INNOVATIONS in pharmacy (Iip - E-Journal)
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Pharmacy-Based Assessment and Management of Herpes Labialis (Cold Sores) with Antiviral Therapy
Get PDFHerpes labialis, commonly known as cold sores, is an infection of the mouth and surrounding area. Antiviral therapy can be used to block viral replication, which shortens the duration of symptoms, facilitates resolution of lesions, and lessens the risk of spreading the virus. Increasing access to antivirals targeted against herpes labialis by allowing assessment and prescribing by a pharmacist may decrease time to treatment for HSV-1, and improve patient satisfaction. Experience from Canada, Australia, New Zealand and the United States demonstrate that pharmacist management of cold sores has a safe track record and may be considered by other jurisdictions.
Commentar
Prescription Adaptation Services: A Win for Patients and Providers
Get PDF“Prescription adaptation services” (PAS) refers to the ability of pharmacists “to adapt an existing prescription when, in their professional judgment, the action is intended to optimize the therapeutic outcome of treatment.” If structured appropriately, PAS can provide a benefit in enhancing the timeliness of patient care, while reducing the administrative burden on both physicians and pharmacists. Moreover, it leverages the strengths of both health professions, specifically the medication expertise of pharmacists. Unfortunately, in most states it will require a change in regulations in order to enable PAS
Developing a Co-Curricular Activity to Introduce Student Pharmacists to the Cultural Proficiency Continuum Framework
Get PDFBackground: As the United States becomes more culturally diverse, health professionals must be able to demonstrate competency in caring for a multitude of diverse patients. The cultural proficiency continuum has proven to be an effective framework to assess where individuals and institutions are on the continuum of cultural sensitivity and competence in educational settings.
Innovation: A co-curricular activity was developed as an exercise in self-awareness to allow first year pharmacy students the opportunity to explore potential biases by evaluating comfort in both social and patient care settings. The 90-minute activity employed a lecture, followed by both small and large group discussions and a debriefing session.
Findings: Student survey responses showed their appreciation of this framework and its application to patient-centered care. Student self-rated knowledge increased by 3 points on a 10-point scale after completion of the activity. Students agreed that their level of cultural awareness would lead them to respond appropriately in cross-cultural situations, and that the provision of care is dependent on approaches that are culturally proficient.
Conclusion: This activity dismantles the misconception of cultural competence as an attainable finite skill, but instead presents it as an ongoing process of self-awareness. The co-curricular activity offers an easy to implement model of education that could potentially fit the needs of pharmacy programs searching for ideas to teach cultural competency and social determinants of health, while circumventing the need to affect curricular structure
Use of Medication Error Simulations in Continuing Professional Education to Effect Change To Practice
Get PDFIntroduction: A novel continuing professional education CPE training program and simulation were used to teach pharmacists and pharmacy technicians about continuous quality improvement and how to identify, report, and communicate information regarding medication related errors using root cause analysis.
Methods: Pharmacists and pharmacy technicians attending a statewide pharmacy association meeting voluntary attended a CPE training program and simulation. During the simulation, learners investigated and identified medication related errors in three different pharmacy settings. A collection of items found at each pharmacy and audio recordings were used by learners to identify the medication related error. After each simulation, facilitators led a debriefing to discuss the learners’ experiences. Data was collected using online surveys. Descriptive statistics and chi-square tests were used to analyze the data.
Results: Fourteen months following the program, 15 of the 67 participants responded to an anonymous survey. Of the 15 responding participants, 73.3% (11/15) were confident or very confident they could establish or maintain a high-quality continuous quality improvement plan at their practice site. Sixty percent (9/15) felt the experience reinforced their current practices, 13.3% (2/15) had implemented changes to their practice, and 13.3% (2/15) felt they needed more information before considering changes to their practice. Reported barriers to establishing a continuous quality improvement program were time constraints, 40.0% (6/15), system constraints, 26.7% (4/15), or lack of staff 20.0% (3/15).
Conclusion: A CPE training program and simulation reinforced practice for pharmacy personnel, resulted in changes to practice, and positively increased participants’ confidence in establishing a continuous quality improvement plan in the workplace
How CEO Deans in Academic Pharmacy Describe and Manage High-performing and Low-performing Faculty
Get PDFObjectives: Gather Chief Executive Officer (CEO) deans’ perspectives on: distinguishing a “star” faculty versus one that is “productive”; faculty who are “deadweight” to the organization; the role of organizational fit in defining stars and deadweight faculty; current efforts to recruit and retain star faculty; and the actions taken in regard to deadweight faculty.
Methods: A focus group panel of CEO deans was convened at the American Association of Colleges of Pharmacy (AACP) 2019 Interim Meeting. A semi-structured interview based on an organizational behavior framework was used to guide discussion in the focus group. Content analysis with axial coding was used to uncover themes from the data.
Results: Panelists indicated productivity to be a given, but that star faculty are the ones who exhibit extraordinary citizenship and leverage their talents and networks to make the program and their peers more effective. They identified nascent activities with the need to strengthen those in regard to recognizing star faculty. The panelists explicitly distinguished between deadweight, or unproductive faculty versus those who are more deleterious, even while the former might actually present a more challenging human resources management situation.
Conclusions: The research corroborated the growing recognition of the importance of faculty comportment with behaviors that extend beyond performance metrics, alone. The findings can serve as a platform for additional studies that guide decision making for organizational effectiveness in academic pharmacy
Influence of Pharmacy Characteristics and Customer Quality of Life on Satisfaction of Community Pharmacy Customers
Get PDFObjectives: The study objectives were to evaluate customer satisfaction with community pharmacy services and measure the relationships between customer satisfaction and pharmacy/pharmacist characteristics and customer quality of life.
Methods: This was a cross-sectional survey of a convenience sample of customers at 20 community pharmacies in 10 different geographical areas in Baghdad city between May and September 2018. We used the satisfaction items which were developed by Paterson and colleagues in 2013. The survey also assessed customer quality of life (QoL) with 12 QoL items.
Results: The study recruited 400 pharmacy customers. Overall, customers reported good satisfaction with community pharmacy services. The most three satisfying aspects were the professional appearance of the pharmacy, the professionalism of pharmacy staff and explanations of possible adverse medication effects. Three customer characteristics were associated with high satisfaction rates including male gender, buying medications without a prescription, and seeking services for themselves. Three pharmacy characteristics increased the customer satisfaction rate including the availability of female pharmacists, having more than one pharmacist, and whether the pharmacy is open full time. For quality of life, patients who had a limitation in their activities and those who accomplished less than they would like were less satisfied with pharmacy services.
Conclusions: To improve pharmacy services, pharmacists need to enhance their professional appearance, allocate more time for patient counselling, help patients to manage their medications and extend their working hours to meet customer needs.
Article Type: Original Researc
Cultivating a Community of Practice through Podcasting
Get PDFWhile innovation in pharmacy education can be sparked through many avenues, the opportunity to learn and engage with others through practice communities is considered by many as a creative outlet for exchange and discovery. This commentary specifically describes a contemporary approach to promote such a dialogue globally through podcasting, which is a free and highly accessible medium for dissemination and exchange of innovative teaching practices. In 2018, two faculty from two colleges of pharmacy created a podcast titled Leadership Development in Pharmacy Education (LDPEcast), which provides a unique modality to stimulate discussion and disseminate ideas within the community of practice. This commentary provides a case illustration for how a podcast can be intentionally designed and implemented with the goal of inspiring engagement across a global practice community. Early results of the podcast have been largely successful with nearly 1000 episode downloads and an additional 445 episode streams from audience members. While this podcast was designed specifically to discuss leadership integration within pharmacy training, opportunities may exist for further exploration of podcasting to spread innovative ideas, practices, and evaluative approaches in pharmacy education, while strengthening connections and elevating communities of practice across institutions.
Article Type: Commentar
Attitudes and Perceptions of Tobacco-Related Products in College Students
Get PDFBackground – Despite the highly publicized health consequences, some college students do not perceive tobacco consumption as harmful. Historically-Black College and Universities (HBCUs) have the lowest rates of tobacco-free policies compared to other colleges, universities, and minority-serving institutions, making their students at higher risk for tobacco abuse. A campus Alcohol, Tobacco, and Other Drug Prevention Committee (ATDP) was formed and led by a pharmacist to develop all tobacco cessation policies at the HBCU.
Objectives – (1) To determine the knowledge and attitudes of cigarettes, cigars, smokeless tobacco, electronic cigarettes, and hookah among college students in a rural area with high tobacco usage; (2) To assess perceptions on the effectiveness of smoking cessation resources on the college campus led by the ATDP committee.
Methods – A cross-sectional study was conducted on 99 students between 18 – 26 years attending a HBCU in Maryland. The online survey was disseminated to assess student’s health behaviors and attitudes towards tobacco products and their successfulness in abstinence using campus resources with the Health Belief Model.
Results – Participants had more perceived harms with smoking tobacco (cigarettes and cigars) and smokeless tobacco, and greater perceived benefits with using electronic cigarettes and hookah (P < 0.001). Most students had limited knowledge of the four tobacco categories (5.8 ± 2.6 on a 10-point Likert scale). Self-efficacy to quit was 4.2 ± 1.7 on a 10-point Likert scale despite the current resources at the HBCU.
Conclusion – Students had a perceived benefits sequential rank order with hookah, e-cigarettes, smokeless tobacco, followed by smoking tobacco. Campuses should investigate barriers for abstinence, raise awareness about the dangers of tobacco, and create programs that enhance self-efficacy when quitting.
Innovation and Practice Implication - This is the first study of its kind that compares all major tobacco products head-to-head in a rural and underrepresented population. Additionally, the development of a campus-wide tobacco policy was novel as it was pharmacist-led. The results show this population has limited knowledge of tobacco products with more perceived benefits among newer nicotine delivery systems. Targeted education and public health programs should be implemented to prevent this susceptible group from initiating and continuing tobacco products.
Article Type: Original Researc
GPAs, PCATs, and Coupons: Wilting Quality in Pharmacy School Admissions and the Impact on Pharmacy Faculty
Get PDFIntroduction: The number of available seats in US pharmacy schools has reached unprecedented numbers as applications are on the decline. A combination of forces signals that admissions to pharmacy school are becoming less selective.
Commentary: The conflict of balancing a need to fill the incoming class while maintaining selectivity is a growing problem in pharmacy education. Faculty may notice changes in the student quality and ultimately, program and graduate quality. Pressure from administration hinders faculty governance with negative consequences that impact faculty morale and the profession as a whole. Maintaining a firm position in the face of reduced applications is challenging but necessary if we are to protect the students we seek to support as faculty and stewards of the pharmacy profession.
Implications: Faculty governance is at risk as pressure exists to admit less-prepared students into programs. Faculty must advocate for responsible leadership by initiating dialogue on admissions and selectivity. Furthermore, faculty mentorship programs need a new level of discussion that includes analysis and understanding of this paradigm in pharmacy academia.
Article Type: Commentar
Impact of Adherence Education and Monitoring on Community Pharmacy Performance Scores and Patient Satisfaction
Get PDFBackground: Adherence, specifically to noninsulin diabetes medications, statins, and renin-angiotensin system antagonists (i.e. angiotensin-converting-enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and aliskiren), is a measure tracked by the Centers for Medicare and Medicaid Services (CMS) to give Medicare Part D plans a star rating; pharmacies are impacted by these star ratings. The pharmacy is given a performance score based on the measure. Some pharmacies use a performance information management platform (PIMP) that allows pharmacies to better understand performance information to impact patient care.
Objectives: (1) To evaluate if a monthly adherence monitoring and education service impacts the percentage of patients adherent determined by pharmacy performance scores; (2) To determine patient satisfaction with the service in a large community pharmacy chain.
Methods: A six-month prospective interventional pilot study including patients with a proportion of days covered (PDC) of less than 80% for oral diabetes or renin-angiotensin system antagonists (RASA) medications was conducted in two pharmacies of a large community pharmacy chain in Southwest Virginia. Using pharmacy internal data analytics and PIMP data, the percentage of patients who are adherent to oral diabetes or RASA medications was determined including the baseline PDC for each patient. At the start of the study, the standard of care in this large community chain pharmacy was to address adherence, follow-up in one month and every three months thereafter. In this study, pharmacists provided monthly telephonic adherence monitoring and education for a six-month period. Each session was scripted for medication adherence history, education and data collection. The pharmacist provided guidance and counseling based on how the patient answered the questions. Pharmacists gathered information about adherence patterns and behaviors using a 14 item Likert-scale and multiple choice-based questionnaire during the first session. After completion of the final adherence monitoring and education session, pharmacists gathered patient satisfaction information using an eight item Likert-scale questionnaire. At the end of the six-month period, using PIMP data, the percentage of patients adherent to oral diabetes or RASA medications was determined based on pharmacy performance scores. The data was analyzed using uni-variate and bi-variate statistics to determine if there was a difference in pharmacy performance scores from the pre-study analysis. The adherence patterns and behaviors, as well as patient satisfaction with the program was evaluated to determine factors influencing nonadherence.
Results: A total of 55 patients were identified in two pharmacies, ten of which were excluded or declined involvement, leaving 45 enrolled in the adherence monitoring and education service. Of the 45 enrolled patients, ten completed the adherence patterns and behaviors questionnaire. About half of the patients were men (50.95%) with an average age of 71.17 years and taking an average of 6.55 prescription medications. All patients had Medicare Part D insurance and majority had a yearly income of less than $40,000. The average baseline PDC was 68.92. In pharmacy 1, the average performance score for oral diabetes medications trended down and the average performance score for hypertension medications trended up over the study period. In pharmacy 2, the average performance score for oral diabetes medications trended up and the average performance score in hypertension medications trended up over the study period. The adherence patterns and behaviors questionnaire revealed the majority of patients rarely forgot to take medications or run out of medications. Additionally, cost of medications did not seem to impact adherence and majority of patients knew the names and indications of their medications. Only one patient completed the patient satisfaction survey.
Conclusions: An adherence monitoring and education service had mixed results in improving patient adherence and pharmacy performance scores. Only one patient completed the satisfaction survey, thus no conclusions can be made regarding patient satisfaction of the program. More research needs to be done regarding telephonic adherence programs.
Article type: Original Researc