bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetic Analysis of Meropenem and Piperacillin in Critically-Ill Patients Requiring Continuous Ven-Venous Hemodiafiltration
Authors: Ferlas Brandon , Nelson Kristina , Junghare Milind , Boeser Kimberly
Published: January 2018

Background: Literature has demonstrated proper antibiotic selection and prompt initiation of antibiotics are associated with lower morbidity and mortality. Septic patients have altered pharmacokinetics and often require continuous renal replacement therapy which contributes to altered drug clearance and metabolism. The current study evaluates the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.

Purpose: This observational, prospective, single-center, nonrandomized study evaluated the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.

Methods: Plasma drug concentrations were determined via high-performance liquid chromatography using three post-dose blood samples after steady-state antimicrobial agent administration.

Results: Meropenem peak drug concentrations ranged from 35.9 to 61 mcg/mL, while trough concentrations ranged from 3.9 to 16.7 mcg/mL. Piperacillin peak drug concentrations ranged from 240 to 331.8 mcg/mL, while trough concentrations ranged from 152.7 to 194.9 mcg/mL. Both drugs examined displayed peak concentrations relatively consistent with those expected from the literature, but observed trough concentrations for meropenem and piperacillin were uniformly high.

Conclusions: Intravenous doses of meropenem and piperacillin result in peak drug concentrations similar to those previously reported and trough concentrations significantly greater than those in the literature. While concentrations above an organism’s MIC are desirable given the time-dependent nature of these beta-lactam antibiotics, decreased renal clearance of patients maintained on CVVHDF therapy while receiving higher doses of antimicrobials creates a situation in which drug accumulation and toxicity may occur. Given the complex nature of ICU patient care, increased pharmacovigilance and therapeutic drug monitoring are necessary in this unique population.

 

Type: Original Research
Development and Implementation of Charitable Pharmacy Services within a Federally-Qualified Health Center (FQHC)
Authors: Mospan Cortney M. , Alexander Katelyn M.
Published: January 2018

Underserved patient populations often have limited access to health care services, especially medications, leading to lower quality care due to their transitional status and lack of access. To ensure access to medications for underserved patients in the Johnson City, Tennessee area, the Colleges of Nursing and Pharmacy at ETSU developed a charitable pharmacy to serve those of greatest need in hopes of improving quality of care. By establishing a community pharmacy within a FQHC, clinical community pharmacists were able to establish enhanced community pharmacy services as a part of the health-care team. This manuscript describes the development, implementation, and benefits of the community pharmacy integration within a FQHC

 

Type: Clinical Experience
Community Pharmacist-Provided Osteoporosis Screening and Education: Impact on Patient Knowledge
Authors: Brookhart Andrea L. , Brown Fountain K. Michelle , Moczygemba Leticia R. , Goode Jean-Venable R.
Published: January 2018

Objective: To evaluate the impact pharmacist-provided screening and education had on patient knowledge of osteoporosis and preventive strategies.

Methods: A prospective, randomized, controlled study was conducted at 16 locations of a national supermarket chain pharmacy in the Richmond, Virginia area. Women 30 years and older with no history of osteoporosis were enrolled in the study. Patients self-selected into the study by agreeing to the bone density screening, pharmacist-provided education, and completion of a knowledge survey. Subjects were randomized to complete the osteoporosis-related knowledge survey either before (Group A) or after (Group B) the screening and education session. The survey was developed after guideline and literature evaluation and was pretested with a group of patients for content and clarity. The survey evaluated knowledge of osteoporosis, risk factors for the disease, appropriate age for testing, and preventive strategies. Groups A and B were compared using t-tests. Results: A total of 110 women were enrolled in the study. The mean (±SD) age was 52.5 ± 13.1 years in Group A (n=52) and 52.7 ± 11.5 years in Group B (n=58). Knowledge scores were higher in the group who received pharmacist-provided education prior to completing the survey in each category (knowledge of the disease, risk factors, preventive strategies, and appropriate age for testing) and overall (p<0.001).

Conclusions: Community pharmacist-provided osteoporosis screening and education increased patient knowledge about osteoporosis and preventive strategies. Community pharmacist involvement with increasing patient knowledge may empower patients to engage in prevention strategies to improve bone mass.

 

Type: Original Research
Smart Phone Apps: An Innovative Approach to Improving Pediatric Medication Adherence
Authors: Wytiaz Rebecca M. , Lee Hyung M. , Odukoya Olufunmilola K.
Published: January 2018

Children suffering from chronic illnesses often struggle to adhere to their medication regimens and are rarely involved in the management of their medications. The use of innovative technology, such as medication adherence mobile apps, may be beneficial in increasing medication adherence rates and self-care knowledge in the pediatric population. Children serve as an optimal population with which to use mobile apps as intervention tools, as children utilize smart phone technology far more than most other populations. By striving to improve children’s medication perceptions, adherence and willingness to continue medication therapy for a chronic condition may improve during adolescent years and may persist as they transition into adulthood. As community pharmacists interact with children with chronic conditions during routine visits, they can also engage them in conversations about their medication adherence through use of mobile apps. Although many medication adherence apps are currently available on the market, none of these apps are tailored towards pediatric patients. Thus, further research should be conducted in order to develop mobile apps conducive to this population.

 

Type: Student Project
Integrating a Patient Care Development Model to Enhance Community Pharmacy Residency Programs
Authors: Rodis Jennifer L. , Ulbrich Timothy R. , Jennings Brandon T. , Elswick Betsy M. , Jackowski Rebekah
Published: January 2018

Purpose: The purpose of this paper is to describe integration of a community-based patient care service development model, Partner for Promotion (PFP), within five community pharmacy residency programs (CPRPs) across the United States and provide insights and examples of methods for optimizing community pharmacy resident experiences, developing new patient care services, and achieving residency accreditation standards.

Summary: Five community pharmacy residency programs have integrated PFP that affiliated with Midwestern University – Glendale, Northeast Ohio Medical University, Ohio State University, University of Utah, and West Virginia University. Each college and residency program has identified different strategies through which PFP enhances their residency training and service development including completion of training modules, reflections and discussion on application of the PFP service development model to practice, research, and teaching, use of assignments to guide service creation, and mentoring of PFP student-pharmacist teams. All five sites directly link these activities to objectives required in PGY1 CPRP accreditation standards. PFP has resulted in resident-facilitated service development of a variety of patient care programs.

Conclusion: PFP applied to CPRPs enhances training on service development, builds new services within residency training sites, and assists programs with meeting residency accreditation standards. The experiences of five community pharmacy residency programs across the U.S. that have adopted the program has been positive, with creation of new services and residency sites, integration of novel teaching, practice, research, and learning opportunities for residents, and direct links from the PFP experience to achievement of residency objectives.

 

Type: Idea Paper
Association Between Perceived Health Care Provider Support and Satisfaction with Insulin Pumps in Children with Type 1 Diabetes Mellitus: Opportunities for Pharmacists
Authors: Jowers Laura Brooke , Shahpurwala Zainab , West-Strum Donna , Strum Matthew W.
Published: January 2018

Purpose: The purpose of this pilot study was to describe parents’ perceived healthcare provider support for integrating technology, satisfaction with insulin pump use in their child with T1DM, and the relationship between parents’ perceived healthcare provider support and satisfaction with insulin pump use.

Methods: A cross-sectional, correlational design was used to collect data for the present study. The study was conducted through an Internet survey among Mid-South parents who have a child with T1DM, 18 years old or younger using an insulin pump and/or continuous glucose monitoring (CGM). Frequencies, descriptive statistics, and correlation coefficients were calculated.

Results: Most of the parents surveyed used an endocrinologist/pediatric endocrinologist as their primary diabetes healthcare provider and considered three to four healthcare professionals as part of the diabetes healthcare team who helped them utilize insulin pumps and advanced technologies. Parents (23.4%) indicated a pharmacist was part of the healthcare team who helped them utilize technology. Parents appeared to perceive support for using insulin pumps; however, there is room for improvement. The more perceived support for integrating technology, the more satisfied the parents were with using insulin pumps (r=0.431, p=0.005).

Conclusions: Results from this study suggest that parents and children need continued education, support and training to integrate insulin pumps into diabetes self-management. As more patients attempt to adopt insulin pumps and other advanced technologies, it will be important for pharmacists to support the adoption and integration of these technologies and be knowledgeable and helpful if asked about technology-related challenges.

 

Type: Student Project
Evaluating Pharmacy Student Attitudes Toward the Medium of Comics for Providing Information on Adult Immunizations
Authors: Muzumdar Jagannath M. , Nania Anthony M.
Published: January 2018

Objectives: This study aimed at designing and assessing educational materials for adult immunizations through the medium of comics. The study design evaluated the effects of two vaccine information flyers (a CDC flyer vs a flyer designed in Comic medium) on participants’ attitude towards the flyers.

Methods: A between-group, randomized trial was used to compare the effectiveness of two vaccine information flyers on participants’ attitude towards the flyers. Upon approval from the human subjects review committee, student participants (age ≥18 years) were randomly assigned either the CDC or comic flyer. They were then asked to respond to survey items developed to measure the flyers’ effect on participants’ attitude towards the flyer. Items were measured using a 7-point semantic differential scale. Cronbach’s alpha was computed for reliability testing of the study instrument. Independent-samples t-test was used to compare means of the two groups with respect to their attitudes toward the flyer.

Results: A total of 170 third-year pharmacy students participated in the study (N = 91 for Comic flyer & N = 79 for CDC flyer). There was a significant difference in attitudes toward the flyer between students who read comic flyers (mean = 6.14; SD = 0.62) and those who read CDC flyers (mean = 4.93; SD = 1.20). Additional comments provided by students further confirmed the quantitative findings of the study. Student responses to the use of comics as a medium of providing information on adult immunization were constructive and encouraging.

Conclusion: The study findings showed that the flyer with comics was evaluated more attractive than the CDC flyer. The positive findings of our study could provide a new direction for developing educational materials about adult immunizations. Future research on comics, as a medium of communication, could explore its use as a tool for providing healthcare information to consumers.

 

Type: Original Research
An Interdisciplinary Experience focused on Pharmacogenetics: Engaging pharmacy and physician assistant students in conversations about antiplatelet therapy with respect to CYP2C19 genotype
Authors: Calinski Diane M , Kisor David F
Published: January 2018

Objective: The goals of the interdisciplinary laboratory were to educate and engage pharmacy and physician assistant (PA) students in a discussion focused on the collection, interpretation, and application of pharmacogenetic data.

Design: Interdisciplinary teams participated in a one-hour, case-based discussion and provided a therapeutic recommendation using the Clinical Pharmacogenetics Implementation Consortium guidelines.

Assessment: All students were surveyed before and after the laboratory on knowledge and application of pharmacogenetics and working in interdisciplinary teams. The interdisciplinary laboratory successfully enhanced the student’s knowledge about sample collection and interpretation of pharmacogenetic information. Additionally, the laboratory improved student confidence in working in interdisciplinary teams to apply pharmacogenetic information to clinical decision making. Furthermore, the majority of students indicated that the interdisciplinary laboratory is valuable and useful in healthcare curriculums.

Conclusion: The laboratory highlighted the differences between pharmacy and PA education regarding PGt, and brought to light several important uncertainties: (1) What is the depth of PGt knowledge that healthcare practitioners need? (2) What are best practices for conveying PGt information?

 

Type: Case Study
Description of the methods for describing and assessing the appropriateness of antibiotic prescribing and adherence to published treatment guidelines in an academic medical clinic
Authors: Klepser Michael E , Altom Ashley , MacCallum Colleen , Nordquist Eric , Klepser Donald G
Published: January 2018

Overuse and inappropriate use of antibiotics have been associated with increased rates of antimicrobial resistance and increased healthcare expenditures. Tracking inpatient antimicrobial use has helped quantify the value of stewardship programs aimed at improving the rational use of antibiotics among hospitalized patients. Unfortunately, similar methods for tracking and assessing antibiotic use in the outpatient setting have not been well described. We developed a novel method to capture trends and assess appropriateness of antibiotic usage. This strategy is based on identification of antimicrobial prescriptions in an electronic medical record system, linking prescribing to patient data, and capturing information regarding dosing and indications for use. Using information on dose, frequency, and duration of the antibiotic prescribed, a parameter to quantify antibiotic exposure (Prescribed Therapeutic Regimen, PTR) is calculated. This parameter is compared to a database of information on agents recommended in published guidelines (Recommended Therapeutic Regimen, RTR). By linking an ICD-9 code and the prescribed antibiotic we determine the appropriateness of the PTR by comparing it to the RTR for a given indication. Data are used to establish a baseline pattern of antibiotic use in the clinic to gauge the impact of future stewardship activities. Additionally, individual clinics and prescribers are given a snapshot of their antibiotic use compared to other clinics and prescribers. This is a novel means of describing antibiotic use in the outpatient setting that could serve as a standardized model for various adult and pediatric outpatient practices.

 

Type: Original Research
Pharmacist Behavior Changes Following a Medication Counseling Training Program Targeting Teach-Back and Plain Language
Authors: Hager David R , Hartkopf Katherine , Margolis Amanda , Martin Beth A
Published: January 2018

Purpose: To evaluate whether active learning-based training in teach-back and plain language (TBPL) techniques can lead to observable changes to patient-centered practices in pharmacist-patient counseling.

Methods: All pharmacists in direct patient care roles, inpatient and outpatient, were required to complete a didactic module and a workshop / webinar or small group training. The workshop / webinar and small group modalities incorporated elements of adult education theory. Following completion, pharmacists were surveyed to assess their ability, confidence and commitment to incorporating TBPL techniques into practice. Evaluation of pharmacist-patient counseling was completed pre- and post- training through direct observation. Student pharmacists were trained to evaluate pharmacists’ consultations on patients with ≥2 new medications. Students recorded completeness rates for 39 communication techniques.

Results: One-hundred and eighteen pharmacists completed the TBPL training program and 59 pharmacists completed an evaluation. A total of 84 direct observations were completed (40 pre-training and 44 post-training). Skills improved included: using plain language (p

Conclusion: Implementing a TBPL training program improved observable pharmacist-patient consultation skills. This approach is replicable and could be utilized as a model for other competencies.

 

Type: Original Research
Engagement in a Diverse Urban Community to Describe Community Residents’ Perceptions of Pharmacists as Immunizers
Authors: Pattin Anthony , Rowe Zachary , Kilgore Paul E , Farhat Nada , Kaurala Stephen , Kaljee Linda
Published: January 2018

Objective: To describe the perceptions of pharmacist-delivered vaccination services among community members that live in a diverse urban metropolitan area and to identify potential strategies to improve the use of vaccines provided by pharmacists.

Design: Qualitative study. Setting: Metropolitan urban diverse community in Wayne County, MI. Participants: Individuals 50 years of age and older that reside in a defined urban metropolitan community. Intervention: Four, 45-minute, focus group discussions were conducted to gather the experiences and perceptions of participants around pharmacists that immunize. A focus group guide was developed to facilitate focus group sessions. Main Outcome Measures: Focus group discussions were audio-recorded and transcribed. Content analysis was used to analyze data and identify relevant themes. Results: Three main themes were identified related to the use of pharmacist-delivered vaccination services: trust with vaccine providers, interaction with pharmacy personnel, and the factor of accessibility. Conclusion: Study participants expressed views that will guide the development of interventions aimed to reduce disparities in vaccine utilization. It is suggested that future efforts improve accessibility to pharmacy-delivered vaccines in this community and enhance the interaction between patients and pharmacists.

 

Type: Original Research
Greater Expectations for Pharmaceutical Value: Better Care, Healthier People, Smarter Spending
Authors: Schommer Jon C. , Isetts Brian
Published: January 2018

Type: Commentary
Nullius in verba: The University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations
Authors: Langley Paul C
Published: January 2018

The University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations (GFE) are designed to focus on the credibility of clinical and cost-outcomes claims in formulary decision making. The last few years have witnessed increasing concern over the credibility of trial based efficacy claims, with a surprisingly high proportion of claims falling short. At the same time cost-outcomes claims, where comparative clinical claims are a key input, have been presented where the claims made are not open to experimental or observational assessment. This follows from standards recommended for modeled and simulated claims. In the absence of cost-outcomes claims being presented in an evaluable form, it is impossible not only to replicate the claim or to judge whether or not it is credible. Claims for product value based on such claims are unacceptable. The guidelines proposed here are designed to overcome these limitations and support an evidence base that is both credible and replicable for formulary decisions. This is achieved by focusing on short-term modeled or simulated claims for cost-effectiveness. The requirement for modeled or simulated claims that are evaluable within a time frame that is meaningful for formulary decisions marks a major departure from format submissions already in play, not only in the US but in other developed economies. Rather than subscribing to the gold standard of long term or lifetime cost-per-QALY claims a short-term time horizon of no more than 2-years is recommended. This allows products to be provisionally placed on formulary but subject to a protocol that supports an evaluation to be reported back to a formulary committee as part of ongoing disease area or therapeutic class reviews. The place of the product and its contracted price can then be reviewed.

Conflict of Interest

None

Type: Commentary
Imaginary Worlds: A Systematic Review of the Status of Modeled Cost-Effectiveness Claims Published in the Journal of Medical Economics from January 2015 to December 2015
Authors: Langley Paul C , Rhee Taeho Greg
Published: January 2018

The purpose of this review is to evaluate the credibility of modeled claims for cost-effectiveness studies published in the Journal of Medical Economics (JME) in the period January 2015 to December 2015. Credibility is assessed in terms of the standards of normal science. Are the claims made capable of falsification and replication? Following the PRISMA-P recommendations, abstracts of all papers published in the JME were evaluated by both authors independently against a MeSH terms checklist: cost, cost-effectiveness, cost-utility, outcomes, QALY and Markov. A total of 32 studies were identified. A systematic review of each study was then evaluated. The consensus was that all studies be included in the review. Each study was judged against four criteria: (i) Is the model capable of generating evaluable claims? (ii) did the author(s) attempt to generate evaluable claims? (iii) did the author(s) suggested how the claims might be evaluated? and (iv) did the author(s) caution readers as to the implications of generating non-evaluable clams for the credibility of the analysis? None of the studies presented their claims or projections in an evaluable form and none suggested how they might be evaluated. None met the standards of normal science. The claims made for cost-effectiveness were either impossible to verify, or if potentially verifiable, were not presented in an evaluable form. The studies lacked credibility. There was no basis for assessing whether the claims were right or even if they were wrong. The JME is not alone. As part of an ongoing systematic review program, covering the leading journals and focusing on chronic condition areas, it is clear that the majority of cost-effectiveness papers also fail the test of credibility. Of course, it might be that the consensus opinion among practitioners is that non-evaluable projections are acceptable. Evidence is not discovered, but is constructed through models and simulations. This lack of scientific credibility is a major concern. If medical economics is to advance through the formulation and testing of hypotheses, then editors of journals should consider whether or not to set standards for the acceptance of publications to include the requirement for evaluable claims and the results of claims assessment. If this is not acceptable, then it should be made clear that published papers are simply imaginary worlds or thought experiments.

 

Type: Commentary
Comparison of Reading Levels of Pharmacy Students and Reading Level of Primary Literature
Authors: Ficzere Cathy H , Hagan Angela , Ness Genevieve Lynn , Greene Elisa M. , Hill Kayla
Published: January 2018

Objectives: The project purpose was to evaluate pharmacy students’ reading levels using the Nelson-Denney Reading Test (NDRT) and compare these results with the reading level of primary literature to investigate incongruities between student’s comprehension ability and the readability level of assigned reading in the curriculum.

Methods: The NDRT was administered to first- through third-year student pharmacists to determine grade equivalents (GE) for vocabulary and reading comprehension. Twenty articles previously identified as Patient-Oriented Evidence that Matters (POEMs) were analyzed to determine the Flesch-Kincaid Grade Level and Gunning-Fog Score. Student demographics, information regarding language spoken, and reading habits, were also assessed. Pearson product moment correlations, t-tests, ANOVA, and descriptive statistics were used to assess relationships between demographic data and NDRT scores.

Results: One hundred students participated. The mean NDRT total grade equivalent (±SD) was 16.95 ± 2.1 (median = 17.3). NDRT grade equivalents were statistically different for students with different racial or ethnic backgrounds (t(98)=3.74, p=0.026), English as a second language (ESL) students (t(98)=5.19, p=0.021), and students that read works of fiction for pleasure (t(98)=4.31, p=0.002). The average Gunning-Fog Score for all primary literature articles was 11.48, with the introduction section being the most complex. The average Flesch-Kincaid Grade Level was 17.04, with the results section scoring the lowest average grade level.

Implications: While the overall reading grade level of our pharmacy students suggests that they are capable of comprehending reading assigned in the pharmacy curriculum, minority students and students for whom English is a second language may struggle with comprehending complex text.

Conflict of Interest

We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

 

Type: Original Research
The Drug Court Pharmacist: Expanding Pharmacy Practice and Addressing Substance Abuse
Authors: Palombi Laura C , Koh-Knox Cynthia P
Published: January 2018

Problem solving courts, including Drug Court, were established to address substance abuse while providing an alternative to prison sentences and traditional corrections supervision. Drug Courts have been shown to reduce crime in participants and graduates, save the criminal justice and health care systems money, reduce victimization, and restore families. Pharmacists in Tippecanoe County, Indiana, and Carlton County, Minnesota, have established innovative practices as members of Drug Court teams; these practices include the provision of a variety of pharmaceutical and health-related services that other Drug Court team members are not able to provide. The role of the pharmacist on the Drug Court team deserves exploration in light of the increasing needs of problem-solving courts across the United States and the current substance abuse epidemic that unfortunately includes prescription drugs.

Conflict of Interest

"We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties."

 

Type: Idea Paper
The Relationship Between Treatment Adherence and Non-picked Up Medications in Community Pharmacies
Authors: Nguyen Vu Phan Hoang , Wertheimer Albert
Published: January 2018

Medication adherence is one of the major factors that determine an outcome of a treatment. Despite the effort of healthcare providers to improve the adherence rate, it still remains a serious issue in our health care system today. Many patients do not take their medications as directed or just simply do not want to fill or refill their prescriptions. A small survey performed by pharmacy students at Temple School of Pharmacy showed that there is a significant number of patients did not pick up their medications. Cardiovascular medications are the most common non-picked up drugs. There are various reasons that patients use to justify for this non-adherence behavior. However, they are unaware that their actions create a tremendous negative effect not only on the treatment itself but also on the entire health care system. The consequences include expensive therapies, inaccurate research data, and poor treatment outcomes. Many solutions have been utilized to solve this problem, but it is still the major problem for healthcare providers to keep in mind when planning a drug regimen. Although many people believed that pharmacists are responsible for solving this problem, it should be a multidisciplinary effort of all healthcare providers to improve the medication adherence.

Conflict of Interest

We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

 

Type: Student Project
Preceptors' Need For Support In Tutoring Pharmacy Students in Finnish Community Pharmacies
Authors: Löfhjelm Ulla , Pitkä Katja , Passi Sanna , Airaksinen Marja
Published: January 2018

A pharmacy degree in Finland includes a six-month obligatory internship. The internship is integrated with theoretical studies and adds up to 30 European Credit Transfer and Accumulation System (ECTS) credits of the BSc (Pharm) degree. Learning is supported by reflective assignments from the university. The preceptors have an important role in organizing the internship and tutoring students successfully in community pharmacy settings.

Objective: to assess whether the preceptors of University of Helsinki’s teaching pharmacies need pedagogic support in tutoring and if so, in which core pharmaceutical tasks or tutoring skills.

Methods: The survey was sent to all preceptors of University of Helsinki´s teaching pharmacies (n=326) in 2011 (response rate 58%, n=190). The data was analyzed statistically using Excel (version 12.3.6). The open-ended questions were analyzed by qualitative content analysis.

Results: The majority of preceptors found their skills in tutoring the students mainly good. However, assessment of learning (27% of the respondents), giving feedback (23%) and organizing the learning situations supportive for learning (23%) were the areas in which the preceptors mostly indicated a need for support. Teaching current care guidelines and pharmaceutical care (36%) and multi-professional collaboration (28%) were the areas in which the preceptors expressed that they needed to update their skills.

Conclusions: The faculty should focus the support on the pedagogic skills of preceptors, particularly in improving their skills in assessment of learning and in reflective dialogue. In addition, their skills in teaching clinical and patient care aspects of pharmacy practice should be enhanced.

Conflict of Interest

We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties

 

Type: Original Research
True North: Building Imaginary Worlds with the Revised Canadian (CADTH) Guidelines for Health Technology Assessment
Authors: Langley Paul C
Published: January 2018

In March 2017 the Canadian Agency for Drugs and Technologies in Health (CADTH) released the 4th edition of their Guidelines for the Economic Evaluation of Health Technologies: Canada. These guidelines, which were first published and revised for a 3rd edition in 2006 are intended to help decision makers, health systems leaders and policy makers make well-informed decisions. They are designed, apparently, to support best practice in conducting health technology assessments in Canada. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the CADTH standards capable of generating claims for competing products that are credible, evaluable and replicable? The review argues that the standards proposed by CADTH do not meet the standards expected in normal science. Technical sophistication in building reference case imaginary worlds is not a substitute for claims that are experimentally evaluable or capable of assessment through systematic observation. There is no way of judging whether imaginary claims are right or even if they are wrong. CADTH is not alone in setting standards that fail to meet the standards of normal science. Recent commentaries on formulary submission guidelines in a number of other countries, to include Ireland, the Netherlands, France, Australia, the UK and New Zealand conclude that they are subject to the same criticism. If the CADTH guidelines were never intended to support feedback to health system decision makers, then this should be made clear. If not, then consideration should be given to withdrawing the guidelines to ensure they conform to these standards. Hopefully, future versions of the CADTH guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback and not the building of imaginary worlds.

 

Type:  Commentary
Drug-induced Adverse Events and Prescribing Cascades in Older Adults: Pharmacy Stakeholder Survey
Authors: Vouri Scott Martin , Reckenberg Kristine A.
Published: January 2018

Objectives: The aim of this study was to assess pharmacists’ and student pharmacists’ understanding of drug-induced adverse events (DIAEs) and prescribing cascades (PC) and assess their willingness to use system-level approaches to identify DIAEs and PC for future patient interventions.

Methods: Following a continuing education presentation on DIAEs and PC, pharmacists and student pharmacists completed a survey. A retrospective post-then-pre method was used to assess knowledge. McNemar tests and chi-square analyses were used to determine differences in understanding of DIAEs and PCs, as well as between pharmacists and student pharmacists.

Results: A total of 53 participants completed the survey including pharmacists (n=39) and student pharmacists (n=14). Fewer participants had previously heard of the term (40%; p<0.001) and concept (60%; p<0.001) of PC compared to the term and concept (98% in both) of DIAE. Student pharmacists were less likely to have heard of the term PC (14%) compared to pharmacists (40%; p=0.029). There was no difference in knowledge of the concept of PC. Nearly all respondents were willing to assess for DIAE and PC in their patients, and over 75% of respondents were willing to receive systems-based alerts for DIAE and PC.

Conclusion: There was a differential in understanding DIAE and PC among respondents. Programs aimed at building understanding, as well as systems-level alerts for PC, are needed.

Conflict of Interest

Disclosures: This author declare no conflicts of interest for this manuscript.

Support: This publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448, sub-award KL2TR000450, from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).

 

Type: Student Project
A Qualitative Analysis of Student Pharmacists’ Response after an Auditory Hallucination Simulation
Authors: Ness Genevieve L , McGuire J. Michael , Taylor Prisca
Published: January 2018

Objectives: The goal of this research was to evaluate pharmacy students’ experiences and reactions when exposed to an auditory hallucination simulator.

Methods: A convenient sample of 16 pharmacy students enrolled in the Advanced Psychiatry Elective at a private, faith-based university in the southeastern United States was selected. Students participated in an activity in which they listened to an auditory hallucination simulator from their personal laptop computers and completed a variety of tasks. Following the conclusion of the simulator, students composed a reflection guided by a five-question prompt. Qualitative analysis of the reflections was then completed to identify and categorize overarching themes.

Results: The overarching themes identified included: 1) students mentioned strategies they used to overcome the distraction;

2) students discussed how the voices affected their ability to complete the activities; 3) students discussed the mental/physical toll they experienced; 4) students identified methods to assist patients with schizophrenia; 5) students mentioned an increase in their empathy for patients; 6) students reported their reactions to the voices; 7) students recognized how schizophrenia could affect the lives of these patients; and 8) students expressed how their initial expectations and reactions to the voices changed throughout the course of the simulation. Overall, the use of this simulator as a teaching aid was well received by students.

Summary: In conclusion, pharmacy students were impacted by the hallucination simulator and expressed an increased awareness of the challenges faced by these patients on a daily basis.

Conflict of Interest

We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

 

Type: Original Research
Community Pharmacists’ Classification of Prescription Drugs into an Expanded Class of Nonprescription Drugs under the FDA's Proposed NSURE Initiative
Authors: Shah Ruchitbhai M. , Holmes Erin R. , West-Strum Donna S. , Patel Amit
Published: January 2018

Objectives: There has been considerable debate over the last few decades about creating a third class of drugs that would not require a prescription or not be available freely over the counter, but require a pharmacist’s consultation upon purchase. These debates reignited again in 2012, when the Food and Drug Administration (FDA) held a hearing about a third class of drugs positioned as an expanded nonprescription drug class under the FDAs Nonprescription Safe-Use Regulatory Expansion (NSURE) Initiative. The objective of this study was to determine which prescription drugs community pharmacists believe are acceptable additions to an expanded definition of nonprescription drugs that would be available pending pharmacists’ consultation with a patient.

Methods: This cross-sectional study was conducted using a self-report, web-based survey administered to a national panel of community pharmacists. The survey contained a list of 24 current “prescription-only” drugs which may be potential candidates for an expanded nonprescription drug class, based on criteria outlined by the FDA, and questions related to respondent demographic and practice characteristics. The respondents were asked to indicate whether a particular drug should be marketed as a prescription drug, nonprescription drug or as part of an expanded non-prescription drug class. Descriptive analyses were conducted to determine the drugs that community pharmacists believed would be suitable additions to an expanded non-prescription drug class under the NSURE initiative.

Results: 462 completed surveys were received. Most respondents indicated that clopidogrel bisulfate (85.3%) and zolpidem (86.6%) should continue to be dispensed as prescription drugs. Atorvastatin, metformin, and sildenafil (among others) were considered appropriate to be marketed as an expanded nonprescription drug, in other words, dispensed without a prescription but upon pharmacist consultation. Desloratadine (64.6%) and pre-natal vitamins (50.2%) were considered appropriate for nonprescription status (over-the-counter, without pharmacist intervention).

Conclusions: Respondents suggested that 18 out of 24 drugs (75%) on the list provided could be categorized into an expanded class of nonprescription drugs. Adding more drugs to an expanded nonprescription drug class has the potential to expand pharmacists’ provision of patient care under the FDA’s proposed NSURE program.

 

Type: Student Project
Partnership-Based Health Care: Suggestions for Effective Application
Authors: Potter Teddie M
Published: January 2018

Societal transformation often starts with one visionary and a compelling idea. However, if there are no followers, the idea quickly becomes marginalized. It “takes a village” to build a movement, and the more system layers that can be addressed, the more likely the transformation will take hold. This article describes the framework for creating the necessary changes for partnership-based health care. It also makes suggestions for ensuring successful application of partnership-based systems change. This article is for all readers seeking to apply partnership principles in their own fields of influence.
Civilized Uncoupling: A Non-Adversarial Approach to Divorce
Authors: Curtis Gaylen
Published: January 2018

The word divorce can conjure images and expectations of ugly battles and emotional brutality involving parasitic attorneys profiting from the whole process. For many people the only hope for peace is to just walk away without a fight. There is another way for divorcing people. It is possible to get through a divorce and avoid the ugliness. This requires the willingness of the litigant and problem-solving skills of the attorney, as well as judges who demand compliance with court rules and accountability from both lawyers and litigants. Most of all, keeping divorce peaceful requires the viewpoint that it is possible to do so. This article advocates for this perspective.
Quarterly Publication, and Invitation to Artists
Authors: Potter Teddie M , Eisler Riane , Lewis-Hunstiger Marty
Published: January 2018

The mission of the Interdisciplinary Journal of Partnership Studies is to be an anthology for scholarly writing about the art and science of partnership, with contributions from both academicians and practitioners. Our vision is to be a vehicle for cultural transformation from domination to partnership. We are moving to a quarterly publication schedule in 2016, and invite artists in all media to participate in the partnership movement by submitting cover art.
Nurturing Children’s Humanity: Partnership Education
Authors: Eisler Riane
Published: January 2018

This article proposes that the unprecedented challenges of our rapidly changing world require more than piecemeal educational reform. It describes partnership education as an integrated template for redesigning the three main components of education: content, process, and structure. In addition, it provides examples of how various elements of partnership education can be incorporated into current classrooms, both in schools and universities. It illustrates how partnership education can help young people develop their full potentials, not only preparing them to navigate through our difficult times but providing them the knowledge and skills to help build a more peaceful, equitable, and sustainable future.
Appreciative Organizing: Charting a Course for Community Engagement
Authors: Parini-Runge Shelly A.
Published: January 2018

This article provides a brief overview of Appreciative Organizing (AO), a term coined by the author in her graduate work to describe the roles that dialogue, listening, storytelling, community networks, social bonding, and leadership play in designing and leading meaningful community engagement initiatives that result in transformative partnerships. It offers constructive steps and a real-life example of how AO was used to strengthen relationships between an institution of higher learning and the community it serves. AO posits that in order to strengthen America’s sense of community, public engagement practices must become more inclusive and innovative, and better networked. It illustrates how this community-centered method, grounded in the philosophical principles of partnership, appreciation, hope, and imagination, transformed an administration and built a culture of continuous engagement that helped the college meet and exceed its institutional goals. Further, through this example, the article’s larger objective is to share ways in which this method, when broadly applied, can be used to build trust and strengthen working relationships within a community setting.
Global Learning and Relational Diplomacy
Authors: Santulli David P.
Published: January 2018

Drawing upon lessons learned from peace builders on the island of Cyprus as well as from leaders in the fields of service-learning, experiential education, and leadership development, this article presents frameworks for both academics and practitioners alike which will be helpful not only in fulfilling their unique goals towards global learning and partnership development across an array of fields and disciplines, but also in bringing about a more peaceful, cohesive, and sustainable world.
Relationship of Hospital Architecture to Nursing Staff Caring for Self, Caring for Patients, and Job Satisfaction
Authors: Hozak Mary Ann , Nelson John , Gregory Debbie
Published: January 2018

Historically, the fields of architecture (design) and nursing (health) have been separate disciplines without much intersection. In recent years, the healthcare building boom has created a specialty practice for architects, focusing on healthcare design. With this new focus and specialty within architecture, the science of evidence-based design and the collaboration with clinical care staff have created a new partnership paradigm that is improving the built environment.

Ten dimensions of caring have been espoused by Watson’s Caritas Theory to comprise the construct of caring, which in turn facilitates healing for both the care giver and care recipient (Nelson & Watson, 2012). This article describes a study that examined the relationship between selected elements of architectural design and other factors (recent architectural change, unit size and shape, intersecting hallways, number and proximity of bathrooms and supply rooms, availability of nourishment, number and availability of computers, and rooms for staff gathering, for solitude, and for practice of Watson Caring Factors) and outcomes of caring that are important to nursing, including clinical staff caring for self, caring for others, and job satisfaction. The study took place in a hospital that was implementing Watson’s concepts of caring within their framework of care delivery. Statistically significant relationships were:

Caring for self was negatively related to number of supply rooms and number of Watson rooms or boxes. Caring for patients as reported by staff was negatively related to number of Watson rooms or boxes. Job satisfaction was positively related to number of bathrooms and negatively related to number of supply rooms. A small sample size required adjustment of the alpha to .15 and an effect size of .25, suggesting that replication studies with larger sample sizes may assist with development of a model of architecture that promotes behaviors as proposed by Watson and better outcomes for both patient and staff.