bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobilizing pharmacists to address the opioid crisis: A joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy
Authors: Coon Scott A. , Hill Lucas G. , Hutchison Robert W. , Arnold Lindsay M. , Jarrett Jennie B. , Ottney Anne R. , Oung Alvin B. , Painter Nathan A. , Smith Michael A. , Stranges Paul M. , Tran Tran H. , McFee Winans Amanda R. , Bratberg Jeffrey P. 
Published: April 2022

AbstractThe opioid crisis represents one of the largest failures of our current health care system as it continues to claim lives at an unprecedented rate and has caused a devastating range of preventable morbidity. Although the availability of highly potent synthetic opioids has amplified the urgency of the crisis for patients and communities, this problem has evolved over several decades. Pharmacists are in a position to offer many potential solutions due to their widespread accessibility, extensive drug knowledge, and integration into various health care settings. This opinion paper challenges the status quo by calling on all pharmacists to embrace evidence‐based opioid stewardship and harm reduction practices, contribute to the medical management of opioid use disorder, and address the misconceptions and prejudices that serve as barriers to effective, compassionate patient care. Regardless of practice setting or available resources, pharmacists can take deliberate and impactful steps to address the opioid crisis. Some pharmacists may be positioned to implement innovative and far‐reaching pharmacist‐led clinical services, while others may simply begin with careful consideration of the language they use when speaking to and about patients with substance use disorders. To optimize patient outcomes, the ineffective laws, regulations, and policies that negatively impact pain and addiction care must be addressed so that evidence‐based solutions can be widely disseminated. Pharmacists must aggressively advocate for the removal of barriers preventing high‐level clinical practice or policies that perpetuate patient harm and abandonment. Finally, there must be support for continued research on pain and opioid use disorder treatments and services, as well as the impacts of harm reduction practices and pharmacist‐led clinical services, so that resources can be allocated effectively.
Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data
Authors: Rahhal Alaa , Mahfouz Ahmed , Al‐Amri Maha , Aljundi Amer , Khir Fadi , Hamid Yousra , Alyafei Sumaya , Arabi Abdul Rahman 
Published: April 2022

AbstractBackgroundSecondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context.MethodsThis retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge.ResultsA total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P = .002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P = .004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P = .038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P = .018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers.ConclusionMedication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI.
Letters of reference for PGY1 pharmacy residency candidates: A survey of residency program directors and opinion statement
Authors: Skrupky Lee P. , Dy‐Boarman Eliza A. , Gurgle Holly E. , Isaacs Alex N. , McCreary Erin K. , Nisly Sarah A. , Paloucek Frank , Peterson David M. , Smith Andrew , Schramm Garrett E. ,   The Education and Training Practice and Research Network
Published: April 2022

AbstractIntroductionAlthough letters of reference (LORs) are required for postgraduate year one (PGY1) residency applications and used to distinguish between candidates, an evaluation of residency program director (RPD) perceptions and values surrounding LORs has not been described.ObjectiveThe aim of the study was to describe PGY1 RPDs' processes, values, and perceptions surrounding LORs.MethodsThis was a cross‐sectional descriptive survey. After assessing content validity, the Education and Training Practice and Research Network (PRN) taskforce sent a 25‐item electronic survey to 1266 PGY1 RPDs. Survey questions captured program demographics, LOR requirements, processes for LOR review, and perceptions about the value of LORs. Two open‐ended questions solicited suggestions for LORs and the existing standardized form; responses were evaluated via thematic analysis.ResultsA total of 291 (24%) programs completed the survey. LORs were rated as extremely or quite valuable by 82% of respondents and moderately valuable by 16% of respondents. Scoring rubrics for LOR evaluation were used by 79% of programs, and performance ratings were reported to impact interview consideration by a majority of programs. Accuracy, detailed comments, and inclusion of specific candidate strengths and areas for improvement were rated as extremely or quite important characteristics by 90% or more of respondents. Specific strengths were reported to be present in LORs more than half of the time by 81% of programs; however, accuracy, detailed comments, and inclusion of specific areas for improvement were only reported to be present about half the time or less by 41%, 63%, and 63% of respondents. Among 207 suggestions submitted to improve LOR utility, common themes included a desire for LOR authors to have candid discussions with candidates prior to letter writing, to contextualize their relationship with the candidate, and provide honest and specific assessments.ConclusionLORs remain highly valued by PGY1 RPDs during application review. Several notable findings were observed, resulting in recommendations for LOR authors, residency applicants, and the standardized LOR form.
Prescribing and documentation by critical care clinical pharmacy specialists with around‐the‐clock staffing: A single‐center evaluation
Authors: Westmoreland Kearsten , Bovio Franck Jessica , Franck Andrew J. 
Published: April 2022

AbstractIntroductionEvidence supports pharmacists as essential team members in the intensive care unit (ICU). Data are limited for pharmacist prescribing and documentation, ideal pharmacist staffing, and timing of clinical pharmacy activities in the ICU.ObjectiveThe purpose of this evaluation was to assess the frequency, timing, and most common areas of prescribing and documentation for critical care clinical pharmacy specialists (CPSs) in a single medical center with around‐the‐clock staffing.MethodsA Veterans Affairs (VA) medical center implemented a collaborative practice model in which CPSs provide direct ICU patient care around the clock. Direct patient care activities are provided for two ICUs with three multidisciplinary teams (medical, surgical, and cardiovascular), the nutrition support team, and emergency response teams. Documentation through an electronic health record progress note is required any time a CPS performs a patient encounter and uses prescriptive authority. A retrospective evaluation was performed to evaluate critical care CPS patient encounters and clinical interventions from October 1, 2016 through September 30, 2020.ResultsCumulatively, 78 622 CPS clinical interventions requiring prescriptive authority were made during 17 938 documented encounters. For clinical interventions, 40 897 (52.0%) were during daytime hours and 37 725 (48.0%) were after‐hours. Of the documented encounters, 10 461 (58.3%) were during daytime hours compared with 7477 (41.7%) after‐hours. Medication‐related prescribing interventions accounted for 57 400 (73.0%) of the interventions, while 6931 (8.8%) were nonpharmacologic and 14 291 (18.2%) were additional interventions. The most common disease states for prescribing interventions included Anticoagulation (13.8%), Infectious Diseases (13.1%), Cardiovascular (10.5%), Nutrition/Gastrointestinal (6.6%), Neuropsychiatric (5.3%), Endocrine (4.3%), Nephrology (3.5%), and Pulmonary (1%).ConclusionThis evaluation provides details of prescribing and documentation by critical care CPSs with an around‐the‐clock staffing model. This may be useful for ICU clinicians and administrators considering expanding critical care pharmacy services.
Adaptation of clinical pharmacy services to meet patient care needs during the COVID‐19 pandemic
Authors: Danelich Ilya M. , Thomson Lynda , Alberto Judith , Bonanni Shirley , Buckler Rebecca , Foley John , Phillips Samantha , Rall Braden , Thoma Brandi , Merli Geno , Wordell Cindy 
Published: April 2022

AbstractThe coronavirus disease 2019 (COVID‐19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 has challenged health systems to find innovative ways of delivering patient care while protecting staff from infection with the virus. As the COVID‐19 pandemic has continued to evolve establishing “hot spots” in various areas of the country, clinicians have learned more about caring for these patients. This has required the Department of Pharmacy at Thomas Jefferson University Hospital to constantly update the approach it has taken during this time, and the guidance which is provided for the pharmaceutical care of these patients. Because Philadelphia was in the initial stages of the pandemic within the United States, operations within the Department of Pharmacy at Thomas Jefferson University Hospital needed to be redesigned. This brief report provides an example of the swift changes that were made in the pharmacy practice model at a large academic medical center. Herein we describe the impact of the pandemic on the Department of Pharmacy at Thomas Jefferson University Hospital with a focus on clinical and operations aspects. The areas that will be highlighted in this report represent areas that required rapid and transformational change to the operations and/or clinical care in order to protect the health of pharmacists and allow them to continue to provide the necessary level of patient care.
What is the ideal clinical pharmacy practice model? A satisfaction comparative study
Authors: Al‐Jazairi Abdulrazaq , Hijazi Hala , Samarkandi Hadeel , Akhras Nathem , Devol Edward , Hamasni Ibrahim 
Published: April 2022

AbstractIntroductionCurrent pharmacy practice models vary. Unit‐based pharmacists are in charge of patients in specific locations, placing emphasis on timely order verification. In contrast, service‐based pharmacists are assigned to multidisciplinary teams who provide consultations without order verification duties. Hybrid‐based pharmacists provide clinical activities in addition to half‐day order verification. There are conflicting opinions regarding the ideal model in providing care. Currently, there are limited studies comparing these approaches in a specialized health care system.ObjectivesThe primary objective of this study is to compare staff satisfaction; nurses, physicians, pharmacist peers, patients, and self‐satisfaction, with respect to the three models.MethodsThis is a prospective study conducted in a tertiary care facility comparing different pharmacy practice models by assessing the satisfaction of different members of the health care team through satisfaction surveys. Assuming 15% difference, 116 observations were required for each arm. Secondary end points compared the number of medication errors reported, clinical interventions documented, order verification, adverse drug reactions reported, protocol/guideline reviews, and total parenteral nutrition orders entered as well as nonformulary reviews within each model. The study was approved by Research Advisory Council.ResultsA total of 377 surveys were collected. In the total general average of overall satisfaction, unit‐based model achieved a rate of 70.61%, service‐based 69.84%, and the hybrid model 59.9%. Both unit and service‐based models had a higher overall satisfaction when compared to hybrid model; unit‐based (70.61% vs 59.97%, P = .005), service‐based (69.84% vs 59.97%, P = .009). Nurses and patients favored unit‐based pharmacists with a satisfaction rate of 72% and 89%, respectively. The unit‐based pharmacists were the most satisfied, 76%, compared to their peers in other models.ConclusionBased on this study, the majority of the surveyed cohort, including nurses, patients, and self‐surveyed pharmacists, favored the unit‐based model.
Pharmacists' perceptions on patient care services and social determinants of health within independent community pharmacies in an enhanced services network
Authors: Daly Christopher J. , Costello Jessica , Mak Anna , Quinn Bryan , Lindenau Ryan , Jacobs David M. 
Published: April 2022

AbstractBackgroundHealth care is transitioning from fee‐for‐service towards value‐based care. Community pharmacies are providing an increasing number of patient care services (PCS) that improve medication adherence, medication knowledge, and overall patient health. The provision of these services may differ based on the socioeconomic characteristics of the patient population. There is a lack of information on PCS delivery in independent community pharmacies and how these services are provided to underserved populations.ObjectivesThe objectives of this study were to: (a) Evaluate the current level of commitment and readiness of independent community pharmacies in delivering PCS, and (b) Assess community pharmacists' perceptions of addressing social barriers and health disparities among underserved populations.MethodsThis was a cross‐sectional electronic survey distributed to independent community pharmacies who were members of a pharmacy advocacy or PCS organization in New York State.ResultsOne‐hundred and twenty‐five surveys were distributed, with 65 responses (52% response rate) from a high proportion of pharmacy owners (75%). A majority of pharmacies (53%) devoted more than 10 hours per week to PCS, such as immunizations and home delivery. Many pharmacies (47.7%) were willing to devote more than 20 hours per week to PCS with proper reimbursement and were willing to hire additional staff to support these services. Most pharmacies did not use their pharmacy software to target patients for PCS, instead enrolling via staff recommendation or self‐referral. Many pharmacies (48%) reported that greater than 30% of their patient population experienced social‐related barriers including low income and transportation issues. Pharmacies addressed social barriers by offering tailored services towards patient needs.ConclusionsIndependent community pharmacies remain diligent and actively involved in delivering PCS. Many pharmacy patients experience social‐related barriers towards care, and pharmacies are responding by offering tailored services. Further research is needed on the implementation and economic sustainability of PCS in community pharmacy settings.
Postgraduate year two ambulatory care residency program evaluation with a tool for assessing ambulatory care pharmacist practice
Authors: Wesling Megan , Schumacher Christie , Liu Jiajun , Kliethermes Mary Ann , Borchert Jill S. 
Published: April 2022

AbstractIntroductionA standardized set of required competency areas, goals, and objectives are used in accreditation to create consistency in learning experiences across programs. The individual postgraduate year two (PGY‐2) ambulatory care residency program is subsequently tasked with designing activities to achieve the defined goals and objectives, which may lead to variability in the constructed activities across residency programs.ObjectivesThe primary objective of this study was to describe (define, assess, and stratify) the current landscape of direct patient care activities provided within PGY‐2 ambulatory care residency program training environments.MethodsThis was a national, descriptive, cross‐sectional study using the Tool for Assessing Ambulatory Care Pharmacist Practice (TAAPP). The TAAPP questionnaire was disseminated via electronic mail to PGY‐2 ambulatory care Residency Program Directors (RPDs) meeting inclusion criteria. RPDs were requested to complete the questionnaire and disseminate it further to two preceptors of required rotations and all 2017‐2018 residents.ResultsIn total, 108 responses were received out of a possible 595 and 10 were excluded due to the respondents not meeting inclusion criteria or the questionnaire was incomplete. Ninety‐eight (16.5% response rate) underwent descriptive and statistical analysis. Fifty‐two participants (53%) indicated they provide a comprehensive or broad delivery of direct patient care, 44 respondents (45%) provide activities within a moderate scope of practice, and 2 respondents (2%) engage in a narrow scope of practice. Forty‐seven of the pharmacists (36%) stated they were functioning under a disease state specific collaborative practice agreement (CPA), 40 (31%) under a broad or comprehensive CPA, 24 (19%) under a protocol‐driven, and 13 (10%) under a medication‐specific agreement.ConclusionVariability in PGY‐2 ambulatory care residency programs was found with just half of participants functioning under a broad scope of pharmacist practice. Opportunities exist for programs to further standardize and advance program training environments.
Current and future state of clinical pharmacist‐led precision medicine initiatives
Authors: Tillman Emma M. , Beavers Craig J. , Afanasjeva Janna , Momary Kathryn M. , Strnad Kyle G. , Yerramilli Aparna , Williams Anne M. , Smith Brooke A. , Florczykowski Brittany , Fahmy Monica 
Published: April 2022

AbstractThis white paper evaluates the current and future state of clinical pharmacist‐led precision medicine initiatives, focusing on an overview of pharmacogenomics (PGx) in three key areas: clinical practice, education, and research. These key facets are described in detail, followed by a review of potential and perceived barriers concerning PGx and recommendations for the clinical pharmacist's role in overcoming these barriers. This paper reviews the current state of clinical pharmacist‐led precision medicine and presents a vision for the future of pharmacy practice in this quickly evolving field.
Implementation and evaluation of a virtual objective structured clinical examination for pharmacy students
Authors: Hsia Stephanie L. , Zhou Crystal , Gruenberg Katherine , Trinh Trang D. , Assemi Mitra 
Published: April 2022

AbstractIntroductionThe University of California, San Francisco (UCSF) School of Pharmacy employs Objective Structured Clinical Examinations (OSCEs) to assess students' skills. The Coronavirus disease 2019 (COVID‐19) pandemic made in‐person OSCEs infeasible. This article describes the implementation and evaluation of a two‐station virtual OSCE (vOSCE) for first‐year pharmacy students.MethodsA summative vOSCE was conducted in June 2020 using Zoom and ExamSoft. Faculty and residents served as standardized patients (SPs) and evaluated student performance. Students and SPs were surveyed on their perceptions post‐vOSCE. A mixed methods analysis was conducted, incorporating thematic analysis of survey responses and quantitative analyses of student performance on the virtual vs in‐person OSCE.ResultsNinety‐six (75%) students and 17 SPs (94.4%) completed the survey. Students and SPs (69% vs 88%, P = .10) felt that vOSCEs were acceptable alternatives for demonstrating knowledge, communication, and telehealth skills. SPs felt that in‐person OSCEs were more effective to assess communication skills and ability to conduct in‐person encounters (P < .05). Qualitative comments from students and SPs corroborated these differences, emphasizing limitations of vOSCEs for demonstrating nonverbal skills, and additional considerations regarding exam administration and assessment. Students who failed an OSCE generally had lower median communication scores (P < .01). Technological difficulties, before OSCE performance, and before telehealth experience were not associated with passing the vOSCE (P > 0.05).DiscussionThe virtual environment did not seem to negatively impact student performance. However, students and SPs felt vOSCEs may be less effective to demonstrate and assess nonverbal communication. To address these limitations, future implementation of vOSCEs may include providing students with instruction on nonverbal telehealth skills and SP training on virtual assessment of nonverbal communication skills.
Medication therapy problems identified by pharmacists conducting telephonic comprehensive medication management within a team‐based at‐home care program
Authors: Graybill Margo , Duboski Vanessa , Webster Leeann , Kern Melissa , Wright Eric , Graham Jove , Blanchard Carrie , Gionfriddo Michael R. 
Published: April 2022

AbstractIntroductionComprehensive Medication Management (CMM) is a collaborative patient‐centered approach to medication optimization. We recently implemented telephonic CMM as part of a multidisciplinary team within a team‐based at‐home care program. The objective of this study was to describe the type and frequency of medication therapy problems (MTPs) identified by pharmacists delivering CMM as part of this program, as well as the acceptance rates of the recommendations made to rectify them.MethodsWe conducted a retrospective chart review of all patients receiving CMM within the program between December 12, 2018 and December 31, 2019. We identified and classified MTPs based on the framework developed by the Pharmacy Quality Alliance. Descriptive statistics were used to determine the quantity of MTPs, as well as the acceptance rates of the recommendations.ResultsWe identified 307 patients who received CMM. Of these patients, 58% were female (178/307) and 96% identified as White (296/307). Average age was 72 years old (SD 13). On average, pharmacists identified 4 MTPs/patient with a 35% acceptance rate (431/1228) for their recommendations. Of those accepted, pharmacists were able to resolve 185 (43%) of these MTPs on their own while providers resolved the remaining 246 (57%) MTPs. Acceptance of MTPs was more likely if patients were spoken to (38.4% vs 29.5%, relative risk [RR] = 1.30, 95% CI 1.10‐1.54, P = .002).ConclusionsPharmacists were able to identify several MTPs when conducting telephonic CMM within a team‐based at‐home care program. These MTPs and their associated recommendations however, often failed to be resolved. Recommendations were more likely to be resolved if patients were spoken to, highlighting the importance of engaging the patient as part of CMM. Future studies should examine ways to improve intervention acceptance as well as the clinical and economic impact of changes made as a result of telephonic CMM and MTP identification.