Objective. To describe a health equity curriculum created for pharmacy students and evaluate students’ perceptions and structural competency after completion of the curriculum. Methods. A health equity curriculum based on transformative learning and structural competency frameworks was implemented as a 10-week mandatory component of the pass-no pass neuropsychiatric theme for second year pharmacy students. Each week, students reviewed materials around a neuropsychiatric-related health equity topic and responded to discussion prompts through asynchronous forums or synchronous online video discussions. The effectiveness of the health equity curriculum was evaluated through assessment of structural competency through a validated instrument, an objective structured clinical examination (OSCE), and a questionnaire. Results. All enrolled second year pharmacy students (n=124) participated in the health equity curriculum. Of the 75 students who completed the structural competency instrument, 46 (61%) were able to identify structural determinants of health, explain how structures contribute to health disparities, or design structural interventions. Ninety-six of the 124 students (77%) were able to address their OSCE standardized patient’s mistrust in the health care system. Thematic analysis of student comments elucidated three themes: allyship, peer connection, and self-awareness. Students rated asynchronous discussion forums as significantly less effective than online video discussions and patient cases for achieving curricular objectives. Conclusion. A mandatory curriculum delivered remotely throughout the didactic pharmacy curriculum using a blended learning approach was an effective way to incorporate health equity content and conversations into existing courses. Implementation of this or similar curriculums could be an important step in training pharmacy students to be advocates for social justice.

Introduction: There are currently no guidelines for switching patients from oral risperidone to paliperidone palmitate (Invega Sustenna®). Furthermore, the paliperidone long-acting injectable (LAI) package insert does not recommend bridging with oral antipsychotics, which may result in inadequate serum concentrations in patients on ≥4 mg/d risperidone. Methods: This study evaluated the effects of suboptimal dosing and bridging in patients switched from oral risperidone to paliperidone LAI on hospitalization days, emergency department (ED)/mental health urgent care visits, and no-shows/cancellations to mental health appointments. Patients were categorized into optimal or suboptimal dosing based on their loading and maintenance paliperidone doses. Patients on risperidone ≥4 mg/d were categorized as bridged if they received risperidone for ≥7 days after the first paliperidone injection. Results: There were no significant differences in outcomes between optimally and suboptimally dosed patients. There were statistically significant reductions in hospitalization days in patients who were bridged compared with patients who were not bridged. There were statistically significant reductions in hospitalization days and ED/mental health urgent care visits after switching to paliperidone LAI. Discussion: The results of this study indicate that bridging patients who are on ≥4 mg/d risperidone, when converting to paliperidone LAI, is associated with reductions in hospitalization days. However, more research is required to determine the optimal dose and duration of the bridge. The results also indicate that switching patients from oral risperidone to paliperidone LAI, even if the dose is suboptimal, is associated with reductions in hospitalization days and ED/mental health urgent care visits.

The prevalence of smoking among young adults aged 19–28 years old in the United States persists at rates of 14.3%. Young adults underutilize pharmacotherapy for smoking cessation, and the use of e-cigarettes has increased. We analyzed comments from online smoking-cessation support groups to understand young-adult smokers’ views of pharmacotherapy and e-cigarettes, to provide a more in-depth insight into the underutilization of pharmacotherapy. A qualitative analysis was performed on comments about pharmacotherapy and e-cigarettes from participants enrolled in online smoking-cessation support groups in 2016–2020. A codebook was developed with a deductive approach to code the comments, followed by thematic analysis. Eighteen themes were identified, with four dominant themes: interest, benefit, knowledge, and flavor. Participants expressed less interest in both nicotine-replacement therapy and e-cigarettes; moreover, they expressed unfamiliarity with and misconceptions about pharmacotherapy, and recognized the enticing flavors of e-cigarettes. Participants often felt e-cigarettes were not useful for smoking cessation, but the flavors of e-cigarettes were appealing for use. Participants had mixed opinions about the use of e-cigarettes for smoking cessation, but predominantly felt e-cigarettes were not useful for smoking cessation. The use of social media may be an effective way to address misconceptions about pharmacotherapy for smoking cessation and increase willingness to accept assistance.