Patient Education Initiatives Research Articles

The impact of digital health technologies on pharmacy services and patient care

This comprehensive review delves into the profound impact of digital health technologies on the landscape of pharmacy services and patient care. The integration of electronic prescribing medication adherence apps, and tele-pharmacy services has revolutionized medication management in pharmacies. This amalgamation has not only streamlined processes but has also significantly minimized errors, leading to enhanced operational efficiency. Pharmacists, equipped with wearable devices, now engage in remote patient monitoring, allowing for personalized interventions and proactive healthcare strategies. The incorporation of genomic data, data analytics, and clinical decision support systems marks a transformative shift towards precision medicine within pharmacies. These technologies empower pharmacists to design tailored treatment plans based on individual genetic profiles, thereby optimizing therapeutic outcomes. As pharmacies increasingly embrace these digital tools, they metamorphose into dynamic healthcare hubs. Beyond traditional roles, pharmacies now offer virtual consultations and actively participate in patient education initiatives. This paradigm shift underscores a commitment to patient-centered care, exemplified by improved medication safety and a more interconnected healthcare ecosystem. The ongoing integration of digital health technologies holds promise for continued advancements in pharmacy services. This trajectory signifies a significant departure towards a more proactive, personalized, and technologically driven approach to patient care. The review underscores the transformative potential of digital health technologies in redefining the role of pharmacies and elevating the standards of patient-centered healthcare delivery.

Impact of Enhanced Recovery after Surgery® Protocol Compliance on Length of Stay, Bowel Recovery and Complications after Radical Cystectomy

Background: Despite existing standardized surgical techniques and the development of new perioperative care protocols, radical cystectomy (RC) morbidity remains a serious challenge for urologists. Postoperative ileus (POI) is one of the most common postoperative complications, often leading to a longer length of stay (LOS). The aim of our study was to assess the impact of compliance to the Enhanced Recovery After Surgery (ERAS®) protocol on bowel recovery, 30-day complications and LOS after RC for bladder cancer (BC). Methods: Data from consecutive patients undergoing RC for BC within an ERAS® dedicated protocol were analyzed. Exclusion criteria were urinary diversion other than ileal conduit and palliative RC. Patients were divided into two groups according to their compliance (A: low-compliance and B: high-compliance). ERAS® compliance was extracted from the ERAS® Interactive Audit System (EIAS) database. Postoperative complications were prospectively recorded by a dedicated study nurse 30 days after RC. POI was defined as the placement of a nasogastric tube. Logistic regression analysis was used to identify predictors of 30-day complications and POI. Results: After considering the exclusion criteria, 108 patients were included for the final analysis. The median global compliance to the ERAS® protocol was 61%. A total of 78 (72%) patients had a compliance <65% (group A), while the remaining 30 (28%) had a compliance >65% (group B). No significant differences were found among the two groups regarding the 30-day complication rate (86% in group A versus 73% in group B, p = 0.82) and LOS (14 days in group A versus 15 days in group B, p = 0.82). The time to stool was significantly shorter in group B (4 days versus 6 days, p = 0.02), and the time to tolerate solid food was slightly faster in group B but not significant (8 versus 7 days, p = 0.23). The POI rate was significantly lower in patients with a higher ERAS® compliance (20% versus 46%, p = 0.01). A multivariate analysis showed that ERAS® compliance was not significantly associated with 30-day total complications. However, a lower compliance to the ERAS® protocol and age > 75 years were significant independent predictors of POI. Conclusions: Our study provides further evidence to support the beneficial effect of the ERAS® protocol in patients undergoing RC, particularly in terms of facilitating a faster recovery of bowel function and preventing POI. Future research should focus on investigating novel approaches and interventions to improve compliance with the ERAS® protocol. This may involve patient education, multidisciplinary teamwork, and continuous quality improvement initiatives.

Comprehensive Review Of Rheumatoid Arthritis: Insights, Challenges, And Prospects

This comprehensive review explores the multifaceted landscape of rheumatoid arthritis (RA), encompassing its epidemiology, pathophysiology, clinical manifestations, diagnosis, treatment approaches, and the impact on patients' quality of life. The review delves into the global prevalence of RA, demographic patterns, and associated risk factors, shedding light on the complex interplay of genetics, immunology, and environmental triggers in disease development. The pathophysiological mechanisms involving immunological dysregulation, genetic factors, and environmental triggers are elucidated, providing a foundation for understanding the intricate processes driving RA. Detailed insights into the clinical manifestations of RA, including joint involvement, extra-articular manifestations, and the progression of the disease, are provided. The diagnostic landscape is explored, covering the ACR/EULAR classification criteria, diagnostic imaging, and laboratory tests that facilitate accurate and timely identification of RA. Treatment approaches, from pharmacological therapies like DMARDs and biologics to non-pharmacological interventions such as physical and occupational therapy, emphasizing a holistic management strategy. The economic burden of RA, its impact on healthcare utilization, and the broader societal implications are scrutinized, providing valuable insights into the challenges faced by both individuals and healthcare systems. Prevention and disease management strategies are highlighted, emphasizing the importance of early intervention, patient education, and public health initiatives in mitigating the impact of RA. Current challenges in RA management are outlined, with proposed future research directions aimed at advancing understanding and treatment.

Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland – a qualitative interpretive description study

ABSTRACT Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (n = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants’ everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.

The Implications of Readmission on Cost and Patient Outcomes Following Distal Pancreatectomy and Splenectomy.

Robotic platform usage for distal pancreatectomy and splenectomy has grown exponentially in recent years. This study aims to identify the impact of readmission following robotic distal pancreatectomy and splenectomy and to analyze the financial implications of these readmissions. We prospectively followed 137 patients after robotic distal pancreatectomy and splenectomy. Readmission was defined as rehospitalization within 30 days post-discharge. Total cost incorporated initial and readmission hospital costs, when applicable. Outcomes were analyzed using chi-square/Fisher's exact test and Student's t test. Data are presented as median (mean ± SD). Of 137 patients, 20 (14%) were readmitted. Readmitted patients were 67 (66 ± 10.3)years old and had a BMI of 30 (30 ± 7.0)kg/m2; 9 (45%) had previous abdominal operations. Non-readmitted patients were 67 (62 ± 14.7)years old and had a BMI of 28 (28 ± 5.7)kg/m2; 37 (32%) had previous abdominal operations (P = NS, for all). Readmitted patients vs non-readmitted patients had operative durations of 327 (363 ± 179.1) vs 251 (293 ± 176.4)minutes (P = .10), estimated blood loss (EBL) of 90 (159 ± 214.6) vs 100 (244 ± 559.4) mL (P = .50), and tumor diameter of 3 (4 ± 2.0) vs 3 (4 ± 2.9)cm (P = 1.00). Initial length of stay (LOS) for readmitted patients vs patients who were not readmitted was 5 (5 ± 2.7) vs 4 (5 ± 3.0)days (P = 1.00); total hospital cost of those readmitted, including both admissions, was $29,095 (32,324 ± 20,227.38) vs $24,663 (25,075 ± 10,786.45) (P = .018) for those not readmitted. Despite a similar perioperative course, readmissions were associated with increased costs. We propose thorough consideration before readmission and increased patient education initiatives will reduce readmissions after robotic distal pancreatectomy and splenectomy.

Results of VOICE: a global survey of disease-specific knowledge and perspectives of real-world patients with CLL

AbstractThe Virtual Opinions poll Independent Centered on CLL patients’ Experience (VOICE) evaluated patients’ knowledge about chronic lymphocytic leukemia (CLL), their perspectives on diagnosis and treatment, and their unmet needs. Clinicians and patient advocacy group representatives developed and distributed the survey from March through December 2022 in 12 countries, and 377 patients with ≥1 line of previous CLL treatment responded from Europe, Latin America, the United States, Australia, Egypt, and Turkey. A majority of them (90%; 336/374) relied on their physicians for information regarding CLL and treatment. If at high risk, respondents prefer oral medications to intravenous (78%; 232/296), fixed duration treatment over treatment until progression (69%; 185/270), outpatient over inpatient treatments (91%; 257/283). Over three-fourths of respondents (78%; 286/368) wanted to be involved in treatment decisions, but a minority actually participated (44%; 138/313). COVID-19 vaccinations were widely available (97%; 273/281), but one-fifth (19%; 63/331) were unaware that CLL increases vulnerability to infections. Most patients’ physicians explained their treatment options (84%; 297/355), and 90% (271/301) understood their treatment. Notably, >10% would continue treatment normally if they experienced cardiac problems or arrhythmias, whereas 23% would consider stopping treatment if they developed skin cancer. Treatment–associated side effects affected 27% to 43% of patients. These results in a global patient population highlight gaps in patients’ knowledge of risk groups, their susceptibility to infections including COVID, and the side effects of common treatments. Such knowledge can guide the appropriate targeting of patient education initiatives by clinicians, advocates, and policymakers.

Patient perspectives on CLL treatment side effects: A sub-analysis of the VOICE survey.

7534 Background: Treatment for chronic lymphocytic leukemia (CLL), including chemoimmunotherapy and targeted drugs, is associated with various adverse events. We surveyed patients with CLL about their knowledge and attitudes regarding treatments and “side effects” (SEs), a more widely understood term for adverse events. Methods: Clinicians and patient advocacy group representatives developed and distributed a survey from March through December 2022 in 12 countries to patients with CLL who underwent ≥1 line of treatment. The anonymous survey was available via an electronic platform, digital questionnaires (.pdf), or paper forms. This sub-analysis includes items regarding SEs during treatment intervals, although the SEs queried were not comprehensive. Results: Treatment SEs had a moderate or high impact on 27%–43% of patients in every domain queried (Table). Most patients (300/370; 81%) discussed SEs with their physicians “always” or “sometimes”, but (117/277) were seeking more information about the benefits and SEs associated with their treatment, primarily via the internet. When asked how they would respond to common SEs, most patients would consult their physician first . Notably, >10% of them would continue treatment normally if they experienced arrhythmias or cardiac problems, and 21% would continue if they developed hypertension (Table). A similar proportion (11%) would continue treatment if they had an infection, while 23% of them would consider stopping treatment without medical advice if they developed skin cancer. Conclusions: These results show the impacts of SEs from CLL treatment affect substantial numbers of patients in multiple life areas. The responses suggest that despite patient-physician communication about SEs, there is a need to help patients find reliable information about their treatments online as well. Finally, patients’ willingness to stop or continue treatment in the event of various SEs, including cardiovascular or oncologic events, indicates a critical knowledge gap regarding the risk associated with these events. The real-world data presented herein highlights areas in which improved patient education initiatives could directly improve patient outcomes. [Table: see text]

What do patients with asthma want to know? Google Trends insights into U.S. general population interest between 2004 and 2022 can help structure patient education initiatives

What do patients with asthma want to know? Google Trends insights into U.S. general population interest between 2004 and 2022 can help structure patient education initiatives

Antihypertensive Teach-Back to Reduce Delays, Cancellations, and Interventions in a Freestanding Gastroenterology Clinic.

The purpose of this study was improving patient compliance with the 2014 American College of Cardiologists/American Heart Association Joint Task Force Clinical Practice Guidelines recommendation regarding continuation of antihypertensive medications throughout the perioperative period. A patient education initiative, using the teach-back method of instruction, was implemented and evaluated. Effectiveness of instruction was measured by tracking hypertension requiring pharmacological intervention, procedure delay, and procedure cancellation. Pre- and postintervention data were collected from electronic health records using a retrospective cohort design. A χ 2 analysis compared pre- and postintervention groups. The p value was calculated using the χ 2 analysis, (χ 2 [1, N = 1,044] = 7.71, p = .00548). No incidence of case delay or cancellation was experienced in either test group. Incidence of patients requiring preprocedural pharmacological intervention decreased by 70.5%. Statistically significant decreases in pharmacological treatment of hypertension supported permanent inclusion of the antihypertensive patient teaching method at the project gastroenterology clinic.

The Global Cardiovascular Nursing Leadership Forum: Promoting Optimal Cardiovascular Health Worldwide.

The Global Cardiovascular Nursing Leadership Forum: Promoting Optimal Cardiovascular Health Worldwide.

Antimicrobial Prescription Habits among Community Pharmacists and Patent and Proprietary Medicine Vendors in Nigeria: A Rational Use of Drugs Survey

Introduction Antimicrobial Resistance (AMR) poses a global health threat, exacerbated by the misuse and overuse of antimicrobials. The need to investigate knowledge, attitudes, and practices among Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) in Nigeria cannot be overemphasized. This study addresses the gaps in understanding antimicrobial dispensing practices among CPs and PPMVs in Nigeria. Materials/Methods A Community-based Antimicrobial Stewardship survey was conducted across five Nigerian states. A total of 384 PPMVs and 135 CPs were interviewed using a well-structured questionnaire covering demographic information, knowledge, attitudes, and practices related to antimicrobial use. The survey utilized descriptive statistics, and the data were analyzed to identify strengths, weaknesses, threats, and opportunities in addressing AMR. Results The study revealed inadequate knowledge regarding AMR among both PPMVs and CPs. Despite educational backgrounds, a significant proportion believed antibiotics were the best treatment for fever and diarrhea. Dispensing practices included selling antibiotics without prescriptions and, in some cases, dispensing medicines by proxy. The Safety Net Protocol, involving patient education and follow-up, was often neglected by both PPMVs and CPs. Conclusion The findings underscore the importance of enhancing knowledge, attitudes, and practices related to antimicrobial prescription among PPMVs and CPs in Nigeria. Regulatory authorities should enforce strict guidelines to curb non-prescription antibiotic sales. Patient education and follow-up initiatives should be prioritized to mitigate AMR risks. In order to develop strategies to improve antimicrobial dispensing practices we recommend the following: AMR education for PPMVs and CPs, Enforce rules to prevent antibiotic sales without prescriptions through regulatory compliance, public awareness on antibiotic risks and prescription importance, implement Safety Net Protocol for post-purchase education to prevent antibiotic misuse and provision of ongoing professional development for PPMVs and CPs with updated practices that will sustain learning.

Management of Dyslipidemia and Hypertension – Journey Mapping in the Philippines

Literature was reviewed semi-systematically with the purpose of generating Philippines-specific data for the patient journey stages for dyslipidemia and hypertension, namely, awareness, screening, diagnosis, treatment, adherence, and control. A structured search was conducted on EMBASE and MEDLINE databases for studies published in English in the last 10 years, whose full text was available. An unstructured search was conducted on Google, and websites of health ministries and international organizations, without any limits. The last search was run for dyslipidemia on 12.11.2019 and for hypertension on 28.07.2020. For dyslipidemia, six records out of 590 records were retrieved, and for hypertension, seven records and one unpublished conference presentation out of 160 records retrieved, were included in the final synthesis. The review estimated that in the Philippines, the prevalence of dyslipidemia was 38.8%, while 59.0% of patients were undergoing treatment, with 44.2% of patients achieving control. Prevalence of hypertension was 27.5% and estimated rates at different stages of patient journey were- awareness- 61.5%, screening- 3.2%, diagnosis- 39.7%, treatment- 65.4%, adherence- 57%, and control- 57.6%. Potential contributory factors for low assessment rates and suboptimal management include low doctor-to-population ratio, inadequate time for screening and counseling, absence of locally validated tools for cardiovascular screening, low awareness and utilization of clinical practice guidelines, and some misperceptions of current treatment recommendations. Effective training of physicians, patient education initiatives, and multi-sectoral coordination are some of the recommendations to improve the status of management of dyslipidemia and hypertension in the Philippines.

Practice Patterns in Prescribing Buprenorphine in the New Jersey Department of Corrections.

Inmates have high rates of opioid use disorder and are at risk for morbidity and mortality both during incarceration and after release. We conducted a retrospective chart review to assess prescribers' fidelity to the New Jersey Department of Corrections practice guideline for prescribing maintenance or prerelease buprenorphine. We compared the entire group of inmates prescribed buprenorphine at the conclusion of 2019 (n = 875) with a sample of inmates diagnosed with opioid use disorder (OUD) but not prescribed buprenorphine (n = 396) and a sample of inmates not diagnosed with OUD (n = 367). Inmates on buprenorphine were more likely to be male, White, in treatment for a mental illness, have higher scores on the Texas Christian University Drug Screen, be closer to release, have multiple substance use disorder comorbidities, and have more substance-related disciplinary charges. They were most often prescribed buprenorphine-naloxone strips, with doses ranging from 2 mg to 12 mg, and a median dose of 8 mg. Racial disparities in prescribing were observed, though the reasons for this are likely multifactorial, and research from the community has shown similar findings. We propose strategies to reduce these differences, including staff education, patient education, and quality improvement initiatives.

Role of pharmacists in healthcare delivery

Pharmacists play a multifaceted role in healthcare delivery, contributing significantly to patient care, medication management, and public health initiatives. This paper explores the diverse responsibilities and contributions of pharmacists within healthcare teams, highlighting their expertise in medication therapy management, preventive care, chronic disease management, and medication access and adherence. Through collaborative practice models, patient education initiatives, and innovative interventions, pharmacists play an integral role in promoting optimal health outcomes and improving the quality, safety, and effectiveness of healthcare delivery.

Clinical pharmacist involvement in expanding naloxone distribution in a veteran population.

To describe the process used in a clinical pharmacist specialist (CPS)-led Opioid Overdose Education and Naloxone Distribution (OEND) program initiative to increase naloxone distribution to veterans at high risk for overdose via provider education and identification of barriers to naloxone distribution. Drug overdose is the leading cause of accidental death in the United States. One step toward counteracting the epidemic includes expanding access to and use of naloxone. The Veterans Health Administration has developed initiatives to target veterans at risk for opioid overdose, such as the Veterans Affairs (VA) OEND program. Pharmacists can play a unique role in OEND by both prescribing naloxone and educating patients and providers on risk mitigation strategies. Through provider education, patient education, and facility-wide initiatives, naloxone prescribing was increased by 9-fold from August 2016 to August 2018. In addition, the number of new naloxone prescribers increased by almost 7-fold during the intervention period. Naloxone distribution to high-risk groups drastically increased across all target groups. CPS involvement in promoting OEND at VAPHS drastically increased rates of prescribing of naloxone kits to veterans at risk for opioid overdose. This initiative showed that a CPS can play multiple roles in supporting OEND outreach at a large healthcare setting.

FP02.04 Immunotherapy in Lung Cancer: Analysis of Patients’ Awareness and Perceptions

Scientific advances in immuno-oncology have contributed to improved survival of lung cancer patients, and immunotherapy is part of the daily clinical practice. Due in part to these hopeful results, immunotherapy is a relatively popular subject in mass media. The scientific community has undertaken significant efforts to educate and inform patients about several aspects of immunotherapy, particularly regarding some common misconceptions, but the results are inconclusive and anecdotal. CareAcross, a digital multilingual platform which provides personalized, evidence-based support to cancer patients undertook the initiative to investigate the level of education and information of cancer patients regarding immunotherapy. From June 2020 to February 2021, specific questions were posed to the members of the CareAcross online platform. Members were predominantly from the UK, France, Spain, Italy or Germany, and were diagnosed with lung, breast, colorectal or prostate cancer. Their responses were correlated with other characteristics of their health profile and cancer journey. This analysis focuses on lung cancer patients, and compares the perceptions of those who have received immunotherapy vs those who have not. Among 5589 responders, 1131 had lung cancer; 241 had received immunotherapy (21%; henceforth “IO-treated”) while the rest had not (890 or 79%; henceforth “non-IO-treated”). Regarding the mechanism of action, 29% of patients responded either “do not know” or ”not sure”; non-IO-treated were the least aware subgroup (33% vs 11% of IO-treated). Regarding the timing of action, 28% of patients reported knowing that immunotherapy starts working some time after treatment initiation (41% of IO-treated vs 24% of non-IO-treated). 44% of patients could not respond (22% of IO-treated vs 50% of non-IO-treated). Most patients (77%) were confident that chemotherapy causes more side-effects than immunotherapy (86% of IO-treated vs 74% of non-IO-treated) and only 3% of all believed the opposite. The main difference was observed regarding ignorance: 8% of IO-treated were unaware, compared to 23% of non-IO-treated. When comparing immunotherapy’s toxicity with that of targeted therapies, more than half of all subgroups did not know. While all subgroups believed that immunotherapy was the least toxic of the two, IO-treated were the most ambivalent, resulted in a smaller gap (with 20% considering immunotherapy more toxic than targeted therapy, vs 24% for the opposite). Regarding the perception of costs to the healthcare system, 21% believe that immunotherapy costs more than targeted and chemotherapy (35% of IO-treated vs 17% of non-IO-treated). Each of the other two modalities were considered the most expensive by 12% of each subgroup, across the board. The remainder was accounted for by those who did not know (50% of all; 40% of IO-treated vs 53% of non-IO-treated) or believe they cost the same (5%; 3% of IO-treated vs 5% of non-IO-treated). The overall understanding of immunotherapy, its mechanism of action, impact, and costs, is still relatively low, even among lung cancer patients who have received such treatment. Given immunotherapy’s growing applicability, these findings highlight the need for broader, continuous and frequently updated patient education initiatives. These can improve knowledge, instill confidence, reduce misconceptions, and enhance patient-clinician collaboration.

Same-day discharge after robotic hysterectomy for gynecologic malignancy: a study of cost analysis and resource utilization

Objectives: To determine impact and cost savings of a quality intervention involving enhanced patient, provider, and staff education focused on same day discharge after robotic assisted total hysterectomy, and/or bilateral salpingo-oophorectomy with sentinel and/or additional lymph node dissection. Methods: A quality project was undertaken at our institution to improve the rate of same day discharge after robotic assisted hysterectomy and to assess the resource utilization savings of such an intervention. Literature supports feasibility and safety of same day discharge for robotic assisted hysterectomies alone or with other procedures for benign and malignant indications. Complex robotic assisted hysterectomies include bilateral salpingo-oophorectomy plus sentinel or additional lymph node resection. We collected historical data via chart review for the 12 months of 2018 (Group A) to determine our baseline same day discharge rate for complex robotic hysterectomies. Faculty, outpatient clinic and perioperative clinic staff were provided with education regarding the same day discharge goal for complex robotic assisted hysterectomies for patients from a single institution in our gynecologic oncology practice. We then prospectively collected the outcome data on patients undergoing complex robotic hysterectomies for the subsequent 12 months in 2019 (Group B). We compared demographic, clinical factors, and factors of resource utilization such as time in surgery and recovery and length of admission. Descriptive statistics and t-test were utilized to compare the groups. Results: One hundred three patients underwent complex robotic assisted hysterectomy in 2018, and 5% (5 patients) were discharged home on the day of surgery (Group A). One hundred twelve patients underwent complex robotic assisted hysterectomy in 2019 (Group B), and 32% (36 patients) were discharged home on the day of surgery. There was no significant difference between mean age (62 vs 64) or BMI (37 vs 36) in the two cohorts, respectively. Median length of stay was 21 hours for patients that were not discharged on day of surgery and 3.5 hours for patients discharged day of surgery. Of the 41 total patients undergoing same day discharge (Group A + Group B), there was one urgent care visit, one ER visit and and no readmissions in 30 days post procedure. A savings of approximately $1975 per case when patient discharged day of surgery. By promoting same day discharge after robotic assisted hysterectomy, 648 in-patient care hours were saved during the 12 months post intervention. Conclusions: A low cost patient and provider education initiative to increase same day discharge after robotic hysterectomy in gynecologic oncology patients positively impacted cost and resource utilization without negatively impacting readmission rates and ER utilization. In 12 months, the same day discharge rate in one facility was increased from 5% to 32% of robotic hysterectomy cases.

The health literacy disparity in adolescents with sickle cell disease.

There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD. This is a cross-sectional, descriptive, exploratory study. One hundred and thirty-four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples t tests. There was a significant relationship between health literacy, age (r = .286, p < .01) and grade level (r = .317, p = .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (r = .235; p < .05) and parental education (r = .263; p < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (t = 4.772; p < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD. There are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is needed to gain more insight into this phenomenon.

Efficacy of Hypertension Self-Management Classes Among Patients at a Federally Qualified Health Center.

Structural racism has contributed to persistent racial disparities in hypertension control, with Black men suffering the highest prevalence of uncontrolled hypertension. Lincoln Community Health Center, our urban Federally Qualified Health Center (FQHC), aimed to use hypertension self-management classes to improve hypertension control among our clinic patients, particularly Black men. Patients attending classes learned about hypertension, were given blood pressure cuffs to use at home, and had the opportunity to speak to physicians in a group setting. We used a nonexperimental quality improvement intervention design to identify baseline differences between participants who attended multiple classes and those who attended only 1 class. Participants who attended multiple classes, most of whom were Black men, achieved an average blood pressure reduction of 19.1/14.8 mm Hg. Although the classes were effective, current policies around health insurance reimbursement and federal quality reporting standards hamper the ability of health care providers to implement such patient education initiatives.

Improving outcomes and shared decisions in pancreatic cancer using animated pancreas patient (APP) visual formats of learning: A National Pancreas Foundation (NPF) patient education initiative.

e16242 Background: Pancreatic cancer (PC) outcomes continue to be dismal in the United States (US) and worldwide. Efforts are focused on early diagnosis, treatment, and prevention. However, knowledge translation in PC and effective resources that address patient-provider collaborative decisions are limited and barriers to health literacy continue to impede patient understanding. Evidence increasingly supports the need for informative education for patients to facilitate shared decisions in critical cancer interventions. We evaluated the National Pancreas Foundation’s APP, a visual approach to learning, to determine how shared-decision making and patient barriers to health literacy can be improved, leading to better patient-provider decisions and outcomes. Methods: Using visual formats of learning (animations, videos, and slide shows), we monitored APP website and YouTube metrics from September 2013 to February 2021. We evaluated learner activity, number of views with highest retention in US and globally. Results: APP gathered 4,551,079 views (489,091 views on the APP website and 4,061,988 views on YouTube) from over 100 countries. The majority of viewers (60%) were from the US with 54% being patients, 17% family/caregivers, 16% healthcare providers and 13% other. The animations "Understanding Clinical Trials", "Pancreatic Cancer: Treatment and Outcomes", “Pancreatic Cancer: Signs, Symptoms and Risk Factors", and "Pancreatic Cancer: Pathophysiology, Diagnosis and Staging" had 1,372; 4,643; 8,819 and 4,359 views respectively on the website and 180,845; 77,942; 56,151 and 23,112 views respectively on YouTube. Top expert videos viewed most were "What are the different stages of pancreatic cancer?", "What are the symptoms of pancreatic cancer?", “What is a “Placebo” in a clinical trial and is it always used?”, and “What should I expect following surgery to remove a malignant pancreatic cancer tumor?" with 488; 1,558; 76 and 239 views respectively on the website and 14,869; 10,917; 5,206 and 3,624 views respectively on YouTube. Conclusions: Our study suggests visual formats of education are effective in communicating complex health information to persons with poor health literacy. Pancreatic cancer education based on visual formats have vast potential to provide effective learning for patients. Continued efforts should be made to provide resources for patient-provider shared decisions and address patient health literacy barriers for best health outcomes.