Do pharmacists use social media for patient care?

Background Social media are frequently used by consumers and healthcare professionals. However, it is not clear how pharmacists use social media as part of their daily professional practice. Objective This study investigated the role social media play in pharmacy practice, particularly in patient care and how pharmacists interact online with patients and laypeople. Setting Face-to-face, telephone, or Skype interviews with practising pharmacists (n = 31) from nine countries. Method In-depth semi-structured interviews; audio-recorded, transcribed verbatim, and thematically analysed. Main outcome measure Two themes related to the use of social media for patient care: social media and pharmacy practice, and pharmacists’ online interactions with customers and the public. Results Most participants were community pharmacists. They did not provide individualized services to consumers via social media, despite most of them working in a pharmacy with a Facebook page. No participant “friended” consumers on Facebook as it was perceived to blur the boundary between professional and personal relationships. However, they occasionally provided advice and general health information on social media to friends and followers, and more commonly corrected misleading health information spread on Facebook. Short YouTube videos were used to support patient counselling in community pharmacy. Conclusions Participants recognized the potential social media has for health. However, its use to support patient care and deliver pharmacy services was very incipient. Pharmacists as medicine experts are well equipped to contribute to improvements in social media medicines-related information, learn from consumers’ online activities, and design new ways of delivering care to communities and individuals.     

Relapses in bipolar patients: changes in social rhythm?

The Ramadan month represents a valuable opportunity to test the hypothesis that the course of the illness of bipolar patients can be disrupted by the change in social rhythm which usually occurs during this month. The objectives of this study were to follow up the mood state and blood lithium level of fasting Muslim bipolar patients who had been on lithium therapy for at least 3 months, and were clinically stable before being included in the study. Twenty bipolar patients were enrolled during the month of Ramadan in 1997. Diagnosis of bipolar disorder was according to ICD-10 criteria. Patients were assessed during the week before Ramadan, the second and the fourth weeks of the fasting month and the first week after its end, with the Hamilton Depression and Bech-Rafaelsen scales. The plasma concentration of lithium was also assessed. The main finding of the study was that 45% of the patients relapsed, 70% during the second week and the remaining patients at the end of Ramadan. These relapses were not related to plasma concentration of lithium. Most of the relapses were manic (71.4 %). Patients who did not relapse had insomnia and anxiety during the second and third weeks of the study. Side-effects of lithium increased and were observed in 48% of the sample, mostly dryness of the mouth with thirst and tremor. The result of this pilot study indicates that the Ramadan month may disrupt the mood state of bipolar patients. More studies are needed to confirm this observation and to evaluate the validity of the Ramadan model to study the impact of social rhythms on bipolar patients.     

Adolescents’ anticipated social outcomes for drinking alcohol and being drunk

The aim of this study was to investigate the social outcomes adolescents anticipate from three social figures (mother, father and peers) for two alcohol-related behaviours (drinking alcohol and being drunk) and how these anticipated social outcomes relate to adolescents’ engagement in underage drinking and experience of alcohol-related harm. The sample was comprised of 651 (329 female) adolescents (age range: 12–16 years; 81% White). Results revealed that the anticipation of less social censure, from mother and peers, for drinking alcohol, related to greater engagement in underage drinking. Further, when underage drinkers were examined separately, lower levels of censure anticipated from mothers and peers for being drunk were associated with higher levels of alcohol-related harm. These findings highlight the importance of not considering social outcomes as a monolithic process. Instead, the results underscore the complexity of adolescents’ social environment and the need for research and interventions to examine this context in terms of the different social figures that influence adolescents and the different alcohol-related behaviours adolescents may engage in. Further, it highlights the notable influence of mothers and peers on adolescents' drinking self-regulation, and their potential roles in intervention programs aimed at reducing underage drinking and its associated harms.     

Does co-occurring social phobia interfere with alcoholism treatment adherence and relapse?

This study investigates the impact of social phobia on adherence to and outcomes 6 months following standard alcohol treatment and Alcoholics Anonymous (AA) group meetings among alcohol-dependent patients with and without social phobia.

In a cohort study, 300 detoxified alcohol-dependent individuals in Porto Alegre, Brazil, were interviewed during, as well as 3 and 6 months after hospital detoxification. At both follow-up points, treatment adherence was low and relapse rates were high among patients with and without social phobia, and no significant differences were seen between the two groups of patients in relapse, adherence to AA, or adherence to psychotherapy.

Findings from this sample suggest that although alcohol-dependent patients with social phobia showed a tendency for less adherence at AA and felt less integrated with their AA group, social phobia comorbidity was not a significant risk factor for alcohol use relapse or for nonadherence to AA or psychotherapy.     

Sellers’ risk perceptions in public and private social media drug markets

IntroductionFrom the early use of pagers and cellular phones to the darknet and smartphones, technological developments have facilitated drug deals in various ways, especially by altering time and space boundaries. Traditional drug market literature theorises about how physical markets, within which sellers act according to their risk perceptions and motivation, are led by supply, demand, and enforcement. However, there is an almost absolute research gap in understanding how this relates to digital markets and social media markets in particular. It is expected that the plasticity of technology makes digital markets highly mouldable so that the sellers are able to shape markets according to their use.Research aimThe aim of the study is to describe and understand drug dealing on social media within the structure of existing markets. We aim to do so by analysing how drug sellers’ risk perceptions and motivations form and are formed by social media technology.MethodsWe conducted a three-month digital ethnographic study on Facebook and Instagram in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), as well as 107 semi-structured qualitative interviews with sellers (2/3 of the sample) and buyers (1/3 of the sample) using online markets within the same countries.ResultsDrug dealing on social media varies according to the structure of the chosen media and users’ risk perceptions and motivations. Two market forms are suggested: 1) public digital markets (e.g., Facebook groups and Instagram) allow sellers to expand their customer lists, but the risk is quite high, while 2) private digital markets are based on one-on-one communication and demand greater knowledge but are perceived as more secure. Sellers choose which media to use and how to use them based on perceived risk and, therefore, have a significant impact on the formation of social media drug markets.     

Intoxigenic digital spaces? Youth,social networking sites and alcohol marketing

Introduction and Aims. To examine how young people in New Zealand engage with alcohol and reproduce alcohol marketing messages and alcohol‐related branding in ‘Bebo’, a popular social networking site (SNS) on the Internet. Design and Methods. Data are drawn from information posted on approximately 150 Bebo Web pages and analysed by way of textual analysis and cyberspace ethnography. Results. Social networking sites, such as Bebo, provide young people with a digital space in which to share a range of alcohol marketing messages via peer‐to‐peer transmission. Bebo also enables youth to communicate to one another how they consume alcohol and their views of alcohol marketing messages. The information being shared by young people who use Bebo is openly provided in the form of personal information, forum comments, digital photographs and answering quizzes about their engagement with alcohol. Discussion and Conclusions. Through this sharing of information in the digital Internet environment, young people are creating ‘intoxigenic social identities’ as well as ‘intoxigenic digital spaces’ that further contribute towards the normalisation of youth consumption of alcohol. A better understanding of how youth are using the Internet to share their experiences with alcohol and engagement with alcohol‐related messages is crucial to public health research as alcohol marketing practices rapidly evolve.[Griffiths R, Casswell S. Intoxigenic digital spaces? Youth, social networking sites and alcohol marketing. Drug Alcohol Rev 2010]     

Why should we bother? Ethical and social issues in individualized medicine

Individualized medicine, methodologically rooted in pharmacogenetics and pharmacogenomics, is now venturing into clinical application. Prescribing the right drug in the right dose to the right patient according to specific health needs and individual characteristics is a core mission of individualized medicine. The intrinsic values of this mission are so self-evident that--at first glance--the ethical and social issues raised by individualized medicine seem to be negligible. However, the translation of pharmacogenetics and pharmacogenomics into clinical routine not only requires the collection and evaluation of large amounts of individual genetic data, but also heralds the need for further clinical studies on the applicability of genotype-related pharmacotherapy. Both requirements raise a set of specific normative issues. We argue that ethical and social questions of the desirability and applicability of individualized medicine should be integrated in a reconstructive approach to biomedical ethics, which is guided by criteria of social accountability. As a first step, we analyse the ethical and social issues of individualized medicine in the transition to clinical practice, using social accountability heuristically and as an evolutionary approach. Since the pharmacogenetics and pharmacogenomics of neuropsychiatric disorders are among the most advanced fields of individualized medicine, as a second step we use depressive disorders to elucidate the specific, crucial ethical and social questions involved in assessing patients' situations, disease entities and phenotypes to relate them to genetic variations for the purpose of individualized drug regimens.     

Pharmacists’ provision of information to Spanish-speaking patients: A social cognitive approach

BackgroundHispanics with limited English proficiency face communication challenges that affect medication use and outcomes. Pharmacists are poised to help patients’ use medications safely and effectively; however, scant research has explored factors that may impact pharmacists’ communication with Spanish-speaking patients (SSPs).ObjectiveGuided by social cognitive theory (SCT), the purpose of this study was to examine the relationships between pharmacy environmental factors, pharmacists’ cognition, and pharmacists’ communication with SSPs.MethodsA cross-sectional survey used a vignette to quantify the amount of information pharmacists would provide to an SSP. Pharmacy environmental factors (language-assistance resources, Spanish-speaking staff, and number of SSPs) and pharmacists’ cognition (self-efficacy beliefs and cultural sensitivity) that may influence communication also were assessed. The relationships between environmental factors, cognition, and pharmacists’ communication with SSPs, including indirect relationships, were examined using composite indicator structural equation (CISE) modeling.ResultsOf the 183 respondents, most were white (91%) and male (63%) with a mean age of 47 years (SD = 12.77). The CISE modeling revealed that the number of SSPs served by the pharmacy and the pharmacist’s self-efficacy in communicating with SSPs were significantly directly associated with pharmacist’s provision of information to SSPs. Two environmental factors (presence of interpreter services and Spanish-speaking staff) operated indirectly through self-efficacy to significantly impact the provision of information.ConclusionsStudy findings identify both environmental factors and cognition that could contribute to pharmacists’ communication behavior with SSPs. Thus, future interventions to improve pharmacists’ communication with SSPs may include training pharmacists to integrate interpretative services and Spanish-speaking staff into service delivery and strengthening pharmacists’ self-efficacy beliefs.     

Effects of social and spatial contexts on young latinas’ methamphetamine use initiation

ABSTRACT

In this article, we examine methamphetamine (meth) use initiation as influenced by Latinas’ social positions within institutions (e.g., family and economy). We conducted ethnographic fieldwork in five women’s residential substance use treatment facilities in Los Angeles County with women who considered meth to be their primary drug of choice. Using an urban ethnographic framing, we demonstrate the effects of low-income young Latinas’ spatial- and social-context rendered vulnerability to abuse and neglect, and the resulting emotional distress, on meth use initiation. When considering pathways to substance use intervention for vulnerable Latina girls and women, clinicians, researchers, and policy makers need to understand substance use pathways as dynamic processes to cope with psychosocial stress while living in communities with easy access to illicit substances such as methamphetamine.     

Self-medication or social learning? A comparison of models to predict early adolescent drinking

The current study examined the effects of social anxiety, depressive symptoms, and alcohol expectancies of social behavior change on alcohol involvement to determine whether the self-medication and/or social learning models predicted drinking behavior in a sample of over 400 eighth grade students. Middle school students completed confidential surveys that assessed current alcohol use and expectancies as well as negative affectivity including social anxiety and depressive symptoms. Consistent with the self-medication hypothesis, depressive symptoms predicted more frequent and heavier alcohol use as well as solitary drinking. The social learning model was supported by a negative association between social anxiety and quantity/frequency of drinking and less drinking at parties, and a positive association between alcohol expectancies and all drinking outcomes. Additionally, social anxiety moderated the association between expectancies and alcohol use. These findings suggest that self-medication and social learning processes may both play a role in predicting early adolescent alcohol use and the contexts in which youths drink.     

Diversion and criminal justice drug treatment: mechanism of emancipation or social control?

In Australia, as elsewhere, there has been a rapid growth in programs to divert drug‐using offenders from the criminal justice system to assessment and treatment. In this Harm Reduction Digest, which builds on papers presented at the APSAD Conference in Melbourne, November 2005, Clancey and Howard take a reflexive look at the Australian experience since the launch of the National Illicit Drug Diversion Initiative in 1999. In putting diversion within a broader criminological and societal context, they suggest that we may have criminalised drug policy and may ultimately be doing more harm than good.     

Let’s celebrate recovery. Inclusive Cities working together to support social cohesion

Abstract

Recovery from illicit drug and alcohol use takes place over time and is characterised by a dynamic interaction between internal and external components. An integral part of all recovery journeys is effective community reintegration. After all, recovery is not mainly an issue of personal motivation rather it is about acceptance by family, by friends and by a range of organisations and professionals across the community. Therefore to support pathways to recovery, structural and contextual endeavours are needed to supplement individually-oriented interventions and programmes. One way to do this, is by introducing Inclusive Cities. An Inclusive City promotes participation, inclusion, full and equal citizenship to all her citizens, including those in recovery, based on the idea of community capital. The aim of building recovery capital at a community level through connections and 'linking social capital' to challenge stigmatisation and exclusion, is seen as central to this idea. Inclusive Cities is an initiative to support the creation of Recovery-Oriented Systems of Care at a city level, that starts with but extends beyond substance using populations. This paper describes (and gives examples of) how it is possible to use recovery as a starting point for generating social inclusion, challenging the marginalisation of other excluded populations as well by building community connections.     

Twelve-step program use among Oxford house residents: Spirituality or social support in sobriety?

Oxford House is a self-help, self-governed, democratic communal-living environment for recovering alcoholics and polysubstance abusers. In this study, 134 male residents (M age = 34 years old) were personally interviewed on their recovery process and, in particular, on their experiences with 12-step programs such as Alcoholics Anonymous (AA). Most residents (76%) reported they attended weekly AA meetings to assist in their recovery, mainly to acquire effective techniques to maintain sobriety (72%). Many AA attendees (43%) claimed no sense of spirituality prior to joining AA, and for most of these men (71%), attendance at weekly meetings was not motivated by “spirituality” aspects of the program. In contrast, the majority of residents (53%) attending weekly AA meetings claimed that a sense of fellowship with similar recovering others was their reason for program involvement. It appears that among men living in a communal setting with other recovering addicts, the need for social support for sobriety from similar others continues beyond the confines of their residence.     

Cannabidiol reverses the reduction in social interaction produced by low dose Δ-tetrahydrocannabinol in rats

While Δ⁹-tetrahydrocannabinol (THC) is the main psychoactive constituent of the cannabis plant, a non-psychoactive constituent is cannabidiol (CBD). CBD has been implicated as a potential treatment of a number of disorders including schizophrenia and epilepsy and has been included with THC in a 1:1 combination for the treatment of conditions such as neuropathic pain. This study investigated the effect of THC and CBD, alone or in combination, on some objective behaviours of rats in the open field. Pairs of rats were injected with CBD or vehicle followed by THC or vehicle and behaviour in the open field was assessed for 10 min. In vehicle pretreated rats THC (1 mg/kg) significantly reduced social interaction between rat pairs. Treatment with CBD had no significant effect alone, but pretreatment with CBD (20 mg/kg) reversed the THC-induced decreases in social interaction. A higher dose of THC (10 mg/kg) produced no significant effect on social interaction. However, the combination of high dose CBD and high dose THC significantly reduced social interaction between rat pairs, as well as producing a significant decrease in locomotor activity. This data suggests that CBD can reverse social withdrawal induced by low dose THC, but the combination of high dose THC and CBD impairs social interaction, possibly by decreasing locomotor activity.