The Rapid HIV Test in Spanish Pharmacies: A Novel Program to Reach Heterosexual Men?

OBJECTIVES:

Spain has been a pioneer in the implementation of rapid HIV testing programmes in pharmacies to increase access to testing. However, no formal evaluation of the effectiveness of these programmes has been carried out to date. Our aim was to evaluate the ability of a novel in-pharmacy rapid HIV testing programme to promote diagnosis and reach vulnerable populations.

METHODS:

Between 2011 and 2012, 2168 people underwent testing in 16 urban pharmacies in 10 cities of a Spanish region with a low prevalence of HIV infection. The main outcomes of the programme were compared with those of the regional surveillance system for new HIV diagnoses (RHSS-CyL).

RESULTS:

Overall, 52.8% of those tested were heterosexual men, 15.8% were men who have sex with men (MSM) and 25.3% were women. Nine per cent were immigrants and 41.9% were < 30 years old. In total, 59.5% of the heterosexual men, 44.6% of the MSM and 65.3% of the women were previously untested. There were 23 positive results, representing 6% of all new regional diagnoses in 2011. The global prevalence was 1.1% (95% confidence interval 0.6-1.5%) and the prevalence in MSM was 3.8%. Of the reactive results, 60.9% were in MSM, 34.8% in heterosexual men and only 4.3% in women, vs. 35.4%, 37.5% and 15.0%, respectively, reported by the RHSS-CyL. The mean age of those testing positive was 32.7 years vs. 38.7 years in the RHSS-CyL. Fifty per cent of MSM and 75% of heterosexual men testing positive were previously untested.

CONCLUSIONS:

In Spain, this is the first programme not targeted at the most at-risk populations, and has been shown to be effective in reaching and diagnosing heterosexual men, who are the group most affected by delayed diagnoses. Heterosexual men accounted for over half of those tested and a third of those diagnosed, and most of them were previously untested. Young and previously untested MSM also greatly benefitted from the programme.

Purchase full article at:   http://goo.gl/zxwJFT

By:  Fernández-Balbuena S1,2, Marcos H3, Pérez-Rubio A3, Hoyos J1,2, Belza MJ2,4, de la Fuente L1,2.

• 1National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain.
• 2CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
• 3Epidemiological Surveillance Service, Public Health Directorate, Regional Ministry of Health of Castilla and León, Valladolid, Spain.
• 4National School of Health, Carlos III Health Institute, Madrid, Spain. 
• HIV Med. 2015 Jul;16(6):362-9. doi: 10.1111/hiv.12224. Epub 2015 Feb 17.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Community Pharmacists' Experiences in Mental Illness & Addictions Care: A Qualitative Study

BACKGROUND:

Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists' interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists' experiences with service provision to this population remain. Improving knowledge regarding the pharmacists' experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities.

METHODS:

We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews.

RESULTS:

Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity.

CONCLUSIONS:

Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.

Below:  The Behaviour Change Wheel [47]. From Michie et al. [47]

Full article at:   http://goo.gl/X1l4Xh

By:  Murphy AL1, Phelan H2, Haslam S3, Martin-Misener R4, Kutcher SP5, Gardner DM6.

• 1College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. andrea.murphy@dal.ca.
• 2College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. heather.phelan@dal.ca.
• 3College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. scott.haslam@dal.ca.
• 4School of Nursing, Dalhousie University, 5869 University Ave., PO Box 15000, Halifax, NS, B3H 4R2, Canada. ruth.martin-misener@dal.ca.
• 5Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, 5850 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada. Stanley.kutcher@iwk.nshealth.ca.
• 6Department of Psychiatry, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada. david.gardner@dal.ca.
• Subst Abuse Treat Prev Policy. 2016 Jan 28;11(1):6. doi: 10.1186/s13011-016-0050-9. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Handout for California Pharmacists for Take-Home Naloxone

Via:   http://goo.gl/UUT9XJ

Pharmacy Students’ Knowledge and Attitudes Regarding Medical Marijuana

To determine pharmacy students’ knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic.

Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions.

Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers’ questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students.

With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum.

Percentage of Pharmacy Students Identifying an Adverse Effect of Medical Marijuana

Pharmacy Students Opinions Towards Marijuana

Full article at: http://goo.gl/HuhPAu

By: Karen E. Moeller, PharmD and Barbara Woods, MA, RPh

Department of Pharmacy Practice, University of Kansas, 2010 Becker Dr., Lawrence, KS 66047. Tel: 913-588-5379. Fax: 913-588-2355. E-mail: ude.cmuk@relleomk

More at:  https://twitter.com/hiv_insight