bluuebunny/crossref_metadata_2025 huggingface dataset:
"Until they know how much you care": A qualitative analysis of an innovative practice in community pharmacy
Authors: Melczak Michael , Pringle Janice
Published: January 2018

Purpose: This qualitative study was concerned with investigating community pharmacists' thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM) services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy) setting as part of a previous parent study. We describe this practice (using these scales in a novel setting) as an innovative practice, report on the pharmacists' experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice.

Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions.

Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (mis)understanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients.

Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure patient outcomes and therapeutic alliance. Pharmacists had varying opinions on the degree to which the use of these scales could impact patient medication adherence, although they perceived other value and benefits secondary to the interactions. While most pharmacists did not maintain formal use of the scales after study end, they took away general principles of patient-centered care and individualized feedback.

 

Type: Original Research
An estimation of the effect of 100% Compliance with Diabetes Treatment: Can we reduce cost of illness with higher compliance rates?
Authors: Kockaya Guvenc , Wertheimer Albert I.
Published: January 2018

Introduction: The current study was designed to estimate the direct cost of noncompliance of diabetes patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial.

Materials and Method: The study was conducted in three parts. First, a computer search of National Institutes of Health websites and professional society websites for organizations with members that treat diabetes, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of non-compliance and undiagnosed diabetes. Third, risk calculations were performed using the information obtained in part one and the formulas developed in part two.

Results: Direct risk reduction for diabetes-related kidney disease, stroke, heart disease, and amputation were estimated for 100% compliance with diabetes treatment. Risk, case and yearly cost reduction calculated for a 100% compliance with diabetes treatment were 13.6%, 0.9 million and US$ 9.3 billion, respectively.

Conclusion: Society, insurers, policy makers and other stakeholders could invest up to these amounts in screening, education and prevention efforts in an effort to reduce these costly and traumatic sequelae of noncompliant diabetes patients.

 

Type: Original Research
Community Pharmacy Marketing: Strategies for Success
Authors: Wood Kristina D. , Offenberger Megan , Mehta Bella H. , Rodis Jennifer L.
Published: January 2018

Purpose: As community pharmacies are implementing increasingly more clinical services they are faced with a new challenge of marketing these services. This article discusses The Ohio State University College of Pharmacy Clinical Partners Program's (Clinical Partners) experiences in marketing clinical services to patients, barriers encountered through these experiences, and presents suggestions for future marketing of services.

Experience: Clinical Partners developed two targeted marketing projects and evaluated impact on patient enrollment in services. In January 2008, the pharmacy ran a series of radio advertisements, newspaper print advertisements, and face to face marketing in the community with the focus of each being patient care services. During this project five individuals expressed interest in Clinical Partners' services. Four indicated that they heard about Clinical Partners through the radio ad and one through the pharmacy website, though none chose to enroll in services. In 2009 Clinical Partners focused on marketing MTM in the form of a comprehensive medication review to current patients already enrolled in its anticoagulation management service. Following a three month period, 6 patients (8%) of the 71 patients receiving the marketing intervention chose to enroll in MTM. Four additional patients have enrolled in MTM since conclusion of the project.

Discussion: These projects and a review of available literature revealed barriers that pharmacies encounter when marketing clinical services to patients in an outpatient setting including patients' unawareness of the role a pharmacist can play outside dispensing medications, patients' belief they do not need clinical services, and patients' unwillingness to pay a pharmacist out of pocket for services.

Future Implications: To overcome these identified challenges, community pharmacies should consider integration of marketing techniques such as tailoring marketing to a target population, forming and utilizing relationships with patients, and looking to past marketing successes in developing marketing plans. Pharmacists should also be adventurous in exploring new ways to promote pharmacy clinical services to find creative solutions to barriers encountered. As community pharmacies continue to grow the realm of clinical services offered to patients, it is important also to develop and implement marketing strategies to support the services and expansion of the profession so that these services can be embraced by patients and the health care community.

 

Type: Idea paper
Older Adult Perceptions of a Self-reported Medication Risk Questionaire: A Focus Group Study
Authors: Witry Matthew J. , Chang Elizabeth H. , Mormann Megan M. , Doucette William R. , Newland Brand A.
Published: January 2018

Background: Medication therapy management (MTM) has been shown to resolve medication-related problems and decrease health care expenses. Public and private health insurers, providers, and other stakeholders are looking for ways to involve patients in the MTM process. One option is to engage patients through the use of a medication risk questionnaire.

Objective: To investigate older adults' perceptions of completing a medication risk questionnaire and receiving a rating of their risk for medication-related problems.

Methods: Four, 75 to 90 minute focus groups were conducted using a semi-structured interview guide and copies of a medication risk questionnaire to collect qualitative data from 36 community dwelling older adults in Iowa, USA. Sessions were audio-recorded, transcribed, and analyzed thematically using an iterative process.

Results: The thematic analysis yielded a general theme of comprehensive medication reviews, and two themes on the medication risk questionnaire: "process and items" and "risk category reactions." Overall, participants were unfamiliar with pharmacist services beyond counseling. They were open to the questionnaire, but suggested it would be more useful as a topic for discussion with a provider than to screen patients. Despite their medication risk rating, most did not express interest in seeking a comprehensive medication review based on the result of the questionnaire as they considered themselves at low risk for problems.

Conclusions: Using a medication risk questionnaire as a topic for discussion could provide health insurance plans or providers an opportunity to increase beneficiary familiarity with MTM. These beneficiary perspectives may be useful to health plan administrators and MTM providers as they pursue new ways to involve patients in the medication management process.

 

Type: Student Project
Association Between Student Loan Debt on Graduation, Demographic Characteristics and Initial Choice of Practice Setting of Pharmacists
Authors: Yusuf Akeem A. , Schommer Jon C. , Mott David A. , Doucette William R. , Gaither Caroline A. , Kreling David H.
Published: January 2018

Objectives: (1) To examine trends in level of student loan indebtedness for groups of pharmacists that were first licensed between 1980 and 2006; (2) To examine if demographic variables are associated with level of student loan indebtedness; (3) To examine the association between student loan debt and choice of practice setting while controlling for demographic variables.

Methods: Data for this study were collected from a national random sample of 3,000 pharmacists using a self administered survey. Descriptive statistics were used to examine trends in level of indebtedness. The relationships between level of indebtedness, demographic variables and practice setting choice were examined using Chi-square statistics. Multinomial logistic regression was used to determine the independent association of student loan debt and choice of practice setting while controlling for demographic variables.

Results: The proportion of licensed pharmacists reporting student loan debt after graduation, and the mean amount of debt incurred increased between 1980 and 2006. Non-white pharmacists incurred debt at a higher proportion compared to white, and they also incurred significantly higher levels of debt. A lower level of indebtedness was associated with choosing independent practice over chain practice.

Conclusions: Student loan indebtedness has been increasing over time, especially for non-white pharmacy students. Future research should be done to examine other factors that might influence student debt load, work contributions and choice of practice settings. The affordability of pharmacy education for students of color and how salaries may or may not help off-set these costs also should be examined closely.

 

Type: Original Research
Medication Information Seeking Behavior in a Social Context: The Role of Lay and Professional Social Network Contacts
Authors: Kjos Andrea L. , Worley Marcia M. , Schommer Jon C.
Published: January 2018

This study provided a view of the social context of medication information seeking from a patient's perspective.This was an exploratory qualitative study with 40 adults to determine how patients communicate within social networks to seek medication information. Semi-structured interviews were used to determine the structure (who), the content provided (what), and the function of social sources of information (how/why). Data underwent ethnographic content analysis using theory and prior research driven themes. Coding matrices were created to identify emerging patterns for who supplied what information and how the information was used. Participants described seeking medication information from health professional or lay social network sources. Health professional sources' strongest role was to provide factual information. In contrast, lay sources provided factual information and affective information such as personal experiences and beliefs or attitudes. Information sought from social sources displayed similar functioning roles in terms of how the information was used by the participants seeking the information. The study concluded that medication information is sought from social sources both inside and outside of healthcare. Emerging patterns found that lay sources may provide patients more than affective information about medications. Further, patients may be receiving factually based information other than from health professionals. By coming to a more complete understanding of the social nature of the information environment, health professionals can better understand information needs from a patient's perspective.

 

Type: Original Research
Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services
Authors: Isetts Brian J. , Schommer Jon C. , Westberg Sarah M. , Johnson Julie K. , Froiland Nickie , Hedlund Julie M.
Published: January 2018

The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementation, and (6) marketing plan evaluation.

The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS). Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.

 

Type: Original Research
Antidepressant Use Amongst College Students: Findings of a Phenomenological Study
Authors: Singh Reshmi L. , Schommer Jon C. , Worley Marcia M. , Peden-McAlpine Cynthia
Published: January 2018

Background: Depression among college students is an escalating problem and could have serious consequences such as suicide. There has been an increase in use of antidepressants on college campuses in United States. However, an in depth understanding of this phenomenon from the college student's perspective is lacking in the literature.

Objective: This study examined college students' experiences and treatment decision making during their depression treatment.

Methods: A longitudinal, phenomenological research methodology was completed. The participants were nine students who were taking antidepressants for diagnosis of depression. Recruitment was done via brochures placed at University bulletin boards, and a mental health clinic. Three audio taped, unstructured interviews were conducted with each participant over four months. The central question asked was: What has the experience of treating depression been for you? Analysis of text was done using Van Manen's lifeworld existentials of lived body, lived time, lived relation and lived space as the organizing framework.

Results: Thirteen themes were identified within the four lifeworlds. The results showed that lived relation with providers was important for college students' decision to both initiate and continue antidepressant use. Students' role was defined in conjunction with provider's role by them as wanting to be a 'player' in their treatment decisions and needing to be 'acknowledged' as such by their providers.

Conclusions: Overall, the underlying essential theme of ‘autonomy’ was portrayed by the students’ experiential accounts of their depression treatment and treatment decision making.

 

Type: Original Research
Design and Implementation of Antidepressant Decision Making Aids
Authors: DeJongh Beth , Haight Robert
Published: January 2018

Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression.

Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness.

Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful.

Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient's medication adherence needs to be addressed in future studies.

 

Type: Student Project
Building Community Pharmacy Work System Capacity for Medication Therapy Management
Authors: Schommer Jon C. , Goncharuk Katerina , Kjos Andrea L. , Worley Marcia M. , Owen James A.
Published: January 2018

Questions within and outside of the pharmacy profession frequently arise about a community pharmacy's capacity to provide patient-care services and maximize contributions to public health. It is surmised that community pharmacy locations must possess specific attributes and have identifiable resources within the location to effectively initiate and optimize their capacity to deliver patient care services in conjunction with medication distribution and other services. The purpose of this paper is to describe three research domains that can help pharmacies make the transition from "traditional" business models to "patient care centered" practices: (1) Work System Design, (2) Entrepreneurial Orientation, and (3) Organizational Flexibility. From these research domains, we identified 21 Work System Design themes, 4 dimensions of Entrepreneurial Orientation, and 4 types of Organizational Flexibility that can be used in combination to assist a practice location in transforming its business model to a "patient care centered" practice. The self-assessment tools we described in this paper could help realign an organization's activities to initiate and optimize capacity for patient care.

 

Type: Idea Paper
Market Diffusion of Extended Cycle Hormonal Contraceptives
Authors: Schumacher Megen Leeds , Pettia Ashley Cetola , Wertheimer Albert I
Published: January 2018

Background: Extended cycle hormonal contraceptives (e.g. Seasonale, Seasonique) when introduced in 2003 were considered a very novel approach to contraception. The idea of manipulating the menstrual cycle so that women would experience just four menstruations a year was radical and was assumed to be responsible for the slow acceptance rate among the general public.

Objective: This report analyzes two different aspects of the acceptance of this unique idea in the population. The first was the level of usage of extended cycle hormonal contraceptives in the general population, which was measured by a review of sales figures over time in the United States. The second was an examination of market diffusion as it relates to consumer perceptions regarding the characteristics of these products.

Methods: To determine the degree of usage of extended cycle hormonal contraceptives the yearly sales, in terms of units sold, were compared with that of other leading methods of hormonal contraception. Along with the data, survey answers were obtained from 65 women who volunteered to participate in the study. Participants were selected randomly to represent the target population to assess the level of awareness about the benefits, risks, and any other concerns regarding the use of extended cycle hormonal contraceptives.

Results: The yearly sales data of units sold showed a definitive increase in the sales of extended cycle hormonal contraceptives since their release on the market. The survey results showed an overwhelming awareness in the study population about the extended regimen. However, only about half of the women in the survey group were aware of its benefits. The main concern reported was the perceived significant side effect profile.

Conclusion: Though awareness about the extended cycle hormonal contraception regimen was widespread, the survey population was not well informed about the advantages and the disadvantages regarding the degree of severity of side effects. To address these knowledge deficits, these aspects should be the focus when distributing information about extended cycle hormonal contraceptive regimens. This may boost the use of a potentially advantageous contraceptive regimen by a population who would derive benefit from its usage.

 

Type: Original Research
A Case Based Learning Model in Therapeutics
Authors: Jesus Ângelo , Gomes Maria João , Cruz Agostinho
Published: January 2018

Nowadays, learning a Pharmaceutical Profession is an increasing challenge. Apart from traditional texts, lectures and self-guided individual learning, pharmaceutical educators are encouraged to find and implement ways to promote higher order thinking, collaborative learning and to increase students' motivation. One way of achieving these objectives is to complement traditional learning methods with the development and implementation of Case Based Learning (CBL), supported in real life situations. Methods regarding real problems stand in contrast to a more traditional approach to learning and instruction. They promote learner-centered, small group, interactive learning experiences, instead of large group, didactic, teacher-centered instruction. Developing such a learning approach can be a challenge. In this sense, it becomes relevant to promote and share experiences already underway and by doing so, disseminate knowledge in this field. It is our goal with this text to share our experience in the design and implementation of a Case Based Approach to Therapeutics.

 

Type: Idea Paper
Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program
Authors: McKenzie Mallory C. , Lenz Thomas L. , Gillespie Nicole D. , Skradski Jessica J.
Published: January 2018

Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program.

Design: Retrospective analysis of medication adherence using pharmacy refill data.

Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof.

Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM), lifestyle medicine and care coordination.

Main Outcome Measures: The Proportion of Days Covered (PDC) and the Medication Possession Ratio (MPR).

Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01). The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence) for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01). The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence) pre enrollment versus post enrollment (+10%, P=0.086). The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively.

Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for at least one year and was shown to be better when compared to a matched cohort of similar age, condition and region.

 

Type: Original Research
Evaluation of a Patient Perspective Module in a Required Medication Safety and Quality Course at a College of Pharmacy
Authors: Battaglia Jessica N , Lis Jennifer E , Chui Michelle A
Published: January 2018

Objectives: To develop and evaluate the impact of a module discussing the patient's perspective on medication errors in a required medication safety course at a college of pharmacy.

Methods: Students were required to read Josie's Story, a true story written by a mother after her daughter died from a medical error, and attend an in-class discussion regarding the book. A questionnaire, which employed a pre-post retrospective method and extracted items from the Caring Ability Inventory, was then administered to measure the change in students' perceptions of patient care. Additional questions gathered students' perceptions of the assignment, their personal experiences with the topic, and the importance of medication safety. Results: 120 out of 138 students (response rate = 87%) completed the questionnaire. 56% of students indicated they would be more likely to speak with a patient directly about a medication error after reading the book, whereas only 3% were less likely, and 42% indicated they were just as likely. Most students (59%) reported that they felt more motivated to learn about medication safety after reading Josie's Story.

Implications: This course previously addressed strategies to prevent medication errors. Successfully adding a component that introduces how a medication error impacted a patient and her family may help motivate students to recognize the importance and need for a culture of safety, personalize how medication errors impact patients, and provide a venue for students to gain patient centeredness and caring skills.

 

Type: Original Research
Development of an Active Follow-up Process in a Stand-alone Medication Therapy Management (MTM) Clinic
Authors: Hager Keri D.
Published: January 2018

Without following-up with patients, one cannot determine the outcomes of interventions made with patients. To ensure follow-up was occurring in a stand-alone MTM clinic, a process for active follow-up and an easy-to-use way to trigger and document follow-up was developed.

 

Type: Clinical Experience
Community Pharmacists' Awareness of Intimate Partner Violence: An Exploratory Study
Authors: Barnard Marie , West-Strum Donna , Holmes Erin , Yang Yi , Swain Kristen Alley
Published: January 2018

Background: Intimate partner violence (IPV) is a serious public health problem, impacting more than 12 million people in the United States each year. The only know effective health care intervention is routine screening for IPV exposure; however, this intervention has been poorly adopted. Expansion of screening efforts to the community pharmacy setting provides an opportunity to have a substantial impact on the health and well-being of pharmacy patients. However, little is known about pharmacists' knowledge, attitudes, and behaviors related to IPV.

Objective: The objective of this study was to conduct an exploratory investigation of community pharmacists' current level of knowledge, attitudes, behaviors, and intentions related to IPV and to IPV screening.

Methods: A cross-sectional study using an online questionnaire was conducted. Surveys were distributed via email. Descriptive analyses of survey responses were conducted.

Results: A total of 144 community pharmacists completed the survey. Results indicated most (67.4%) had no IPV education/training. Participants were significantly more willing to conduct screening with targeted patients compared to all patients. (X2=129.62; df=36; p<0.0001). There was strong agreement with interest in and willingness to participate in continuing education.

Conclusions: Most respondents indicated relatively low levels of IPV knowledge and training and very little current IPV screening activity. Continuing education on IPV should be considered for pharmacists to increase knowledge and awareness of IPV.

 

Type: Original Research
Exploring a Laboratory Model of Pharmacogenetics as Applied to Clinical Decision Making
Authors: Kisor David F. , Talbot Jeffery N. , Stockert Amy L. , Smith Angela
Published: January 2018

Objective: To evaluate a pilot of a laboratory model for relating pharmacogenetics to clinical decision making.

Case Study: This pilot was undertaken and evaluated to help determine if a pharmacogenetics laboratory should be included in the core Doctor of Pharmacy curriculum. The placement of the laboratory exercise in the curriculum was determined by identifying the point in the curriculum where the students had been introduced to the chemistry of deoxyribonucleic acid (DNA) as well as instructed on the chemistry of genetic variation. The laboratory included cytochrome P450 2C19 genotyping relative to the *2 variant. Twenty-four students served as the pilot group. Students provided buccal swabs as the source of DNA. Students stabilized the samples and were then provided instructions related to sample preparation, polymerase chain reaction, and gel electrophoresis. The results were reported as images of gels. Students used a reference gel image to compare their results to. Students then applied a dosing algorithm to make a "clinical decision" relative to clopidogrel use. Students were offered a post laboratory survey regarding attitudes toward the laboratory. Twenty-four students completed the laboratory with genotyping results being provided for 22 students (91.7%). Sixteen students were wild-type (*1/*1), while six students were heterozygous (*1/*2). Twenty-three students (96%) completed the post laboratory survey. All 23 agreed (6, 26.1%) or strongly agreed (17, 73.9%) that the laboratory "had relevance and value in the pharmacy curriculum"

Conclusion: The post pilot study survey exploring a laboratory model for pharmacogenetics related to clinical decision making indicated that such a laboratory would be viewed positively by students. This model may be adopted by colleges to expand pharmacogenetics education.

 

Type: Case Study
Awareness of and Readiness for Medication Therapy Management Among Community Pharmacists in New York City: Results from a Focus Group
Authors: Arya Vibhuti , Pinto Sharrel , Khan Tasmiya
Published: January 2018

For pharmacist-provided Medication Therapy Management (MTM) services to operate effectively and efficiently, pharmacists must understand the process of MTM delivery, assess the barriers and challenges in creating a sustainable MTM program, and realize the willingness and readiness of their colleagues to deliver such services. In order to assess feasibility of such services among high-risk neighborhoods in New York City (NYC), a focus group design was used to qualitatively assess pharmacists' perceptions of MTM. Findings showed that reimbursement and allocation of resources were the most discussed challenges/barriers to the provision of pharmacist-provided MTM services. Overall, pharmacists were willing, but not yet ready, to provide MTM services on a large scale. Lack of understanding of MTM structure/process, reimbursement challenges, and the need for collaboration between providers were key components to pharmacists' willingness to provide services. Additional training opportunities were deemed necessary for them to feel confident to conduct clinical services. Although pharmacists discussed several issues regarding MTM, they were still interested in participating and seeing how MTM would impact their community practice settings. Understanding these perceptions of pharmacists on MTM allowed us to better understand and assess ways for continuous quality improvement of services that will enhance patient care.

 

Type: Original Research
Individualized Dosing of Children's Liquid Medications in the Community Pharmacy Setting: A Survey of Parents and Guardians
Authors: Shelly Jamie , Hiller Debbie , Zhai Lingxiao , Ferreri Stefanie , Marciniak Macary Weck
Published: January 2018

Objectives: 1) To determine parents' and/or guardians' interest in having pharmacists provide children's liquid medications in a pre-measured, individualized dosing device 2) To assess parents' and/or guardians' perception of dosing liquid medications for a child.

Design: Observational survey

Setting: Regional chain pharmacy in North Carolina

Participants: > 18 years old, parent/guardian of a childchain, responsible for administering child's liquid medication

Intervention: 14 item questionnaire

Main Outcome Measure: Interest in pharmacists providing children's liquid medications in pre-measured, individualized dosing devices

Results: 250 questionnaires were mailed; 42 were marked "return to sender" (16.8%), 22 were returned completed (10.6%), and 20 of the 22 met inclusion criteria (9.6%). 95% of study participants reported being interested in having pharmacists provide children's liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is "not at all difficult" to understand the amount of dose a child is to receive, while 55% reported it is "not at all difficult" to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child's medication.

Conclusion: Community pharmacists should explore providing children's liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide.

 

Type: Original Research
Design and Implementation of an Interdisciplinary Elective Course in Drug Discovery, Development, and Commercialization
Authors: Ettouati William S. , Hirsch Jan D. , Ma Joseph D.
Published: January 2018

Objective: To describe the design and implementation of an elective course in drug discovery, development, and commercialization for pharmacy, medical, biomedical graduate, business, and law students.

Case Study: This course included didactic lectures, student group discussions, a longitudinal assignment, and a question and answer panel session. A 9-item instrument using a 5-point response scale was used for course evaluation. The longitudinal assignment was the creation and presentation of a product lifecycle strategic plan (PLSP). Respondents rated 'agree' and 'strongly agree' in the course providing useful information on drug discovery (39% and 53%), drug development (39% and 60%), and drug commercialization (33% and 60%). The majority of student-reported overall understanding of the drug discovery and drug development process was rated 'very good' (49% and 46%), while the drug commercialization process was rated 'good' (46%).

Conclusions: An elective course on drug discovery, development, and commercialization included enrollment of students with diverse educational training. The course provided useful information and improved overall student understanding.

 

Type: Case Study
The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System
Authors: Wood Kristina D. , Greene Elisa M. , Franks Rachel B. , Poole Traci M. , Ficzere Cathy H. , Johnston Philip E.
Published: January 2018

Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.

Setting: Ambulatory care and community practice

Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers.

Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients.

Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system.

Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.

 

Type: Idea Paper
Accessibility to Essential Medicines in New York City by Zip Code Income Levels and Boroughs
Authors: Aronson Yan , Addo-Atuah Joyce
Published: January 2018

Access to essential medicines is fundamental to medication adherence, continuity of care and hence population health outcomes and overall quality of life. Disparities in the availability and the cost of these medications in New York City, especially for low income neighborhoods, would compound the underlying health disparities in these neighborhoods. This study examined the physical and financial accessibility to 8 of the 150 Most Frequently Prescribed Drugs in New York, 2 each for Asthma, Diabetes, Hypertension, and Hyperlipidemia, 4 conditions that are among the top 10 most costly conditions in the United States. The study did not find any significant differences in mean drug prices between the high, medium, and low income neighborhoods in the City. However, the significantly different income levels and uninsured rates across neighborhood income strata in the City (p<0.001 for both), coupled with the high disease burden and other underlying disparities in low income neighborhoods, would point to potential affordability challenges for needed medications in these neighborhoods. On the other hand, significant differences in mean prices between the 5 City boroughs were found for 3 of the study drugs: Advair™, p=0.009; Amlodipine 10mg, p<0.001; and Lisinopril 10mg, p=0.046. No such significant differences were observed for the mean prices of the other 5 study drugs-Proventil HFA,™ Metformin HCL 500mg, Glipizide ER 5mg, Simvastatin 20mg, and Atorvastatin 10mg. The study findings did not also suggest that drug prices are dictated by the number of pharmacies in a neighborhood. Further studies would be needed to better understand the complexities associated with the accessibility of essential medicines in New York City. These studies could include qualitative ones which would examine the perceptions and experiences of City residents with respect to the accessibility of prescribed medications as the basis for targeted interventions directed at promoting access to needed medications for all New Yorkers.

 

Type: Student Project
Team-based learning (TBL): An Argument for Faculty's Evaluation
Authors: Kebodeaux Clark D. , Vouri Scott Martin , Hurd Peter D.
Published: January 2018

Team-based learning (TBL) is increasingly used for presenting educational information to students in colleges of pharmacy. Several studies have shown a positive impact on students both in terms of academic performance and comprehension. Current literature does not provide the full perspective of faculty, who are incorporating this methodology into the classroom. Cross-sectional surveys and commentary within manuscripts describe mixed findings regarding the faculty's perception of TBL. The aims of this paper are: 1) to describe why faculty evaluation of TBL is important, 2) to outline variables for consideration in faculty evaluations of TBL, and 3) to describe uses for the data from faculty evaluation of TBL.

 

Type: Idea Paper
Recognizing and Disseminating Innovations in Scholarly Teaching and Learning to Support Curricular Change
Authors: Janke Kristin , Kolar Claire
Published: January 2018

Type: Invitation
Perceived Impact of a Longitudinal Leadership Program for All Pharmacy Students
Authors: Mort Jane R. , Strain Joe D. , Helgeland David L. , Seefeldt Teresa M.
Published: January 2018

Objective: To describe a longitudinal leadership program involving all students and report the perceived impact.

Design: The program included a first year Leadership Interview, a third year Report of Leadership, and a fourth year Professional Business Meeting Attendance. Activities involved guided reflection.

Assessment: Students (n=138) indicated the activities helped them recognize the importance of leadership and their leadership potential (e.g., 72.5% and 62.3% of students due to meeting attendance, respectively). Students participated in leadership activities that they would not have pursued otherwise, either in response to the activity (27.7% due to interview) or as a requirement of the activity (51.1% for leadership report). Students reported developing specific leadership skills through the activities. Most students planned to be involved in a district/regional (72.5%), state (84.1%), and national (51.4%) meeting in the five years following graduation.

Conclusion: Students reported a positive impact on leadership perceptions and participation. The report is a preliminary step in the development and assessment of a longitudinal curricular initiative involving all pharmacy students.

 

Type: Case Study
Assessment of Asthma Inhaler Technique in Two Community Pharmacies
Authors: Farabaugh Nicole , McMillan Ashlee , Garofoli Gretchen
Published: January 2018

Objectives: To 1) assess inhaler technique in patients with asthma who present to a community pharmacy and 2) determine if patients find it desirable to have further inhaler education from pharmacists.

Methods: Participants were recruited when picking up their inhalers at either one chain or one independent pharmacy from May 2012 to December 2012. Any person 18 years of age or older, diagnosed with asthma, and currently prescribed an inhaler was eligible for inclusion in the study. Those who voluntarily agreed to participate were provided a written survey to evaluate current inhaler usage and past education from pharmacists. Participants were then asked to demonstrate how they currently operate their inhalers and observations regarding technique were recorded. Participants were then educated on what improvements could be made in their technique, if applicable.

Results: A total of 31 surveys were completed for this study, of which only 3(9.6%) of the respondents were observed to be using their inhalers properly; however 18(58%) rated their technique as a 5 out of 5 on a Likert scale with 5 being the best. Almost all respondents (96.7%) classified their inhalers as "easy" or "very easy" to use, and 13 (41.9%) would prefer more education from pharmacists regarding their inhalers.

Conclusion: The results of this study identified a significant need for patients to be educated on proper inhaler technique. It also revealed a high patient preference for pharmacists to offer additional education to patients using asthma inhalers upon initiation of inhaler therapy and with inhaler refills.

 

Type: Student Project
Are We Treating The Patient or the Disease?
Authors: Vogt Eleanor , Shane Patricia , Kahn Henry
Published: January 2018

The evidence abounds. A compelling body of research estimates that psychosocial stressors play a role in a significant number of patient complaints seen in primary care. In addition to the challenges faced by primary care clinicians who must consider their patients' psychosocial stressors, these factors can also affect pharmacists' care. Patient stress, through a number of mechanisms, can limit the efficacy of medicine as well as our efforts to achieve optimal medication management, and adds a poorly examined complexity to patient care practices. A landmark Institute of Medicine report calls for "whole patient "care, addressing psychosocial health needs, not as an embellishment, but as part of routine care. Whole patient care requires a fundamental shift, with patient needs at the center of healthcare delivery, and psychosocial-linked distress considered as integral to that model. These considerations place this topic squarely within the pharmacists' scope of practice and urgently call for an expanded approach to patient care and an opportunity for pharmacists to address that need. To parallel this discussion, the contributing role of practitioner stress is briefly reviewed.

 

Type: Idea Paper
A Student-Initiated, Integrated Pharmacotherapeutics Learner-Centered Course
Authors: Hopman Shawn , Popovich Nicholas G.
Published: January 2018

Objective: To evaluate a learner-centered, elective course complementing pharmacotherapeutic instruction.

Design: A one credit-hour elective as developed. Enrolled students were responsible for article selection and to lead in-class discussions. A content-validated discussant rubric was use to peer review each discussant.

Assessment: Enrolled students kept current on the literature and nurtured an obligation to themselves and their peers to be prepared on a weekly basis to discuss the selected article. Discussion demonstrated varied opinions and provided ample opportunity for students to use technical/clinical language. Also, the course allowed for thinking at a higher level, discussing complex ideas/issues, and developing oral communication skills.

Conclusions: This learner-centered approach allowed the enrolled students to take ownership of their learning and complement their learning from the traditional mode of learning in two pharmacotherapeutic courses. It encouraged the students to investigate the clinical literature as a means to complement and enhance their knowledge.

 

Type: Note