Search

Background : There is a shortage of primary care medical providers, particularly in rural communities and communities of racial and ethnic minority groups. Clinical pharmacists can help fill gaps in care among these vulnerable populations. Obj ective : To identify characteristics of ambulatory care pharmacists that pursue and maintain employment within underserved areas. Methods : An original survey was distributed nationwide to ambulatory care clinical pharmacists in underserved settings. Respon dent characteristics were analyzed using descriptive statistics. Results : Of the 111 completed surveys, a majority of respondents were White, non - Hispanic, female, with English as their only spoken language. A majority of pharmacists completed a clinical experience or specialized training focused on underserved care prior to their position. The top three motivators for pharmacists accepting their clinical position as well as staying at their job were pas sion for caring for underserved populations, the pres ence of a faculty appointment, or the freedom and flexibility of advanced clinical roles. Conclusions : With a large majority of our respondents identifying as White and unilingual, there remains a large opportunity to increase diversity in the clinical ph armacy ambulatory care workforce caring for underserved populations. There is an observed correlation between early experiential or specialized training in underserved care and pharmacists pursuing employment in the se areas. Thus, one potential long - term s trategy to diversify and grow the ambulatory care clinical pharmacist workforce in underserved settings is for clinical practice sites to partner with colleges of pharmacy to recruit and maintain quality individuals who can meet the needs of diverse patien t populations as well as expand student and resident training opportunities in underserved settings.

More than 50% of Americans possess at least one chronic condition and another 25% suffer from two or more, leaving primary care teams tasked to care for the chronic, acute, and preventive care needs of their large patient panels. Pharmacists can reduce the burden on busy providers by effectively managing chronic diseases as members of health care teams. Many private physician practices lack the resources to include pharmacists on their teams. A centralized, remote clinical pharmacy services model allows pharmacists to remotely manage chronic disease in patients in collaboration with primary care providers. The purpose of this report is to describe how a centralized, remote clinical pharmacy team was developed, trained, and effectively integrated into multiple, diverse primary care settings across the U.S.

With a primary care physician shortage, utilization of pharmacists in the ambulatory care setting has proven to have positive economic and clinical outcomes for the practice and for patients. To extend the reach of the pharmacists, students may assist with patient care activities, such as medication reconciliation, point-of-care testing, and counseling. Evidence has shown that students benefit in building confidence, as well as improved perceptions of interprofessional care, while positive patient outcomes are maintained. There are many methods for schools to integrate these experiences early into their curriculum, as well as for students to explore opportunities on their own.

Background: The role of the community pharmacist is rapidly expanding to encompass the care of veterinary patients in the United States of America This change makes it imperative for pharmacists and veterinarians who practice in community settings to establish mutual agreement on the roles of pharmacists in the care of these patients. Objective: To examine community-based pharmacist and veterinarian viewpoints on interprofessional collaboration and the role of the community pharmacist in veterinary patient care. Methods: Cross-sectional surveys were sent to pharmacists and veterinarians who practice in a community setting in Ohio. Surveys collected demographic information and addressed the following themes: attitudes toward collaboration, perceived roles of the pharmacist, expectations of the pharmacist, and previous collaborative experiences. A chi-square test was used for statistical analysis. Results: In total, 357 pharmacists and 232 veterinarians participated in the study. Both professions agreed that pharmacist-veterinarian collaboration is important in order to optimize veterinary patient care (chi-square (1, N=589)=7.7, p=0.006). Overall, veterinarians were more likely to identify an important role of the community pharmacist to be compounding medications (chi-square (1, N=589)=26.7, p

Background: Discovering methods of Residency Teaching Certificate Programs (RTCPs) will allow for collaboration in developing best practices to ensure both high quality of programming and outcomes for participants. Objective: The primary objective of this project is to describe and compare how RTCPs are conducted in the state of Ohio. Secondarily, to identify current practices in assessing RTCPs in both programmatic effectiveness and individual resident teaching outcomes. Methods: The seven coordinators of the seven Ohio RTCPs (n=7) were contacted via email and asked to participate in an IRB-approved interview, either in-person or telephonically. Standardized questions were developed to inquire about six categories of interest: demographics/background, administration/logistics, content, assessment of the resident, program financing, and program continuous quality improvement (CQI). All seven programs participated in interviews. Data was coded by multiple members of the research team for presentation in aggregate form. Results: RTCPs include seminar days at the respective pharmacy colleges; however, the number, length, and content of seminars vary. The majority of programs (n=5) stated using inherited curriculum and materials passed down from previous coordinators. While each RTCP requires participants to submit a teaching portfolio, only three of seven programs assess the summative portfolios. All programs (n=7) award participants a certificate based on completion of requirements without a defined minimum performance standard. Two programs are collecting participant feedback after every session for CQI however no programs are completing an annual programmatic assessment of resident outcomes. The majority of coordinators (n=7) are interested in collaborating and sharing “best practices” between RTCPs in the state. Conclusions: Although published and available resources exist surrounding the development and delivery of RTCPs, in Ohio, their use varies greatly. The most striking outcomes highlighted the lack of resident and program assessment of outcomes in RTCPs. The research has brought forth ideas of ways to improve these programs through resident assessment, program assessment and also leads to reflection and innovation around the best way to deliver these programs.

Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others (LGBTQIA+) patients face stigma and barriers to health care, including a lack of health care professionals’ knowledge and confidence in treating this patient population. Pharmacists are in prime position to decrease this health disparity. United States pharmacy schools have limited LGBTQIA+ content, continuing the concern of recent graduates without knowledge and confidence. This commentary discusses potential barriers to introducing LGBTQIA+ content into school of pharmacy curricula and presents five strategies currently in use by nursing, medical, and pharmacy schools. Schools of Pharmacy should consider proactive incorporation of this content to graduate practitioners able to provide quality care to LGBTQIA+ patients.

Objective: To identify barriers to healthcare access, to assess the health literacy levels of the foreign-born Arabic speaking population in Iowa, USA and to measure their prevalence of seeking preventive healthcare services. Methods: A cross-sectional study of native Arabic speaking adults involved a focus group and an anonymous paper-based survey. The focus group and the Andersen Model were used to develop the survey questionnaire. The survey participants were customers at Arabic grocery stores, worshippers at the city mosque and patients at free University Clinic. Chi-square test was used to measure the relationship between the characteristics of survey participants and preventive healthcare services. Thematic analysis was used to analyze the focus group transcript. Results: We received 196 completed surveys. Only half of the participants were considered to have good health literacy. More than one-third of the participants had no health insurance and less than half of them visit clinics regularly for preventive measures. Two participant enabling factors (health insurance and residency years) and one need factor (having chronic disease(s)) were found to significantly influence preventive physician visits. Conclusions: This theory-based study provides a tool that can be used in different Western countries where Arabic minority lives. Both the survey and the focus group agreed that lacking health insurance is the main barrier facing their access to healthcare services. The availability of an interpreter in the hospital is essential to help those with inadequate health literacy, particularly new arriving individuals. More free healthcare settings are needed in the county to take care of the increasing number of uninsured Arabic speaking patients.

Objective: This ex post facto matched control study was conducted to evaluate the effect of targeted short-form messages or continuing medical education (CME) on fluoroquinolone prescribing among high prescribers. Methods: A total of 11,774 Medscape healthcare provider (HCP) members prescribing high volumes of fluoroquinolones were randomized into three segments to receive one of three unique targeted short-form messages, each delivered via email, web alerts, and mobile alerts. Some HCPs receiving targeted short-form messages also participated in CME on fluoroquinolone prescribing. A fourth segment of HCPs participated in CME only. Test HCPs were matched to third-party-provider prescriber data to identify control HCPs. We used prescriber data to determine new prescription volume; percentage (%) of HCPs with reduced prescribing; new prescription volume for acute bacterial sinusitis (ABS), uncomplicated urinary tract infection (uUTI), and acute bacterial exacerbations of chronic bronchitis in those with chronic obstructive pulmonary disease (ABECB-COPD). Open rates for emailed targeted short-form messages were also measured. Results: Targeted short-form messages and CME each resulted in significant new prescription volume reduction versus control. Combining targeted short-form messages with CME yielded the greatest percentage of test HCPs with reduced prescribing (80.1%) versus controls (76.2%; p

Objective: The purpose of this study was to characterize and classify significant events of pharmacy students who completed an early practice experience. Methods: Significant event analyses (SEAs) were reflections submitted by students about events that they found impactful during their early practice experiences. An online repository has stored 287 SEAs submitted by first year pharmacy students for later use in a pharmacy course. For this study, all significant events were read and coded according to the pre-specified themes and tones (positive, negative, neutral, hybrids) of the event. Themes used were derived from prior literature characterizing major themes from other health professional students’ experiences. Additional themes were added by authors for those that did not fit into the pre-set categories. All themes of the narratives were subsequently categorized. To assure confirmability, the investigators conferred to discuss new themes that emerged and events that were ambiguous. To assure credibility, an external audit of a sample of the coded SEAs was completed. Upon reaching consensus between primary reviewer and secondary reviewers, data were reported as frequencies and percentages. This study received ethics clearance from the Office of the University Registrar and was deemed exempt by the University Institutional Review Board. Results: A total of 1,055 coded responses were analyzed. The majority of SEAs were positive in tone (n=190, 66.2%) and many were hybrids of negative-turned-positive emotions (n=62, 21.6%). The most common major content theme was “patients and the provision of patient care” (n=412, 39.1%), followed by “pharmacy students and their behavior” (n=260, 24.6%). The most prevalent subthemes were “learning by doing” (n=134, 12.7%) and “feelings of usefulness or uselessness” (n=111, 10.5%). Conclusions: The majority of students framed significant events in their pharmacy practice experiences in a positive light, even from challenging interactions. The events that resonated most frequently with these students centered around patient interactions and providing patient care. These results will be useful for pharmacy educators developing pharmacy school curriculums to better prepare students to excel and feel more comfortable in direct patient care experiences.

This review focuses on the studies and opinions around issues of transition from the BPharm to the PharmD degree in the U.S., Japan, South Korea, Pakistan and Thailand. The transition to the clinically orientated PharmD degree in many countries was seen to be a means of developing the profession. However, some countries have both clinically-oriented and pharmaceutical sciences-oriented PharmD programme that are designed to meet the needs of their countries. Each country created a different process to handle the transition to an all-PharmD programme, but mostly had the process of school accreditation mandated by the regulatory bodies. The main barrier to the transition in most of the countries was the issue of educational quality. A set of indicators is needed to measure and monitor the impact/outcome of the PharmD degree. Each country has different needs due to the different contexts of health care systems and the scope of pharmacy practice. In order to increase their chances of benefiting from the new programme, academic leaders should critically assess their countries’ needs before deciding to adopt a PharmD programme.

Background: There is a need to train healthcare professionals to provide first aid to people experiencing a mental health crisis. Research testing the association between Mental Health First Aid (MHFA) training and the use of MHFA behaviors could provide evidence of program effectiveness in the pharmacy setting. Objectives: The objectives of this study were to measure the preparedness of pharmacy professionals to function in a MHFA role, and compare preparedness and the use of MHFA behaviors based on demographic characteristics. Methods: Pharmacists and student pharmacists attended MHFA training under a multi-state pharmacy initiative in 2018. An anonymous electronic survey was administered to 227 participants using 4 contacts in May to June, 2019. The survey evaluated if participants had recommended MHFA to others, their preparedness to engage in MHFA behaviors (13 items), and their frequency of performing a set of MHFA behaviors (7 items). Descriptive statistics, bivariate analysis, and ANOVA were used to describe the sample and compare these variables across groups. Results: The analysis was based on 96 responses (42.3%). Almost all respondents (96%) had recommended MHFA training to others. Respondents reported that the training program prepared them to provide a range of MHFA behaviors for multiple mental health conditions, particularly for depression and anxiety. Participants most often reported asking about a distressed mood and listening non-judgmentally. Almost half of participants had asked someone if they were considering suicide and a similar percent had referred someone considering suicide to resources. Those reporting the highest levels of preparedness engaged in significantly more MHFA behaviors than those with lower levels of preparedness (p=0.017). Preparedness and use of MHFA behaviors were not significantly associated with respondent demographic characteristics. Conclusion: These data suggest that pharmacy professionals who had MHFA training felt prepared to engage in MHFA and many used behaviors like asking about suicide and making referrals since being trained in MHFA. Research is warranted to better understand what makes someone feel maximally prepared to use MHFA behaviors compared to lower feelings of preparedness.

Background: United States pharmacies repackage medications into multi-dose vials, enabling customized dosing for prescription drugs. Investment in infrastructure has made this the predominant approach to packaging for US prescriptions. Although recent changes to labeling now discourage the use of auxiliary labels (small stickers highlighting information germane to the safe and effective use), they are still allowed by USP, provided their use comes from an evidence-based perspective. Objectives: Evaluate how ‘interactive,’ placements of auxiliary labels (placement requiring physical manipulation of the warning to accomplish a task (e.g. opening)) garner attention as compared to those placed vertically or horizontally. Methods: Ninety-six participants were eye tracked while opening three prescription vials (each with an auxiliary warning label with a different placement: vertical, horizontal and interactive). Recall and recognition were tested subsequently. Linear mixed models were used to analyze the continuous variables while the binary response variables were analyzed using generalized linear mixed models. The effect of auxiliary labels was fitted as a fixed effect and the subject-to-subject variation was considered as a random effect in the model. Participants’ age, health literacy and sex were added to the models if their effect was statistically significant at alpha=0.05. Results: The placement of the warnings significantly impacted the time spent viewing the information they contained at alpha=0.05; people spent significantly longer on interactive placements (0.96; SD 0.13 seconds) than either, horizontal placements (0.27; SD 0.037 seconds) or those placed vertically (0.18 seconds; SD 0.035). Participants were equally as likely to see information presented in an interactive placement (90%; SD 3.8) or horizontal placement (78%; SD 05.5) but less likely to view warnings placed vertically (60%; SD 6.9). Free recall responses also supported the use of interactive placement (62%; SD 6.8 recall) as compared to horizontal placements which were 29%; SD 3.0 and 20%; SD 6.0 for vertical placements. Conclusions: Data provides evidence which suggests that interactive and horizontal placements out-perform auxiliary labels placed vertically on prescription vials with regard to garnering patient attention.

Background: The CDC has reported 399,230 opioid-related deaths from 1999-2017. In 2018, the US surgeon general issued a public health advisory, advising all Americans to carry naloxone. Studies show that enhanced naloxone access directly reduces death from opioid overdose. Despite this, health care professional learners report low knowledge and confidence surrounding naloxone. Therefore, it becomes critical that medical education programs incorporate didactic and experiential sessions improving knowledge, skills and attitudes regarding harm reduction through naloxone. Objectives: 1. Describe the components and evaluation of a replicable and adaptable naloxone didactic and skills session model for medical providers; 2. Report the results of the evaluation from a pilot session with family medicine residents and physician assistant students; and 3. Share the session toolkit, including evaluation surveys and list of materials used. Methods: In July 2017, a literature search was completed for naloxone skill training examining best practices on instruction and evaluation. A training session for family medicine residents and physician assistant learners was designed and led by University of Cincinnati College of Medicine and College of Pharmacy faculty. The same faculty designed a pre and post session evaluation form through internal review on elements targeting naloxone knowledge, attitude, and self-efficacy. Results: The training session included one hour for a didactic and one hour for small group live skills demonstration in four methods of naloxone administration (syringe and ampule, nasal atomizer, branded nasal spray and auto injector). Forty-eight participants showed statistically significant (p

Objective To identify barriers to completing and publishing pharmacy residency research projects from the perspective of program directors and former residents. Methods This was a cross-sectional survey of pharmacy residency program directors and former post-graduate year one and two residents. Directors of pharmacy residency programs whose residents present their projects at the Western States Conference (n=216) were invited to complete an online survey and asked to forward the survey to former residents of their program in 2009, 2010, or 2011. The survey focused on four broad areas: 1) demographic characteristics of the residency programs, directors, and residents; 2) perceived value of the research project; 3) perceived barriers with various stages of research; and 4) self-identified barriers to successful research project completion and publication. Results A total of 32 program directors and 98 residents completed the survey. The minority of programs offered formal residency research training. Both groups reported value in the research project as part of residency training. Significantly more directors reported obtaining institutional review board approval and working through the publication process as barriers to the research project (46.7% vs. 22.6% and 73.3% vs. 43.0%, respectively p

Background: Modern medical care increasingly requires coordinated teamwork and communication between healthcare professionals of different disciplines. Unfortunately, healthcare professional students are rarely afforded the opportunity to learn effective methods of interprofessional (IP) communication and teamwork strategies during their education. The question of how to best incorporate IP interactions in the curricula of the schools of health professions remains unanswered. Objective: We aim to solve the lack of IP education in the pharmacy curricula through the use of high fidelity simulation (HFS) to allow teams of medical, pharmacy, nursing, physician assistant, and social work students to work together in a controlled environment to solve cases of complex medical and social issues. Methods: Once weekly for a 4-week time period, students worked together to complete complex simulation scenarios in small IP teams consisting of pharmacy, medical, nursing, social work, and physician assistant students. Student perception of the use of HFS was evaluated by a survey given at the conclusion of the HFS sessions. Team communication was evaluated through the use of Communication and Teamwork Skills (CATS) Assessment by 2 independent evaluators external to the project. Results: The CATS scores improved from the HFS sessions 1 to 2 (p = 0.01), 2 to 3 (p = 0.035), and overall from 1 to 4 (p = 0.001). The inter-rater reliability between evaluators was high (0.85, 95% CI 0.71, 0.99). Students perceived the HFS improved: their ability to communicate with other professionals (median =4); confidence in patient care in an IP team (median=4). It also stimulated student interest in IP work (median=4.5), and was an efficient use of student time (median=4.5) Conclusion: The use of HFS improved student teamwork and communication and was an accepted teaching modality. This method of exposing students of the health sciences to IP care should be incorporated throughout the curricula.

Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR) program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%), non-formulary omission (16.2%), dose discrepancy (10.1%), and frequency discrepancy (4.1%). Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (P

Background: Public health priorities can be addressed by pharmacists through channels such as medication therapy management (MTM) to optimize patient and population outcomes. However, no studies have specifically assessed pharmacists’ perceptions of addressing public health priorities through MTM. Objective: The objective of this study was to assess pharmacists’ opinions regarding the feasibility and appropriateness of addressing seven areas of public health priority through MTM services to impact public health in direct patient care settings. Methods: An anonymous 37-question electronic survey was conducted to evaluate Ohio pharmacists’ opinions of advancing seven public health priorities identified from Healthy People 2020 (family planning, preconception care, smoking cessation, immunizations, nutrition/biometric wellness assessments, point-of-care testing, fall prevention) through MTM activities; to identify potential barriers; and to collect demographic information. The cross-sectional survey was sent to a random sample of 500 pharmacists registered with the Ohio State Board of Pharmacy. Results: Seventy-six pharmacists responded to the survey, resulting in a 16% response rate. On average, it took respondents 5-10 minutes to complete the survey. The majority of respondents thought that each of the seven public health priorities were “important” or “very important” to patient health; the most commonly identified areas included smoking cessation, immunizations, and fall prevention (97.5%). When asked to indicate which of the seven areas they thought they could potentially have a role to provide services through MTM, on average pharmacists picked 4 of the priority areas. Only 6.6% indicated there was no role for pharmacists to provide MTM services for any of the listed categories. Staffing, time, and reimbursement represented the most commonly perceived barriers for pharmacists in providing MTM services. Fifty-seven percent indicated an interest in learning more about MTM, with 98% of responders selecting continuing education as the preferred source. Conclusion: The majority of pharmacists indicated they could make an impact on public health priorities through MTM services.

Objective: The purpose was to assess factors potentially affecting care pharmacists provide to HIV/AIDS patients including comfort level, confidence, education, experience, professional competence, continuity of care and patient-provider relationship between pharmacists and HIV-infected patients. Methods: A 24-item questionnaire assessed the constructs of this study. Surveys were distributed from October 2009 to April 2010 to pharmacists in Alabama with varying levels of experience treating HIV-infected patients. Chi-square tests determined whether relationships existed between responses, consisting of how often respondents reported treating HIV-infected patients, amount of HIV education respondents had, participants' confidence with HIV/AIDS knowledge and comfort level counseling HIV-infected patients about their medications. Results: Thirty-three percent of the pharmacists cared for HIV-infected patients on a monthly basis, yet 86% do not feel very confident with their HIV/AIDS knowledge. Forty-four percent were not comfortable counseling patients on antiretroviral medications, and 77% would feel more comfortable with more education. Significant, positive relationships were revealed concerning how often respondents treat HIV-infected patients and their comfort level counseling them (r=0.208, p

Objective: To determine knowledge of folic acid use for neural tube defect (NTD) prevention and counseling practices among community pharmacists registered in Ohio. Methods: A cross-sectional study was performed on a random sample (n=500) of community pharmacists registered with the Ohio Board of Pharmacy and practicing in Ohio. A survey previously used by researchers to assess folic acid knowledge and practices among samples of other healthcare provider groups in the United States was adapted with permission for this study. The final tool consisted of 28 questions evaluating the knowledge, counseling practices, and demographics of respondents. The cover letter did not reveal the emphasis on folic acid, and surveys were completed anonymously. The university institutional review board deemed the study exempt. Results: Of the 122 pharmacists who completed the survey, 116 (95.1%) knew that folic acid prevents some birth defects. Twenty-eight (22.9%) responded that they "always" or "usually" discuss multivitamins with women of childbearing potential, and 19 (15.6%) responded that they "always" or "usually" discuss folic acid supplements. Some gaps in knowledge specific to folic acid were revealed. While 63.1% of pharmacists selected the recommended dose of folic acid intake for most women of childbearing potential, 13.1% could identify the dose recommended for women who have had a previous NTD-affected pregnancy. Respondents identified continuing education programs, pharmacy journals/magazines, and the Internet as preferred avenues to obtain additional information about folic acid and NTD. Conclusion: This study represents the first systematic evaluation of folic acid knowledge and counseling practices among a sample of pharmacists in the United States. As highly accessible healthcare professionals, community pharmacists can fulfill a vital public health role by counseling women of childbearing potential about folic acid intake. Educational materials may be beneficial in augmenting knowledge of folic acid and facilitating patient education.

Despite attempts to control college-aged drinking, binge and underage drinking continues at colleges and universities. Although often underutilized, faculty have the potential to influence students’ behaviors and attitudes towards drinking. Little information is available pertaining to college faculty drinking patterns, views on drinking, or their influence on college drinking. What little information is available predates the economic crisis, mandates for increased alcohol education, and the American Pharmacists Association’s call for increased alcohol awareness in pharmacists.Objectives: This study was designed to determine alcohol use patterns and viewpoints among faculty at U.S. colleges of pharmacy, in particular, to identify alcohol practices among faculty, use of alcohol with their students, mentioning alcohol in classroom as a social norm, and perceived drinking norms within their colleagues.Methods: Following Institution Review Board approval, 2809 invitations were emailed to U.S. pharmacy faculty for this survey-based study. The survey consisted of demographic questions, the World Health Organization Alcohol Use Disorders Identification Test (AUDIT), and questions pertaining to personal and institution attitudes on drinking and on drinking with students.Results: More than 96% of 753 respondents had a total AUDIT score

Objective: To describe the education, research, practice, and policy related to pharmacist interventions to improve medication adherence in community settings in the United States. Methods: Authors used MEDLINE and International Pharmaceutical Abstracts (since 1990) to identify community and ambulatory pharmacy intervention studies which aimed to improve medication adherence. The authors also searched the primary literature using Ovid to identify studies related to the pharmacy teaching of medication adherence. The bibliographies of relevant studies were reviewed in order to identify additional literature. We searched the tables of content of three US pharmacy education journals and reviewed the American Association of Colleges of Pharmacy website for materials on teaching adherence principles. Policies related to medication adherence were identified based on what was commonly known to the authors from professional experience, attendance at professional meetings, and pharmacy journals. Results: Research and Practice: 29 studies were identified: 18 randomized controlled trials; 3 prospective cohort studies; 2 retrospective cohort studies; 5 case-controlled studies; and one other study. There was considerable variability in types of interventions and use of adherence measures. Many of the interventions were completed by pharmacists with advanced clinical backgrounds and not typical of pharmacists in community settings. The positive intervention effects had either decreased or not been sustained after interventions were removed. Although not formally assessed, in general, the average community pharmacy did not routinely assess and/or intervene on medication adherence. Education: National pharmacy education groups support the need for pharmacists to learn and use adherence-related skills. Educational efforts involving adherence have focused on students’ awareness of adherence barriers and communication skills needed to engage patients in behavioral change. Policy: Several changes in pharmacy practice and national legislation have provided pharmacists opportunities to intervene and monitor medication adherence. Some of these changes have involved the use of technologies and provision of specialized services to improve adherence. Conclusions: Researchers and practitioners need to evaluate feasible and sustainable models for pharmacists in community settings to consistently and efficiently help patients better use their medications and improve their health outcomes.

Objective: To evaluate beta blocker persistence six months after beta-blocker initiation or dose titration in heart failure (HF) patients with COPD compared to those without COPD. Secondary objectives included comparison of beta-blocker dose achieved, changes in left ventricular ejection fraction (LVEF) and incidence of hospitalizations or emergency department (ED) visits during follow-up. Methods: We conducted a matched, retrospective, cohort study including 86 patients with COPD plus concomitant HF (LVEF ≤40%) and 137 patients with HF alone. All patients were followed in an outpatient HF clinic. Eligible patients had a documented LVEF ≤40% and were initiated or titrated on a beta-blocker in the HF clinic. Patients were matched based on LVEF (categorized as ≤ 20% or 21-40%), gender, and age (> or ≤70 years). The primary outcome was beta blocker persistence at 6 months. Secondary outcomes were dose achieved, LVEF, and incidence of hospitalizations or ED visits. Results: There were no differences between the COPD and non-COPD groups in beta-blocker persistence at six-month follow-up (94.2% vs. 93.4% respectively, adjusted p=0.842). The proportion of patients who achieved a daily metoprolol dose equivalent of at least 100 mg was similar between the groups (adjusted p=0.188). The percent of patients with at least one ED visit or hospitalization in the six-month post-titration period was substantial but similar between the groups (53.5% and 48.2% for COPD and non-COPD patients, respectively, adjusted p=0.169). Conclusion: Our results support the use of beta-blockers in the population of heart failure patients with COPD and without reactive airway disease.

Objective: To describe a standard approach to provide a support structure for pharmacy resident research that emphasizes self-identification of a residency research project. Methods: A subcommittee of the residency advisory committee was formed at our institution. The committee was initially comprised of 2 clinical pharmacy specialists, 1 drug information pharmacist, and 2 pharmacy administrators. The committee developed research guidelines that are distributed to residents prior to the residency start that detail the research process, important deadlines, and available resources. Instructions for institutional review board (IRB) training and deadlines for various assignments and presentations throughout the residency year are clearly defined. Residents conceive their own research project and emphasis is placed on completing assignments early in the residency year. Results: In the 4 years this research process has been in place, 15 of 16 (94%) residents successfully identified their own research question. All 15 residents submitted a complete research protocol to the IRB by the August deadline. Four residents have presented the results of their research at multi-disciplinary national professional meetings and 1 has published a manuscript. Feedback from outgoing residents has been positive overall and their perceptions of their research projects and the process are positive. Conclusion: Pharmacy residents selecting their own research projects for their residency year is a feasible alternative to assigning or providing lists of research projects from which to select a project.

Background: The pharmacist’s role in dispensing emergency contraception (EC) has become controversial due to the intersection of personal and professional ethics. Therefore, to examine the issue of EC availability, we surveyed a sample of West Texas pharmacists. West Texas is a religiously and politically conservative region where no methods of EC have been made available. Objective: to survey a sample of pharmacists in West Texas about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC. Methods: We asked a convenience sample of 75 pharmacists about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC. Results: Sixty-four (85%) pharmacists agreed to complete the study questionnaire. None carries EC in his/her pharmacy, and scientific understanding of EC was generally poor. Fourteen percent stated EC conflicts with their religious views, 17% considered it a method of abortion, 11% would not be willing to fill an EC prescription written by a doctor. 58% would be willing to offer EC over the counter. The presentation encouraged more to offer it over the counter, but in general did not significantly change their beliefs. Conclusion: Our sample of West Texas pharmacists demonstrated very little experience with, a general lack of knowledge about, and some personal and religious objections to EC. Antecedentes: El papel del farmacéutico dispensando contraceptivos de emergencias (CE) es controvertido debido a la intersección de la ética personal y profesional. Así que para examinar el problema de la disponibilidad de CE investigamos una muestra de farmacéuticos de West Texas. West Texas es una región religiosa y políticamente conservadora donde no están disponibles métodos de CE. Objetivo: Investigar una muestra de farmacéuticos de West Texas sobre sus experiencias, creencias y conocimiento de CE antes y después de una presentación sobre la literatura actual sobre CE. Métodos: Preguntamos a una muestra de conveniencia de 75 farmacéuticos sobre sus experiencias, creencias y conocimiento sobre CE antes y después de una presentación de la literatura actual sobre CE. Resultados: Sesenta y cuatro (85%) farmacéuticos aceptaron completar el cuestionario del estudio. Ninguno posee CE en su farmacia, y el conocimiento científico de la CE era realmente pobre. El catorce por ciento afirmó que la CE colisiona con sus creencias religiosas, el 17% lo consideró un método de aborto, el 11% no era capaz de dispensar una receta de CE escrita por un médico. El 58% sería capaz de ofrecer CE de libre venta. La presentación animó a ofrecerla como libre venta, pero en general no cambió sus creencias significativamente. Conclusión: Nuestra muestra de farmacéuticos de West Texas demostró muy poca experiencia, una falta general de conocimientos y algunas objeciones personales y religiosas sobre la CE.

Objective: The objective of this study was to assess the need for research support, faculty development, and topics of interest to clinical track pharmacy faculty that would facilitate scholarship in research. Methods: A cross-sectional survey of pharmacy practice-based faculty at University of Illinois at Chicago (UIC) completed via the web in November 2005. Results: Of 39 clinical track faculty respondents (48% response rate), 100% indicated they were interested in being co-investigator or 77% lead investigator on a research grant proposal. The majority of respondents expressed "a lot" or "extreme" interest in receiving methodological guidance and administrative support in order to pursue research interests. The greatest interest in research support services related to sample size calculations, selection of appropriate statistical tests, grant writing, and writing for journals. Barriers to research cited by faculty included lack of confidence in ability, the need for balancing responsibilities, and reward for efforts. Suggestions included the creation of specific research interest groups, research seminars, formal mentoring and statistical support services. Conclusions: Clinical-track faculty are interested in research-related scholarship but typically lack the confidence or skills to lead research. While this study was limited to UIC clinical faculty, UIC faculty are attracted from Colleges of Pharmacy across North America and it is notable that such barriers can be quickly identified using a brief web-based survey in order to inform a plan that provides resources and support for research by clinical pharmacy faculty. Objetivo: El objetivo de este estudio fue evaluar la necesidad de apoyo a la investigación, desarrollo del profesorado y los puntos de interés para el profesorado clínico que facilitaría la enseñanza en investigación. Métodos: Estudio transversal de una facultad basada en la práctica de la Universidad de Illinois en Chicago (UIC) a través de la Web en noviembre de 2005. Resultados: De los 39 académicos clínicos respondentes (48% tasa de respuesta), 100% indicó que estarían interesados en ser co-investigador o el 77% investigador principal en una solicitud de beca de investigación. La mayoría de los que respondieron expresó "mucho" o "extremo" interés en recibir guía metodológica y apoyo administrativo para conseguir los intereses investigadores. El mayor interés en servicios de apoyo se relacionó con los cálculos del tamaño de muestra, selección de los apropiados tests estadísticos, escritura de becas y escritura de artículos para revistas. Las barreras a la investigación citadas por los académicos incluyeron la falta de confianza en su capacidad, la necesidad de equilibrar las responsabilidades, y el premio por los esfuerzos. Las sugerencias incluyeron la creación de grupos específicos de investigación, seminarios de investigación, tutela formal y servicios de apoyo estadístico. Conclusiones: Los académicos clínicos están interesados en enseñanza relacionada con la investigación, pero generalmente carecen de confianza o habilidades para liderar investigación. Mientras que este estudio se limitó a los académicos de la UIC; los académicos de UIC son llegados desde otros puntos de Norte América y es notorio que estas barreras pueden identificarse usando un breve cuestionario en la Web para informar a un plan que proporcione recursos y apoyo a la investigación para los académicos clínicos.

Background: Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations. Objective: The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers’ perception of patients’ health literacy. Methods: We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS). Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared. Results: Inadequate health literacy was identified in 31 out of 61 patients (50.8%) using 2 questions from the BHLS. Only 9 (29%) of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy. Conclusions: These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.

Objective: To assess the feasibility of clinical pharmacist-led CYP2C19 genotype-guided P2Y12 inhibitor antiplatelet drug therapy recommendations to cardiologists in an outpatient cardiology practice. Methods: This was a prospective, open-labeled, single-arm study conducted in an integrated healthcare delivery system between March 1, 2013 and January 23, 2014. Patients requiring non-emergent cardiac catheterization were included. A clinical pharmacist provided interpretation and recommendations from genotyping results. The feasibility of implementing CYP2C19 genotype-guided antiplatelet therapy was assessed by the: 1) percentage of patients approached who consented to CYP2C19 genotyping, 2) percentage of patients with CYP2C19 genotyping results available prior to cardiac catheterization, and 3) percentage of clinical pharmacist CYP2C19 genotype-based antiplatelet recommendations accepted by cardiologists. Results: Of the 43 patients identified for potential recruitment, 22 of these were eligible for study enrollment and 6 (27%) patients consented and received CYP2C19 genotyping. All patients had genotyping results available prior to catheterization and all clinical pharmacists’ antiplatelet therapy recommendations were accepted by the patients’ cardiologists. Three patients had the CYP2C19 wild-type (*1/*1) genotype and the clinical pharmacist recommended clopidogrel therapy. CYP2C19 variant genotypes (i.e., *1/*2, *1/*17, and *2/*17) were found in the other three patients; alternative antiplatelet therapy was recommended for the patient with the *1/*2 genotype, while clopidogrel was recommended for those with *1/*17 and *2/*17 genotypes. Conclusion: A relatively small proportion of patients undergoing non-emergent cardiac catheterization consented to pharmacogenetic testing; however, their cardiologists were receptive to clinical pharmacists conducting such testing and providing corresponding pharmacotherapy recommendations. Future studies should identify patient barriers to pharmacogenetic testing.

Objective: To determine doctor of pharmacy (PharmD) students' perceptions of a PharmD and master of public health (MPH) dual degree program. Methods: A seven-item survey instrument was developed and distributed to students at a large metropolitan school of pharmacy during scheduled class time in April 2012. Results: Among the 611 students enrolled in the PharmD program, 447 (73%) responded. Of those who responded, 72.3% were either "very likely" or "likely" to consider enrolling in such a PharmD/MPH dual degree program, and 77.4% believed that it would be attractive to future students. The most commonly identified potential limitations to pursuing the dual degree were time commitment (19.9%), increased workload and stress (11.2%), and tuition cost (10.3%). The most notable advantages documented were increased job opportunities for public health-related pharmacy positions (26.9%), increased ability to serve patients and the community (13.4%), and increased marketability for future jobs (8.7%). Conclusions: PharmD student participants demonstrated overall positive attitudes and interest towards a PharmD/MPH dual degree program.

Background: Whether the available Continuing Education (CE) programs meet pharmacists' continuously increasing needs and preferences is open to question. Objectives: to investigate pharmacists' perceptions and attitudes concerning available CE programs, evaluate the pharmacists' choices with regard to selecting among different CE programs, and investigate the factors that are associated with preference to utilize online CE programs. Method: A 17-question survey was developed and mailed to a random sample of 600 Texan pharmacists. In addition to collecting basic demographic information, the survey investigated pharmacists' choices with regard to delivery and content of CE programs, motivations to participation in CE programs, and pharmacists' preferences for future CE programs. Results: A total of 161 pharmacists completed the survey and mailed back their responses. Excluding the 75 undeliverable surveys, the response rate was 31%. Approximately 83% of respondents found that currently available CE programs met their educational needs. The most important factors influencing pharmacists' choices with regard to CE programs were the scope programs, the location where programs are held, and the cost associated with enrolling in such programs. Online CE was the most preferred mode of CE among participants. The factors that were associated with pharmacists' preferences to complete 50% or more of required CE through online programs were previous use of online CE programs, preference to limit the duration of CE programs to 1 or 2 hour-long, and perceived ability to find adequate CE programs among currently available CE programs. Conclusion: The findings suggest modalities for CE programs providers on how to improve CE programs in the future in order to meet the preferences of local pharmacists.

Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigorous goals of therapy. Objective: The purpose of this project was to evaluate this type of care model in a high cardiac risk patient population. Methods: A retrospective cohort study determined the ability of a cardiologist-pharmacist care model (n=59) to lower blood pressure and achieve blood pressure goals (< 130/80 mmHg) in patients with or at high risk for coronary artery disease compared to usual cardiologist care (n=58) in the same clinical setting. Results: The cardiologist-pharmacist care model showed a higher percentage of patients obtaining their goal blood pressure compared to cardiologist care alone, 49.2% versus 31.0% respectively, p=0.0456. Greater reductions in systolic blood pressure (-22 mmHg versus -12 mmHg, p=0.0077) and pulse pressure (-15 mmHg versus -7 mmHg, p=0.0153) were noted in the cardiologist-pharmacist care model. No differences in diastolic blood pressure were found. There was a shorter duration of clinic follow-up (7.0 versus 13.2 months, p=0.0013) but a higher frequency of clinic visits (10.7 versus 3.45, p

The Joint Commission continues to emphasize the importance of medication reconciliation in all practice settings. Pharmacists and student pharmacists are uniquely trained in this aspect of patient care, and can assist with keeping accurate and complete medication records through patient interview in the outpatient setting. Objective: The objective of this study was to quantify and describe medication reconciliation efforts by student pharmacists in an outpatient family medicine center. Methods: A retrospective review was conducted of all standard medication reconciliation forms completed by student pharmacists during patient interviews from April 2010 to July 2010. The number of reviews conducted was recorded, along with the frequency of each type of discrepancy. A discrepancy was defined as any lack of agreement between the medication list in the electronic health record (EHR) and the patient-reported regimen and included any differences in dose or frequency of a medication, duplication of the same medication, medication no longer taken or omission of any medication. Results: A total of 213 standard medication forms from the 4 month period were reviewed. A total of 555 discrepancies were found, including medications no longer taken, prescription medications that needed to be added to the EHR, over-the-counter(OTC) and herbal medications that needed to be added to the EHR, medications taken differently than recorded in the EHR, and medication allergies which needed to be updated. An average of 2.6 discrepancies was found per patient interviewed. Conclusion: Student pharmacist-initiated medication reconciliation in an outpatient family medicine center resulted in the resolution of numerous discrepancies in the medication lists of individual patients. Pharmacists and student pharmacists are uniquely trained in medication history taking and play a vital role in medication reconciliation in the outpatient setting.

Hazardous use of alcohol continues to be recognized as a problem at the university level. Knowledge regarding alcohol consumption in healthcare professional students is limited, especially in regards to pharmacy students. Much of the information available focuses on pharmacy student drinking patterns in specific geographic regions or is simply outdated. Objectives: This study was designed to assess levels of alcohol consumption and estimate the level of hazardous drinking among pharmacy students in a larger sample size that is representative of US pharmacy schools. Methods: An anonymous survey regarding alcohol usage was offered to students at nine schools of pharmacy across the United States. The survey consisted of demographic questions, the World Health Organization Alcohol Use Disorders Identification Test (AUDIT), and questions that assess particular alcohol-induced behaviors. Results: More than 25% of 1161 respondents had a total AUDIT score > 8, which indicates a risk of alcohol-related problems. Students that were male, in their first or second professional year of school, not married, and without children were statistically more likely to have AUDIT scores in the hazardous drinking range. Grade point average and student housing did not statistically affect student´s AUDIT scores. Conclusion: These results indicate that over one-fourth of pharmacy students surveyed have indicators of harmful alcohol use. Pharmacy schools should continue to address and confront hazardous alcohol use on campuses in order to curtail heavy alcohol consumption and reduce the risk of alcohol-related problems in pharmacy students.

As colleges of pharmacy prepare a new generation of practitioners, it is important that during practice experiences students learn the impact of clinical interventions. For over ten years, pharmacy students have been a vital part of the multidisciplinary team at the military treatment facility. The overall impact of the student interventions on patient care has not been evaluated. To evaluate the impact, the students began documenting their clinical interventions in Medkeeper RxInterventions™, an online database. The program is used to document faculty and fourth year pharmacy students’ pharmaceutical interventions.Objective: The objective of this study was to analyze the interventions completed by fourth year pharmacy students during a general medicine advanced pharmacy practice experience at a military treatment facility.Methods: The students completing their general medicine advanced pharmacy practice experience at the military treatment facility are responsible for self reporting all interventions made during clinical rounds into the Medkeeper RxIntervention™ database. The researchers retrospectively collected and analyzed interventions made from June 2008 to June 2009.Results: The total number of interventions recorded by 8 fourth year pharmacy students was 114. Students averaged a number of 14.3 interventions during an eight week practice experience. Students spent an average of 5 minutes per intervention. Ninety- five percent of the interventions were accepted.Conclusion: Fourth year pharmacy students’ recommendations were accepted at a high rate by resident physicians. The high acceptance rate may have the ability to positively impact patient care. Keywords: Students, Pharmacy. Education, Pharmacy, Graduate. United States.

Objectives: The purpose of this study is to determine the percentage of patients admitted for acute myocardial infarction currently prescribed a statin, with low-density lipoprotein (LDL) 0.2 ng/dL and lipid panel performed within 96 hours of troponin. Patients with a triglyceride level > 400 mg/dL were excluded. The residual risk population consisted of patients currently taking a statin with LDL

Objective: To determine the influence of demographics on patient preferences for community pharmacist attire. Methods: A 10-item questionnaire was developed and administered to patients visiting a chain pharmacy or an independent pharmacy in the Birmingham, Alabama metropolitan area. Mann– Whitney was used to examine if statistical differences existed in chain versus independent pharmacy patient’s selections based on pharmacist attire. Results: A statistically significant difference in patient preference for pharmacist attire between the settings in regards to which pharmacist patients felt was more approachable was observed; 51.2% of chain pharmacy respondents compared to 30% of independent pharmacy respondents identified the pharmacist pair with business formal attire and white coat as more approachable. Differences in education was also apparent with 70% of respondents in the independent pharmacy setting reporting having a Bachelor’s degree or higher compared to 45% of respondents in the chain pharmacy setting. Conclusion: With the exception of approachability, patients indicated preference for pharmacist with the white coat regardless of community setting. Given the importance of patient-pharmacist communication for building successful patientpharmacist relationships, if patients do not perceive the pharmacists as approachable, communication and subsequent development of said relationships may not occur regardless of perceived knowledge and competency.

*Guidelines have been published for management of chronic systolic heart failure to reduce patient morbidity and mortality. Objective: A quality review of the heart failure medical therapy for a community family medicine residency program clinic and a multidisciplinary heart failure specialty clinic was performed to compare adherence to ACC/AHA heart failure guidelines, with regard to medications and in titrating to recommended target doses. Methods: The study was a retrospective chart review and data collected included name and dose of any ACEI, beta-blocker, ARB, or other medication addressed in the guidelines. Results: Specialty clinic patients had significantly lower systolic blood pressures and ejection fractions. Significantly more patients were prescribed beta-blockers in the specialty clinic population (98% vs 80%, p

*Objective: The goal of this project was to categorize and classify bulletin board postings pertaining to pharmaceutical policy from both the professional and lay press. Methods: Bulletin board postings were used to supplement in-class discussion to keep students, faculty and staff up-to-date on emerging trends. A bulletin board located in the main classroom area of the College of Pharmacy Building where students would pass by on the way to class and congregate during break periods was used to display articles from various sources concerning topics related to pharmaceutical policy. Information is presented about the primary subject matters addressed in the articles, the types of publications from which they were drawn, and the top ten sources of articles displayed. Results: This project showed that coverage of issues related to pharmacists is predominantly seen in newspapers and most pertinent issues are business related. Conclusions: It can be seen from this analysis that the issues facing pharmacists are varied. The pharmaceutical policy field is transforming and many of these changes are very relevant to the general population. This is seen from the coverage of all of these issues in the lay press.

Objective: To assess the impact of a national immunization training certificate program on the perceived knowledge, skills and attitudes of pharmacy students toward pharmacy-based immunizations. Methods: The study design utilized a pre- and post-survey administered to pharmacy students before and after the American Pharmacists Association´s (APhA) Pharmacy-Based Immunization Delivery program. The primary outcome explored was a change in the perceived knowledge, skills, and attitudes of the pharmacy students. A five-point Likert scale (i.e. strongly agree = 5, strongly disagree = 1) was used for measuring the main outcomes, which was summated by adding the individual item scores in each section to form a composite score for each outcome. Results: The certificate training program resulted in a significant improvement in knowledge (38.5% increase in score, p

Objectives: New guidelines require preceptors to deliver approximately 30% of the doctor of pharmacy curricula. With preceptor’s increasing responsibilities, colleges are faced with the task of training preceptors as educators. Identifying preceptor’s training format preferences (i.e. electronic vs. live) should contribute to the more effective and efficient creation of training materials and programs. Methods: A preceptor training video was created and made available electronically and was distributed to 400 preceptors with a brief 2-part questionnaire about preceptor training preferences, electronic training preferences after viewing the video, and available technology resources for participating in electronic training. Results: 38.25% of the questionnaires were returned. The majority of respondents (57%) preferred electronic to live preceptor developing training and the majority (53%) had not previously attended the live annual preceptor development conference offered by the college. 51.6% participants reviewed the electronic training video created by the OU College of Pharmacy. Of the respondents who did not watch the video, 73% cited having too little time, problems accessing the video, or technical reasons for not watching the training video. The majority of responders in all age groups preferred electronic training to face-to-face training except those ages 61-65 and the majority (55.7%) would participate in on-line training again in the future. The majority of respondents have the technical resources to participate in electronic training. Conclusion: Preceptors have limited time to participate in preceptor development training, although they view training as an important activity. This study reveals three main findings: (1) the majority of preceptors prefer electronic preceptor development training programs regardless of age; (2) would participate in future electronic training after having participated in electronic training; and (3) have the available resources to participate in electronic training. Future preceptor development programs should have flexible formats to accommodate preferences for live and electronic programming.

Objectives: This pilot study was designed to evaluate the impact of a pre-rotation workshop (PRW) on pharmacy students’ clinical skills and preparation for clinical Advanced Pharmacy Practice Experiences (APPE) involving direct patient care. Methods: Randomized controlled trial of an educational intervention with Institutional Review Board approval. PRW activities designed to simulate rotation activities around five competencies, patient charts, medication histories, SOAP notes, patient presentations, and professionalism. Endpoints were evaluated using clinical rotation preceptors’ evaluation of performance and students’ performance on objective structured clinical exams (OSCE). Results: Eight fourth-year students and eight GPA matched controls (20% of the total class) were selected to voluntarily participate. The PRW demonstrated a positive impact on students’ clinical skills and preparation for rotations by improving OSCE performance. However, no significant differences were found between groups when comparing preceptor evaluations of skills on rotations. These results are limited by the small sample size, potential OSCE "test-wiseness" effects, lack of OSCE evaluator blinding to study groups, potential case specificity effects due to the limited number of cases used on the OSCE and possible lack of sensitivity of the rotation evaluation tool to capture true differences among the experimental and control group participants. Conclusion: The PRW was successful at advancing students’ clinical skills and preparation for rotations and may be considered as a tool to help bridge didactic to clinical experiences in the Pharm.D. curriculum. Objetivos: Este estudio piloto se diseñó para evaluar el impacto de un taller pre-rotación (TPR) en las habilidades clínicas de los estudiantes de farmacia y en su preparación para las Practicas Clínicas Avanzadas de Farmacia (PAF) que envuelven atención directa al paciente. Métodos: Ensayo aleatorizado controlado de una intervención educativa con aprobación de la Junta de Revisión Institucional. Las actividades del TPR se diseñaron para simular las actividades de la rotación sobre 5 competencias: historias clínicas, historiales farmacoterapéuticos, notas SOAP, presentaciones de pacientes, y profesionalismo. Los resultados se evaluaron utilizando la evaluación de tutores de prácticas clínicas y exámenes clínicos estructurados objetivos (OSCE). Resultados: Se seleccionaron 8 estudiantes de cuarto año y 8 GPA controles emparejados (20% del total e la clase) para participar voluntariamente. El TPR demostró un impacto positivo en las habilidades clínicas de los estudiantes y en la preparación para sus rotaciones mejorando el desempeño en el OSCE. Sin embargo, no se encontraron diferencias significativas entre los grupos cuando se compararon las evaluaciones de los tutores de las habilidades en las rotaciones. Estos resultados están limitados por el pequeño tamaño de la muestra, posibles efectos de conocimiento de los exámenes OSCE, la falta de un evaluador OSCE ciego para los grupos de estudio, posibles especificidades de los casos debido al número limitado de casos usados en el OSCE, y posible falta de sensibilidad del instrumento de evaluación de la rotación para encontrar verdaderas diferencias entre los grupos control e intervención. Conclusión: El TPR tuvo éxito en aumentar las habilidades clínicas de los estudiantes y la preparación para la rotaciones, y podría considerarse una herramienta para reducir la brecha didáctica a la práctica clínica en el currículo de Doctor en Farmacia.

Objective: To compare the quantity of manuscripts published in journals by departments of pharmacy practice at schools and colleges of pharmacy in the United States for the years 2001-2003. Methods: We utilized the Web of Science bibliographic database to identify publication citations for the years 2001 to 2003 which were then evaluated in a number of different ways. Faculty were identified via American Association of Colleges of Pharmacy rosters for 2000-2001, 2001-2002, and 2002-2003 academic years. Results: Rankings were done based on the number of publications per institution and average number of publications per faculty member at an institution. Upon linear regression analysis, a relationship exists between an institution's faculty size and the total number of publications but not for tenure/nontenure-track faculty ratio. Rating highest in overall publication number did not guarantee high rankings in the average number of publications per faculty member at an institution assessment. Midwestern schools were responsible for more publications per institution than other regions. Many schools only generated minimal scholarship over this evaluative period. Conclusion: While many schools have pharmacy practice faculty that strongly contributed to the biomedical literature, other schools have not. Pharmacy practice faculty in the Midwest publish more journal manuscripts than faculty in other regions of the country. More pharmacy schools need to engage their faculty in scholarly endeavors by providing support and incentives. Objetivo: Comparar la cantidad de manuscritos publicados en revistas por departamentos de práctica farmacéutica (farmacia práctica) en las escuelas y facultades de farmacia en los Estados Unidos entre los años 2001-2003. Métodos: Utilizamos la base de datos bibliográfica de Web of Science para identificar las citas de publicaciones de los años 2001 a 2003 que fueron evaluadas de varias diferentes formas. Los académicos fueron identificados mediante los registros de la Asociación Americana de Facultades de Farmacia para los años académicos 2000-2001, 2001-2002, y 2002-2003. Resultados: Se realizaron ranking con el número de publicaciones por institución y la media de publicaciones por miembro académico de la institución. Mediante un análisis de regresión lineal, existe una relación entre el tamaño de una institución y el número total de publicaciones, pero no para el ratio de académicos titulares/no titulares. Puntuar en lo más alto del ranking de publicaciones totales no garantizó las puntuaciones en la evaluación del número de publicaciones por miembro académico en la institución. Las facultades del Medio-Oeste fueron responsables de más publicaciones por institución que las otras regiones. Muchas facultades solo generaron una mínima producción durante este periodo de evaluación. Conclusión: Mientras muchas facultades tienen académicos de farmacia práctica que contribuyen fuertemente a la literatura biomédica, otras facultades no. Los académicos de farmacia práctica del Medio-Oeste publicaron más manuscritos en revistas que los académicos de otras regiones del país. Más facultades de farmacia necesitan involucrar a sus académicos en acciones científicas proporcionando apoyo e incentivos.

Objectives: The purpose of this study was to gather longitudinal data on a pharmacy class cohort concerning programmatic components as well as develop a profile of student experiences as they progress through the curriculum.Methods: The Class of 2006 (n = 67) completed a 2 page instrument at the conclusion of the first 3 professional years (PY) concerning hours spent in various activities, overall quality of various programmatic components, relationships with others in the college, and employment information. During senior week, a more extensive exit survey was administered.Results: At the conclusion of PY1, 56.5% of the class was working as a pharmacy intern. By PY3 this increased to 88.1% with a decrease to 65.7% in the final year. The hourly range of hours worked followed the same pattern. The rating of Dean’s Office Staff and interactions with faculty members remained constant across all 4 years. In the final exit survey the 2 lowest rated program components were the quality of the interaction with assigned faculty advisor and the availability of professional electives. There was no difference across the professional years for the quality of relationships with staff or faculty; however, the mean rating of the quality of relationships with other students was higher for PY4 when compared to PY1.Conclusions: College faculty, administrators, and committees have used the information gathered from students in program assessment and enhancement efforts. Longitudinal data collection allows for tracking of changes and interventions.

During patient care rounds with the medical team, pharmacy students have made positive contributions for the benefit of the patient. However, very little has been documented regarding the impact these future healthcare professionals are making while on clinical rotations. The objective of this study was to assess the impact that clinical interventions made by 6th year pharmacy students had on overall patient outcome. Using a special program for a personal digital assistant (PDA), the students daily recorded the pharmacotherapeutic interventions they made. The interventions ranged from dosage adjustments to providing drug information. Data was collected over a 12-week period from various hospitals and clinics in the Jacksonville, Florida area. In total, there were 89 pharmaceutical interventions performed and recorded by the students. Fifty interventions involved drug modification and fifty-four interventions were in regards to drug information and consulting. Of the drug information and consulting interventions, 15 were drug modification. This study shows the impact pharmacy students make in identifying, recommending, and documenting clinical pharmacotherapeutic interventions. Similar to pharmacists, pharmacy students can also have a positive contribution towards patient care. Durante las rondas de atención a pacientes con el equipo médico, los estudiantes de farmacia realizan contribuciones positivas en beneficio del paciente. Sin embargo, se ha documentado muy poco en relación al impacto de estos futuros profesionales de la salud en las rotaciones clínicas. El objetivo de este estudio fue evaluar el impacto que las intervenciones clínicas hechas por estudiantes de sexto año tenían sobre los resultados generales del paciente. Utilizando un programa especial para PDA, los estudiantes registraban diariamente las intervenciones farmacoterapéuticas que hacían. Las intervenciones iban desde ajustes de dosis a provisión de información de medicamentos. Los datos se recogieron durante 12 meses de varios hospitales y clínicas en el área de Jacksonville, Florida. En total, hubo 89 intervenciones farmacéuticas realizadas y registradas por los estudiantes. Cincuenta intervenciones involucraban modificación de medicamento y 54 intervenciones estaban relacionadas con la información de medicamentos y consultas. De estas informaciones de medicamentos y consultas, 15 fueron modificaciones de medicamentos. Este estudio muestra el impacto de los estudiantes de farmacia al identificar, recomendar y documentar intervenciones clínicas farmacoterapéuticas. Al igual que los farmacéuticos, los estudiantes de farmacia pueden tener una contribución positiva en la atención al paciente.

Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists´ practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER). Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain) and practice location (rural or urban). A multivariate Poisson regression model with robust error variance estimated risk ratios (RR) of KASPER utilization by characteristics of pharmacists´ practice environment. Results: Responses were received from 563 pharmacists (response rate 27.9%). Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84%) indicated they or someone in their pharmacy had requested a patient´s controlled substance history since KASPER´s inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94%) than pharmacists in chain pharmacies (75%; p

*Background: Medication reconciliation in the outpatient setting is an important part of preventing medication errors, and is mandated by the Joint Commission. Objective: To describe and quantify medication reconciliation efforts by student pharmacists in an outpatient family medicine center. Methods: A retrospective review was conducted of medication reconciliation documentation forms completed by student pharmacists during an outpatient clinical rotation between May 2012 and April 2013. Discrepancies were defined as any lack of agreement between the medication list in the electronic medical record and the patient reported regimen. Descriptive statistics were used to report results. Results: A total of 557 medication reconciliation documentation forms from 12 student pharmacists were reviewed. The average number of medications per patient interviewed was 9 (range 0-25). A total of 1,783 medication discrepancies were found with an average of 3.2 discrepancies per patient. An additional 272 medication allergy discrepancies were identified. The most common discrepancy was medications the patient was no longer taking (37.3%, n=766). The second most common discrepancy was over-the-counter and herbal medications that had not been added to the medication list (16.2%, n=335). Patient counseling was documented 159 times during the medication reconciliation process. Conclusions: Medication reconciliation by student pharmacists in an outpatient family medicine center resulted in the identification of many discrepancies in medication lists in an electronic health record. Student pharmacists also documented and clarified medication allergies and performed patient counseling.

Objective: To understand whether underserved populations attend to prescription warning label (PWL) instructions, examine the importance of PWL instructions to participants and describe the challenges associated with interpreting the information on PWLs.Methods: Adults from an underserved population (racial and ethnic minorities, individuals with low income, older adults) who had a history of prescription medication use and were able to understand English took part in semi-structured interviews. Participants were presented with eight different prescription bottles with an attached PWL. Participants were asked, “If this prescription was yours, what information would you need to know about the medicine?” The number of participants who attended to the warning labels was noted. Other questions assessed the importance of PWLs, the challenges with understanding PWLs, and ways a pharmacist could help participant understanding of the PWL.Results: There were 103 participants. The mean age was 50.25 years (SD=18.05). Majority attended to the PWL. Participants not currently taking medications and who had limited health literacy were likely to overlook the warning labels. Majority rated the warning instructions to be extremely important (n=86, 83.5 %), wanted the pharmacist to help them understand PWLs by counseling them on the information on the label (n=63, 61.2%), and thought the graphics made the label information easy to understand.Conclusions: PWLs are an important method of communicating medication information, as long as they are easily comprehensible to patients. In addition to placing PWLs on prescription bottles, health care providers need to counsel underserved populations on medication warnings, especially individuals with limited health literacy who are not currently using a prescription medication.