bluuebunny/crossref_metadata_2025 huggingface dataset:
Method validation in pharmaceutical analysis: from theory to practical optimization
Authors: Eserian Jaqueline Kaleian , Lombardo Márcia
Published: January 2018

The validation of analytical methods is required to obtain high-quality data. For the pharmaceutical industry, method validation is crucial to ensure the product quality as regards both therapeutic efficacy and patient safety. The most critical step in validating a method is to establish a protocol containing well-defined procedures and criteria. A well planned and organized protocol, such as the one proposed in this paper, results in a rapid and concise method validation procedure for quantitative high performance liquid chromatography (HPLC) analysis.

 

Type: Commentary
Evaluation of Medication Kit Processing Time Using Radio Frequency Identification (RFID) Technology
Authors: Summerfield Marc R. , Xiao Yan
Published: January 2018

A study was conducted to evaluate the time devoted to medication kit processing using radio frequency identification (RFID) technology versus traditional processing. The article reviews the traditional, non-automated process as well as the automated RFIDbased process. The comparative methodology is reviewed, including limitations. The result shows a statistically significant time savings with the RFID-based technology in both process components (restocking and verifying) and the total. Other elements important in institution decision-making are reviewed.

 

Type: Original Research
An Advanced Registered Nurse Practitioner-Community Pharmacist Team-Based Approach to Managing Hypertension in a Rural Community Pharmacy
Authors: Parker Christopher P. , Kelchen Sherry L. , Doucette William R.
Published: January 2018

Purpose: To evaluate the implementation of an Advanced Registered Nurse Practitioner (ARNP) – community pharmacist team-based collaborative model for managing hypertension in a rural, Midwestern, community pharmacy and family medicine clinic using the core functions of the patient centered medical home model (PCMH).

Methods: Thirteen patients with uncontrolled hypertension, 5 of who were newly diagnosed, were referred to the pharmacist by the ARNP. The pharmacist rechecked the patient’s blood pressure (BP) every 2 weeks after referral and made drug therapy change recommendations to the ARNP if the patient was not below goal.

Results: Following the intervention, the average SBP and DBP decreased 24 mmHg and 12mmHg, respectively. The pharmacists made 21 recommendations (dose increase (11), add a medication (6), change a medication (2), and addition of an adherence tool (2)), 100% of which were accepted by the ARNP.

Conclusion: A team-based approach to managing hypertension in a rural community pharmacy and family medicine clinic was an effective way to lower blood pressure. In addition, the core functions of the PCMH model can be delivered in a small family medicine practice. Creating specific expectations for each member of the team prior to referring patients improved the efficiency of the intervention.

 

Type: Original Research
Perceptions of Preparedness for Interprofessional Practice: A Survey of Health Professional Students at Three Universities
Authors: Sevin Alexa M. , Pruchnicki Maria C. , Ulbrich Timothy R. , Adkins Sarah E. , Maguire Michelle A. , Green Christopher G. , Brown Nicole V.
Published: January 2018

Objective: The purpose of this study was to evaluate health professions students’ understanding of their own and others’ roles on interprofessional (IP) teams, assess students’ perceptions of their preparedness to practice in an IP team, and determine differences by type of learning institution and participation in interprofessional education (IPE).

Methods: Medical, nursing, and pharmacy students at three Ohio universities with unique IP learning models were surveyed. Descriptive statistics, analysis of variance (ANOVA), chi-square, and two sample t- tests were used to compare measures of knowledge, IPE participation, and preparedness.

Results: Of the 981 invited students, 273 completed the survey (27.8% response). Overall, 70.7% of participants felt prepared to work on an IP team. Those who reported participation in IPE were more likely to feel prepared to practice on an IP team compared to those who did not (76.8% [149/194] vs. 55.3% [42/76], p=0.0005). Participation in IPE did not significantly affect knowledge scores (participators 79.6% vs. non-participators 81.0%, p=0.1731). Those who had higher profession-specific knowledge scores were more likely to feel prepared to work with that specific profession.

Conclusions: Participation in IPE activities in the representative institutions was high, as was knowledge of professional roles. Both participation in IPE and increased knowledge of roles were associated with increased student-assessed preparedness. Advancement of skills and behaviors including knowledge of roles and other competencies may all be important. Pharmacy in particular should prioritize IPE as a means to elucidate our role on the patient care team.

 

Type: Original Research
Knowing Your Pharmacist's Name
Authors: Dragic Lisa , Pham Vivan , Wertheimer Albert
Published: January 2018

Pharmacists are the most accessible health care providers to the general public. Pharmacists are experts in helping patients get the most out of today’s complicated medications. Pharmacists ensure safe and effective use of medications. The American Pharmacists Association pitched a campaign, “Know your medicine, know your pharmacist.” Before one can know their medicine, one must know their pharmacist. This study was conducted to see whether older or younger and male verse female patients knew their pharmacist’s name better in the Philadelphia area, as a pilot study.

 

Type: Commentary
Integration of Rural Community Pharmacies into a Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis
Authors: Hagemeier Nicholas E. , Blevins Sarah R. , Hagen Kyle S. , Sorah Emily L. , Shah Richa S. , Ferris Kelly M.
Published: January 2018

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET) PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions.

Findings: A 47.8% response rate was obtained. Most key informants (88%) were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%), improved relationships with providers in the community (75.9%), and professional development opportunities (69.0%) were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63%) and workflow disruptions (20%) as the biggest barriers to PBRN participation.

Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas.

 

Type: Original Research
Potential Rx-to-OTC Switch Drug Candidates
Authors: Phan Victor , Wertheimer Albert
Published: January 2018

The purpose of this study was to gain insight in what Rx legend drugs pharmacists think have a good enough safety profile to sell as OTC and, if any, what OTC drugs pharmacists think should be legend only. This study was performed as a non-directional survey asking the 2 following questions: “What are some prescription only medications that you think would be okay to sell as nonprescription (over-the-counter and behind the counter)” and following that “If any, what are some OTC/BTC medications that you think should be prescription only?” Pharmacists who were surveyed were those in the Philadelphia area within convenient traveling distance or whose contact information was available or accessible. There were three modes of collecting data. The first method was traveling to pharmacies in person and giving the pharmacist a physical survey to complete. The second method was the creation of a survey monkey, identical to the physical survey, which was sent electronically via email, text, or Facebook. The third method was telephoning pharmacies and conducting the survey over the phone. Demographics of respondents’ age range, education, area of work, and gender were collected. All methods were done as similarly as possible; with the same greeting and wording of questions, etc. Data analysis was done based on noticeable trends of answers and tallying frequencies of responses. In all, 101 pharmacists were contacted. The most common suggestion for Rx-to-OTC switch was oral contraceptives.

 

Type: Student Project
Opening A New Independent Pharmacy 101
Authors: Elabed Azam , Wertheimer Albert , Ibrahim Sabri
Published: January 2018

Opening an independent pharmacy is a process that involves multiple components. The rationale of this project is to discuss different issues that must be investigated prior to opening a new independency pharmacy. This includes the location, structure of the corporation, start-up cost, picking a wholesaler, fulfilling state board requirements and Philadelphia requirements, having a valid license, making professional relationships, and knowing basic marketing research. Methods used include using the knowledge and expertise from an independent pharmacy owner, visiting pharmacies, and interviewing neighbors for basic marketing research. Many aspects of opening an independent pharmacy differ significantly from a retail pharmacy, as there are various issues within the pharmacy and outside the pharmacy that must be extensively researched prior to opening in order to be successful.

 

Type: Student Project
Critical Thinking Development in Pharmacy Education: A Meta-Analysis
Authors: Peeters Michael J , Zitko Kimberly L , Vaidya Varun A
Published: January 2018

Objective: The investigators aimed to summarize prior studies of critical thinking development among pharmacy students, using the California Critical Thinking Skills Test (CCTST), Health Sciences Reasoning Test (HSRT), and Defining Issues Test (DIT).

Methods: Independently, two investigators (KLZ, MJP) systematically searched available literature using PubMed, Google Scholar, ERIC, PsychInfo, as well as pharmacy education conference abstracts in American Journal of Pharmaceutical Education. Their search terms were ‘pharmacy’, and [‘critical thinking’, ‘HSRT’, ‘CCTST’, and ‘DIT’]. Studies included were those that investigated pharmacy students, used one of the tests (CCTST, HSRT, DIT), and used a longitudinal design with test administration at two or more time-points for the same subjects (i.e., development). On review, the CCTST and HSRT seem more foundational to analytical/critical thinking, while the DIT appears to measure moral/complex thinking. Summarizing used meta-analysis with Cohen’s d and random-effects modelling.

Results: Five studies involved thinking development with 10 separate cohorts for meta-analysis (8 cohorts for CCTST, 2 for DIT, and 0 for HSRT). At 5 institutions, 407 and 1148 students were included (CCTST and DIT, respectively). For the CCTST, the overall effect was 0.33 (0.19-0.47 95%CI) with some heterogeneity among study cohorts (I2=52%). For the DIT, the overall effect was -0.23 (-0.83-0.37 95%CI) with considerable heterogeneity between study cohorts (I2=95%). For the CCTST and DIT, some studies showed effect-sizes greater than 0.5. Meta-analysis of the HSRT could not be conducted (i.e., 0 studies found).

Implications: While measuring different aspects of “critical thinking”, the CCTST and DIT showed responsiveness to change and appear to be promising measures of cognitive development. These tests should be used in further well-designed research studies that explore strategies for improving cognitive development in pharmacy education.

Conflict of Interest

We declare no conflicts of interest or financial interests that the we or members of our 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
Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)
Authors: Singrey Amanda M , Casper Kristin A , Brown Nicole V , Mehta Bella H
Published: January 2018

Pharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management.

 

Type: Original Research
Access to Breathing Medications in an Uninsured and Underinsured Patient Population
Authors: Singrey Amanda M , Pruchnicki Maria C. , Seifert Jennifer , Peng Juan , Young Gregory , Casper Kristin A.
Published: January 2018

The purpose of this study was to explore access to breathing medications in an uninsured and underinsured patient population and identify needs for additional medication access resources. Quantitative data were collected from a dispensing report, financial database, and medical records review of patients who filled prescription medications at a charitable pharmacy in Ohio between December 11, 2014 and March 11, 2015, and qualitative data were collected from five semi-structured interviews with patients regarding breathing medication access. A total of 181 patients filled a breathing medication during the study period, which is nearly a quarter of the pharmacy’s patient population. The majority of patients were African American or Caucasian, and almost half were uninsured. Ultimately, the pharmacy had to purchase nearly half of breathing medications provided despite utilizing several medication access routes. Thus, access remains a significant challenge. Efforts are needed to ensure that vulnerable populations can consistently access breathing medications.

 

Type: Clinical Experience
Sunlit Uplands: The Genius of the NICE Reference Case
Authors: Langley Paul C
Published: January 2018

The NICE reference case has received widespread acceptance in health technology assessment. The lifetime cost-per-QALY model and constructed claims for product impact have been widely emulated in country-specific guidelines for formulary submission as well as in publications in the leading health technology journals. Unfortunately, from the perspective of the standards of normal science, adherence to the reference case standard means that the claims made are typically non-evaluable. They have to be taken at face value. They may suggest potential evaluable hypotheses for clinical and cost-effectiveness claims, but there is no requirement in the reference case for claims to be put in an evaluable form and for manufacturers to suggest possible protocols for product impact assessment. This is not an acceptable situation. Absent the standards for falsification and replication, which are at the core of the scientific method, we have no idea whether the claims accepted by NICE are right or even if they are wrong. If we accept the reference case paradigm should we conclude that the sunlit uplands of formulary decisions based on non-evaluable simulated claims for cost-effectiveness has been reached? Have we rejected natural selection in favor of intelligent design?

Conflict of Interest

None

Type: Commentary
Great Expectations: Cost-Utility Models as Decision Criteria
Authors: Langley Paul C
Published: January 2018

One of the more puzzling features of published claims for cost-effectiveness is the popularity of claims presented in terms of quality adjusted life years (QALYs). Despite the popularity of QALYs as the ‘gold standard’ outcome measures among academic audiences, professional groups and a number of single payer health care systems, there is no evidence to suggest that cost-per-QALY based claims have ever been assessed, either through experimentation or observation, to support formulary decisions. In part this stems from the fact that cost-per-QALY claims are typically not expressed in evaluable terms; it also stems from the fact that, despite the plethora of QALY publications, QALYs are not collected on a regular basis by any health care system as part of administrative claims or electronic medical records. In the US QALYs have typically been ignored by health care decision makers. Given this, the continuing popularity of utility-based measures for studies published in the leading pharmacoeconomics journals is difficult to understand. One possible explanation is that those promoting QALY claims are locked into a relativist position that defends the publication of nontestable product claims. A position that is reinforced by recommendations from ‘peer organizations’ such as the Academy of Managed Care Pharmacy (AMCP) in their promotion of their Format for Formulary Submission standards which support the role of lifetime cost-per-QALY modeled imaginary worlds or thought experiments. Another explanation is that QALYs have been taken at face value with little though given to how they might be implemented to support both initial formulary decisions as well as ongoing disease area therapeutic class reviews. The purpose of this review is to put the case that the continued emphasis on cost-per-QALY claims has no practical benefit in formulary decision making.

 

Type: Commentary
Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals
Authors: AL-JUMAILI ALI AZEEZ ALI , Jabri Aminah M. , Al-Rekabi Mohammed D. , Abbood Sarah K. , Hussein Ahmed H.
Published: January 2018

The objectives of this study were to measure the incidence and types of medication prescribing errors (MPEs) in Iraqi hospitals, to calculate for the first time the percentage of physician agreement with pharmacist medication regimen review (MRR) recommendations regarding MPEs, and to identify the factors influencing the physician agreement rate with these recommendations. Methods: Fourteen pharmacists (10 females and 4 males) reviewed each hand-written physician order for 1506 patients who were admitted to two public hospitals in Al-Najaf, Iraq during August 2015. The pharmacists identified medication prescribing errors using the Medscape WebMD, LCC phone application as a reference. The pharmacists contacted the physicians (2 females and 34 males) in-person to address MPEs that were identified. Results: The pharmacists identified 78 physician orders containing 99 MPEs with an incidence of 6.57 percent of all the physician orders reviewed. The patients with MPEs were taking 4.8 medications on average. The MPEs included drug-drug interactions (65.7%), incorrect doses (16.2%), unnecessary medications (8.1%), contra-indications (7.1%), incorrect drug duration (2%), and untreated conditions (1%). The physicians implemented 37 (37.4%) pharmacist recommendations. Three factors were significantly related to physician acceptance of pharmacist recommendations. These were physician specialty, pharmacist gender, and patient gender. Pediatricians were less likely (OR= 0.1) to accept pharmacist recommendations compared to internal medicine physicians. Male pharmacists received more positive responses from physicians (OR=7.11) than female pharmacists. Lastly, the recommendations were significantly more likely to be accepted (OR= 3.72) when the patients were females. Conclusions: The incidence of MPEs is higher in Iraqi hospitalized patients than in the U.S. and U.K, but lower than in Brazil, Ethiopia, India, and Croatia. Drug-drug interactions were the most common type of MPEs in hospitals. Physician specialty and pharmacist gender and patient gender significantly influenced physician agreement with the pharmacist comments. Only one-third of the pharmacist recommendations were implemented. Phone drug applications would be helpful for daily hospital pharmacy practice. More pharmacist-physician collaboration is needed to address MPEs. Pharmacist-led MRR can identify and address MPEs to improve patient safety.

 

Type: Original Research
Designing a Free Academic Early Alert System
Authors: Welch Adam C , Greever Adam , Linne Carmen
Published: January 2018

This manuscript describes the development and implementation of a cloud-based, academic early alert system using Google Sheets. It was written for a non-computer savvy person to be able to develop the early alert system. By creating a Master Sheet and using the syntax from the share function of Google Sheets, a unique sheet can be created for each advisor that limits information sharing of their specific advisees. By adding a Google Form to the sheet, advisor interventions can be captured that reflect interventions made as a result of the early alert sheet.

Approximately 52% of students were identified on the early alert sheet by having at least one non-passing score on an exam. There were 35-50% of faculty advisors who documented their interventions in the sheet. The template and coding used to develop this academic early alert sheet may be applied to other central documentation needs, such as professionalism early alert.

Conflict of Interest

Dr. Welch reports owning stock in Alphabet, Inc, however, was not involved in the selection of Google as the preferred platform at this institution.

 

Type: Note
An Overview of Comic Books as an Educational Tool and Implications for Pharmacy
Authors: Muzumdar Jagannath
Published: January 2018

Objective: To present an overview of comic books as an educational tool and discuss the use of comic books in pharmacy education.

Literature Identification: This research is comprised of a narrative literature review and critical analysis of the information retrieved. Key words included: comic(s), graphic novels, and pharmacy education. News articles, dissertations, theses, books, and scholarly articles from peer reviewed journals were selected and reviewed for inclusion in this article.

Results: Comics have been used as a pedagogical tool to motivate students to read, help them remember the content, and make the whole learning process fun. They have been used as supplemental readings in biochemistry, physics, and business ethics. Comic books have been used in educating patients about the challenges of dialysis, promoting health, and informing consumers about diseases such as AIDS and cancer.

Conclusion: In today’s media rich environment, comic books could be a visually interactive and innovative educational tool. Pharmacy faculty could use comic books or graphic novels as stand-alone texts or as part of a larger curriculum. Comic books could help students learn pharmacy-relevant content while enjoying the reading.

Conflict of Interest

The author declares 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: Review
Use of A Comic Book to Assist Student Learning of Dimensions of Patient-Centered Care
Authors: Muzumdar Jagannath
Published: January 2018

Objective: To evaluate the use of comic books as a supplemental reading to assist student learning of the dimensions of patient-centered care. The Innovation: A comic book titled Mom’s Cancer was used as a supplemental reading in a course that introduced 2nd year pharmacy students (in a 0-6 year program) to the social aspects of pharmacy practice. Students read the book and provide their reflections about the book and topic covered in it. Critical Analysis: A total of 100 students registered in two sections of the course provided their responses. Student responses to the comic book activity were overwhelmingly positive. More than half of the student reflections included their personal experience with the healthcare system. The comic book format helped illustrate patient experiences with chronic illness to students. The range of comic books is not enough to give a comprehensive coverage of all the topics in the pharmacy curriculum. Getting the appropriate comic book for the respective topic could be challenging. Also, the effectiveness of comics as an education tool may be limited, if readers are less likely to take information provided via this medium seriously. Next Steps: The positive responses from students highlight the point that pharmacy faculty could use comic books in their pharmacy courses. Further research is needed to determine topics that would be effectively addressed by comic books and best practices for comic book use in pharmacy curriculum.

Conflict of Interest

The author declares 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: Note
Impact of Pharmacists’ Religious and Personal Beliefs in Dispensing Contraceptives
Authors: Krupa Anna , Wertheimer Albert I
Published: January 2018

Background: Until recently, pharmacies were not permitted to dispense any emergency contraceptives to women to prevent pregnancy. No legal statutes existed under which pharmacists with religious, moral or ethical objections could refuse to fill a prescription for contraceptives, nor were there direct guidelines describing the pharmacist’s professional obligations.

Objectives: The purpose of this study is to explore the frequency of cases in which pharmacists have refused, due to their personal beliefs, to provide counsel regarding contraceptives or have refused to refer to a patient to a different pharmacist or healthcare provider. This study will compare and contrast the differences between independent pharmacies and chain pharmacies (i.e. time spent, location, most common recommended contraception). Finally, this study will compare the results evident between male pharmacists and female pharmacists.

Method: Quantitative method employed uses two interview questions directed to pharmacists:

(1) “I am moving in with my fiancée/boyfriend next month and I have never used contraceptives. What are my options?”

(2) “If I use a condom and it breaks, do I have any choices to prevent pregnancy after the fact?”

The survey was conducted in two locations, the greater Philadelphia area and Hershey, PA. The survey was conducted through face-to-face interactions with pharmacists, either employed at independent pharmacy or at a chain pharmacy. Data collected from each pharmacist included number of approximate age/gender; minutes spent in each consultation with a patient; the kind of privacy provided during the consultation; and the referrals given, if any.

Results: Fifty (50) pharmacists were interviewed. No pharmacist indicated that counseling would be denied, although one (1) pharmacist refused to counsel on Plan B and four (4) pharmacists referred the interviewer to a doctor immediately, indicating that all medications require a prescription. Two (2) pharmacists spent more than 10 minutes providing the best possible counseling.

 

Type: Student Project
Combining Chalk Talk with PowerPoint to Increase In-class Student Engagement
Authors: Betharia Swati
Published: January 2018

In striving to attain a higher degree of in-class student engagement, and target a larger number of preferred student-learning styles, this case study describes a multimodal teaching approach. PowerPoint slides have gradually gained popularity over the more traditional chalk and talk lecture design. The student population in today’s age seeks more non-passive modes of information delivery. Numerous novel approaches to enhance active learning, such as flipped classroom and problem-based learning, have recently been explored. While working well for therapeutic and lab-based courses, these formats may not be best-suited for all basic science topics. The importance of basic science in a pharmacy curriculum is well emphasized in the 2016 ACPE Standards. To actively involve students in a pharmacology lecture on diuretics, a session was designed to combine the PowerPoint and chalk talk approaches. Students created 10 concept diagrams following an instructor, who explained each step in the process using a document camera. For visual learners, these diagrams provided a layered representation of the information, gradually increasing in complexity. For learners with a preference for the reading learning style, the information was also available in corresponding PowerPoint slides. Scores from pre- and post-session quizzes indicated a high level of concept understanding and recall (median 1 [IQR 0 – 2] vs 4 [IQR 3 – 5]; p<0.001). The student perception survey data reported higher in-class attention levels (76%), an appreciation for the utility of self-created concept diagrams (88%), and a call for additional sessions being presented in this format (73%). Targeting a variety of student learning styles by using the active development of concept diagrams, in addition to traditional PowerPoint slides, can promote student engagement and enhance content understanding.

 

Type: Case Study
Evaluation of Qatari and Canadian Pharmacy Students Learning Together about Cultural Competency using Videoconference Educational Activities
Authors: Jorgenson Derek , Wilby Kyle J , Taylor Jeff
Published: January 2018

Background: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care.

Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1) student knowledge and confidence pertaining to cultural competency concepts, (2) attitudes and perceptions towards being a culturally competent pharmacist, and (3) academic performance related to cultural competency case studies.

Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25) and the University of Saskatchewan in Saskatoon, Canada (n=85) participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85) worked collaboratively (via video conference) with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1) a pre and post session survey measuring student knowledge and confidence; (2) pre and post session student self-reflections; and, (3) student academic performance on care plans and an observed structured clinical exam (OSCE).

Results: The survey identified small but statistically significant (p<0.05) improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81) of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the students who worked collaboratively across the two schools compared with those who did not.

Conclusion: The cultural competency student activity showed small improvements in pharmacy student knowledge, attitudes and confidence, but did not affect academic performance. Future research in this area could utilize a greater diversity of methodological approaches, including a focus on student self-reflection and qualitative assessment, to better capture student competency.

 

Type: Original Research
Nullius in verba: Version 2.0 of the University of Minnesota, School of Social and Administrative Pharmacy Program, Proposed Guidelines for Formulary Evaluation
Authors: Langley Paul C
Published: January 2018

The principal objective in introducing Version 2 of the proposed Minnesota Guidelines for Formulary Evaluation is to recognize the challenges faced by formulary committees and other health care decision makers with the introduction of next generation sequencing (NGS) in therapy choice across a range of disease areas. The adoption of NGS promises to disrupt accepted standards in product development and formulary assessment. Although the standards expected in presenting, evaluating and replications clinical and cost-effective claims will still be central to the assessment process, the application of NGS platforms to link therapy choices to identified mutation clusters will require a robust evidence base. These Guidelines are intended to provide the framework for that evidence base by setting protocol driven standards for (i) choosing the appropriate NGS platform and (ii) evaluating NGS platforms in the identification of therapy pathways for target populations in disease states.

 

Type: Commentary
Building Health Literacy and Cultural Competency Through Video Recording Exercises
Authors: Henriksen Brian , Henriksen Jennifer , Thurston J. Scott
Published: January 2018

Video creation skills would allow pharmacists to create content tailored to their patients’ needs and include relevant aspects of cultural competency to achieve the goal of improved health literacy. Video recording exercises can provide students with an opportunity to build their drug knowledge and health literacy skills.

Conflict of Interest

None

 

Type: Commentary
Medication Use Evaluation of Dronedarone in Comparison to Amiodarone
Authors: Corey Adam , Johnston Nita
Published: January 2018

Amiodarone is the most effective rhythm-control for atrial fibrillation, but produces serious potential side effects. Dronedarone was designed to eliminate amiodarone toxicities, but increased the risk of mortality in clinical trials. This medication use evaluation compares one year of dronedarone use with a matched cohort of amiodarone patients at a single hospital in Greensboro, NC. Forty-eight patients were included with an average age of 71.8 years and 37.5% female population. No significant difference was found for the primary composite outcome of death, myocardial infarction, stroke, and systemic embolism (OR = 2.4, p = 0.148). Likewise, no statistical significance was demonstrated between the two groups for QTc prolongation, hypothyroidism, liver dysfunction or maintenance of normal sinus rhythm. In conclusion, the clinical decision process demonstrated no increased risk of death or other adverse events in the use of dronedarone.

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
How Can Pharmacists Support STI Prevention and Treatment Among Female Adolescents and Young Adults?
Authors: Abraham Olufunmilola , Brothers Amanda , Rubin Mara , DeBlasio Richelle
Published: January 2018

Sexual and reproductive health is a critical focus area for adolescents and young adults (AYAs). Of the 20 million newly diagnosed Sexually Transmitted Infections (STIs) annually, nearly half of them are contracted by young people between the ages of 15 to 24. It has become increasingly necessary to improve awareness and prevention of STIs during adolescent years. The knowledge gained through appropriately relevant sexual and reproductive health education may persist as adolescents transition into adulthood. Community pharmacists interact with AYAs frequently and are therefore well positioned to engage this vulnerable population in conversations about their sexual and reproductive health through use innovative and interactive technologies. For instance, mobile applications are easily accessible to AYAs and can allow pharmacists to disseminate relevant medication information to smartphone users that download adolescent-tailored mobile applications. Although many medication adherence apps are currently available on the market, none of these apps are tailored towards sexual reproductive health information for female AYAs. A mobile-based program designed to provide a pharmacist-guided sexual and reproductive health education to female AYAs may help to address the lapses in current adolescent-aged school health classes. In the future, usage of this intervention would improve the accuracy and comprehension of female adolescents and young adults’ awareness and knowledge of their sexual and reproductive health. As a result, further research should be conducted to develop mobile applications conducive to adolescent and young adults to address sexual and reproductive health issues.

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
Associations between Modifiable Health-Risk Behaviors and Personality Types
Authors: Schommer Jon C. , Tieger Paul D. , Olson Anthony W. , Brown Lawrence M.
Published: January 2018

Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire) are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1) the quality of patient-physician relationships, (2) patient-physician communication, and (3) preferred method for receiving information.

Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics Panels from March 14-30, 2016. Chi-square analysis was used for making comparisons between categories of personality types and items related to health-risk behaviors. Statistical significance was set at p < 0.05. However, chi-square analysis with large sample sizes (e.g. 10,500 in this study) readily yields statistical significance. Practical significance was set at four or more percentage points above or below the overall mean.

Results: Regarding objective 1, personality type was associated with all nine health-risk behaviors studied. Personality types within the Experiencer temperament (17% of the U.S. population) accounted for 46% of the undesirable scores we computed for health-risk behaviors. The Idealist temperament (17% of population) accounted for 32% of the undesirable scores. Conceptualizers (10% of population) accounted for 17% of the undesirable scores and Traditionalists (46% of population) accounted for 5% of the undesirable scores. Regarding objective 2, the findings showed that personality type was associated with (1) the importance people place on the patient-physician relationship, (2) which characteristics of that relationship are most desirable, (3) desire for more communication with their physician, and (4) the preferred method for receiving information.

Discussion and Conclusions: Precision medicine has been proposed as a way to create a new taxonomy of disease that uses individual specific data to develop accurate diagnosis, targeted treatment, and improved health outcomes. Based on the findings of this study, we propose that inclusion of personality type is an important component of these efforts so that the health care system can conform more to the individual patient in order to increase engagement and adherence, reduce errors, minimize ineffective treatment and waste, and can be cost effective.

Conflict of Interest

Co-author, Paul Tieger is CEO of SpeedReading People, LLC which holds copyright for the Individual Wellness Plan and Adherence Predictive Index tools that are mentioned in this manuscript.

 

Type: Original Research
Use of an Innovative Interprofessional Mini-Series Movie to Train Preceptors
Authors: Cox Craig D , Samuel Nephy G , Cheon Jongpil
Published: January 2018

Objectives: To evaluate the effectiveness of the innovative “Preceptor Mini-Series: Adventures in Interprofessional Precepting” movie program in training pharmacy preceptors on interprofessional competencies and to determine pharmacy preceptors’ perceptions of the effectiveness of the Mini-Series format.

Methods: Chronicled by two preceptor experts, the Mini-Series movie follows the challenges of pharmacy, nursing, and medicine students and their preceptor during six-week experiential rotations. Pharmacy preceptors were invited to events held at movie theatres or local classrooms in three different cities. Participants were asked to provide basic demographic information and answer four “pre-program” and “post-program” survey questions focused on working in an interprofessional environment on a 5 point scale, 1=strongly disagree, 5=strongly agree. The post-program survey also included six additional questions to assess participant’s attitudes toward the effectiveness of this medium.

Results: Fifty-eight (58) individuals attended the movie events. The majority had more than ten years of preceptor experience (n = 21, 36.2%), were female preceptors (n = 40, 69.0%), and practiced in an interprofessional environment (n = 48, 82.8%). The participants’ scores on all four interprofessional confidence level questions were significantly increased after viewing the Mini-Series movie and the overall mean increased from 4.47 (pre-confidence level) to 4.79 (post-confidence level, p < 0.001). There were no significant differences of confidence levels based on gender, location, or number of students a preceptor took on rotation each year. However, participants with fewer years of preceptor experience (0-10 years) had a significantly higher perceived learning score than those with more preceptor experience (>10 years) (4.89 vs. 4.63, p = 0.020). The mean for satisfaction (4.9, 3 questions) was slightly higher than the means for perceived learning (4.8, 1 question), and instructional approach (4.87, 3 questions).

Implications: After program completion, pharmacy preceptors indicated an increase in confidence level for precepting in an interprofessional environment. The Mini-Series movie program also yielded positive feedback on its delivery format and suggests the medium may be effective to use for similar future training initiatives.

Conflict of Interest

The authors report no conflicts of interest or financial incentives to disclose related to this project. Dr. Craig D. Cox conceptualized, developed, and directed the Mini-Seriesprogram described in the manuscript. All funding for and all income generated by the program studied is the property of the Texas Tech University Health Sciences Center School of Pharmacy.

 

Type: Original Research
Incorporation of Video Vignettes into Pharmacy Residency Application Processes
Authors: Ware Kenric , Johnson Jessica , Stroud Hannah
Published: January 2018

This commentary discusses the introduction of video vignettes (VVs) into the context of pharmacy residency application processes. An extension of the conversation around which items are requested of pharmacy candidates when applying to pharmacy residency programs is provided. In conjunction with other documents that provide insights into candidates’ abilities, video vignettes (VVs) are presented as viable considerations to gain additional perspective. Implications for time-saving and cost conservation by utilizing VVs are also in view. Hiring employees will presumably have the latitude to require the content of VVs to address aspects deemed more relevant to their institutional operating procedures. Foreseeable benefits and challenges to video vignette (VV) adoption are described within this setting. Counterpoints are presented in response to disadvantages to adoption that may surface. An example of a VV has been crafted to actualize sample components that may be feasible for future use. The challenges faced by healthcare facilities to filling pharmacy residency positions from a vast number of applicants remain pronounced. Creativity in the pharmacy residency selection process is often stifled by routinized methods of application review. Innovative models such as VVs could offer a refreshing alternative to candidates for showcasing individualities and perhaps afford evaluating bodies a unique resource for further candidate differentiation.

 

Type: Commentary
Foreign Accent Syndrome Secondary to Medication Withdrawal: A Case Report
Authors: Schuh Michael J.
Published: January 2018

Objective: The purpose of this case report is to demonstrate a possible alternative etiology related to dopamine may exist for foreign accent syndrome (FAS).

Methods: A 79-year-old, 205 pound, Caucasian woman originally presented to the department of Neurology for treatment and subsequently to the pharmacist pharmacotherapy service for evaluation of bilateral upper extremity tremor of high amplitude but was found to also exhibit FAS.

Discussion: This case report contributes to the limited literature regarding foreign accent syndrome and adds to the few case reports of psychogenic origin, as opposed to the majority, which are of neurogenic origin. This also represents the first case that seems related to withdrawal of medication rather than psychotic exacerbation and ranks a six on the Naranjo algorithm.

Conclusion: FAS is a rare disorder and little is understood about it. This case presentation also suggests that chronic use of high-dose dopamine and/or anticholinergic agents may alter pathways in the brain, which in this case, may have potentially contributed to the development of FAS. There remain many unanswered questions regarding FAS, but hopefully more clarity may be found as more cases are discovered and published.

Conflict of Interest

I 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: Case Study