Adults experiencing homelessness find learning from pharmacy students about health-related topics effective.

Clozapine remains the definitive gold standard for treatment-resistant schizophrenia despite limitations in use because of hematological abnormalities. Neutropenia or leukopenia are often treated with interruption of clozapine treatment, frequently resulting in clinical decompensation, hospitalization, increased burden to patient care, and increased risk of suicide. Colony-stimulating factors, including granulocyte colony-stimulating factors and granulocyte-macrophage colony-stimulating factors, are cytokines that stimulate proliferation and differentiation of myeloid precursor cells. Their use in the prevention and treatment of clozapine-associated neutropenia presents an alternative to clozapine discontinuation in certain cases. We present a case report of successful periodic granulocyte-macrophage colony-stimulating factor use with clozapine in a patient with treatment-resistant schizophrenia, as well as discussion of a practical approach to patients with possible clozapine-induced neutropenia or leukopenia.

Background In 2016, the Centers for Disease Control and Prevention (CDC) published opioid prescribing guidelines. The literature review identified an association between opioids prescribed for acute pain and an increased risk for long‐term use. Guidelines recommend 3 days or less of therapy in most cases of acute pain. Prescriber education may be necessary. Objective To assess the impact of the CDC opioid prescribing guidelines and targeted prescriber education on postsurgical prescribing. Methods This study was a single‐center, retrospective, observational analysis of adult Veterans admitted for carotid endarterectomy or endovascular aneurysm repair during preguideline, postguideline, and posteducational intervention time frames. Exclusion criteria included chronic opioid use/abuse, hospitalization over 72 hours, and repeat operation. Pharmacists provided education on opioid prescribing during monthly surgery orientation. The primary end point was mean morphine equivalents (MMEs) prescribed at discharge. Secondary end points included distribution across morphine equivalents ranges, the days' supply of opioids prescribed, and percentage prescribed nonopioid therapy. Results MMEs decreased following guideline publication (295.82 MMEs preguidelines vs 160.68 MMEs postguidelines; P = 0.003). After prescriber education, a further absolute reduction in MMEs was seen, although not statistically significant (160.68 vs 139.29; P = 0.810). Days' supply prescribed decreased following guideline publication (8.17 days preguidelines vs 4.71 days postguidelines; P = 0.009); however, no statistical difference was observed posteducation (4.71 vs 3.29 days; P = 0.294). In addition, no difference was found in the percentage of nonopioid therapy prescribed postguidelines (70.83% vs 68.18%; P = 0.988) or posteducation (68.18% vs 64.29%; P = 1.00). Conclusions The 2016 CDC opioid prescribing guidelines likely had an impact on postsurgical opioid prescribing, evident by decreased MMEs and opioid days' supply following guideline publication. Although these end points did not reach statistical significance following prescriber education, the trends suggest clinical significance.

Background: Less than half of adults with mental illness receive mental health services. Several barriers exist to accessing care including stigma and shortage of mental health clinicians. Due to the increasing demand for mental health services, the American health care system has begun moving toward an interprofessional approach.