Oral anticancer chemotherapy (OC) has been misperceived as being safer than intravenous chemotherapy, leading to its increased risk of improper handling and disposal. This survey study assessed the knowledge, practices and attitudes of pharmacists and patients regarding OC handling and disposal, gaps in knowledge and barriers to patient education. Surveys were developed based on literature review and pilot study validation results. Patients completed a 33-item paper or electronic survey whereas pharmacists completed a 38-item electronic survey. Descriptive statistics and Fisher's exact test computed using the R Project were used for analyses. Pharmacist group (16/25, 62.5%) and patient group (14/29, 48.3%) believed that the oral route is safer than IV. Average overall correct response rates for pharmacist and patient groups were 78.3% and 61.9%, respectively. Significant gaps in knowledge between groups were observed in three sections (p < 0.05). Common barriers to providing patient education were insufficient training (70.8%) and insufficient time (50%). Pharmacist and patient knowledge, awareness and practices of OC safe handling and disposal are suboptimal. Areas of knowledge gaps and barriers to patient education were identified. Enhanced supports are needed to empower pharmacists to assume an active role in patient education on safe handling and disposal of OC.

Purpose. This study evaluates the effectiveness of a novel, live continuing pharmacy education program regarding gained knowledge and comfort in providing interventions to promote healthy pregnancies, as well as pharmacist motivation to incorporate these interventions in their practice.Methods. Pharmacists and student pharmacists completed assessments before and after a continuing pharmacy education program about pharmacologic interventions for healthy pregnancies. The assessments evaluated knowledge, comfort level, and practices on healthy birth spacing, preeclampsia, and preterm birth in a total of 186 participants. Data were analyzed by comparing responses from the pre- and post-assessments using paired t-tests.Results. Following the program, participants’ average knowledge score increased from 40% to 86% on the pre- and post-assessment, respectively (p&lt;0.001). Participants’ comfort level increased in identifying and counseling patients in need of low-dose aspirin for preeclampsia prevention, progesterone injection for preterm birth prevention, and postpartum contraception use for healthy birth spacing (p&lt;0.001). Participants also showed interest in prescribing self-administered hormonal contraception under statewide protocol. Most pharmacists identified logistical hurdles as challenges to incorporating the new knowledge into practice.Conclusion. Pharmacists and student pharmacists significantly increased their knowledge about healthy birth spacing, preeclampsia prevention, and preterm birth prevention after attending a novel continuing pharmacy education program. Participants also reported greater comfort with identifying and counseling patients in need of selected pharmacologic interventions. With motivation to implement relevant interventions in their practice and sufficient training, pharmacists can serve as highly accessible and valuable resources for the provision of reproductive health services to patients in the community.

Purpose. This exploratory study tested the effectiveness of an academic detailing (AD) intervention for improving pharmacist emergency contraception (EC) practices compared to a handout intervention in a state where pharmacists can prescribe EC using a statewide protocol. AD is a peer educational outreach designed to encourage evidence-based practices that improve patient outcomes and healthcare costs.Methods. In this pilot randomized controlled trial, four community pharmacies in San Diego County, California, received an AD intervention or a control handout intervention regarding pharmacist prescribing of EC. The AD intervention group received a one-hour training from an expert pharmacist regarding EC prescribing and an informational EC handout, while the handout intervention group received only the handout. Participants completed a survey assessing EC practices, knowledge, and attitudes before and after the interventions. Phone interviews were performed one month following the interventions.Results. Participants in the AD intervention group demonstrated greater knowledge of clinical considerations for prescribing ulipristal acetate (UPA) EC and California statewide protocols for pharmacist prescribing of EC compared to the handout intervention. Participants in the AD intervention were also more likely to have begun prescribing EC following the intervention compared to those in the handout intervention, which was observed in both quantitative and qualitative results.Conclusions. Increased prescribing rates in the AD intervention group highlight the utility of AD for implementation of pharmacist services. Training that focuses on the clinical considerations for the EC products and statewide protocol for pharmacists’ prescribing of EC could lead to increased community access to EC in pharmacies and more accurate counseling by pharmacists.

Delta variant….Duration of efficacy of vaccines…boosters, third shots, no boosters….there are numerous vaccine-related questions, confusion and misinformation regarding these issues. Pharmacists are in the unique position to sort out and evaluate the data, educate patients and the public and provide the vaccines. There are also avenues to research vaccine uptake, hesitancy and patient views.Equally important is the focus on overdose deaths in the nation related to opioids. Pharmacists play very important roles in the whole 360 degree of this problem.Health equity and pharmacists’ role in addressing it – as recently noted by the Johns Hopkins Center for Health Security report.These topics and the continuum of medication and health-related questions that continually face and intrigue us are all areas which need discussion, debate and inquiry.The Journal is a conduit for dissemination of these efforts, and we welcome manuscripts that tell your stories, and your research on addressing social determinants of health, health equity, vaccination efforts and hesitancy, opioid related issues, in addition to examining medication and practice related topics.Featuring in this issue are important and interesting articles, including articles on two different topics related to women’s reproductive health: CPESN California UpdateEnd of Life Option Act UpdateDirect Pharmacist Prescribing of Emergency Contraception: Findings of an Academic Detailing Intervention Pilot StudyEvidence-based Appraisal of the CARAVAGGIO TrialEvaluation of a Continuing Pharmacy Education Program on Pharmacologic Interventions for Healthy PregnanciesPlease reach out and feel free to provide feedback that can improve OUR journal.

CPESN California has been busy these past few months. Our local network has increased to over 100 independent pharmacies that have delivered on clinical services from COVID vaccine to Point of Care testing. Many of our independent pharmacies have collaborated with their local county health departments, fire departments, schools, employer groups, and long-term care facilities to vaccinate thousands of patients against COVID-19.CPESN California pharmacies have worked tirelessly to ensure that all those that wished to get vaccinated did. Haller’s Pharmacy in Fremont, California, under the direction of Dr. Sanjay Patel, partnered with local fire departments to host many clinics. Pucci’s Pharmacy in Sacramento, California, led by Dr. Clint Hopkins, partnered with Sacramento Public Health Departments to host onsite high school clinics. San Joaquin Drug in Planada owned by Dr. Katie Bass not only worked with her public health department to secure vaccines early but also held clinics every weekend to ensure their community had the opportunity to get vaccinated. Manor Drug and Barr Pharmacy in Fresno California held an onsite COVID clinic in Sanger, California to promote wellness through vaccination. Dr. Michael Ohashi led this effort with strong collaboration from Pam Yoshikawa both are owners of CPESN pharmacies. In Southern California, Western University School of Pharmacy has been working with college students and the underserved in their community. Dr. Bruno Tching at Inland Pharmacy has been collaborating with both local providers and Riverside County Public Health to identify patients with access disparities, such as home bound patients in need of vaccinations, and to provide remote clinics in HPI quartile 1 and 2 areas of the county. They have also been working with local advocacy organizations like the NAACP to promote vaccinations and help tackle disparity issues in low vaccination areas.However, delivering COVID vaccine was not the only thing our CPESN California Networks did. Our Flip the Pharmacy teams led by Dr. Karl Hess from Chapman University transformed their traditional dispensing pharmacy to one that integrates clinical services as part of their daily workload. They began to offer services that centered around diabetes care and social determinants of health. Each providing necessary education and screening to prevent any mishaps in care.It is through these partnerships, community relationships, and focus on providing outstanding individualized care that our CPESN California stores are breaking boundaries to elevate the care they give. Being a part of this community of forward-thinking pharmacists who are willing to think beyond the bottle and focusing on the patient allows our network to be highly successful in delivering exceptional care. If you are interested in learning more about how CPESN California can improve your practice and your relationships with community leaders contact us at www.cpesn.com.

OA is the most common form of arthritis. It results from the degradation of the joint through overuse or injury. It is estimated that 30.8 million adults in the United States suffer from OA. Treatment options of OA come in both non-pharmacologic and pharmacologic forms, with varying levels of efficacy for each option depending on the joint it is intended to be used for. In 2019, the American College of Rheumatology (ACR) updated the guidelines for the management of osteoarthritis of the knee, hip, and hand. The guidelines have been updated to state that acetaminophen is no longer the first line option for OA. In addition supplements like glucosamine and chondroitin are also no longer favored for use in the management of OA. This clinical capsule aims to describe the guidelines for OA as outlined by the ACR so that pharmacists in any type of setting, but especially in the community, can recommend appropriate therapy and counsel patients accordingly.