Specific Aims: As the world population ages, it is vital for all pharmacists to be competent in geriatric medicine. The purpose of this project is to examine Arizona pharmacists’ knowledge level, comfort level (self-efficacy), and attitudes towards older adults with geriatric care and medication management. Methods: Participants were recruited to complete an online survey using the University of Arizona R. Ken Coit College of Pharmacy preceptor listserv, consisting of ~1500 pharmacists. The survey was broken into 3 parts: a comfortability/attitude section using a modified version of Kogan’s attitude towards older people scale, a knowledge section, and a demographic section. Data collection was limited to those who practice only in Arizona. The mean (± standard deviation) score of all participants in the knowledge assessment, as well as the median response for the comfortability/attitude section, were calculated. A Fisher’s exact test was used to determine if there were gender-based differences on the scores from the knowledge section. Results: The survey was completed by 20 men and 31 women, with 32% of all participants having 20+ years of experience. The mean score on the knowledge section was 6.9 ±1.8. Median response in the comfortability section was 4 (scale of 1 to 5), indicating that most felt mostly confident in treating and managing medications for geriatric patients. The median response in the attitude section was of 4 (scale of 1 to 5), indicating that most had a moderately positive attitude towards older adults. There was no statistical significance between gender and scores on the knowledge section (male average = 71%, female average = 67%, p = 0.17). Conclusion: Most pharmacists practicing in Arizona are knowledgeable and comfortable with geriatric care and medication management, and have a positive attitude towards older adults.

Specific Aims: This study aimed to (1) identify the five most frequently reported substance exposures to Arizona Poison and Drug Information Center (AZPDIC) from 2021-2024, (2) estimate healthcare cost savings associated with home management following AZPDIC consultation, and (3) evaluate service utilization by county. Methods: An IRB exempt, retrospective descriptive analysis was conducted using de-identified caller data from AZPDIC spanning January 2021 to December 2024. Data was obtained via QueryBuilder and analyzed using Microsoft Excel. Variables included substance(s) involved, and case outcomes. Analysis of case volume by substance identified the most common exposure types. For cases deemed manageable at home following consultation, estimated cost savings were calculated using average cost of emergency department (ED) visits for unintentional poisonings and the percentage of patients that were recommended to manage the poisoning on-site. Results: The most common unintentional exposure types included scorpion stings, ibuprofen, melatonin, bleaches (hypochlorite), and acetaminophen. 86.7% of cases were safely managed at home, total cost savings was calculated to be $272,636,912. Pima county serves as the largest utilizer of AZPDIC services. Limitations include the utilization of a cost estimate for the average ED visit due to poisoning, use of subjective caller data and the inability to assess cases that did not utilize AZPDIC services prior to presenting to the ED. Conclusion: AZPDIC serves as a valuable resource that enhances public access to drug information and plays a pivotal role in preventing ED visits by providing timely, expert consultation, thus reducing associated healthcare costs.

Specific Aims: To evaluate the impact of the COVID-19 pandemic on opioid overdose trends in Arizona, including differences between urban and rural counties, and to examine patterns in naloxone administration as well as the potential role of pharmacists in harm reduction. Methods: Data were collected from the Arizona Department of Health Services Opioid Dashboard from 2019 to 2024. Opioid-related deaths, non-fatal overdoses, and naloxone administration events were analyzed by year and county. Descriptive statistics and one-way ANOVA were used to assess differences in overdose and fatality rates across counties and years. Due to insufficient data, Greenlee and La Paz counties were excluded from the county-level analysis. Results: Naloxone administration peaked in 2022 (n=8346) and decreased in 2024 (n=6737), nearing 2019 pre-pandemic levels (2019 n=6413). Opioid-related deaths per 100,000 varied by year, rising from a mean of 14.6 in 2019 to 25.9 in 2022, then declining to 18.0 in 2024. Non-fatal overdose rates increased during the pandemic (mean 55.1 in 2020), then declined in 2023 and 2024 (mean 35.8 and 37.2), though differences by year were not statistically significant. Significant differences by county were found in both fatal (p<0.001) and non-fatal overdoses (p<0.001), with rural counties such as Gila and Apache experiencing the highest rates. Conclusions: The COVID-19 pandemic was associated with increased opioid-related mortality and naloxone use in Arizona. Although rates have since declined, rural counties remain disproportionately affected. These findings highlight opportunities for targeted pharmacist-led interventions and naloxone distribution in high-risk areas.

Specific Aims: To assess BCID2 sensitivity in bacteremia patients, comparing subsequent therapeutic interventions to initial empiric treatments. The study evaluated frequency of BCID2 results and culture/susceptibility (C&S) reports, time to preliminary and final organism/resistance marker identification, and time to targeted therapy. Methods: This retrospective study reviewed data from January 1 to August 31, 2023, including adult patients with positive blood cultures, C&S, and BCID2 performed. Exclusion criteria included patients flagged positive after discharge, receiving palliative care, or readmitted during therapy. Data collected included demographics, culture/BCID2 results, and therapy timelines. Results: Of 68 isolates, 29 (42.6%) were gram-positive bacteria (GPB), 38 (55.9%) gram-negative bacteria (GNB), and 1 fungal (1.4%); 15 (22.1%) were part of a polymicrobial infection. BCID2-reported resistance was similar to C&S. With mismatched-result GPB, resistance was more likely to be identified on BCID2 and vice versa for GNB. Time from first positive result to culture results was shorter with BCID2 at 16.8 hours [8.1-20.6] compared to C&S at 68.8 hours [60.6-91.1]. First empiric therapy was 88.2% effective and initiated at a median of 0.45 hours [0.07-2.0] while 97.1% of final therapy was effective and initiated at 32.9 hours [20.4-67.9]. Conclusions: BCID2 testing remains reliable for early identification of blood pathogens and resistance markers. C&S should still be done to identify a wider range of pathogens and more clearly elucidate drug resistance.

Psychedelic compounds, once marginalized as drugs of abuse, have gained recognition as potential therapeutic agents for mental health disorders. Substances such as ayahuasca, dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), 3,4-Methylenedioxymethamphetamine (MDMA), and psilocybin have shown promise in treating conditions such as depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder (PTSD) in small scale studies. Recent FDA designations of MDMA and psilocybin as breakthrough therapies highlight their potential in the future of mental health treatment. With ongoing mental health issues, a systematic review is warranted to evaluate the clinical effectiveness of these psychedelics, particularly in treatment-resistant depression (TRD), depression associated with life-threatening illness, and PTSD. This systematic review evaluated clinical research on the efficacy of psychedelics—specifically ayahuasca, LSD, MDMA, and psilocybin—in treating mental health disorders with an unmet need. The focus was on assessing the impact of ayahuasca and psilocybin on TRD and depression associated with chronic illness, the impact of MDMA on PTSD, and that of LSD in anxiety. Psychedelic therapies show potential for treating these disorders, particularly in cases resistant to conventional treatments or in acute exacerbations. This review provides a comprehensive assessment of their clinical efficacy, highlights research gaps, and suggests directions for future studies to validate and optimize psychedelic-based treatments for mental health disorders. Findings from identified trials suggest significant antidepressant effects of psychedelics, with MDMA- and psilocybin-assisted therapies showing promise in PTSD and TRD, respectively. The emerging evidence supports their potential as effective alternatives or adjuncts to traditional therapies, although challenges remain regarding long-term efficacy, optimal dosing, and regulatory hurdles.

Specific Aims: To evaluate the accuracy of ChatGPT and MathGPT produced answers to pharmaceutical calculation questions. Methods: Fifty questions within nine calculation categories were tested. ChatGPT and MathGPT responses were cross-examined with student and instructor produced answers in July 2024. New chat queries were used for each question to limit adaptive responses, and all responses were acquired the same day. Responses were assessed for answer and explanation accuracy in comparison to the instructor key by three independent reviewers. Descriptions of the answer disparities between the instructor key and the Large Language Models (LLMs) were documented. Logistic regression analysis was performed, and data was analyzed using Stata version 16.1. Results: Of the 50 questions, 35 (70%) of the ChatGPT responses and 35 (70%) of the MathGPT responses were deemed accurate. Both LLMs answered the same number of questions correctly, so there is no difference between them in overall accuracy (P = 1). Logistic regression analysis did not find an association between an accurate response from ChatGPT and question type (OR 0.979; 95% CI, 0.889 to 1.079) or topic (OR 1.015; 95% CI, 0.89 to 1.158). Similarly, logistic regression did not find an association between accurate response from MathGPT and question type (OR 1.006; 95% CI, 0.9126 to 1.108) or topic (OR 0.921; 95% CI, 0.799 to 1.062). Conclusion: Students should be cautious and not fully rely on LLMs as they do not always provide accurate or appropriate answers.

Specific Aims: To assess the relationship of student pharmacists’ overall sleep quality with their self-reported predicted grade point average (GPA), and level of hope. Methods: This is a descriptive, observational, and cross-sectional study. The data was collected anonymously using a REDCap® survey. The first year (P1), second year (P2), and third year (P3) student pharmacists enrolled at the University of Arizona R. Ken Coit College of Pharmacy in 2023-2024 academic year were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and level of hope using the Adult Hope Scale (AHS). The survey consisted of four sections (1) demographics, (2) PSQI, (3) self-predicted GPA, and (4) AHS. The survey was distributed three times via emailing the classlists between January 29, 2024 and April 12, 2024. Descriptive statistical analysis using Microsoft Excel® 2024 was performed. PSQI and AHS scores were manually calculated by study personnel. Predicted GPAs were self-reported by the students. Results: Out of 423, a total of 82 student pharmacists completed the survey for a response rate of 19.4%. There were 36 and 46 responses from Phoenix and Tucson campuses, respectively. High self-predicted GPA of >3.5 was seen in 78.3%, 50%, and 40% of students with mild, moderate, and severe sleep difficulty. Most students with mild sleep difficulty (91.3%) scored hopeful to high hope versus 69.9% of students with moderate and 60% of students with severe sleep difficulties. Conclusions: Student pharmacists’ sleep quality may inversely be associated with their perceived academic performance and level of hope.

Specific Aims: This study evaluates the advantages of 3D-printed oral Spritam over traditionally manufactured levetiracetam in treating epilepsy, focusing on cost, bioavailability, and patient adherence. Additionally, it explores structurally similar medications that may benefit from 3D printing technology. Methods: This descriptive study utilized data from three double-blind, placebo-controlled clinical trials involving 899 epilepsy patients. Key endpoints included disintegration time, patient preference, cost considerations, and potential chemical candidates for future 3D printing, sourced from peer-reviewed journals and FDA documentation. Results: Spritam demonstrated equivalent efficacy and safety compared to traditional levetiracetam but offered faster disintegration and improved ease of administration—especially in patients with dysphagia or pediatric populations. Although Spritam’s production cost is higher due to the novelty of 3D printing technology, it holds long-term promise for manufacturing efficiency. Patient adherence was notably better in those requiring rapid-dissolving formulations. Brivaracetam, piracetam, and pramiracetam were identified as structurally similar agents that could benefit from 3D printing for personalized formulations and improved patient compliance. Conclusions: While clinical efficacy and safety are comparable, 3D-printed Spritam improves adherence and patient convenience, supporting its role in personalized epilepsy care. Expanding 3D printing to similar agents like brivaracetam and piracetam may offer enhanced drug delivery in specific populations. Further research should evaluate long-term outcomes and cost-effectiveness of broader 3D printing applications in pharmaceutical development.

Specific Aims: To identify barriers in and outside of the classroom experienced by R. Ken Coit College of Pharmacy (RKCCOP), Doctor of Pharmacy students on the Phoenix Bioscience Core campus and the University of Arizona Health Sciences campus in Tucson. Methods: An online REDCAP survey was distributed by email on 01/19/2024, 02/21/2024, and 03/07/2024 to the current RKCCOP, Doctor of Pharmacy students. The survey questions were constructed using barriers identified through the literature. Data was collected, stored and analyzed on the REDCAP database. Response rates for each cohort were calculated and responses reviewed to determine what barriers were experienced by students. Results: Surveys were completed by 144 students. Forty two students from the class of 2024, 37 from the class of 2025, 63 from the class of 2026, and 2 from the class of 2027. The sample population was 44% Phoenix versus 53% Tucson campus. Students reported experiencing a barrier during the live online (64%), in-person lecturer (72%), and remote lecturer (76%) class modalities. Overall, the most frequently reported barriers from the three class modalities were: struggle with maintaining engagement, connection issues or delays between the local classroom and the remote end classroom, and discomfort speaking into the microphone. Eighty four percent of students reported experiencing outside barriers, with the most common being inadequate rest/relaxation (n=73, 60%). Conclusions: Barriers in and outside of the classroom do have an impact on student engagement and participation. Future research should be conducted to determine ways to lessen these barriers and improve participation.

Specific Aims: To evaluate the association between barriers to colorectal cancer screening and health literacy among individuals in a rural U.S. border community. Methods: This quality improvement initiative assessed the effect of pharmacist-led interventions on colorectal cancer screening completion rates in a medically underserved, average-risk population aged ≥45 years. During routine diabetes clinic visits, eligible patients were referred for stool-based testing (e.g., Cologuard) unless a colonoscopy had been recently completed or scheduled. Participants were stratified by risk level based on a standardized questionnaire and categorized by screening outcome: test submitted, not submitted, no response after follow-up, or completed colonoscopy. Statistical analysis was conducted using SPSS, with chi-square tests and post-hoc analyses performed. Rural and rural-suburban populations were included to explore disparities associated with geographic status. Results: Among 231 questionnaires reviewed, 72 patients submitted FIT/Cologuard samples; 13.9% (n=10) were positive and 86.1% (n=62) negative. Overall, 28.6% of patients had no screening test initiated. A significant association was observed between a personal/family history of polyps and test completion (Pearson Chi-Square p=0.017). Conclusions: Patients residing in rural impoverished areas experienced substantial barriers to colonoscopy access, including specialist shortages, prolonged travel times, and transportation challenges, contributing to health inequities. Pharmacist-led screening interventions effectively identified at-risk individuals, facilitating earlier detection and promoting improved patient outcomes in underserved settings.