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Objective: To describe our experience with a practice-based research training network (PBRTN) in a 1-year residency program.Setting: Ohio State University in Columbus from 1997 to 2007.Practice Description: The program includes two accredited postgraduate year 1 residencies and one postgraduate year 2 residency. Seven residents, 11 preceptors, and three faculty members participated during the time frame discussed in this article. Practice settings included three community sites and three ambulatory sites.Practice Innovation: The PBRTN includes a residency director, a research director, preceptor and resident members, and research faculty. The group works collaboratively to meet training goals. The PBRTN maintains a project timeline, foundational training, and structured research development, implementation, and presentation phases. Each resident submits five required research products: abstract, grant, poster, podium presentation, and research manuscript.Main Outcome Measures: Quantitative measures included the number of abstracts, grants, and peer-reviewed publications over two time periods, one before and one after a deliberate attempt to increase the research focus of the residencies. The ratio of research products to number of residents was used as a measure of productivity. Postresidency career choice and postresidency publications are reported.Results: Over a decade, the program has produced 37 graduates, 50 abstracts, 15 grants, and 12 peer-reviewed publications. The publication-to-resident ratio increased from 0.25 in the pre-emphasis period of 1997-2001 to 0.56 in 2002-2007, after the research focus was intensified. Of graduates, 38% are in faculty positions, with 48 postresidency publications.Conclusion: Use of a PBRTN has successfully provided research training and improved research outcomes for the program. This model could be implemented in other residencies. [ABSTRACT FROM AUTHOR]

Objective: As the profession of pharmacy continues to evolve, it is important to integrate pharmacy practice change learning into the Doctor of Pharmacy (PharmD) curriculum. The objective of this project was to evaluate how pharmacy practice change was being taught within a PharmD curriculum and to identify strategies for improvement., Methods: The College of Pharmacy's PharmD Curricular Leadership Committee (PDCLC) developed a definition for practice change learning and assembled a team of faculty experts to map practice change to the PharmD curriculum. After conducting student focus groups to gather input on practice change learning experiences and importance from the learner perspective, the team engaged faculty in interviews and mapped actual practice change learning experiences with 2016 Accreditation Council for Pharmacy Education (ACPE) standards and Ohio State University (OSU) College of pharmacy's (COP) ability-based outcomes, highlighting gaps and opportunities., Results: Primary opportunities for improvement in practice change learning were identified and included: integration of value-based outcomes that influence healthcare reimbursement and quality, communication simulations around community health and the value of the pharmacist with organizations outside traditional healthcare settings and with payors, and exposure to careers beyond traditional pharmacy settings., Conclusion: A faculty member has been appointed to lead integration of this content and optimization of practice change knowledge and skill building across courses and years in the program. Future directions involve curricular integration and obtaining alumni feedback to refine effectiveness of the curriculum., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The primary objective of this study was to evaluate the students' choice of activities and perception of a cocurricular program (CCP). Attitude and skill development and areas for program improvement were also assessed., Methods: Data were evaluated from 2 sources: a student survey administered to all Doctor of Pharmacy students to determine student perceptions of the CCP and barriers to success and student activity reporting data from postexperience submissions to evaluate the CCP. Data were stratified by student demographics to identify trends. A comparison of data was conducted from both sources on the students' perception of learning value., Results: Data for 405 students were available for analysis. The highest preference overall from students for hosts of activities were professional student organizations; the highest preference of location was online, asynchronous. The most meaningful benefits were learning information about a new subject (n = 258, 63.7%), ability to extend learning from the classroom to real life (n = 247, 61%), and networking opportunities (n = 218, 53.8%). The top barriers for completion of the program included scheduling challenges (n = 296, 73.1%), lack of time (n = 249, 61.5%), and lack of interest (n = 187, 46.2%). Subpopulations identified different benefits and barriers to completion., Conclusion: Students have overall positive perceptions of the CCP and its value for skill development. Findings were applied to adjust the CCP at the institution, including a reduction in total hours required. The continuous evaluation of CCPs is important to optimize student learning and address curricular overload., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To describe the implementation and validation of a novel patient profile review tool in the electronic medical record (EMR) at an academic medical center., Summary: Pharmacy leaders at The Ohio State University Wexner Medical Center aspired to develop a data-driven approach to clinical pharmacy services. The initial phase of this vision highlighted a need to define the clinical activities of a pharmacist and leverage use of the EMR to seamlessly capture data. A comprehensive list of clinical activities was developed and analyzed to determine which activities were currently uncaptured. Patient profile review was prioritized and determined to be variable among staff and undefined. A profile review tool was developed and implemented across the medical center while requiring minimal additional documentation through the EMR. Phase II determined what user audit trail data in the EMR were automatically recorded based on performing various levels of pharmacist-recorded profile review and validated the consistency in utilization of this tool. The information gathered as a result of this study identified interactions within the patient chart that matched profile reviews that were not captured during manual documentation. The department of pharmacy will utilize the data generated from this tool to better make decisions and build a comprehensive clinical productivity model., Conclusion: The implementation of a pharmacist patient profile review tool built within the EMR successfully defined, stratified, validated time spent on, and captured a clinical activity., (Published by Oxford University Press on behalf of the American Society of Health-System Pharmacists 2022.)

Higher scrutiny is befalling public payors regarding drug costs and patient access to medications. These issues exist in a complex contractual environment where minimal oversight of pharmacy claim adjudication and reimbursement practices can occur. The complexity of prescription benefits, and the lack of defined expectations or accountability in the system contribute to a sense of frustration by the public. Key areas of improvement for this sector of the health care industry include legislative and regulatory shifts requiring ongoing analyses, reporting, and accountability of pharmacy benefit managers (PBMs) in order to improve payment transparency. These improvements will enable plans to eliminate misaligned incentives in the industry and drive value. Changes in public sector programs should be comprehensive in their approach so that the policy will result in a reduction in costs, enhanced patient access, better patient safety, and improved health outcomes., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective. To assess the current practices of US schools and colleges of pharmacy pertaining to teaching legislative advocacy; the engagement of staff, faculty, postgraduates, students, and administrators in legislative advocacy partnerships and activities; and their future goals for legislative advocacy involvement by academic pharmacy institutions. Methods. An electronic survey was distributed to deans of schools and colleges of pharmacy across the United States. Respondents were asked to complete 53 items about their school's involvement in, barriers to involvement in, and relative importance of involvement in legislative advocacy. Responses were evaluated using descriptive statistics. Results. The survey accrued responses from 48 of 143 (33%) schools and colleges of pharmacy. Sixteen percent of responding schools required a course on advocacy and approximately 50% offered an advocacy elective. A majority (58.8%) of responding institutions ranked their institution's involvement in legislative advocacy high (≥7 on a scale of 1-10), and 75.8% ranked the importance of legislative advocacy in external collaboration high. A majority of institutions (60%) ranked the importance of faculty, staff, and postgraduate roles in advocacy high; however, 42.3% did not rank involvement as strongly. Fifty percent of institutions plan to expand involvement in legislative advocacy. Conclusion. Respondents highly ranked the importance of legislative advocacy. Many perceived their institution's involvement as strong and having plans to expand. Moving forward, curricula and resource allocation should be reviewed to diminish the dissonance between an institution's perception of the importance of legislative advocacy and actual implementation of legislative advocacy components., (© 2022 American Association of Colleges of Pharmacy.)

Objective: To (1) describe an educational program for international students about medication access and use, (2) assess perspectives on the session Participants: A College of Pharmacy and Office of International Affairs at a large, public university presented on the U.S. pharmacy system during biannual international student orientation. Methods: During seven, 20-minute presentations, a facilitator discussed the role of pharmacists, defined terms, and reviewed processes. Anonymous, voluntary post-presentation surveys were analyzed to identify common themes. Results: An 86% response rate was achieved ( n  = 1496). Majority of students (98%) found this workshop helpful; a majority felt comfortable filling a prescription (96%) or asking the pharmacist a question (97%). More than 95% understood key terms. Common themes included health insurance and cost. Conclusions: This educational model equipped international students with knowledge to navigate the U.S. medication use system. Other universities may apply the program to prepare international visitors to access and safely use medications.

Numerous studies have demonstrated positive therapeutic and economic outcomes associated with pharmacist-provided care. However, public policy on provider status with subsequent payment for non-dispensing services has been slow to reflect an expanded pharmacist role. It is important for the public to understand the value of a pharmacist outside of the drug distribution system. Pharmacists and other health care and public health practitioners must share this information to further knowledge and affect policies and systems that can most effectively include pharmacists fully in the health care system. The 3 main areas identified in which the pharmacist has economic impact are decreased total health expenditures, decreased unnecessary care, and decreased societal costs. Evidence supports the economic value of the pharmacist; however, public opinion and political movements supporting patients' access to pharmacist-provided care are variable. Strategies to advocate and effect change include advocating to elected leaders for policy change and advocating to other health professionals, patients, and community members to better their understanding of the positive economic value of pharmacist-provided care. Through prioritizing community outreach and legislator education, pharmacist advocates can leverage 3 key areas in which pharmacists have economic value to advance policy and increase patients' access to care., (Copyright © 2020 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Objectives: The primary objectives of this commentary are to (1) summarize the role of pharmacists as an advocate for the health care and appropriate use of medications of migrants in immigration detention centers and (2) describe methods to advocate for this vulnerable population., Summary: There is a current humanitarian crisis occurring within the United States that violates the responsibilities and values held by members of the profession of pharmacy. Reports by reputable news organizations and members of U.S. Congress have shared that there have been inappropriate distribution and use of medications in migrant detention centers along the southern border. Specific instances have been described, including lack of access to vaccinations and vital medications to control chronic conditions and treat acute conditions. The role of the pharmacist is to ensure safe and effective use of medications. This role is not being fulfilled at migrant detention centers in the United States. By advocating to elected leaders, the Department of Homeland Security, and Customs Border and Protection for legislation that ensures the appropriate use and access of medications for migrants in immigration detention centers, pharmacists can push for the appropriate care for this vulnerable patient population., Conclusion: The professional values of a pharmacist should not be hindered by a border or the citizenship of a patient. As is stated in the Oath of a Pharmacist, pharmacists must "consider the welfare of humanity and relief of suffering [their] primary concern." Through advocacy, pharmacists and student pharmacists can uphold their professional ethics and roles on the health care team by advocating for the care of a patient population that needs the profession's help., (Published by Elsevier Inc.)

Purpose: A survey was conducted to evaluate the characteristics and structures of postgraduate year 2 (PGY2) ambulatory care pharmacy residency programs in the United States. The survey results can serve as a guide for current and newly emerging programs., Methods: A 24-question survey was sent to 138 US PGY2 residency program directors (RPDs) in February 2017 to identify key program characteristics, including program type (single-site or multisite), primary practice site, number of residents, length and type of rotations, staffing requirements, additional residency activities, precepting and teaching opportunities, RPD training and credentials, and number and qualifications of preceptors. Descriptive statistics were used to analyze the findings., Results: A 40.6% response rate was achieved. Well over half (57%) of programs had been established within the preceding 5 years. A majority of RPDs reported that their program had 1 (53%) or 2 residents (31%) and/or was a single-site program (80%). Overall, 44 different types of rotations or experiences were offered by the programs. All surveyed programs offered additional teaching opportunities. There were no formal staffing duties in 29% of programs; professional organization membership and conference attendance were highly encouraged but typically not required of residents. Qualifications of the RPD and preceptors closely mirrored those delineated in residency accreditation standards., Conclusion: There is an increased need for specialized training in ambulatory care in order to prepare pharmacists for the changing landscape in healthcare. The profession is adapting to this need, as evidenced by the rapid growth of PGY2 ambulatory care residency programs. Understanding characteristics can benefit continued growth to meet the needs of the profession., (© American Society of Health-System Pharmacists 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Pharmacists are underused in the care of chronic disease. The primary objectives of this project were to 1) describe the factors that influence initiation of and sustainability for pharmacist-provided medication therapy management (MTM) in federally qualified health centers (FQHCs), with secondary objectives to report the number of patients receiving MTM by a pharmacist who achieve 2) hemoglobin A1c (HbA 1c ) control (≤9%) and 3) blood pressure control (<140/90 mm Hg)., Methods: We evaluated MTM provided by pharmacists in 10 FQHCs in Ohio through qualitative thematic analysis of semi-structured interviews with pharmacists and FQHC leadership and aggregate reporting of clinical markers., Results: Facilitators of MTM included relationship building with clinicians, staff, and patients; regular verbal or electronic communication with care team members; and alignment with quality goals. Common MTM model elements included MTM provided distinct from dispensing medications, clinician referrals, and electronic health record access. Financial compensation strategies were inadequate and varied; they included 340B revenue, incident-to billing, grants, and shared positions with academic institutions. Of 1,692 enrolled patients, 60% (n = 693 of 1,153) achieved HbA 1c ≤9%, and 79% (n = 758 of 959) achieved blood pressure <140/90 mm Hg., Conclusion: Through this statewide collaborative, access for patients in FQHCs to MTM by pharmacists increased. The factors we identified that facilitate MTM practice models can be used to enhance the models to achieve clinical goals. Collaboration among clinic staff and community partners can improve models of care and improve chronic disease outcomes.

Introduction: Appropriate management of chronic diseases, including proper use of medications, can lead to better disease control, decrease disease-related complications, and improve overall health. Pharmacists have been shown to positively affect chronic disease outcomes through medication therapy management (MTM). The primary objectives of this project are to increase the number of patients with (1) A1c in control and (2) blood pressure in control; secondary objectives are to (3) describe number and type of medication-related problems identified and resolved by pharmacists providing MTM in Federally Qualified Health Centers (FQHCs), (4) identify potential (pADEs) and actual adverse drug events (ADEs), and refer patients to diabetes self-management education classes, as needed., Methods: This multisite, prospective, descriptive pilot study engaged three FQHC sites with distinct models of established pharmacist MTM services to care for patients with uncontrolled diabetes and/or hypertension. Data were reported in aggregate regarding primary and secondary outcomes., Results: As of December 2015, 706 patients were enrolled in the project. Of the 422 with uncontrolled diabetes, 52.84% (n = 223) had an A1c <9%; 72 patients (17.06%) achieved an A1c between 8% and 9%, 19.19% (n = 81) of patients achieved an A1c <8% and ≥7%, and 16.59% (n = 70) of patients achieved an A1c <7%. The percentage of patients with blood pressure <140/90 mm Hg improved to 65.21%., Conclusion: Pharmacist-provided MTM can improve chronic disease intermediate outcomes for medically underserved patients in FQHCs.

Background: Adult vaccination rates in the United States are well below recommendations with disparities in race, ethnicity, and education level resulting in even lower rates for these populations. This study aimed to identify the barriers to and perceptions of immunizations in adults in an urban, underserved, multicultural community. Understanding the factors that influence adults' decisions to receive routinely recommended vaccines will aid health care providers and public health officials to design programs to improve vaccination rates., Methods: This cross-sectional, survey-based study was conducted in January 2014 in Columbus, Ohio. Participants were recruited from four urban federally-qualified health centers and four grocery stores affiliated with those clinics. The survey gathered self-reported receipt of immunizations, knowledge about indications for immunizations, and factors influencing decisions to receive an immunization. Data was analyzed in 2014. Descriptive statistics were generated for all survey items and Chi-Square or Fisher's Exact tests were used as appropriate to test for associations between demographic characteristics and factors influencing immunization decisions., Results: The top five factors likely to affect the decision to receive an immunization among the 304 respondents were: "doctor's recommendation" (80.6 %), "knowing why I should get a vaccine" (78.2 %), "knowing which vaccines I need" (75.5 %), cost (54.2 %), and "concern about getting sick if I get a vaccine" (54.0 %). Significant differences in factors influencing the immunization decision exist among respondents based on ethnicity and education level. For those participants with self-identified diabetes, heart disease, or asthma, less than half were aware that certain immunizations could reduce the risk of complications associated with their disease(s)., Conclusions: Data from this study may inform and shape patient education programs conducted in clinics, retailers, and communities, as well as advocacy efforts for adult immunizations. Results from this study suggest that patients would respond to programs for promoting vaccine uptake if they focused on benefits and indications for vaccines. The results also highlighted the need for education regarding immunizations for patients with chronic diseases and special indications. The differences in perceptions found between groups can be used to create targeted interventions based on the needs of those patient populations.

Objective: To describe common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships., Setting: Five schools and colleges of pharmacy in the United States., Practice Description: Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training., Practice Innovation: Community pharmacy fellowships, each structured as 2 years long and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill, and The Ohio State University., Evaluation: Program directors from each of the 5 community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs., Results: Common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n = 4) have been successful in securing pharmacy faculty positions., Conclusion: Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice., (Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Objective: To describe the impact on community pharmacy service development of a faculty-student-pharmacist collaborative program offered by five U.S. colleges., Setting: Colleges of pharmacy and community pharmacies in Arizona, Illinois, Ohio, Utah, and West Virginia., Practice Description: Partner for Promotion (PFP) is an elective, longitudinal advanced pharmacy practice experience (APPE) focused on enhancement of community pharmacy management skills, specifically the development and implementation of direct patient care services. This faculty-student-pharmacist collaborative model has been implemented in five U.S. colleges of pharmacy beyond the originating institution., Evaluation: Data on pharmacy demographics and the impact of PFP on service creation and longevity at these partnering schools were reported via annual online surveys completed by faculty directors at each partnering college of pharmacy., Results: Over a 3-year period, 19 pharmacy teams across five states worked to create a total of 15 direct patient care services, 12 of which were still being offered to patients at the time of data collection (80% longevity). The PFP program guided 38 students through the process of developing and implementing a sustainable service at a community pharmacy. All participating faculty from partnering colleges of pharmacy (100%) indicated that PFP model materials were "very useful" (4-point Likert scale; 1, not useful, to 4, very useful), and all five colleges plan to continue offering the program moving forward., Conclusion: The PFP model of training and service development can have a positive impact on the pharmacy profession, serve as an avenue for training students in the development of clinical services, and be a catalyst for establishing the growth of community pharmacy as a patient-centered, service-oriented partner in the health care system.

Objective: To describe pharmacy residents' interest in and pursuit of academic positions., Methods: An electronic presurvey and postsurvey were sent to pharmacy residents during the 2011-2012 residency year. The initial survey evaluated residents' job preferences and interest in academia at the beginning of residency, and the follow-up survey focused on job selection and reasons for pursuing or not pursuing positions in academia., Results: Nine hundred thirty-six residents responded to the initial survey and 630 participated in both the initial and follow-up survey. Forty-eight percent of those responding to both surveys strongly considered a career in academia in the initial survey, 28% applied for an academic position, and 7% accepted a position. Second-year postgraduate residents were more likely than first-year postgraduate residents to apply for and be offered a faculty position., Conclusion: Pharmacy residents are interested in academia. While increasing interest among residents is encouraging for faculty recruitment, the academy should also encourage and develop adequate training experiences to prepare residents to succeed in these positions.

Purpose: An innovative program to help pharmacy students navigate the residency application and interview process is described, including results of a survey evaluating the program's impact., Summary: The Ohio State University (OSU) chapter of the Student Society of Health-System Pharmacy (SSHP) collaborated with OSU College of Pharmacy faculty members, pharmacists from OSU Wexner Medical Center and surrounding areas, and current pharmacy residents to provide programming to equip pharmacy students with skills to succeed as residency candidates. The programming has four components: Curriculum Vitae (CV) Critique, Mock Residency Interviews, Residency 101, and Midyear to Match (M-M), a six-part series that provides guidance on the Residency Showcase at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting, Match day (the annual matching process coordinated by ASHP), and the post-Match "scramble," in which unmatched applicants compete for unfilled residency slots. In an online survey conducted by the SSHP chapter after the 2012-13 residency year, 26 of 57 survey respondents indicated they had pursued a residency. Twenty respondents reported success in the Match (a rate 15% higher than the national average), with 9 reporting acceptance by their first-choice residency site. The mock interview program was rated as the most useful (a mean score of 4.8 on a 5-point scale), followed by the M-M series (mean score, 4.6)., Conclusion: Collaborative programming coordinated by the OSU chapter of SSHP was offered to pharmacy students to improve preparation for the residency application and interview process. The program was well received by participants., (Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)

Objective: To implement a student peer-mentoring program with a drug information response assignment in an introductory pharmacy practice course., Design: Second-year student pharmacists (P2 mentors) enrolled in an independent study course were randomly assigned first-year student pharmacists (P1 mentees) to mentor on a drug information assignment. The P2 mentors provided feedback to P1 mentees' assignment drafts. The P1 mentees had the opportunity to revise the draft prior to turning in the completed assignment to course faculty members for grading., Assessment: Both P1 mentees and P2 mentors agreed the mentorship improved their ability to prepare a drug information response (76% and 100%, respectively). A majority of the student pharmacists would choose to be involved in the program again., Conclusion: The student peer-mentoring program was successful in improving student pharmacists' perceptions of ability to compose a drug information response.

The purpose of this study was to identify medication adherence for patients infected with hepatitis C virus (HCV) referred to an interdisciplinary HCV education and monitoring service, evaluate changes in quality of life (QOL) and medication adherence during the first 3 months of HCV therapy, and determine relationships between adherence and QOL. Patients completed an initial survey before initiating the therapy evaluating medication adherence and QOL. They then received a structured training on HCV medications and monthly monitoring phone call from a pharmacist throughout the therapy. After 3 months of treatment, a follow-up survey was conducted to evaluate adherence, satisfaction, and QOL. Medication adherence was also assessed via patient self-report during follow-up phone calls. Patients expressed satisfaction with the care provided by the pharmacist and nurse practitioner individually and working collaboratively during their HCV therapy. Patients reported taking 99.8% of total interferon and ribavirin doses during the first 3 months of the therapy. Patients who indicated that they sometimes stopped taking medication when they felt worse had higher median aggregate physical functioning scores (p = .04) and those with no comorbidities found dosage times more inconvenient than those with at least one comorbidity (p = .046). Patients in a pharmacist-run HCV education service have high self-reported adherence rates and are satisfied with the interdisciplinary model of care. Quality of life may be associated with adherence; higher functioning, healthier patients may be more likely to stop taking HCV medications owing to side effects or inconvenience.

Objectives: The aim of this study was to identify patients with subconjunctival hemorrhage (SCH) on warfarin therapy, to describe risk factors that may contribute to SCH development, and to identify complications related to SCH., Methods: A retrospective chart review was conducted including patients treated at a university anticoagulation clinic over 2 years (4,334 patient visits). Data collection included patient demographics; international normalized ratios (INRs) before, at time of, and after SCH; risk factors for increased risk of bleeding; patient-reported complications related to SCH; recent changes in medication use; and warfarin dosage adjustments made in response to the event. The data were summarized using descriptive statistics and frequencies described as percentages., Results: Fifteen SCH events were identified at an event rate of 0.35%. Two were excluded because of related surgeries near the time of SCH events. The average patient age was 67.3 years (range, 51 to 82). A total of 76.9% (n = 10) of patients had INRs within the goal range at the appointment before reporting the SCH. A total of 46.2% (n = 6) of patients reported alterations in medication regimens during the month preceding SCH. Various patient conditions were documented that may increase the risk of SCH development. No ophthalmic complications were associated with SCHs., Conclusions: An SCH event rate of 0.35% was identified. Many factors may have precipitated SCH; however, ophthalmic complications were uncommon.

Purpose: Agreement between pharmacy faculty members and the American College of Clinical Pharmacy (ACCP) recommendations regarding the requirement of residency training to provide direct patient care or attain a position in academia is discussed., Methods: Faculty members of the American Association of Colleges of Pharmacy participated in a survey administered by an online survey tool. The survey contained a variety of yes/no, multiple choice, and Likert scale questions. Participants were asked to disclose whether they agreed with the ACCP recommendations. Other data collected included faculty demographics, individual awareness of the ACCP position statement, and postgraduate training recommendations before receiving the survey., Results: The survey was sent to 2414 faculty members, and 623 (26%) of those responded. A majority of the respondents (74.8%) identified themselves as pharmacy practice faculty. Of those who replied, 55.6% agreed that one year of residency training should be required to provide direct patient care. Approximately 64% agreed that a postgraduate year 1 residency should be required in order to be appointed as adjunct clinical faculty or preceptor of pharmacy students, while 50.1% agreed that two years of residency training should be required in order to be appointed to rank assistant professor., Conclusion: A slight majority of faculty members responding to this survey agreed with recommendations in a 2006 ACCP position statement that proposed requiring residencies for all pharmacy students graduating from pharmacy school in order to attain positions in academia or settings providing direct patient care.

Objectives: To implement the Partner for Promotion (PFP) program which was designed to enhance the skills and confidence of students and community pharmacy preceptors to deliver and expand advanced patient care services in community pharmacies and also to assess the program's impact., Design: A 10-month longitudinal community advanced pharmacy practice experience was implemented that included faculty mentoring of students and preceptors via formal orientation; face-to-face training sessions; online monthly meetings; feedback on service development materials; and a web site offering resources and a discussion board. Pre- and post-APPE surveys of students and preceptors were used to evaluate perceptions of knowledge and skills., Assessment: The skills survey results for the first 2 years of the PFP program suggest positive changes occurring from pre- to post-APPE survey in most areas for both students and preceptors. Four of the 7 pharmacies in 2005-2006 and 8 of the 14 pharmacies in 2006-2007 were able to develop an advanced patient care service and begin seeing patients prior to the conclusion of the APPE. As a result of the PFP program from 2005-2007, 14 new experiential sites entered into affiliation agreements with The Ohio State University College of Pharmacy., Conclusion: The PFP program offers an innovative method for community pharmacy faculty members to work with students and preceptors in community pharmacies in developing patient care services.

Objectives: To determine the percentage of residents accepting faculty positions following completion of a community pharmacy residency program (CPRP) and identify influences to pursue/not pursue an academic career., Methods: CPRP directors and preceptors across the United States were contacted and 53 community pharmacy residents were identified. The residents were invited to participate in surveys at the beginning and end of the 2005-2006 residency year., Results: Forty-five residents (85%) completed the preliminary survey instrument and 40 (75%) completed the follow-up survey instrument. Of these, 36 completed both survey instruments. Initially, 28 (62%) respondents indicated a faculty position as one of their potential job preferences. After completing their residency program, 3 (8%) residents accepted faculty positions; and 3 (8%) others were awaiting offers at follow-up. Reasons for accepting a faculty position were positive teaching experiences and the influence of a mentor or preceptor. Reasons for not pursuing a faculty position included lack of interest, geographic location, disliked teaching experiences, lack of preparedness, and non-competitive salary., Conclusion: Many community pharmacy residents consider faculty positions early in their residency but few pursue faculty positions. CPRPs and colleges of pharmacy should work together to enhance residents' experiences to foster interest in academia.

Objective: To provide a summary of community and ambulatory pharmacy practice and billing patterns for medication therapy management services before implementation of Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA)., Design: Cross-sectional survey., Setting: Ambulatory care and community pharmacy practice settings in the United States in January 2004., Participants: Members of the American College of Clinical Pharmacy Ambulatory Practice and Research Network, preceptors of the American Pharmacists Association (APhA) Community Pharmacy Residency Programs, and participants in the APhA Immunizing Pharmacist listserv., Interventions: E-mail invitations to participate in a Web-based survey., Main Outcome Measures: Practice setting; pharmacy services performed; whether pharmacists were billing for pharmacy services; if billing, the billing technique used; if not billing, the reason for not billing., Results: Of 349 respondents, 127 (36.4%) were practicing within a physician office, while 121 (34.7%) were practicing in community pharmacies. Diabetes, anticoagulation, dyslipidemia, hypertension, and smoking cessation management services were performed significantly more often in physician offices. Immunization delivery and diabetes, dyslipidemia, and osteoporosis screenings were performed significantly more often in community settings. A total of 190 (54.5%) pharmacists stated that they were billing for pharmacy services. More community pharmacists were billing for services compared with other combined practice settings (69.2% versus 46.7%, P < .001). Top reasons identified for not billing for services were salaried position, indigent population, and discomfort with the billing process., Conclusion: Valuable baseline data are provided regarding pharmacy services that have been successfully implemented in ambulatory and community practice settings and which billing techniques were used to receive reimbursement before the implementation of MMA.

Objective: To provide a stepwise approach to development and implementation of a point-of-care testing (POCT) patient care service., Setting: Community and ambulatory care pharmacy practice., Practice Description: To provide community and ambulatory pharmacists with the steps involved in integrating POCT services into their pharmacy practice site., Practice Innovation: Authors used various resources to detail the process of implementing pharmaceutical care in community or ambulatory pharmacy settings in combination with individual practice experiences. The five steps involved in developing a POCT service include conducting a needs assessment, researching and organizing information, developing program materials, implementing the service, and evaluating the service. The narrative description of each step is illustrated by a case study example., Interventions: Not applicable., Main Outcome Measures: Not applicable., Results/conclusion: POCT patient care services are a valuable addition to a pharmacy's services, benefiting patients, health care providers, and the pharmacy. This article presents a structured, deliberate approach with resources that can be used to develop a successful POCT service within a community or ambulatory pharmacy setting.

Purpose: The development, implementation, and outcomes assessment of an innovative pharmacist-managed ambulatory care and community pharmacy practice clinic are described., Summary: The Clinical Partners Program at The Ohio State University (OSU) provides an active learning environment for students and residents, offers a patient-focused practice model based on pharmaceutical care principles, and serves as an arena for applied research in pharmacy practice. The program offers multiple services, including anticoagulation management, diabetes self-management, cholesterol management, hepatitis C education, herbal product and dietary supplement consultations, medication management, smoking cessation, and wellness. The practice is currently staffed by two faculty members from the college of pharmacy, with a 0.8 full-time-equivalent (FTE) pharmacist and a 0.65 FTE community pharmacy resident. It has served as a training site for 17 pharmacy residents, 28 bachelor of science (B.S.) in pharmacy students, 30 post-B.S. doctor of pharmacy (Pharm.D.) students, and 132 entry-level Pharm.D. students at various levels of training. The most successful methods of reimbursement for programs have been contracted services with OSU Managed Health Care Systems, Inc., which serves OSU faculty and staff and fee-for-service billing, charged directly to non-OSU patients. Numerous studies have shown that Clinical Partners has consistently demonstrated improved therapeutic outcomes over those achieved in traditional practice. Faculty are exploring outreach services, including the development of advanced practice community sites for the college, establishing patient care services within physician offices, and providing disease management services for self-insured employers., Conclusion: The Clinical Partners Program has improved patient care and provided education and training opportunities for pharmacy students and residents.

Objective: To report 2 cases of decreased international normalized ratio (INR) after initiation of a high-protein, low-carbohydrate diet., Case Summaries: Case 1. A 67-year-old white woman had been receiving warfarin for 3 years for venous thromboembolism. After initiation of a high-protein, low-carbohydrate diet, the patient required a 22.2% increase (from 45 to 57.5 mg/wk) in warfarin dose. Her INR remained in the therapeutic range on this dose for 8 weeks. When the patient stopped the high-protein, low-carbohydrate diet, a decrease back to the original warfarin dose was required to return to a therapeutic INR. Case 2. A 58-year-old white man had been receiving warfarin for 8 years for a cerebrovascular accident. Initiation of a high-protein, low-carbohydrate diet resulted in a 30% increase (from 26.25 to 37.5 mg/wk) in warfarin dose. His warfarin dose was reduced to the original dose after he stopped the high-protein, low-carbohydrate diet., Discussion: The Naranjo probability scale indicated a possible adverse effect between warfarin and high-protein diets. High-protein diets have been shown to increase serum albumin levels. This may result in more warfarin binding to serum albumin, thereby decreasing the anticoagulant effect of warfarin. The increase of albumin occurs rapidly after initiation of a high-protein diet and appears to promptly affect anticoagulation therapy with warfarin., Conclusions: These cases indicate a significant interaction between high-protein, low-carbohydrate diets and warfarin therapy. Patients receiving warfarin therapy should be educated on and monitored for the potential interaction that occurs with warfarin therapy and high-protein, low-carbohydrate diets.