bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providers' perceptions of monitoring process for pregnancy category D or X medication in women of childbearing age
Authors: Lounsbery Jody L. , Leone Barbara , Slattengren Andrew 
Published: January 2018

Background and Objectives: A process for monitoring the prescribing of common pregnancy category D or X medications in women of childbearing age (ages 12 to 50) was developed and implemented by clinical pharmacists within a residency clinic. The project goals were to determine 1) if providers value the monitoring of their prescribing practices, 2) if they value the process used by the clinic, and 3) if providers report changing prescribing practices or note increased awareness when prescribing pregnancy category D or X medications in women of childbearing age as a result of the monitoring process.
METHODS: An electronic survey was distributed to the 43 providers currently practicing in the clinic. Survey questions covered topics including value of monitoring prescribing practices for pregnancy category D or X medications in women of childbearing age, value of the specific monitoring process used at the clinic, frequency of consideration of pregnancy status and contraception use when prescribing medication, and suggestions for improvement on the monitoring process.
RESULTS: The response rate was 81.4% (n=35). Results showed all responders valued the monitoring of their prescribing of pregnancy category D or X medications and the monitoring process used by the clinic. Providers reported the monitoring process increased how often they thought about a patient’s pregnancy status and contraception use when prescribing medications.
CONCLUSIONS: The monitoring process is valued by providers and impacts prescribing practices. It is a quality process that could be implemented by clinical pharmacists in other primacy care practices to enhance the safe prescribing of medications for women of childbearing age.

Type: Original Research
Reducing Health Care Costs and Improving Clinical Outcomes Using an Improved Asheville Project Model
Authors: Bunting Barry A. , Nayyar Deepika , Lee Christine 
Published: January 2018

This study was designed to add to the body of knowledge gained through the original Asheville Project studies, and to address some of the limitations of the earlier studies. Scalability. Since the original Asheville Project publications there have been some successful replications, however, there is a need to broaden the geographic scope and increase the size of the study population. Study Design. Previous studies were limited to pre-post, self-as-control design. We added a control group. Model improvement. We were able to incorporate an electronic record of care. This allows incorporation of medical and prescription claims, ease of documentation, improved data capture, reporting, standardization of care, identification of deficiencies in care, and communication with other health care providers. This enhancement may be worthy of more comment than we devoted to it , however, we didn’t want to detract from the main goal of the study, and we wanted to avoid any hint of commercialization on the part of the organization that provided the electronic record. Relevance to profession. We sincerely hope the relevance goes beyond the profession of pharmacy and that it reinforces the message that the profession of pharmacy offers real solutions to rising health care costs in the U.S.

Type: Original Research
Multiple Bosses: Challenges and suggestions to improve organizational environments in academic settings.
Authors: Feemster Agnes Ann , Mattingly T. Joseph 
Published: January 2018

Practice faculty members are often supervised by more than one individual, creating a reporting structure that mirrors a matrix organization. They are tasked with balancing administrative and teaching responsibilities established by the school with expectations of maintaining a pharmacy practice site. A matrix reporting structure offers opportunities for enhanced development, but risks of additional stress from the organizational complexity must be mitigated to reduce job dissatisfaction. Frequent and consistent communication, mutual agreement and alignment of expectations and priorities, and the ability to manage conflict and adapt to change will aid pharmacy practice faculty in managing the relationship between their primary employer (the school) and the contracted entity.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

Type: Original Research
Imaginary Worlds: Modeled claims for cost-effectiveness published in PharmacoEconomics January 2015 to December 2015
Authors: Langley Paul C 
Published: January 2018

The purpose of this review is to assess whether or not economic evaluation studies published in PharmacoEconomics in 2015 meet the standards of normal science. Two questions are key to the assessment: (i) did the authors attempt to generate testable claims as to the impact of the pharmaceutical product in health care systems and (ii) did the authors suggest how the claims might be evaluated? A total of 31 studies were evaluated, including 14 research articles, 8 systematic reviews and 9 reviews. Although the majority of the studies met recommended standards for cost-effectiveness analysis, none met the standards of normal science. They were best categorized as imaginary worlds or thought experiments. The reader has no idea whether the claims for the products are right or even if they were wrong. Journal editors have two options: (i) require authors to submit cost-effectiveness claims that are evaluable with a protocol suggesting how the claim may be evaluated or (ii) continue to publish non-evaluable cost-effectiveness claims but insist authors indicate that the claims are non-evaluable.
Conflict of Interest
None
Type: Commentary
Assessment of Barriers to Providing Introductory Pharmacy Practice Experiences (IPPEs) in the Hospital Setting
Authors: Gibson Matthew J , Sullivan Donald , Tubbs Crystal , Mirtallo Jay , Kelley Katherine 
Published: January 2018

Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs) in the hospital setting.
Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting.
Results: Sixty-eight of the 287 eligible survey respondents (24%) completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care.
Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students.

Type: Original Research
Perceptions of Medicinal Plant Use Amongst the Hispanic Population in the St. Louis Metropolitan Area
Authors: Grafford Kim M. , Nieto Marcelo J. , Santanello Catherine D. 
Published: January 2018

Introduction: Medicinal plant use in the United States has increased as reported by the National Center of Complementary and Integrative Health and U.S. Census Bureau.However, little is known about how many minority groups in the United States use medicinal plants.There is a rise in the Hispanic population; a community with a steep tradition of medicinal plant use, in the U.S., so understanding the perceptions of medicinal plant use is useful to healthcare providers.
Methods: A survey was designed to gauge a better understanding of the perceptions of medicinal plant use amongst Latino patients with varying education levels who reside in the St. Louis Metropolitan Area. Survey questions highlighted the perceptions of medicinal plants use, patient communication regarding medicinal plant use with healthcare providers (pharmacists and doctors), and the impact the education level has on medicinal plant use.
Results: Surveys were distributed to six different investigational sites around the St. Louis Metropolitan Area from August 2015 to December 2015. Survey respondents identified 45 different plants/herbs that they currently use or had used at some point in their life. Those with higher levels of education had varying opinions on medicinal plant use with their current practices.
Conclusion: The participants’ high interest in the use of medicinal plants exemplifies the need for enhanced communication between patients and healthcare professionals about medicinal plant use. However, it was hard to determine whether the participants’ level of education had any direct relationship to this use.
Conflict of Interest
None

Type: Original Research
Pharmacists’ Provision of Contraception: Established and Emerging Roles
Authors: Peters Lindsey M , DiPietro Mager Natalie A 
Published: January 2018

Pharmacists’ roles in provision of family planning products is expanding in the United States (U.S.). This article details established as well as emerging roles for U.S. pharmacists in the provision of contraception. These include helping patients develop reproductive life plans; dispensing prescription contraceptive products and counseling patients; assisting and educating patients with non-prescription contraceptive products, including emergency contraception; participating in collaborative practice agreements; administering contraception products; and making referrals and developing partnerships. The provision of contraception in the U.S. is dynamic, and pharmacists should continue to be aware of changes that will impact them professionally. As approximately 45% of pregnancies in the U.S. are unintended, through these roles pharmacists can impact an important public health priority.
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
Creative Destruction: Next Generation Sequencing in Drug Development, Formulary Evaluations and Pricing
Authors: Langley Paul C 
Published: January 2018

Next generation sequencing (NGS) has the potential to disrupt not only the accepted process of drug development but also the hurdles a drug manufacturer would be expected to face in securing formulary approval and a possible premium price for the new compound. The purpose of this commentary is to consider the role of NGS in this process, one which is characterized as a process of creative destruction, where adoption of NGS in personalized medicine sets in train a mechanism of incessant product and process review. A mechanism driven by continuing modifications and extensions to NGS platforms as our understanding of the role of mutations and mutation load in therapy choice expands. At the same time this mechanism has significant implications for the continued revision of treatment guidelines and their adoption of NGS as integral parts of the treatment pathway. There are, however, a number of unresolved issues which have to be addressed. These include the choice of NGS platform, barriers to integrating evidence to support NGS-based therapy choices in treatment guidelines, the implications of NGS for drug development and the modification or rejection of current trial structures, the integration of comorbid disease states and the standards that formulary committees should adopt to evaluate NGS claims. The overarching theme, however, is the need to invest in a robust and credible evidence base. While we are a long way from achieving this, the focus must be on putting claims for therapy choice forward that are credible, evaluable and replicable.

Type: Commentary
Community Pharmacist Attitudes on Medication Synchronization Programs
Authors: Witry Matthew , Hoang Thao 
Published: January 2018

Background: Medication synchronization is a service offered by an increasing number of community pharmacies that aligns refilling of a patient’s multiple medications. Purported benefits include increased adherence and improved dispensing efficiency.
Objective: To assess community pharmacist agreement with a set of declarative statements about medication synchronization programs and to identify variation related to pharmacist characteristics.
Methods: In 2015, a cross-sectional survey was mailed to 1,000 pharmacists from 5 Midwestern U.S. states using 4-contacts and an online option. Respondents used a 7-point Likert scale to agree or disagree with 5 statements about medication synchronization. Demographic and workplace characteristics were collected. Data were analyzed using descriptive statistics and factor analysis. Multiple linear regression tested the relationship between pharmacist characteristics and a 4-item attitude composite.
Results: There were 258 usable responses for a response rate of 28.8%. About half (45.0%) reported their pharmacy offered medication synchronization. Most pharmacists (82.6%) agreed this service has a positive impact on patient adherence but 57% agreed that a “significant change to workflow” was or would be required. Pharmacist agreement that the program provides financial benefits to the pharmacy was higher than agreement that the service provides more opportunities for patient interactions (p<0.001). In the multiple regression analysis, having a PharmD and working at a pharmacy offering Medication Therapy Management were associated with more positive scores on the medication synchronization benefits composite whereas working in a staff role (rather than a manager/owner) was lower. No demographic predictors were significantly associated with agreeing that a significant change to workflow would be required for implementation.
Conclusions: Pharmacists generally were positive about medication synchronization programs, although some negative views were present, especially regarding the need for workflow change. Research is needed to understand barriers and facilitators to how medication synchronization programs are implemented and maintained and their effects on outcomes.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

Type: Original Research
Pharmacy-Based Tuberculosis Skin Testing (TST): Approaches to Legal Authority
Authors: Atkinson Dylan , Dering-Anderson Allison M. , Adams Alex 
Published: January 2018

The Mantoux Tuberculin Skin Test (TST) is the standard method for detecting latent tuberculosis and has been provided by pharmacists since at least 2006. In the largest published study of pharmacy-based TST involving 578 patients, the most common reason for obtaining the test were employment or school requirements.Pharmacists have demonstrated high rates of follow-up for the reading of the test, reported to be 92.8% to 94.4%. The biggest barrier to pharmacy-based TST is that a prescription is required for the two tuberculosis (TB) purified protein derivative products available on the market in the United States. States have adopted three strategies to enable pharmacy-based TST prescribing: 1) collaborative practice agreements; 2) statewide protocols; and 3) independent prescribing. These three approaches are reviewed, with a focus on the New Mexico statewide protocol and the recent statutory authority in Idaho that grants pharmacists independent prescriptive authority for TST. States may consider pursuing more autonomous models of TST prescribing given the safety and track record of this service at pharmacies.

Type: Commentary
Development of an Integrated Immunology and Vaccines Pharmacy Elective
Authors: James Stephanie F , Braun LaToya J , Feltman Christine , Haight Robert 
Published: January 2018

Objective: To describe an elective course on immunology and vaccines for pharmacy students that extends beyond basic immunization training.
Design: A three credit-hour Immunology and Vaccines elective was developed and taught by an immunologist, policy research expert, and pharmacist. The learning objectives of the course included: understanding how the immune system works with vaccines to provide protection against infectious diseases, the history and policies involved in immunization practice, and how to counsel the vaccine hesitant individual. Classes were conducted using a variety of formats; group projects, lectures, films, literature reviews and guest speakers. An end-of-course evaluation was used to gauge student opinion on course value. Students were evaluated by four exams and a final group presentation.
Conclusion: Students indicated that this course was valuable to their future pharmacy careers and provided insight into why people choose not to vaccinate and how they could use the course insight to properly educate such individuals.
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: Note
Impact of a Modified Jigsaw Method for Learning an Unfamiliar, Complex Topic
Authors: Kolanczyk Denise , Arif Sally A 
Published: January 2018

Objective: The aim of this study was to use the jigsaw method with an unfamiliar, complex topic and to evaluate the effectiveness of the jigsaw teaching method on student learning of assigned material (“jigsaw expert”) versus non-assigned material (“jigsaw learner”).
Innovation: The innovation was implemented in an advanced cardiology elective. Forty students were assigned a pre-reading and one of four valvular heart disorders, a topic not previously taught in the curriculum. A pre-test and post-test evaluated overall student learning. Student performance on pre/post tests as the “jigsaw expert” and “jigsaw learner” was also compared.
Critical Analysis: Overall, the post-test mean score of 85.75% was significantly higher than that of the pre-test score of 56.75% (p<0.05). There was significant improvement in scores regardless of whether the material was assigned (“jigsaw experts” pre=58.8% and post=82.5%; p<0.05) or not assigned (“jigsaw learners” pre= 56.25% and post= 86.56%, p<0.05) for pre-study.
Next Steps: The use of the jigsaw method to teach unfamiliar, complex content helps students to become both teachers and active listeners, which are essential to the skills and professionalism of a health care provider. Further studies are needed to evaluate use of the jigsaw method to teach unfamiliar, complex content on long-term retention and to further examine the effects of expert vs. non-expert roles.
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: Note
Transparency, Imaginary Worlds and ICER Value Assessments
Authors: Langley Paul C. 
Published: January 2018

The Institute for Clinical and Economic Review (ICER) is seen as offering a credible platform for evaluating the pricing policies for pharmaceutical products and devices. Over the past few years ICER has presented a stream of reports, many of which have recommended substantial price discounts where the results of a lifetime cost-per-QALY modeling suggests they are out of line with notional willingness to pay thresholds and arbitrary budget constraints. At the same time, there have been growing concerns over the lack of transparency in the ICER value assessment process, focusing in particular on the refusal by ICER to allow access to its value assessment modeling framework. The purpose of this brief commentary is to point out that the position taken by ICER over model access is not defensible; the arguments given are specious. This ongoing refusal undercuts the ICER claim to be independent and the credibility of ICER recommendations for price discounting. The solution is for ICER to commit to a transparent process of value assessment, allowing in particular access to its models and for the ICER model to be subject to an independent assessment. At the same time, manufacturers and other stakeholders should have access to the model with the opportunity to challenge the model through developing model frameworks which they feel better represent product value. This advocacy, it should be noted, does not reflect acceptance of the ICER lifetime cost-per-QALY value assessment framework. Health care decision makers would be better served by a value assessment framework that provided short-term credible, evaluable and replicable claims, facilitating meaningful feedback to decision makers, and not on the construction of simulated imaginary worlds.
Conflict of Interest: None

Type: Commentary
Resolving Lingering Problems or Continued Support for Pseudoscience? The ICER Value Assessment Update
Authors: Langley Paul C. 
Published: January 2018

The Institute for Clinical and Economic Review (ICER) released its updated value assessment framework in mid-2017. This included refinements to its conceptual structure and modifications to methods of collecting and assessing evidence. Consequent to this release, a number of authors have commented on the updated value framework, addressing the question of whether the latest framework represents a major revision or merely attempts to resolve lingering problems. The purpose of this commentary is twofold: (i) to revisit what are considered to be fundamental flaws in the ICER value assessment framework and (ii) to question whether or not post-release critiques of the value framework address the fundamental weaknesses in the ICER approach: the absence of credible, evaluable and replicable claims for the benefits and harms of a therapy intervention. The commentary argues that while ICER sees the purpose of its value assessment framework as forming ‘the backbone of rigorous, transparent evidence reports’ in placing ‘scientific methods of evidence analysis at the heart of a clearer and more transparent process’ it falls far short of these ideals. Rather, in attempting to replicate in the US health care environment the evaluation framework mandated by the National Institute for Health and Care Excellence (NICE) in the UK, the ICER falls into the trap of generating value claims for product impact that fail to meet the standards of normal science.

Type: Commentary