Data from the CDC on heart disease in the United States found that the population’s susceptibility to heart disease varies depending on the state and county, according to an analysis from ValuePenguin.

ValuePenguin consolidated the CDC’s state and county information for middle-aged adults between aged 45 and 64 years, as well as seniors to break down the effects that heart attacks, coronary heart disease, hypertension, and stroke have on communities across the country. The most recent data was compiled from deaths per 100,000 residents, from 2016 to 2018. The databases also provided information on the cost of Medicare, the number of uninsured Americans, and those living in poverty.

The analysis showed that people living in the South are disproportionately affected by fatal heart conditions, including heart attacks, hypertension, coronary artery disease, and strokes. Further, heart disease is responsible for more fatalities relative to population in the South than the rest of the country, with the rate of fatal cases being nearly 1/8 higher than average.

Of all the states, Mississippi had the highest rate of deaths from all forms of heart disease relative to its population, with 301 fatal cases of heart disease per 100,000 people. Arkansas led the country in fatal heart attacks and coronary heart disease, where the rate at which people died from heart attacks was triple the country’s average, according to the analysis.

In Oklahoma, hypertension killed 123% more people than average, whereas people in Mississippi were the most likely to die from strokes, though its population had only a 38% greater chance of experiencing a fatal stroke than the rest of the country.

The analysis also found that men have a much greater risk than women of dying from heart disease and are approximately 3 times as likely as women to die from coronary heart disease or a heart attack.

Additionally, the CDC found that Black Americans were more likely to die from heart disease than other groups. Compared to the average of all other races, middle-aged Black men and women were more than 2 times more likely to die from hypertension and strokes.

In 9 of the 10 counties with the highest proportion of cardiovascular deaths, more than 20% of residents were below the poverty line, according to the analysis. Lack of access to health care can be another problem facing areas that have notably high rates of cardiovascular deaths. Of the 10 counties most at risk of fatal cases of heart disease, there were 4 counties with 0 hospitals. While the number of uninsured residents in the most at-risk counties is mostly aligned with the national average, the cost of Medicare per capita is higher than average in 6 of 10.

Heart disease kills 13% more people than average in the southern United States. ValuePenguin. Published September 14, 2020. Accessed September 23, 2020. 

https://www.valuepenguin.com/who-is-at-risk-of-heart-disease

Articles

The databases also provided information on the cost of Medicare, the number of uninsured Americans, and those living in poverty.







Study: Heart Disease Kills 13% More People in the South Than US Average

Lactic acid, citric acid, and potassium bitartrate (Phexxi, Evofem Biosciences) is a prescription combination, non-hormonal contraceptive gel approved by the FDA in May 2020. The vaginal gel was found to be 86.3% effective with typical use when inserted up to 1 hour before vaginal intercourse.



The gel acts as a contraceptive by maintaining the vaginal pH within its normal range of 3.5 to 4.5, an environment too acidic for sperm to survive. This pH regulating mechanism decreases sperm viability and supports bacteria integral to the vaginal microbiome.



The gel is supplied in a package of twelve, single dose (5 grams), pre-filled applicators with an attachable plunger. The applicator should be inserted into the vagina immediately before or up to 1 hour before vaginal intercourse, with a new dose needing to be administered prior to each act of intercourse.



The most common adverse events (AEs) were vulvovaginal burning (20%) and vulvovaginal itching (11.2%). Of local AEs, 23.9% were mild, 18.7% were moderate, and 2.3% were severe. Rates of these reactions mostly decreased over time.



Women with a history of recurrent urinary tract infections or urinary tract abnormalities should not use the gel due to the 0.36% incidence of cystitis or pyelonephritis in clinical trials.



Male partners of women using the gel might also experience local AEs such as burning, itching, and pain. However, the local AEs experienced by male partners were generally mild (74.7%), while 21.4% were moderate and 3.9% were severe.



The contraceptive gel is an option for women who are seeking a non-hormonal or on-demand method of birth control. Women preferring to use multiple methods of contraception can combine the gel with diaphragms and latex, polyurethane, and polyisoprene condoms. However, it should not be used with vaginal rings.



Spermicide is also available as a vaginal gel, but it is only about 72% effective with typical use.

 Like the non-hormonal contraceptive gel, it can be used on-demand. Nonoxynol-9, the active ingredient in most spermicides, can cause vaginal irritation and increase the risk of HIV transmission.

 In a clinical trial comparing nonoxynol-9 to the , incidences of vulvovaginal itching, burning, and irritation were similar, with the non-hormonal contraceptive gel having a slightly higher incidence of vulvovaginal burning.



The contraceptive gel’s novel pH modulating mechanism is currently being studied for prevention of gonorrhea and chlamydia in the phase 2B clinical trial AMPREVENCE. Preliminary results from the 4-month study period showed a 50% relative risk reduction of chlamydia and a 78% relative risk reduction of gonorrhea. The clinical trial will move on to phase 3 later in 2020.



Although the gel will be available as a prescription only treatment in September 2020, patients may face barriers to accessing the gel during COVID-19. Evofem Biosciences plans to launch a telemedicine program to support patient and provider access to the contraceptive gel.

 Additionally, barriers to contraception access could be further mitigated by enabling pharmacists to prescribe birth control.



Thomas MA, Chappel BT, Maximos B, Culwell KR, Dart C, Howard B. A novel vaginal pH regulator: results from the phase 3 AMPOWER contraception clinical trial. 

Phexxi. Prescribing information. Evofem Biosciences; 2020. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208352s000lbl.pdf

https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/spermicide/index.html

FDA. Code of Federal Regulations Title 21; April 1, 2019. 

https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?fr=201.325

Study of Contraceptive Efficacy & Safety of Phexxi™ (Previously Known as Amphora) Gel Compared to Conceptrol Vaginal Gel; March 11, 2020. 

https://clinicaltrials.gov/ct2/show/results/NCT01306331

Evofem Biosciences Reports Positive Top-Line Results from Phase 2b Study of Amphora® for Prevention of Chlamydia and Gonorrhea in Women. Evofem Biosciences; December 2, 2020. 

https://evofem.investorroom.com/2019-12-02-Evofem-Biosciences-Reports-Positive-Top-Line-Results-from-Phase-2b-Study-of-Amphora-R-for-Prevention-of-Chlamydia-and-Gonorrhea-in-Women

U.S. FDA Approves Evofem Biosciences' Phexxi™ (lactic acid, citric acid and potassium bitartrate), the First and Only Non-Hormonal Prescription Gel for the Prevention of Pregnancy. Evofem Biosciences; May 22, 2020. 

https://evofem.investorroom.com/2020-05-22-U-S-FDA-Approves-Evofem-Biosciences-Phexxi-TM-lactic-acid-citric-acid-and-potassium-bitartrate-the-First-and-Only-Non-Hormonal-Prescription-Gel-for-the-Prevention-of-Pregnancy

Lactic acid, citric acid, and potassium bitartrate is a prescription combination, non-hormonal contraceptive gel found to be 86.3% effective with typical use.

New Non-Hormonal Contraceptive Gel Found to Be Effective

Walgreens won the ‘Digital/Mobile Health Solutions’ category in the Fierce Innovation Awards - Healthcare Edition 2020. The annual competition highlights companies that demonstrated innovative solutions that have had the greatest potential to save money, engage patients, or revolutionize the industry over the past year, according to a press release.

The company’s digital health platform, Walgreens Find Care®, helps patients navigate their health care experience virtually, including by accessing convenient in-person and virtual doctor visits to manage chronic conditions. Patients are able to access more than 40 trusted providers that together offer more than 60 services and treat more than 100 conditions.

Walgreens Find Care® can flex and expand to meet emerging and current societal and health issues, according to an email sent to 

 For example, during the coronavirus disease 2019 (COVID-19) pandemic, Walgreens was able to expand the Walgreens Find Care® platform to include new features and telehealth service providers. With guidance from the CDC, the app was able to perform the following tasks:

Help patients connect with a Walgreens COVID-19 testing site.

Allow users to assess their risk for having COVID-19 through the use of a COVID-19 risk assessment tool based on CDC guidelines.

Guide individuals to relevant COVID-19 clinical trials in their area by using the Find My Clinical Trial program.

“We are honored to win this award for the innovative ways Walgreens helps make healthcare simpler, more accessible and more convenient,” said Giovanni Monti, senior vice president of healthcare services of Walgreens Boots Alliance, in a press release. “As a company focused on providing omni-channel solutions that address barriers to healthcare, we have designed Walgreens Find Care® to be the digital ‘front door’ to an integrated healthcare and pharmacy experience. Our goal is that Americans in all communities have convenient access to personalized, high-quality care that helps them lead healthier and happier lives.”

Walgreens Find Care wins Fierce Innovation Award [email]. Sent September 14, 2020. Accessed September 21, 2020.

Walgreens Find Care® receives high honors from Fierce Healthcare. Walgreens. 

https://news.walgreens.com/press-releases/general-news/walgreens-find-care-receives-high-honors-from-fierce-healthcare.htm

. Published September 14, 2020. Accessed September 21, 2020.

Walgreens won the ‘Digital/Mobile Health Solutions’ category in the Fierce Innovation Awards - Healthcare Edition 2020. 

Walgreens Receives Honor for Digital and Mobile Health Solutions in Fierce Innovation Awards 2020

The FDA has approved fluticasone furoate, umeclidinium, and vilanterol (Trelegy Ellipta, GSK) for use in adults with asthma that remains uncontrolled despite treatment with their current maintenance therapy. This is the first and only, once-daily single inhaler triple therapy approved for the treatment of both asthma and chronic obstructive pulmonary disease (COPD), according to GSK.

Andrew Thomas, vice president of Respiratory Business Unit at GSK, said this approval holds major significance for adults with uncontrolled asthma despite treatment with their current maintenance therapy. Due to the challenges that physicians may face to train their patients and prepare them for treatments, as well as the struggle for patients to remember how to take the treatment, this therapy will make a difference.

“There have been multiple inhaler triple therapies used in asthma previously, with a combination of at least 2 inhalers with different dosing regimens,” Thomas said in an interview with 

. “With Trelegy Ellipta, it is only one inhalation a day in a triple therapy.”

The approval was based off the results of the CAPTAIN study conducted in adults 18 years of age and older whose asthma was inadequately controlled despite treatment with ICS/LABA maintenance asthma medication.

The data showed that in patients with uncontrolled moderate or severe asthma on inhaled corticosteroid plus long-acting β 2-agonists, adding umeclidinium improved lung function but did not lead to a significant reduction in moderate and/or severe exacerbations. Further, these patients are recommended to use the single inhaler fluticasone furoate, umeclidinium, and vilanterol due to its favorable, high-risk benefit profile.

Thomas mentioned that not only is this treatment more convenient, but it is 100 ml of improvement in lung function to help patients feel better, breathe easier, and live a fuller life with their asthma.

“We hope that with the addition of these new indications that more adult asthmatics in the United States can get control of asthma symptoms and live better lives because of this, and the same goes for COPD patients,” Thomas said in an interview with 

. “Having this inhaler should make a big difference in the lives of those patients.”

GSK’s Trelegy Ellipta the First Once-Daily, Single Inhaler Triple Therapy Approved for Asthma [email]. Accessed September 18, 2020.

Lee LA, Bailes Z, Barnes N, et al. Efficacy and safety of once-daily single-inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with inadequately controlled asthma (CAPTAIN): a double-blind, randomised, phase 3A trial. The Lancet Respiratory Medicine. Doi:

https://doi.org/10.1016/S2213-2600(20)30389-1

This is the first and only, once-daily single inhaler triple therapy approved for the treatment of both asthma and chronic obstructive pulmonary disease (COPD).

FDA Approves Trelegy Ellipta as First Single Inhaler Triple Therapy for Asthma

the Monitoring the Future (MTF) study showed that vaping marijuana and nicotine rose sharply in the past 3 years among college age students, or students between 19 and 22 years of age, according to a press release.

The percentage of college students who said they vaped marijuana in the past 30 days grew from 5.2% in 2017 to 14% in 2019. Additionally, the corresponding percentages for their non-college-attending peers increased from 7.8% in 2017 to 17% in 2019. 

MTF is an ongoing study of the trends in substance use by adolescents and adults in the United States, with the survey conducted by scientists at the University of Michigan’s Institute for Social Research.

The study showed that the percentage of college-age adults between 19 and 22 years of age who vaped nicotine also rose dramatically between 2017 and 2019. In 2017, 6.1% of college students and 7.9% of those not in college said they vaped nicotine in the past month, increasing to 22% and 18% in 2019, respectively. These increases in vaping marijuana and nicotine are among the largest seen for any substance use reported by the study in its 45-year history, according to the study authors.

“We are seeing an increasingly concerning trend,” said Nora D. Volkow, MD, director of NIDA in a press release. “Many young people may view vaping and cannabis use as ‘safer’, but the reality is that nicotine is highly addictive, and cannabis can also be addictive, particularly in younger adults for whom the brain is still developing.”

The results are based on data from college students 1 to 4 years beyond high school graduation who are enrolled full-time in a 2- or 4-year college in March of the given year, compared with same-age high school graduates not enrolled full-time in college.

The 2019 data also revealed a continuing high prevalence of marijuana use among 

young adults, who are 19 to 22 years of age. In 2018, 43% of this group reported using marijuana in the past year, with this percentage being unchanged in 2019. The prevalence of daily or near-daily use of marijuana (15%) was significant among those not attending college in 2019. This is compared to 5.9% of college students who reported daily or near-daily use of marijuana.

Other highlights in the survey results include the downward trend of cigarette smoking in college students, with only 7.6% of respondents reporting having smoked in the past month. Further, binge drinking has been declining gradually over the past few decades, showing no significant changes for young adults attending or not attending college. Prescription opioid misuse and amphetamine use are also shown to be on a continued decline for college students, according to the study authors.

Vaping, marijuana use in 2019 rose in college-age adults. NIH. 

https://www.nih.gov/news-events/news-releases/vaping-marijuana-use-2019-rose-college-age-adults

. Published September 15, 2020. Accessed September 16, 2020.

The 2019 survey results from the Monitoring the Future (MTF) study showed that vaping marijuana and nicotine rose sharply in the past 3 years among college age students, or students between 19 and 22 years of age.

National Study Shows Vaping, Marijuana Use in 2019 Rose in College-Age Adults

 interviewed Amanda Bowles, the director of the Shopper Science Lab at GSK Consumer Healthcare, on the expansion of coverage eligibility for OTC and menstrual products by health savings accounts (HSAs) and flexible spending accounts (FSAs) this year following the passage of the CARES Act.

The discussion included how this change affects Americans, the duration of the expansion, the role of FSAs and HSAs in the lives of Americans thus far, and the difference between FSAs and HSAs and what that may mean for account holders this year.

“We know that households today spend on average more than $400 a year on OTC products. In fact, the latest number I saw was $442 a year on average. So, if these purchases are made entirely through a tax-advantaged account, the average family could realize some measurable tax savings,” said Bowles. “Being able to use this pre-tax money for OTCs might mean that someone can afford to stock up on the products that they want to have on hand going into the cold and flu season or to plan ahead for their digestive health or pain management needs. It really puts the consumer in better control of their health and their health care spending.”

Bowles also discussed where pharmacists can go to see a complete list of what is covered and isn’t covered now by FSAs and HSAs, how the expansion of OTC eligibility helps to support the health care system during the coronavirus disease 2019 pandemic, how the expansion of eligibility benefits pharmacies, and what the value of a pharmacist is in the education of consumers about eligibility changes when they occur.

Videos

Contemporary Clinic® interviewed Amanda Bowles, the director of the Shopper Science Lab at GSK Consumer Healthcare, on the expansion of coverage eligibility for OTC and menstrual products by health savings accounts and flexible spending accounts this year following the passage of the CARES Act.

OTC Products Are Now Covered by HSAs and FSAs Under CARES Act

Today, the Department of Health and Human Services (HHS) and Department of Defense (DoD) announced a deal with Moderna, Inc, to manufacture and deliver 100 million doses of the manufacturer’s 

.

Moderna will manufacture these vaccine doses, which will be owned by the US government, as clinical trials are conducted simultaneously. In a press release, the DoD and HHS said that manufacturing the vaccine while clinical trials are ongoing will expedite the traditional development timeline.

If the vaccine doses are used as part of a COVID-19 vaccination campaign, it would be available to Americans at no cost; however, health care providers may charge for the cost of administering the vaccine, according to the HHS.

This initiative will also bolster the US government’s Operation Warp Speed, which aims to begin delivering safe and effective COVID-19 vaccines to the US population by the end of 2020.

“In creating a vaccine portfolio for Operation Warp Speed, the Trump Administration is increasing the likelihood that the United States will have at least 1 safe, effective vaccine by 2021,” said HHS Secretary Alex Azar, in a press release. “Today’s investment represents the next step in supporting this vaccine candidate all the way from early development by Moderna and the National Institutes of Health, through clinical trials, and now large-scale manufacturing, with the potential to bring hundreds of millions of safe and effective doses to the American people.”

Should the vaccine be approved by the FDA, doses of the vaccine will be distributed and administered as part of a COVID-19 vaccination campaign, according to the press release.

The Biomedical Advanced Research and Development Authority worked in conjunction with the DoD Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense and Army Contracting Command to provide up to approximately $1.5 billion in funding to produce and deliver the vaccine to government-designated locations across the country, the agencies stated in a press release. Additionally, the US government can acquire up to 400 million additional doses of the vaccine.

The agencies also announced that fill-finish manufacturing will be conducted in US-based facilities, which will ensure the vaccine doses are packaged and ready to ship immediately, subject to successful clinical trials and FDA authorization.

May, Moderna, Inc, announced a collaboration with Lonza Ltd

, to manufacture the mRNA vaccine (mRNA-1273) candidate, for immunization against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on a larger scale.


Over time, the companies plan to maintain additional production sites at Lonza’s facilities internationally, which should allow for the companies to develop to up to 1 billion doses of mRNA-1273 per year, they announced in a 

The mRNA-1273 vaccine was selected by Moderna in collaboration with investigators from Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, a part of the National Institutes of Health (NIH). The first clinical batch was finished on February 7, 2020, and underwent analytical testing at that time. That first batch was then shipped to NIH on February 24, which was 42 days following the sequence selection.

Moderna submitted an Investigational New Drug application to the FDA for phase 2 and late stage studies of mRNA-1273 on April 27, 2020.

A phase 3 clinical trial that began on July 27 is the first government-funded phase 3 clinical trial for a COVID-19 vaccine in the United States.

This article was originally published by Pharmacy Times. 

Moderna will manufacture doses of its experimental coronavirus disease 2019 vaccine candidate as clinical trials are ongoing to expedite the production process.  

100 Million Doses of Experimental COVID-19 Vaccine to be Produced Under New US-Moderna Deal

Officials with the FDA have approved the opioid olicerdine (Olinvyk, Trevena) for intravenous (IV) use in the hospital setting.

Olicerdine is indicated for patients with severe pain who require an IV opioid when alternative treatments prove to be inadequate, according to the press release. It is only approved for short-term IV use in a controlled clinical setting and is not approved for at-home use.

In a controlled, open label trial, 1535 patients were treated with olicerdine. The patients were living with moderate to acute pain after undergoing a bunion or abdominal surgery. Safety and efficacy were established by comparing the opioid against a randomized placebo.

The recommended daily dose limit of olicerdine is 27 mg. Patients who received olicerdine reported a decrease in pain compared with the placebo. According to the press release, olicerdine has a safety profile that is similar to other opioids.

“Addressing the opioid crisis remains a top priority for the FDA. We will continue to do everything we can to reduce the number of Americans who are addicted to opioids and cut the rate of new addiction through a number of cross-agency initiatives…Importantly, the FDA will only approve new drug applications, including those for opioid medications, following a rigorous review to evaluate the risks and benefits and ultimate determination that the data support safety and effectiveness,” Deputy Director for Regulatory Programs in the FDA’s Center for Drug Evaluation and Research, Douglas Throckmorton, MD, said in the press release.

Common adverse reactions were nausea, vomiting, dizziness, headache, and constipation, which is similar to other opioids. According to the press release, olicerdine should not be administered in an unmonitored setting to patients with significant respiratory depression or severe bronchial asthma.





FDA Approves New Opioid for Intravenous Use in Hospitals, Other Controlled Clinical Settings (News Release), White Oak, MD, August 10, 2020, FDA, Accessed August 10, 2020

The FDA has approved olicerdine (Olinvyk, Trevena) for use in patients with severe pain who require an IV opioid when alternative treatments prove to be inadequate. 

FDA Approves New Opioid for Intravenous Use in Hospital Setting

Contemporary Clinic spoke with Jessica Peck, president of National Association of Pediatric Nurse Practitioners (NAPNAP), about COVID-19's affect on the organization and her hopes for the future of NAPNAP.

COVID-19 has effected NPs on a 9/11 scale, according to Peck. "We have found ourselves really in the epicenter of this worldwide crisis, but the good news is we are ideally situated as nursing leaders to engage and equip communities," Peck said. 

According to Peck, the most important part of being a nurse pracitioner is owning your expertise with the various skillsets that NPs have. 

Peck hopes to see the future of NAPNAP continue to grow with its various resources, advocates, and partners. 

The Most Important Part of Being a Nurse Practitioner

New research has found that the risk of reporting a positive test for coronavirus disease 2019 (COVID-19) was greater among front-line health care workers in the United Kingdom and United States, according to a study published by 

The objective of the study was to assess the risk of COVID-19 among front-line health care workers compared with the general community and the effect of personal protective equipment (PPE) on that risk.

The researchers conducted an observational cohort study in the UK and the US of the general community, including front-line health care workers, using self-reported data from the COVID Symptom Study smartphone application from March 24 (UK) and March 29 (USA) to April 23, 2020, according to the press release.

Participants were voluntary users of the app who provided information during their first use of the app on demographic factors, including age, sex, race or ethnic background, height and weight, occupation, and medical history. Further, the participants subsequently reported any COVID-19 symptoms.

The researchers used Cox proportional hazards modeling to estimate multivariate-adjusted hazard ratios (HRs) of the primary outcome, which was a positive COVID-19 test, according to the study.

Among the 2,035,395 community individuals and 99,795 front-line health care workers, the researchers recorded 5545 incident reports of a positive COVID-19 test over 34,435,272 person-days. Front-line health care workers were at an increased risk for reporting a positive COVID-19 test compared with the general community.

An inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test to account for differences in testing frequency between front-line health care workers and the general community, according to the study. In addition, secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.

The study concluded that health care systems should ensure adequate PPE and develop additional strategies to protect health care workers from COVID-19, particularly those from black, Asian, and minority ethnic backgrounds. The researchers noted that additional follow-up of these observational findings is needed.

Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID-19 among front-line health care workers and the general community: a prospective cohort study. 

https://doi.org/10.1016/S2468-2667(20)30164-X

Study finds that health care systems need to develop additional strategies to protect workers from COVID-19.

Study: UK, US Health Care Workers Report Higher Rates of COVID-19 Compared with General Population Early in Pandemic

Retail pharmacy health and wellness services are becoming the center of consumer health care, with increases seen in both satisfaction and consumer spending, according to the J.D. Power 2020 US Pharmacy Study.

Some of the key findings of the study include the growth of health and wellness services, as nearly 48% of retail pharmacy customers have used at least 1 health and wellness-oriented service provided by their pharmacy this year, up a significant 5% from 2019. In addition, overall customer satisfaction with the retail pharmacy is 26 points higher among customers who use health and wellness services versus those who have not.

The study also found that a deeper penetration into primary care drives increased satisfaction and spending. Customers who use at least 1 health and wellness-oriented service provided by their pharmacy spend an average of $11 more per customer than those who do not use these services.

Further, when customers use 2 or more health and wellness-oriented services, that spend average spend climbs up to $58. Among customers who use 2 or more health and wellness-oriented services, the overall satisfaction rate jumps to 907 points versus 861 for those who do not use any service.

Although the survey found that digital ordering drives high levels of satisfaction, utilization remains low, with just 9% of brick-and-mortar pharmacy customers ordering their prescriptions via digital channels. Overall satisfaction among those customers who do order digitally through a brick-and-mortar pharmacy is 859 points, which is 5 points higher than among those who only visit the store in person.

In contrast, mail-order pharmacy customers are far more frequent users of digital ordering, with 32% ordering prescriptions via digital channels. Mail-order digital customers have an even high level of satisfaction, with an overall satisfaction score of 867.

Key influencers are important to health and services utilization, according to the survey. Physician recommendations for pharmacy-delivered health and wellness services are associated with an 80% utilization rate, and recommendations from friends and family are associated with a 75% utilization rate. However, only 8% of customers say they have received a recommendation from their doctor, and 9% have received a recommendation from friends and family.

The most common means of hearing about these pharmacy services is in-store advertising, which drives a 45% utilization rate.

As for brick-and-mortar chain stores, Good Neighbor Pharmacy ranks highest for the fourth consecutive year with a score of 915, while Health Mart ranks second (905), and Rite Aid ranks third (861). However, Sam’s Club ranks the highest for the fifth consecutive year with a score of 885 for brick-and-mortar mass merchandiser pharmacies, followed by Costco and CVS/pharmacy inside Target (each scored an 870).

Among brick-and-mortar supermarket pharmacies, Wegmans ranks the highest for the third consecutive year with a score of 904, with Publix ranked second (889), and Winn-Dixie ranked third (883).

Humana Pharmacy ranks highest in the mail order segment for the third consecutive year, with a score of 904. OptumRx ranked second with a score of 886, followed by Kaiser Permanente Pharmacy ranked third with a score of 883.






Recent Retail Pharmacy Health and Wellness Services Offer Glimpse into Future of Healthcare, J.D. Power Finds [news release]. J.D. Power website. 

https://www.jdpower.com/business/press-releases/2020-us-pharmacy-study

. Published August 5, 2020. Accessed August 6, 2020.



The J.D. Power 2020 US Pharmacy Study has revealed that 5% more customers used at least 1 health and wellness service at a retail pharmacy than in 2019. 

J.D. Power Study Finds Health and Wellness Services Growing at Retail Pharmacies

The FreeStyle Libre 2 iCGM aims to help patients with diabetes manage their condition and to share health data with care providers.

Abbott’s FreeStyle Libre 2 integrated continuous glucose monitoring (iCGM) systemis now available, according to the company.1 The system is available by prescription at participating pharmacies and durable medical equipment suppliers across the United States.2

The device was approved by the FDA in June 2020.1,2 It is indicated for adults and children ages 4 years and older with diabetes.2

The FreeStyle Libre 2 next-generation sensor is worn on the back of the upper arm for 14 days is a third less bulky than other CGM sensors, according to Abbott. It allows patients with diabetes to view their glucose reading, trend arrow, and 8-hour history with a 1-second scan through a handheld reader.2

This new system is designed to help people manage their condition, and it facilitates sharing health data with their doctors. According to Abbott, this technology is critical to achieving better outcomes and more efficient, safe telehealth visits.1

Abbott is offering the new system at the same price as the previously made available FreeStyle Libre 14-day system, a cost that is about 70% less than other CGMs currently available, according to the company.1

Murphy C. Abbott’s FreeStyle Libre 2 is Now Available. Abbott email. Sent July 30, 2020. Accessed August 4, 2020.

Coppock K. FDA Approves FreeStyle Libre 2 iCGM System for Patients With Diabetes. 

. pharmacytimes.com/news/fda-approves-freestyle-libre-2-icgm-system-for-patients-with-diabetes. Published June 15, 2020. Accessed August 4, 2020.

A new integrated continuous glucose monitoring system that aims to help patients with diabetes manage their condition and to share health data with care providers is now available.

New Integrated Continuous Glucose Monitor Available to Patients With Diabetes

Contemporary Clinic spoke with Jessica Peck, president of National Association of Pediatric Nurse Practitioners (NAPNAP), about the organization and the key issues surrounding pediatric nurse practitioners.

Peck described the story of how NAPNAP began, including how the organization is continuing to spread across the globe. Established in 1973, NAPNAP is the first organization to target pediatric nurse practitoners, according to Peck. 

As for the issues surrounding pediatric-focused nurse practitioners, Peck said that nurse practitioners have a professional and moral imperative to serve as leaders in difficult conversations, such as issues of child health and the impacts of the coronavirus 2019 (COVID-19) or the impacts of racism in child health. 

Key Issues Surrounding Pediatric Nurse Practitioners

The American Cancer Society (ACS) is renewing a campaign to eliminate human papillomavirus (HPV) cancers as a public health problem, starting with cervical cancer. Renewal of the campaign, 

 is an effort to boost public health and help keep vaccinations on track during the coronavirus disease 2019 (COVID-19) pandemic.

The ongoing pandemic has created unprecedented challenges for health care providers, patients, and policymakers. One outcome from the past few months is declines in vaccination. A recent report published by the nonprofit Commonwealth Fund showed a 71% drop in health care visits for individuals aged 7 to 17 years. These are ages when critical vaccines such as Tdap, HPV, and meningitis are given, and immunization declines put children and communities at greater risk for outbreaks of vaccine-preventable diseases, according to the ACS.

HPV is a common virus that can cause 6 types of cancer. About 14 million people in the United States become infected with HPV each year. Eight of 10 people will get HPV at some point in their lifetime. Most infections become undetectable, but some can go on to cause cancer. HPV infection has no treatment, but a vaccine can prevent it.

"Just 2 doses of this vaccine, given to kids at age 9-12, can prevent over 90% of HPV cancers," said Debbie Saslow, PhD, managing director, HPV & GYN Cancers for the ACS, in a prepared statement.

HPV vaccination works best when given between ages 9 and 12 years. Vaccination at the recommended ages will prevent more cancers than vaccination at older ages. Children and young adults aged 13 through 26 years who have not been vaccinated, or who haven't gotten all their doses, should get the vaccine as soon as possible. Both boys and girls can get infected with HPV. HPV vaccination helps protect boys from cancers of the throat, penis, and anus later in life. HPV vaccination helps protect girls from cancers of the cervix, throat, vagina, vulva, and anus later in life.

 is to reach a vaccination rate in the United States of 80% of individuals aged 13 years by 2026.

The American Cancer Society Campaign Aims to Increase HPV Vaccination During Pandemic [news release]. August 3, 2020; Atlanta, GA; ACS website. 

http://pressroom.cancer.org/2020-08-03-The-American-Cancer-Society-Campaign-Aims-to-Increase-HPV-Vaccination-During-Pandemic

Vaccinations have declined during the COVID-19 pandemic, but an American Cancer Society aims to boost HPV immunization for cancer prevention with a renewed campaign. 

American Cancer Society Aims to Boost HPV Vaccination

Implementing a communication activity between students in doctorate nurse practitioner (DNP) programs and in pharmacy programs can encourage student growth while preparing them for future interprofessional work.

Jeremy Daniel, PharmD, BCPS, BCPP, and Alex Middendorf, PharmD, MBA, discussed the interprofessional education activity currently used at their institution, the South Dakota State University (SDSU) College of Pharmacy and Allied Health Professions.

A well-designed activity fulfills elements from the 2016 standards from the Accreditation Council for Pharmacy Education (ACPE) as well as the Center for the Advancement of Pharmaceutical Education (CAPE) standards and meets requirements from the Core Entrustable Professional Activities (CEPA).

For example, Daniel said the activity implemented at SDSU fulfills standard 11 of the ACPE standards by preparing students for effective interprofessional communication. Those standards also specify that these activities can be simulations, such as the SDSU activity. CAPE outcomes also emphasize interprofessional work and specifies that students should be prepared for effective verbal and nonverbal communication when interacting with an individual, group, or organization.

Finally, Daniel said CEPA requirements outline exactly what is required and can be a valuable tool for faculty members looking to develop an interprofessional communication activity. By participating in CEPAs, students should be able to collect information to identify medication-related problems and health-related needs; analyze that information to determine the effects of therapy; determine the appropriate care plan and coordinate with patients, caregivers, and other health professionals; and collaborate as a member of an interprofessional care team.

Middendorf said the SDSU program is designed to satisfy all of these requirements and to prepare students for interprofessional work. In the activity, the pharmacy student receives a case that includes 2 major problems and 2 minor problems. Major problems are defined as those that must be addressed immediately, whereas minor problems will not have a dangerous, immediate effect on the patient.

The students have 10 minutes to review the information before logging into a Zoom meeting also attended by the DNP student and pharmacy faculty. Notably, the pharmacy and DNP student have different pieces of information about the case, requiring them to communicate quickly and effectively.

The students complete the case together in approximately 5 minutes. Once they have established the problems and recommendations, the DNP student leaves the Zoom meeting and contacts their faculty member, who acts as the patient. One case is discussed via phone and 2 cases are discussed via email in an effort to simulate telemedicine situations.

Finally, the pharmacy student receives direct feedback from the pharmacy faculty, using a rubric comprised of rated and open-ended questions. The faculty are provided with key clinical information and preferred recommendations, in case they are less familiar with the specific problems presented in the case.

Relatively simple activities such as this not only enable students to actively engage in the material and encourage self-reflection, but Middendorf emphasized that they are also essential to preparing students to be active participants in an interprofessional care team.

Daniel J, Middendorf A. Development, Implementation, and Evolution of a Pharmacy and Nurse Practitioner Student Interprofessional Communication Activity. Presented at: American Association of Colleges of Pharmacy Virtual 2020 Meeting; July 13-31, 2020. 

https://virtualpharmed2020.aacp.org/meetings/virtual/KXZNoqHePGE3WPhGx

Implementing a communication activity between students in pharmacy programs and in doctorate nurse practitioner programs can encourage student growth while preparing them for future interprofessional work.

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