Jeffrey A. Gray

Prescription Drug Abuse and DEA-Sanctioned Drug Take-Back Events: Characteristics and Outcomes in Rural Appalachia

(froschd@pamfri.org). Financial Disclosure: None reported. Author Contributions: Study concept and design: Elwyn, Légaré, and Frosch. Acquisition of data: Frosch. Analysis and interpretation of data: Adams, Légaré, and Frosch. Drafting of the manuscript: Adams. Critical revision of the manuscript for important intellectual content: Adams, Elwyn, Légaré, and Frosch. Statistical analysis: Adams. Obtained funding: Elwyn, Légaré, and Frosch. Study supervision: Frosch. Funding/Support: This work was funded by unrestricted grant 0140 from the Informed Medical Decisions Foundation (Dr Frosch). Previous Presentation: This research was presented in part at the 33rd Annual Meeting of the Society for Medical Decision Making; October 24, 2011; Chicago, Illinois.

The use and misuse of prescription stimulants as "cognitive enhancers" by students at one academic health sciences center.

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten

Prescription Drug Abuse: A Comparison of Prescriber and Pharmacist Perspectives

50 gift cards was used as an incentive. Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality.

Prescription Disposal Practices: A 2-Year Ecological Study of Drug Drop Box Donations in Appalachia

This study compared perceptions of prescribers and pharmacists (N = 89) regarding multiple aspects of prescription drug abuse. Questionnaires were developed to assess perceptions regarding the prevalence of prescription drug abuse, self-perceived communication competence, and additional communication and prescription drug abuse domains. Pharmacists perceived a larger percentage of patients (41%) to be abusing opioid pain relievers as compared with their prescriber colleagues (17%). Both prescribers and pharmacists indicated improvements in prescriber–pharmacist communication would serve to deter prescription drug abuse. Self-efficacy beliefs for detecting and discussing prescription drug abuse with patients were low for both cohorts. Implications and limitations are noted. Year of data collection: 2012 Setting: Rural Appalachia Data Collection Instruments: Prescriber- and pharmacist-specific survey instruments Data Analysis Techniques: Independent samples t-test; Mann-Whitney U test

Prescription Drug Abuse Prevention in East Tennessee: Engaging Communities to Impact an Epidemic

OBJECTIVES We quantified controlled substance donations via permanent drug donation boxes over 2 years in a region with high prescription abuse, assessing medication characteristics, time between dispensing and donation, and weight of medications donated per capita. METHODS In partnership with Drug Enforcement Administration and local law enforcement, we analyzed permanent drug donation box collections in 8 Northeast Tennessee locations from June 2012 to April 2014. We recorded controlled substance dosage units along with the product dispensing date. RESULTS We collected 4841 pounds of pharmaceutical waste, 4.9% (238.5 pounds) of which were controlled substances, totaling 106,464 controlled substance doses. Analysis of dispensing dates for controlled substances indicated a median of 34 months lapsed from dispensing to donation (range = 1-484 months). The mean controlled substance donation rate was 1.39 pounds per 1000 residents. Communities with fewer than 10,000 residents had a statistically higher controlled substance donation rate (P = .002) compared with communities with 10,000 or more residents. CONCLUSIONS Permanent drug donation boxes can be an effective mechanism to remove controlled substances from community settings. Rural and urban community residents should be provided convenient and timely access to drug disposal options.

Prescription Stimulant Misuse among Future Pharmacists, Physicians and Other Healthcare Providers

• Changes in U.S. population demographics characteristics require the preparation of culturally diverse competent healthcare providers who are capable of practicing in an increasingly diverse society.1 • Training in cultural diversity competence has been recognized as a pre-requisite to fostering the transformation of healthcare1 • As response, the accreditation agencies of health-related academic programs have included new requirements of implementing cultural diversity competence along the curriculum.2,3 • Although demonstration of students’ cultural diversity competence and multicultural communication skills are required in most of the accreditation standards for healthrelated programs, more evidence is needed to determine the best teaching and learning practices for achieving these competencies.A Program to Foster Global Citizenship in Pharmacy Education. Ana Maria Castejon, Nova Southeastern University, Dawn Dacosta, Nova Southeastern University, Jaroslav Toth, Comenius University in Bratislava, Jan Kyselovic. Objectives: Understanding the practice of pharmacy from a global perspective is not a traditional curricular outcome in most US pharmacy programs. The objective of this CoCurricular activity was to provide students with an understanding, and appreciation for pharmaceutical and medical practices outside the UnitedStates. A total of 35 student pharmacists participated in aTravel Study Program (TSP) to Slovakia during the summer of 2013 at Comenius University in Bratislava, Slovakia. Topics covered included pharmacognosy, molecular drug design, European pharmaceutical regulatory agencies and the practice of the profession in Slovakia and the European Union (EU). Live lectures, laboratory practices at the host institution together with multiple site visits to different professional practice settings were included in the TSP. Through reflective exercises we assessed the students’ ability to: 1. Compare the practice of pharmacy in the US versus Slovakia and the EU 2. Identify the professional benefits of attending a structured pharmacy TSP Method: The 35 students completed reflective academic assignments and cultural competency activities before and after the three-week visit to Bratislava. The students’ reflective exercises were analyzed using narrative and content analysis, allowing us to capture the multiple meanings and dimensions of the experiences. Results: The students’ narrations reflected a major impact on their professional growth, intercultural sensitivity and competencies. Participants identified major differences in legal and regulatory aspects of the profession. They highlighted the establishment of connections and international learning networks. Implications:We believe that these programs promote global citizenship, while fostering learning and cultural exchange within the pharmacy profession.

Implementation and Evaluation of an Interprofessional Drug Take-Back Event on a University Campus

Objective: The utilization of interprofessional education and collaborative practice delivers optimal health services and improves patient outcomes. Training future healthcare providers in an integrated environment promotes a “collaborative practice-ready” workforce. The aim of this study was to identify ongoing specific interprofessional collaborative projects and promote their awareness among faculty at the St. John Fisher College Wegmans School of Pharmacy. Methods: Faculty members were surveyed to identify the ongoing interprofessional collaborative initiatives among pharmacy faculty. Results: A total of four collaborative practices were identified among faculty: ambulatory care, assistedliving, didactic, and assessment. The ambulatory care setting at an osteoporosis clinic provides patientcentered care with a clinical component. Each patient with a new diagnosis or change in medication therapy receives education/counseling from a pharmacist, a registered nurse for medication administration and a physician for a physical exam. In the assisted-living setting, pharmacy and nursing students are paired to conduct a high-level health assessment in their respective disciplines. Didactic interprofessional efforts are being conducted to create a flexible and comprehensive pain education curriculum. Physicians, dentists, nurses, pharmacists, psychologists, chiropractors, and oriental medicine practitioners will develop the curriculum. The pain module will be adaptable for interprofessional education activities. Finally, recognizing the similarities in accreditation standards for communication and professionalism, the School of Pharmacy and the NY Chiropractic School are sharing strategies and rubrics for assessing these outcomes. Implications: The survey revealed a broader range of interprofessional collaborations than was originally suspected. The school will continue to foster and support interprofessional education and collaborative practice. Disciplines Pharmacy and Pharmaceutical Sciences Comments Poster presented at: • Annual meeting of the American Association of Colleges of Pharmacy in Orlando, Florida, July, 2012. • Faculty Scholarship Celebration at St. John Fisher College in Rochester, New York, October 25, 2012. Abstract is published in American Journal of Pharmaceutical Education 2012; 76 (5) Article 99. https://doi.org/10.5688/ajpe76599is published in American Journal of Pharmaceutical Education 2012; 76 (5) Article 99. https://doi.org/10.5688/ajpe76599 Authors David Hutchinson, Jane M. Souza, Jennifer Mathews, Anthony Corigliano, Katherine Juba, Jill Lavigne, Andrea Traina, Karen A. Bobak, Constance Baldwin, and O.J. Sahler This poster presentation is available at Fisher Digital Publications: https://fisherpub.sjfc.edu/pharmacy_facpub/20 THE CROSSROADS OF INTERPROFESSIONALISM: Four Avenues of Collaboration at the Wegmans School of Pharmacy at St. John Fisher College David Hutchinson, Pharm.D.; Jane Souza, Ph.D.; Jennifer Mathews, Ph.D.; Anthony Corigliano, R.Ph.; Katherine Juba, Pharm.D.; Jill Lavigne, Ph.D.; Andrea Traina, Pharm.D.; Karen A. Bobak D.C. Constance Baldwin, Ph.D.; O.J. Sahler, M.D.