• An Exploratory Survey of Telehealth Instruction in the PharmD Curricula

      Axon, David R.; Nguyen, Jackie; Hu, Stephanie; Kraynik, Cora; Smith, Jordyn; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: 1)To assess the general perception of telehealth among the University of Arizona R. Ken Coit College of Pharmacy (UA:RKCCOP) faculty, 2)To discover the faculty’s opinions regarding the incorporation of telehealth instruction into the doctor of pharmacy (PharmD) curricula, and 3) To determine the faculty’s reasoning behind incorporating telehealth instruction into their courses. Methods: This analytic, observational, prospective study used data obtained through an online questionnaire distributed via email to college of pharmacy faculty members. Responses were collected regarding awareness level of telehealth, comfort level with discussing telehealth, and general perception telehealth instruction as part of the pharmacy curriculum. Demographics were also collected for length of time as a faculty member at any college, at the University of Arizona, having a pharmacy degree, and sex. Results: Questionnaires were completed by 18 participants. The median (interquartile range, IQR) regarding telehealth awareness showed that the majority of the participants were: very aware of telehealth, its benefits and applications, and somewhat aware of its barriers. The median (IQR) showed their level of comfort with telehealth discussion were: very comfortable with discussing the benefits, barriers and telehealth communication, and somewhat comfortable with discussing telehealth application. Analysis showed mean土standard deviation rating (on a scale of 0 - 10) of: 8.1 土 1.5 for general perception of telehealth, 8.6 土 1.6 for value of telehealth services, and 7.7 土 2.7 for value of incorporating telehealth instruction into the curriculum. Conclusions: Overall perception of incorporation telehealth discussions in pharmacy curricula was moderately positive.
    • Exploring How to Improve Professionalism and Engagement During Zoom Learning

      Lee, Jeannie; Hadvani, Kishan; Kim, Ann; Nikolic, Aleksandar; Smith, Jonan; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Objective: To investigate the impact of remote learning on student engagement and professionalism and explore strategies that courses and students used to improve their engagement and professionalism. Methods: Individual structured interviews were conducted with student pharmacists from the class of 2023, 2024, and 2025 using predetermined, open-ended questions. The primary dependent variable was student perceived engagement and professionalism. Students were recruited by e-mail invitations to participate in zoom interviews. Student responses were audio recorded, transcribed, and analyzed via thematic analysis using Delve. Results: Approximately 6% of the students in the eligible cohorts at the University of Arizona College of Pharmacy participated in this study, of which the majority were female (67%) and anticipated to graduate in 2023 (67%). Major themes describing engagement involved active participation, increased distractions with zoom learning, and attendance credit. Major themes describing professionalism involved course camera requirements, Zoom chat etiquette, and speaker muting issues. Common student strategies for engagement involved having a dedicated learning area, writing notes, and staying organized. Common course strategies to increase engagement include Kahoot, quizzes, polls, & breakout rooms. Common student strategies for professionalism included consideration for peers, self-awareness, and professional standing. Common course strategies for professionalism include need for the camera to be on, attendance credit, and in class participation. Conclusions: Most students interviewed stated that interactive learning increased their engagement in online courses. A predominant number of participants reported that remote learning did not impact professionalism of pharmacy students but that camera requirements and chat monitoring could enhance professionalism.
    • Accuracy and Reproducibility of Injections from Prefilled “Code Cart” Syringes Compared to Standard Polypropylene Syringes

      Edwards, Christopher J.; Nix, David E.; Erstad, Brian L.; Kim, Yoona; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To evaluate the accuracy and reproducibility of small-volume injections from prefilled syringes and different sizes of polypropylene syringes. Methods: Atropine and epinephrine prefilled syringes were used to measure volumes of 0.5 mL and 1 mL of drug solution. Different sized polypropylene syringes (1-mL, 3-mL, and 10-mL) were used to measure volumes of 0.4 mL and 1 mL drawn from prefilled syringes. The measured volumes were compared to expected delivery volume. For analysis, t-tests and folded F test were conducted for prefilled syringe data and the general linear model and Levene’s test were used for polypropylene syringe data. Results: Both prefilled syringes demonstrated high variability at the 0.5 mL volume. The coefficient of variance (CV) was 14.3% and 15.0% for atropine and epinephrine for the first delivery and 7.39% and 9.41% for the second delivery. The 10-mL polypropylene syringe overdelivered 0.4 mL doses by 17.1% and 10.6% for atropine and epinephrine, respectively. With the 1 mL volume, the accuracy was improved and the expected delivery range was 0.863 to 1.19 mL (19% error). Use of a 3-mL or 1-mL syringe expectantly resulted in improved accuracy and precision. Conclusions: Using a 10-mL syringe, either prefilled or polypropylene, to measure volumes of 1 mL or less did not result in reproducible delivery of doses at the ±10% error threshold. When preparing doses smaller than the 20% of the total volume of a pre-filled syringe, we recommend using the smallest available polypropylene syringe that will accommodate the volume needed.
    • Outcomes of patients with DKA treated with subcutaneous insulin in the emergency department

      Mossholder, Benjamin; Barrera, Jacqueline; Detherage, Steffen; Nguyen, Brooke; Nguyen, Ngoc; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To examine and quantify the outcomes in patients with mild diabetic ketoacidosis (DKA) treated with subcutaneous insulin (Sub-Q) compared to patients treated with continuous insulin infusions (CII). Methods: This retrospective chart review includes data collected from Tucson Medical Center. Subjects of this study include adult patients admitted to the emergency department from March 1st, 2022 to October 31st, 2022 and diagnosed with DKA during their admission. Eligible subjects were classified as having mild, moderate or severe DKA. Primary outcomes include hospital length of stay (LOS), time to DKA resolution, and percentage of patients that were admitted to the ICU/PCCU; with a secondary outcome of hypoglycemia. Results: 14 patients in the mild DKA group were treated with Sub-Q compared to 53 patients who were treated with CII. The CII group had a higher rate of ICU/PCCU admissions (75.5%) in comparison to the Sub-Q insulin group (21.4%). Sub-Q insulin was associated with a decreased LOS compared with CII: 76.69 hours vs. 106.94 hours. Time to DKA resolution was similar between the CII group and Sub-Q insulin group (14.67 hours vs 20.54 hours respectively). Hypoglycemia occurred more frequently in the CII group when compared to the Sub-Q group (28.3% vs 7.1% respectively). Conclusions: When compared to treatment with CII, subcutaneous insulin exhibited similar outcomes for time to DKA resolution in patients with mild DKA. The use of subcutaneous insulin was associated with less ICU/PCCU admissions and hypoglycemia, and a shorter LOS than continuous insulin infusion.
    • Impact of Student Loan Debt on University of Arizona R. Ken Coit College of Pharmacy Alumni

      Cooley, Janet; Stankus, Bailey; Marchese, Katherina; Robles, Ani; Valdivia-Mier, Marisol; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To examine the financial areas affected by student loan repayment, average time to pay off student loan debt, and the effects student loans have on quality of life. Methods: Qualtrics survey administered to alumni from the four-year Doctor of Pharmacy program at The University of Arizona R. Ken Coit College of Pharmacy. Results: Questionnaires were completed by 33 eligible participants. The average quality of life score was 6.5 for pharmacists currently paying off student loans, with a projected quality of life score of 9 after repayment. Lastly, the level of stress and anxiety was the only statistically significant (p=0.004) finding between pharmacists who have paid off loans vs those that have not. Conclusions: A career as a pharmacist has personal and monetary benefits, however the financial burden of student debt can have negative effects on quality of life.
    • Modified Patient Intake Process and its Effectiveness in Timely Access to Patient Data in Endocrinology Telemedicine Visits

      Alamer, Ahmad; Cameron, Caitlin; Fazel, Maryam; Heydorn, John; Fang, Albert; Diaz, Oscar; Singh, Ravleen; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To determine the frequency of timely and accurate completion of a chart preparation checklist (CPCL), to assess the frequency of timely access to insulin pump and/or CGM data and lab results during the telemedicine visits, and to evaluate the relationship between timely and accurate completion of the CPCL and timely access to data and results. Methods: This was a descriptive, observational, and retrospective cohort study conducted via chart review of clinic visits at the Endocrinology and Diabetes Clinic at Banner - University Medical Center South. Telemedicine clinic visits from June 1, 2020 to December 31, 2020, in which patients ≥ 18 years old with diagnosis of diabetes were seen for diabetes management were included. A CPCL was used as a modified patient intake process for telemedicine visits. In this checklist, patients were asked if they used an insulin pump and or a continuous glucose monitor (CGM), what brand, and if they had recent labs drawn to be able to obtain and have those data available for the visits. CPCL completion and availability of data were deemed to be timely if done/accessible by the time of the visit. CPCL was considered accurate if patient has the noted devices or has had recent labs drawn. Descriptive statistics were used to assess the specific aims as noted above. Results: Out of 293 clinic visits, 80 were included in the analysis. Only 17 (21%) had a completed CPCL by the start of their visits and 31(39%) of the visits had an insulin pump and/or CGM. Of those 31, 19 (61%) had timely data availability with 15 (48%) of those being from visits without CPCL. Of the total 51 patients with laboratory results, 42 (82.3%) had those results uploaded in the chart in a timely manner. Conclusions: This study suggests that CPCL utilization does not have added benefit in timely access to insulin pump/CGM data. As per very low CPCL utilization and the study limitations, further investigations are needed to assess the effectiveness of CPCL and if the checklist and its use need to be revised.
    • A retrospective study evaluating the effect of hepatic steatosis on paclitaxel tolerability in patients with breast cancer 

      Segar, Jennifer; Davis, Lisa; Le, Rambo; Peters, Joshua; Sanchez, Mario; Tran, Heather; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To evaluate the effect of hepatic steatosis on paclitaxel tolerability in patients with breast cancer and determine if metabolic syndrome contributes to the development of hepatic steatosis. Methods: At the University of Arizona Cancer Center, the electronic medical record was used to identify patients who received paclitaxel for breast cancer between September 1st, 2017 to October 15th, 2022. Data was extracted from Cerner PowerChart and stored on RedCap. Information gathered included the presence of hepatic steatosis on abdominal imaging, patient demographics, past medical history, LFT abnormalities, cancer staging, and paclitaxel dosing. Results: 219 patients were identified who met inclusion criteria for the study. 29% of patients had hepatic steatosis on imaging. Of those, 52% were noted to have hepatic steatosis prior to paclitaxel treatment, and 6% during paclitaxel treatment. Dose reduction was not statistically significant in patients with hepatic steatosis versus those without (46% vs 42%, p-value = 0.68). Patients with hepatic steatosis were more likely to be obese and have at least one comorbidity, but did not meet criteria for metabolic syndrome (p-value = 0.09) Conclusion: Paclitaxel was tolerated similarly in those with or without hepatic steatosis. Patients with hepatic steatosis were likely to meet some but not all criteria for metabolic syndrome.
    • Surveying rural healthcare workers for vaccine awareness and hesitancy

      Hall-Lipsy, Elizabeth; Acuna, Adrian; Bustamante, Jose; Chellman, Danielle; Tellez, Daniel; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To compare the perceptions of rural providers and promotores regarding patient barriers and hesitation to COVID-19 immunizations. Methods: Two surveys, one for promotores and one for providers, were created to assess participants’ personal beliefs on local COVID-19 vaccination rates and hesitancy. Survey topics included questions concerning perceived vaccination rates of various groups, reasons for and against vaccination amongst patients, patient populations that would benefit most from associated interventions, and non-identifiable demographic questions. All participants were employees of Mariposa Community Health Center in Nogales, Arizona and were recruited in April – May 2022. Data were analyzed using frequencies, descriptive statistics, and Pearson’s chi-square tests. Results: Surveys were completed by 25 promotores (92% female; 96% Hispanic) and 24 providers (67% female; 50% Hispanic). Overall, 21 promotores and 23 providers believed vaccines are safe and effective (84% vs 96%; p = 0.171). Additionally, 17 promotores and 22 providers stated they were comfortable discussing vaccine topics with patients (68% vs 92%; p = 0.04). Respondents noted that they believed the most common reasons for community members not getting vaccinated against COVID-19 were misinformation (51%), fear and lack of trust (44%), side effects (31%), and personal beliefs (29%). Conclusions: With numerous respondents indicating that vaccines are not as prudent in rural areas, that they (mainly promotores) are not comfortable discussing vaccine topics, and that vaccines are not safe and effective, there are opportunities for educational interventions to encourage healthcare workers to further support immunizations to decrease vaccine hesitancy.
    • Assessing knowledge and integration of updated FDA pregnancy and lactation labeling in practice between rural and urban prescribers and dispensers 

      Hall-Lipsy, Elizabeth; Padilla, Ysabel; Dhaliwal, David; Goodin, Rachel; Hogan, Natalie; McKelvey, Carson; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To compare the knowledge and implementation of the FDA Pregnancy and Lactation Labeling Rule (PLLR) between rural and urban prescribers and dispensers. Methods: An anonymous electronic survey requesting demographic information as well as participation in a short 6-question knowledge and implementation assessment was distributed via email to approximately 500 prescribers and dispensers throughout the state of Arizona. Results: Surveys were completed by 24 dispensers and 11 prescribers. Participants had a mean age of 41.1 years and 11.09 years in practice with 80% identifying as female. There was no statistically significant difference in performance between prescribers and dispensers in the Knowledge Assessment, however the majority of answers were marked as “unsure.” Dispensers scored an average of 41.7% correct on the Knowledge Assessment, with an average score of 2.5 out of 6 with a median of 3 out of 6. Prescribers scored an average of 28.3% correct with an average score of 1.7 out of 6 and a median score of 1 out of 6. Two dispensers answered all 6 Knowledge Assessment questions correctly. However, 86.9% of dispensers and 40% of prescribers reported rarely using the PLLR in their practice. Additionally, 65% of dispensers and 40% of prescribers are self-reported as “uncomfortable” with the use of the PLLR. Rural and underserved providers posted slightly better mean scores for the knowledge assessment, while these results aren’t significant, they suggest the need for additional support for adoption and implementation of the PLLR for the best care of pregnant and lactating patients. Conclusions: Healthcare providers are likely not yet comfortable with utilizing the new Pregnancy and Lactation Labeling Rule, leading to an opportunity of Continuing Education in this area.
    • A Qualitative Analysis of 2022 Request to Speak Comments

      Hall-Lipsy, Elizabeth; Gutierrez, Gabrielle; Barto, Helen; Green, Rebecca; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To quantify and characterize the number of positive versus negative comments on a pharmacists’ role in providing health care based on the Arizona state legislature’s Request to Speak system, which has been implemented to allow the public to register opinions on bills before the legislature. To examine general public opinion based on a bill targeting pharmacist intervention and clinical judgment. Methods: This was a descriptive, observational, retrospective study that used data from public comments on the Arizona State legislature bill inquiry website which are submitted by registered voters in Arizona. Public comments from the Health and Human Services committee meeting on February 19, 2022, and the Rules committee meeting on February 21, 2022, on Senate Bill 1016 were collected and analyzed. Comments were eligible for inclusion if they were available for public viewing. Public comments on Senate Bill 1016 were analyzed and classified into themes according to the planned data analysis, which followed the framework method. Comments identified as “for” consisted of a pharmacist’s limited scope of practice, education, and clinical decision making skills as well as the patient/provider relationship and autonomy over treatment plans. “Against” comments were identified as addressing potential patient safety and a pharmacist’s extensive scope, education, and clinical decision making skills. Results: Out of 280 comments, 11 were excluded due to the lack of applicability, 18 (6.7%) were filed under the “for” SB1016 and 262 (97.4%) were “against.” The major themes found amongst the “for” comments were preserving the provider-patient relationship and misconceptions about the pharmacist’s scope of practice. The major themes determined amongst the “against” comments were understanding of the pharmacist’s scope of practice, patient harm, business autonomy/self-regulation, anti-science/conspiracy theory, civil liabilities, or miscellaneous. Conclusion: Based on the major themes amongst the “for” comments, pharmacists and pharmacy associations would benefit from public relations campaigns addressing the misconceptions about scope of practice. A pharmacist’s specialized and vast clinical knowledge would improve patient trust and care.
    • Do Rural And High Index Of Need Counties Have Different COVID-19Vaccination Rates?

      Naderi, Mandana; Hall-Lipsy, Elizabeth; Daniel, Vanessa; Meghoufi, Khadidja; Podbielski, Chris; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: Specific aims are to compare vaccination rates by zip code, ION and rurality for elderly adults (65+) vs adults (18+). We hypothesize zip codes classified as rural, and those that have a high ION, will have lower vaccination rates. Methods: This study is an observational, retrospective, cross-sectional study using public health data for adult and elderly adult vaccination rates by zip code. Zip codes were categorized as: rural/ urban using USDA RUCA Codes, and as: very low, low, moderate, high and very high ION. Results: The priori alpha level is set at ɑ =0.05; in elderly vaccine ION significance level= 0.327, RUCA significance level= 0.001 therefore RUCA is statistically significant since its level is lower than priori alpha level. In adult vaccines the ION significance level = 0.506, RUCA significance level= 0.003, and pharmacy Y/N significance level= <0.001. Therefore, RUCA and active pharmacy status (Y/N) are statistically significant since the level is lower than priori alpha level. Conclusions: We conclude that rural areas were more likely to have fewer pharmacies, or none at all, within the studied populations. The key discovery of this retrospective study demonstrates that the COVID-19 pandemic had an impact on many populations, but there were many challenges in vaccinating those in rural areas of Arizona. Lack of a rural pharmacy location in Arizona statistically lowered local vaccination rates.
    • A Pilot Educational Video Series Aimed at Orienting Non-Native English Speakers to the U.S. Pharmacy System

      Cornelison, Bernadette; Khokhar, Ifrah; Price, Angela; Purdy, Abigail; Ong, Steven; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To determine the effectiveness of pharmacy based videos on educating refugee patients about pharmacy services in the U.S. Methods: Non-native English speaking refugee patients were asked to complete a pre-survey, watch an educational video, then complete a post-survey in order to assess their understanding on using pharmacy services. These surveys were administered to patients seen at Banner University Medicine: Family Medicine Clinic. These surveys tested the patients’ understanding of basic knowledge of and ability to utilize pharmacy benefits in the US, including providing necessary identification documents, information about prescriptions and over the counter medications, and availability of interpreter services; data on preferred languages, gender, country of origin, age and refugee status were also collected. Results: Of the 15 patients encountered, 20% of patients completed the surveys (mean age = 73 years). All participants had been residents of the U.S. for at least 5 years at the time of the study. Per the pre-survey responses, 2 out of 3 participants were aware of the availability of an Arabic interpreter upon request at the pharmacy. The post-survey responses showed all participants reported an increased understanding of pharmacy interpreter services. All participants reported that these videos would have been beneficial upon arrival to the United States. Conclusions: The educational video did show an increase in understanding regarding access to pharmacy services. Additional participants need to be recruited to further validate the findings of the study.
    • Perceived Mental Health of Student Pharmacists Working in Community Settings During the Coronavirus Disease-19 (COVID-19) Pandemic: A Qualitative Analysis at the University of Arizona College of Pharmacy

      Axon, Rhys; Amado, Stephanie; Francis, Brenda; Francis, Diana; Fuh, Michael; Matti, Rasha; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aim: To describe the self-perceived impact of coronavirus disease-19 (COVID-19) pandemic on the mental health of student pharmacists working in community settings during the pandemic. Methods: This qualitative study obtained data through 30-minute semi-structured, audio-recorded, interviews conducted in July 2022 with 18 students enrolled in the University of Arizona Doctor of Pharmacy program who worked at a community pharmacy during the pandemic. The audio-recordings were transcribed for qualitative analysis. Two researchers conducted independent reviews of each transcript and formed codes. Code lists were reconciled with a 90% agreement. Results: Three themes were identified from the transcripts. Theme 1 was “stress”: represented by the quote: “I felt extremely stressed”. Theme 2 was: "change of future career goals”, represented by the quote: “I want to proceed with post-graduations”. Theme 3 was “exhaustion due to staffing shortages”, represented by the quote: “We were understaffed, so when we had to go back to school, managing all the workload was very stressful in the pharmacy”. Conclusion: The COVID-19 pandemic impacted the overall mental health of student pharmacists working in community settings. While some student pharmacists viewed it as an area to improve the pharmacy as the first point of contact during the pandemic, others thought of this as an opportunity to strengthen their resolve. Students persevered through a challenging environment and continued to effectively manage school and work.
    • Prophylactic Benzodiazepine Use in Bupropion Overdose

      Grossart, Elizabeth; Edwards, Christopher; Dudley, Steven; Carroll, Seth; Kaur, Raman; Pina, Rachel; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Objective: Patients taking bupropion are at an increased risk for suicidal ideation and often times utilize their own medications to overdose. The literature reports that seizures occur in up to 37% of bupropion overdoses. The purpose of this study is to determine if prophylactic benzodiazepine use prevents seizures in bupropion overdoses. Methods: This 5 year retrospective observational chart review analyzed patients who overdosed on bupropion between May 1, 2017 - April 30, 2022. Patients were excluded if their Arizona Poison & Drug Information Center (AZPDIC) chart was incomplete, if they never went to a healthcare facility, left AMA, had a seizure disorder or an anti-seizure coingestant. ToxSentry Query Builder was used to extract the cases. Case details were compiled into a data collection form built in Excel. Statistics were performed using an unpaired t-test in GraphPad Prism version 9.5.0. Results: 355 patients were included in this study. 95 (26.7%) patients received prophylactic benzodiazepines. Of those patients, 6 (6.3%) developed seizures. There were 260 (73.2%) patients who did not receive prophylactic benzodiazepines and 60 (23.0%) of them developed seizures. Thus, prophylactic usage of benzodiazepines in bupropion overdoses resulted in a 16.8 ± 4.6% risk reduction (p=0.0003) [0.95% CI 0.07731 to 0.2579]. Conclusion: The results of this study support the usage of prophylactic benzodiazepines to prevent seizures in patients who are suspected to have overdosed on bupropion. This is the only study to evaluate prophylaxis administration of benzodiazepines in bupropion overdoses.
    • Comparison of Inhaled Epoprostenol and Inhaled Nitric Oxide for COVID-19 Induced ARDS in Critically Ill Adults

      Kopp, Brian; Edwards, Chris; Juarez, Jaclyn; Overholt, Lauren; Willden, Kelly; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To compare the maximum change of PaO2:FiO2 in 24 hours from baseline for both iEPO and iNO. Secondary aims include exploring the in-hospital mortality and duration of therapy. Methods: Retrospective, cohort study conducted at Banner Health Hospitals. Patients who were administered iNO or iEPO during their ICU admission were evaluated from Jan 2020-Jan 2022. ● Inclusion criteria: (1) ≥ 18 y/o ; (2) continuous administration of iNO or iEPO for ≥ 1 hour in mechanically ventilated patients admitted to the ICU; and (3) COVID-19 induced pneumonia (PaO2 FIO2 < 150 mm Hg) ● Exclusion criteria: (1) >2 hours of concomitant iNO and iEPO administration; (2) indication of use was massive or submassive pulmonary embolism (PE); (3) concomitant parenteral prostacyclin administration; or (4) extracorporeal membrane oxygenation (ECMO) at baseline Results: 188 patients met inclusion criteria for analysis. There was a significant difference in weight between groups (iEPO mean 103.5 vs 94.6 in iNO, p=0.025) and no significant findings when comparing patients with included comorbidities. Vasopressor therapy had no significant difference (Norepinephrine equivalents: p=0.077). More patients were placed in a prone position in the iEPO group (p=0.002) and more patients were paralyzed with neuromuscular blocking agents (NMBA) in the iNO group (p=0.003). The primary aim of comparing the maximum change of PaO2:FiO2 in 24 hours from baseline was not found to be significant (p=0.779). Conclusions: There was no statistically significant difference in the maximum change of PaO2:FiO2 in 24 hours from baseline between the two study groups.
    • Implementation and Review of Student Led Meds-to-Beds Intervention on Hospital Readmission Rates and Patient Satisfaction in Advanced Heart Failure

      Martinez, Brandon K.; Cai, Hieu; Boettcher, Stormmy; DeBano, Wendy; Rios, Leah; Huynh, Peter; Wolesensky, Christine; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: To evaluate readmission rates and patient satisfaction among patients with advanced heart failure that participated in the Meds-to-Beds program. To collaborate with hospital staff to enhance the transition of care process, explore barriers to adherence, and improve access to care. Methods: This study was a quality improvement initiative evaluating the transitions of care process in the advanced heart failure population at an academic medical center. The study included bedside educational counseling, medication delivery, and the administration of Counseling Surveys. These evaluated the patients’ current understanding, confidence in management, and satisfaction with education provided with respect to their discharge medications. Patients were included after an admission for decompensated heart failure that required prescription fills in the hospital outpatient pharmacy. The study evaluated patients who were discharged on weekdays between 800 – 1700 from February 1st to April 30th. Results: Eleven patients were evaluated, and six patients met requirements. These patients all completed the Pre-Counseling Survey and education however, only one patient was contacted for follow up. On a scale of 1-10, with 10 being the highest; Pre-Counseling Survey collected responses in respect to the patient’s understanding of their medications, confidence in managing their regimen, and satisfaction in educational services. These responses averaged, 8.5, 8.7, and 9.5, respectively. Only one Post-Counseling Survey was collected with responses of 10, 10, and 10, respectively. Conclusions: Significant conclusions regarding the primary objective are unable to be drawn due to a limited patient population and barriers to survey completion. This intervention identified multiple inaccuracies and inadequacies during transitions of care.
    • The Role of Vaccine Literacy on Vaccination Rates in Maricopa County Health Pods

      Vazquez, Alejandro; Islas, Kevin; Boskie, Brad; Choe, Jonathan; Pawlowski, Matthew; Soldatenkov, Jason; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: The primary objective explored whether vaccine literacy is related to regular adult vaccination adherence. The secondary objective explored whether demographic variables of study participants held relationships with their level of vaccine knowledge. The tertiary objective explored whether preconceived beliefs about vaccines were related to vaccine adherence. Methods: Adult participants were recruited at Maricopa County Vaccine Clinics offered through the University of Arizona College of Public Health. Participants completed an anonymous survey that included demographic information, adherence to regular vaccines, a ten-question section to measure vaccine literacy, as well as “opinion statements” about vaccines that the participant would agree/disagree to. Survey responses were analyzed to determine relationships between participants’ vaccine literacy and other data collected via survey. Results (Primary Objective): Vaccine literacy was determined as the most significant factor that affected vaccination adherence. Participants categorized in the high literacy group had a significantly greater number of vaccine-adherent participants (Chi-squared test, p < 0.001). Results (Secondary Objective): Health insurance status was the only patient demographic that was statistically significant with vaccine literacy, with insured participants obtaining a greater literacy score (Chi-squared test, p = 0.04). Age, gender, formal education, and employment status was not significant to vaccine literacy. Results (Tertiary Objective): The level of agreement/disagreement with vaccine opinion statements showed significance to vaccine adherence. The number of participants with favorable overall opinions in favor of vaccination had higher vaccine adherence. (Chi-squared test, p = 0.04). Conclusions: This descriptive study revealed the correlation between vaccine literacy and vaccination rates within a sample population, in addition to the impact of outside variables affecting both vaccination literacy and rates. Further research is required to better understand these correlations and how they impact patient health outcomes within the greater population.
    • Assessing community pharmacists’ confidence with and knowledge of veterinary medications

      Spencer, Jenene; Boice, Daniel; Huang, Vivian; Nguyen, Trinh; Quigg, Miles; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Objectives: With rising numbers of pet prescriptions, pharmacists play an important role in distinguishing appropriate therapies for animals. This study examined pharmacists’ confidence with and knowledge of veterinary medications. Methods: This descriptive study surveyed pharmacists between January 24, 2023 and March 19, 2023. A link was distributed through many social media platforms, email, and word-of-mouth. The survey contained seven knowledge questions pertaining to counseling points and drug toxicities. Three questions had pharmacists subjectively score their confidence in resolving a given scenario. The primary outcome was to assess pharmacists’ confidence with and knowledge of veterinary pharmacotherapy. The secondary outcome was to determine which demographic factors influenced pharmacists’ confidence and knowledge. All responses were analyzed using a chi-squared test. Results: A total of 622 responses were collected with three pharmacists denying consent and 96 incomplete surveys. A total of 523 responses were analyzed by SPSS software. 41 (7.79%) respondents had a passing score of 70% or higher on the knowledge assessment. 37 (7.03%) respondents scored themselves to having high confidence in situations involving veterinary prescriptions. Baseline characteristics (veterinary prescriptions filled per month, access to veterinary pharmacotherapy resources, and veterinary pharmacotherapy lecture in pharmacy school) were significantly associated with higher knowledge and confidence scores. Conclusions: The lack of reliable resources and education regarding veterinary medicine correlates to pharmacists' knowledge gap. Further studies will need to be conducted to determine if these associations are causal or if other factors affect confidence and knowledge.
    • Comparing Pharmacists’ Triggers for Hand Hygiene in a Community Pharmacy Pre and Post COVID 19 pandemic.

      Nix, David; Kobic, Emir; Gonzalez, Marcos; Riley, Lacey; Salehpour, Niloufar; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: Determine the predictive performance of a single trough with Bayesian estimation and a one-compartment model in predicting future vancomycin concentrations. Methods: This multi-center analytical study used data obtained from retrospective medical records review. Records review was completed between January 1, 2021 through December 31, 2021. Patient records were obtained from Banner University Medical Center -South, Banner University Medical Center – Tucson, and Banner University Medical Center - Phoenix. Criteria for patient selection included prescribed vancomycin therapy with a minimum of two troughs obtained, stable serum creatinine and a BMI of less than 35. Patients were excluded for unstable renal function (more than 0.3 serum creatinine fluctuation), BMI greater than 35, age of 18 years or lower, or having fewer than two serum trough levels. Pharmacokinetic parameters were predicted using the first SVC and the fitted parameters were then used to predict subsequent SVC’s and compare to measured values. Results: A total of 450 patient charts were selected for analysis. The one trough modified Bayesian dosing method was able to predict accurate future throughs with about 40% precision. The predictive performance for the Bayesian method did degrade with subsequent SVC’s which we attributed to time- dependent pharmacokinetics. A change in pharmacokinetic parameters function, which was not necessarily reflected by a change in serum creatinine concentration was frequently observed, thus monitoring trough at least once a week is needed to detect change. Conclusions: Bayesian Analysis with a single trough concentration is useful to support vancomycin AUC dosing. Our data provides evidence of time-dependent pharmacokinetics which will require regular therapeutic drug monitoring regardless of the method used to interpret SVCs
    • Comparing Pharmacists’ Triggers for Hand Hygiene in a Community Pharmacy Pre and Post COVID-19 pandemic

      Matthias, Kathryn; Zand, Nicole; College of Pharmacy, The University of Arizona (The University of Arizona., 2023)
      Specific Aims: The aim of this study was to compare the performance of hand hygiene by pharmacists in the community pharmacy setting before and during the COVID-19 pandemic. Methods: Questionnaires were administered to Arizona community pharmacists in 2018 (pre- COVID-19; data previously collected) and in 2023 (during COVID-19) through the Arizona Pharmacy Association email list. The data collected pertained to the frequency of hand hygiene practices based on a variety of scenarios and responses were compared between the 2018 and 2023 surveys. Data was analyzed using STATA. Results: For the 2023 survey, 74 pharmacists working in a community setting completed the survey, as compared to the 151 who participated in the 2018 population. The two populations were compared to each other with a priori p-value of <0.05. Scenarios that showed improvement in hand hygiene practices in between 2018 vs. 2023 included: “before consulting a patient with a red eye” (19% vs. 27%, p = 0.04), “after consulting a patient with a red eye” (68% vs. 83%, p = 0.033), “before a blood pressure check” (31% vs. 55%, p = 0.029), “after a blood pressure check” (40% vs. 66%, p = 0.02) and “before putting on gloves to give an immunization” (52% vs. 75%, p = 0.01). Other situations asked such as “after giving an immunization” and “after handling cash” did not show significant difference. Conclusions: In many of the survey questions involving direct patient contact such as blood pressure checks, immunizations and dealing with visibly sick patients, a significant change was seen from the before and after the COVID-19 pandemic. However, none of direct patient contact scenario responses including before and after administration of immunizations were 100% in either study subject group. This should serve as a reminder that hand hygiene is not only to be used during flu seasons and periods of high transmissions, but as an everyday safe practice to protect other patients and staff members.