Mental Health Literacy of Pharmacy Students Compared to Nursing and Medical Students

Objectives:  To determine and compare the mental health literacy of pharmacy, nursing, and medical students.  Methods: Pharmacy, nursing, and medical students in the final year of their didactic program were administered a widely used mental health literacy questionnaire either via paper (nursing) or via email (pharmacy and medicine). For email questionnaires, weekly reminder emails with links for survey completion were sent over a three-week period.  The questionnaire consisted of a vignette describing either depression or schizophrenia followed by items about helpfulness of a variety of interventions, medications, and activities.  Depression and schizophrenia versions of the questionnaire were randomly administered to respondents in the three programs such that respondents received either male (John) or female (Jane) versions of the vignettes.  Results:  A total of 161 out of 253 potential students responded to the survey (63.6% response rate).   Majority of the respondents were female (75%), white (84.6%), had currently or in the past year interacted with people diagnosed with mental disorders (90%), and had multiple opportunities for exposure to mental health content in their coursework (49%). While a majority of respondents in all three programs correctly identified the vignettes as either depression (87%) or schizophrenia (73%), depression was identified correctly by a greater percent of those in pharmacy (88.5%) and nursing (88.4%), and schizophrenia was identified by a greater percent in medicine (82%).  However, there were no significant differences by program type for correct identification of vignette.  Helpfulness of various interventions, medications, and activities did not differ significantly for the depression vignette.  Two significant differences by program type were noted for the schizophrenia vignette.  A larger percent (72%) of nursing students perceived antidepressants as helpful for schizophrenia as compared to pharmacy (55%) and medical (18%) students.  Students from all three programs responded similarly to the question on likely prognosis for those with depression/schizophrenia, both with and without professional help (p>0.01).  Conclusions:  Majority of students in each discipline were able to correctly identify patients with depression or schizophrenia and have similar levels of mental health literacy.  The profile of responses suggest that pharmacy and nursing students were more clear about helpfulness of interventions for depression, than for schizophrenia.  Given the extent of the problem of mental health, additional and continuously reinforced training on mental health throughout the four-year curriculum is necessary for first line providers such as pharmacists, nurses, and physicians.    Article Type: Original Researc

Health Literacy Based Communication by Illinois Pharmacists

Objectives: Health literacy has received attention as an important issue for pharmacists to consider when interacting with patients. Yet, there is little information about methods pharmacists use to communicate with patients and their extent of use of health literacy based interventions during patient interactions. The purpose of this study was to examine methods of communication and types of health literacy based interventions that practicing pharmacists use in Illinois. Methods: A survey instrument addressing the study purpose was designed along with other items that were part of a larger study. Eleven items in the survey referred to pharmacist-patient communication. The instrument was pilot tested before administering to a random sample of 1457 pharmacists from the Illinois Pharmacists Association. Data were primarily collected via a mailed survey using Dillman’s five step total design method (TDM). Two reminder letters were mailed at two week intervals to non-respondents. Results: Usable responses were obtained from 701 respondents (48.1% response rate). Using simple words (96%) and asking patients open-ended questions to determine comprehension (85%) were the most frequent methods that pharmacists used to communicate with patients. Only 18% of respondents always asked patients to repeat medication instructions to confirm understanding. The various recommended types of health literacy interventions were “always” performed by only 8 to 33% of the respondents. More than 50% of respondents indicated that they rarely or never had access to an interpreter (51%), or employed bilingual pharmacists (59%). Only 11% of pharmacists said that they rarely/never pay attention to nonverbal cues that may suggest low health literacy. Conclusions: Pharmacists infrequently use action oriented health literacy interventions such as using visual aids, having interpreter access, medication calendars, etc. Additional training on health literacy, its scope, and related interventions coupled with system redesign and compensation for time spent counseling are essential to encourage health literacy tailored communication with patients.   Type: Original Researc

Real-World Experiences of Parkinson's Disease OFF Time and Role of Demographics

Purpose OFF periods are episodes when Parkinson’s disease (PD) medications work suboptimally, with symptoms returning and impacting quality of life. We aimed to characterize OFF periods using patient-reported frequency, severity, and duration, as well as determine these characteristics’ associations with demographics. Methods A retrospective cohort study using Fox Insight Data Exploration Network (Fox DEN) database was conducted. Eligible patients had PD and were > 18 years. The experience of OFF periods was characterized by frequency (number of episodes/day), duration (duration/episode), and severity (impact on activities). Significance level was Bonferroni-corrected for multivariate analyses. Results From a population of 6,757 persons with PD, 88% were non-Hispanic Whites (mean age: 66 ± 8.8 years); 52.7% were males versus 47.3% females; mean PD duration was 5.7 ± 5.2; and 51% experienced OFF periods. Subsequent analyses were limited to non-Hispanic Whites, as they constituted a large majority of the participants and were the subgroup that had the sample size to derive reliable inferences. The analyses showed that 67% experienced 1–2 episodes/day, 90% experienced > 15-minute episodes, and 55% reported slight–mild severity/episode. Lower age was associated with a higher frequency (incidence rate ratio [IRR]: 0.992; P < 0.001) and severity (odds ratio [OR]: 0.985; P = 0.001) of OFF episodes. Income of < $35,000 was associated with 15.1 Conclusions Lower age, income <$35,000, longer PD duration, female gender, and being unemployed are associated with a higher frequency and severity of OFF periods with no associations for duration/episode among non-Hispanic Whites with PD. In time-constrained clinic environments, clinicians should tailor OFF periods management counseling to vulnerable demographic groups to enhance care delivery.(J Patient Cent Res Rev. 2024;11:8-17.

Design and Evaluation of Health Literacy Instructional Video for Pharmacy Students

Objectives: 1) To describe the development of a health literacy video tailored for pharmacy students. 2) To compare the use of a health literacy video as an instructional method to a previously used health literacy instructional strategy by using both and: a) assessing pharmacy students' perceptions of their ability to communicate with low health literacy patients and b) assessing pharmacy students' perceptions of their overall understanding of the role of health literacy in a pharmacy setting. Case Study: A novel pharmacy health literacy instructional video was created providing patient-pharmacist scenarios involving low literacy patients. A previously used role-play activity was performed in a required "Health Promotion and Literacy" course followed by the viewing of the newly designed health literacy instructional video. Two separate paper-based survey instruments were developed and administered to individually assess both active learning strategies and for comparison of the strategies. Statistically significant differences were noted on all five survey questions with the instructional video rating higher than the role play activity in the overall enhancement of students' understanding of health literacy. Conclusions: A pharmacy health literacy instructional video was well received by students. It significantly improved students' perception of their ability to communicate with low health literacy patients in a pharmacy setting and their overall understanding of health literacy.   Type: Case Stud