Objectives: To assess student perceptions of a student-initiated note-taking service (NTS) upon implementation of a NTS in the first professional year of the Doctor of Pharmacy curriculum in a college of pharmacy. Method: A survey instrument assessing perceptions of a NTS was developed and administered to first professional year students (N = 75, 92.6% response rate) prior to the conclusion of the first semester in which the student-initiated service was implemented. Topics addressed in the survey instrument included: service quality, perceived impact on course attendance, grades and student-faculty interaction, willingness to pay for services, and percent of time devoted to study materials, including NTS notes. Non-parametric tests were employed to examine student perceptions across demographic characteristics. Results: 41% of respondents indicated they use the NTS. Approximately 38% of respondents perceived the NTS would increase learning and positively influence grades. Overall, the students were divided in their perceptions with large percentages agreeing and disagreeing with a majority of instrument items. Males were more likely to use the service in P2 and P3 years (p = 0.002), more willing to pay for the service (p = 0.013), and less likely to take their own notes (p = 0.002). Students who used the service estimated lower semester GPAs than those who did not (p = 0.025). Implications: This exploratory study indicated significant variation in student perceptions regarding the NTS. Future research is warranted to better understand both positive and negative aspects of service implementation, particularly as they relate to student learning.

Purpose: This study seeks to determine the incidence of vancomycin-resistant enterococci (VRE) infection in high-risk neutropenic fever patients colonized with VRE and to determine patient characteristics associated with VRE infection. Methods: We conducted a retrospective, single-center, unmatched case-control study. Fifty-three VRE-colonized, high-risk patients with neutropenic fever were identified between January 2006 and February 2009. The two most common diagnoses/conditions included acute myeloid leukemia and hematopoietic stem cell transplantation. Data collected included days of neutropenia, days of fever, demographic data, culture results, and antimicrobial therapy. Results: Twenty of the 53 patients (38%) with VRE colonization developed a VRE infection. The most common VRE infections were bacteremias (26%). The presence of neutropenia lasting longer than 7 days was associated with the development of VRE infection in this high-risk population colonized with VRE. The timeframe to develop VRE infection varied from 1 day to 2 weeks. Conclusion: For patients colonized with VRE, approximately 38% of high-risk neutropenic patients developed a VRE infection. This is the first study to specifically evaluate the incidence of VRE infections in febrile neutropenic patients colonized with VRE. Future research into the use and efficacy of empiric VRE coverage is needed.

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Objectives. We quantified controlled substance donations via permanent drug donation boxes over 2 years in a region with high prescription abuse, assessing medication characteristics, time between dispensing and donation, and weight of medications donated per capita. Methods. In partnership with Drug Enforcement Administration and local law enforcement, we analyzed permanent drug donation box collections in 8 Northeast Tennessee locations from June 2012 to April 2014. We recorded controlled substance dosage units along with the product dispensing date. Results. We collected 4841 pounds of pharmaceutical waste, 4.9% (238.5 pounds) of which were controlled substances, totaling 106 464 controlled substance doses. Analysis of dispensing dates for controlled substances indicated a median of 34 months lapsed from dispensing to donation (range = 1–484 months). The mean controlled substance donation rate was 1.39 pounds per 1000 residents. Communities with fewer than 10 000 residents had a statistically higher controlled substance donation rate (P = .002) compared with communities with 10 000 or more residents. Conclusions. Permanent drug donation boxes can be an effective mechanism to remove controlled substances from community settings. Rural and urban community residents should be provided convenient and timely access to drug disposal options.

Purpose: Nonmedical use of stimulant medications (NMUS) among college students is an important and growing problem. The annual prevalence of NMUS among four-year college students has nearly doubled since 2008 and exceeds NMUS in non-college peers. Community college students are an understudied population regarding NMUS. Given noted NMUS differences in 4-year students and non-college peers, one cannot assume community college students’ cognitions, perceptions, and behaviors mirror either peer cohort. We conducted a web-based survey across 10 community colleges in Tennessee (TN) to assess correlates and consequences of NMUS. Methods: We developed an initial version of the 60-item survey questionnaire using previously validated, theoretically based survey items and other items developed by the research team. The survey instrument was then reviewed and assessed for content validity by our research team, and thereafter pilot tested with East Tennessee State University undergraduate students for range measures, item order, and best practices for survey construction. The final 55-item survey instrument was designed using web-based survey software (i.e., Qualtrics). Ten of 13 community colleges in TN granted approval for their students to participate in the study (N=53096). A modified Tailored Design Method approach was utilized to maximize response rate across four email contacts, and monetary incentives were offered to encourage participation in the study. Regulatory authorities (e.g., institutional review boards, institutional offices) from East Tennessee State University and participating community colleges approved the conduct of this study. Data were analyzed using SPSS (version 22). Descriptive statistics were calculated to evaluate prevalence, source, motives and consequences of NMUS. Student’s t-tests and chi-square tests were conducted to compare nonmedical stimulant users and nonusers across a number of variables. Results were considered significant for p < 0.05. Results: A total of 3113 students completed the survey (response-rate = 5.8%), of which 302 (9.7%) were past-year nonmedical stimulant users. A significantly greater proportion of users were diagnosed with a mental health condition (22.2%) than non-users (9.6%). Compared to non-users, significantly greater proportions of users reported using tobacco products, such as cigarettes (34.5% vs. 14%), e-cigarettes (12.5% vs. 4%), and vapors (18.4% vs. 6.7%). Users further reported using more types of illicit drugs (1.9 ± 0.1), more alcoholic drinks per week (2.9±0.3), and more occasions of binge drinking per month (1.8±0.2) than non-users (1.1±0.02, 1.3±0.07, 0.7±0.04, respectively). Only 14.2% of users (n=43 from 302) reported having prescriptions for prescription stimulants. Common sources of prescription stimulants were friends (62.9%), family members (12.3%), and street suppliers (9.9%). Commonly endorsed reasons for NMUS were ‘to improve academic performance’ (63.9%), ‘to have more energy’ (49.7 %), ‘to relieve tension’ (22.2%), and ‘to feel good or get high’ (16.6 %). Adverse effects resulting from NMUS included: lack of appetite (45.4%), difficulty sleeping (38.4 %), and racing heart (31.1%). Unlike the published findings from 4-year college students, low GPA, male gender, Caucasian race and membership in fraternity organizations were not associated with NMUS in community colleges. Conclusion: The present study provides useful information on characteristics of users and patterns and consequences of NMUS in community colleges students. NMUS appears to be associated with illicit substance use, binge drinking and disrupted mental health in community college students in TN. Friends are the most common source and desire to enhance academic performance is the most salient motive for NMUS. Despite facing adverse consequences, college students continued using stimulants nonmedically. These findings underscore the need for development of public health programs that target prevention of NMUS in community colleges.

The panel laid the foundation for topics discussed during the Summit by noting the historical and current landscape of the opioid epidemic, opportunities for engagement, and why collective partnerships and collaboration are critical to resolving the crisis.

This presentation describes (1) the role of communication in prescription drug abuse prevention and treatment and (2) the outcomes of 5 focus groups conducted in the Appalachian Region.

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Abstract available through the Journal of the American Pharmacists Association.