Engagement in Hepatitis C and HIV Prevention: Community Pharmacists’ Knowledge and Attitudes Regarding Non-Prescription Syringe Dispensing Legislation

Since 2010, the incidence of acute Hepatitis C Virus (HCV) infections in the U.S. has nearly quadrupled. Re-use and sharing of syringes among people who inject drugs (PWID) is a significant contributor to increased rates of HCV transmission and a risk factor for HIV infection. Community pharmacists are uniquely positioned to offer harm reduction services that lower the transmission of HCV/HIV by providing sterile syringes to PWID. However, legislation on non-prescription syringe dispensing varies by state and differences in individual pharmacists’ interpretation and attitudes regarding these laws may impact their willingness to participate in harm reduction services. Little is known about the impact of these factors on pharmacist engagement with harm reduction services in central Appalachia, a region particularly hard-hit by the opioid epidemic. The objective of this project is to qualitatively evaluate open-ended responses collected as part of a survey administered to community pharmacists in three central Appalachian states in order to determine: 1) pharmacists’ knowledge and attitudes regarding their state’s non-prescription syringe dispensing laws; and 2) the correlation of attitudes about state legislation to pharmacists’ intent to sell syringes to PWID. A telephonic community pharmacist survey on non-prescription syringe attitudes and behaviors was conducted between April and June 2018 in Northeast Tennessee, Western North Carolina, and Southwest Virginia. Survey responses were obtained from pharmacists practicing in 391 community pharmacies (51% response rate) in the study region. Transcribed responses to open-ended survey questions were extracted from the dataset and a qualitative analysis was completed using a generalized inductive approach. A single investigator coded all qualitative data and a second investigator coded data from a random selection of 10% of the respondents in order to develop themes through consensus. Descriptive analysis was conducted using SPSS version 25 to compare syringe law attitude thematic categories to respondents’ intent to sell syringes to PWID. Preliminary analysis identified discrepancies in pharmacists’ non-prescription syringe law knowledge, state-specific differences in pharmacists’ non-prescription syringe law attitudes, and underlying differences in willingness to sell syringes to PWID based on attitudes. The findings may encourage pharmacists to reflect on personal attitudes and interpretation of state-specific legislation as factors that may influence participation in an evidence-based harm reduction strategy for prevention of HCV/HIV transmission. This study offers preliminary results that will serve as a basis for larger studies and interventions aimed at reducing ambiguity in pharmacists’ interpretation of non-prescription syringe dispensing laws and encouraging pharmacists to counter the spread of HCV/HIV in an evidence-based manner

Finding Novel and Synergistic Cytotoxic Agents for the Treatment of Multiple Myeloma

Multiple Myeloma is cancer of plasma cells and is known to be highly invasive. Multiple Myeloma makes up 1% of cancer diagnosis in western countries and affects men more predominantly than women. The American Cancer Association estimates that 32,110 new cases will be diagnosed in the United States in 2019. Lenalidomide is one of the main therapies used for multiple myeloma patients, but it has toxic side effects such as thrombocytopenia, neutropenia, and anemia. The purpose of the study is to investigate new cytotoxic agents for the treatment of multiple myeloma. In addition to lenalidomide alone, this study examined the effects of doxycycline alone and in combination with lenalidomide. Lenalidomide cell cultures were treated at concentrations from 0.5μM to 10μM on untreated 24 well plates and doxycycline concentration ranging from 10μM-80μM. Following incubation, cell viability was tested using MTT assay and the samples were analyzed using spectrophotometry. When compared to lenalidomide, doxycycline monotherapy showed a greater decrease in overall cell viability in preliminary results. Our results show that there is benefit of using 10μM of Doxycycline at higher concentration of 5μM and 10μM of lenalidomide. The potential decrease in the concentration of lenalidomide used by adding doxycycline, may reduce the toxic side effects of lenalidomide. Further studies are necessary to confirm these preliminary results and investigate the mechanism of action in order to determine optimal combinations of these drugs