623 for herpes zoster and 1,288 for pertussis. We estimated the average cost of the vaccine to be $18 for flu, $213 for herpes zoster and $43 for pertussis, for a total cost of vaccines of $1.13 M. We estimated the economic burden of disease prevented by the additional vaccinations administered at around $503 million. Around $494 M averted through the additional flu vaccinations; $423,000 Herpes Zoster and $8.8 M Pertussis. This amounts to 444% return on investment.
Conclusions: Complete vaccination records enable pharmacists to make personalized immunization recommendations that results in improved flu and non-flu vaccination rates. Despite the cost of the additional vaccines administered, it decreases the burden of disease and amounts to a high community-based return on investment.
Conduct evaluation related to programs, research, and other areas of practice Protection of the public in relation to communicable diseases including prevention or control