INNOVATIONS in pharmacy (Iip - E-Journal)
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Pharmacy Students as Health Coaches
Get PDFChronic diseases are the main contributor to both health care costs and mortality in the United States, with medication non-adherence and lifestyle modifications being leading causes. To motivate patients with several co-morbidities, the longitudinal care class was used to educate on maintaining adherence to prescribed regimens. Twenty pharmacy students were trained in health coaching and motivational interviewing methods. Specifically, students were to provide patients with education sheets, apply the teach-back method, and motivate the patient to develop and reach SMART goals made with the pharmacy student over a course of one academic school year.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.
Type: Not
Evaluation of Qatari and Canadian Pharmacy Students Learning Together about Cultural Competency using Videoconference Educational Activities
Get PDFBackground: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care.
Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1) student knowledge and confidence pertaining to cultural competency concepts, (2) attitudes and perceptions towards being a culturally competent pharmacist, and (3) academic performance related to cultural competency case studies.
Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25) and the University of Saskatchewan in Saskatoon, Canada (n=85) participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85) worked collaboratively (via video conference) with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1) a pre and post session survey measuring student knowledge and confidence; (2) pre and post session student self-reflections; and, (3) student academic performance on care plans and an observed structured clinical exam (OSCE).
Results: The survey identified small but statistically significant (p<0.05) improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81) of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the students who worked collaboratively across the two schools compared with those who did not.
Conclusion: The cultural competency student activity showed small improvements in pharmacy student knowledge, attitudes and confidence, but did not affect academic performance. Future research in this area could utilize a greater diversity of methodological approaches, including a focus on student self-reflection and qualitative assessment, to better capture student competency.
Type: Original Researc
Nullius in verba: Version 2.0 of the University of Minnesota, School of Social and Administrative Pharmacy Program, Proposed Guidelines for Formulary Evaluation
Get PDFThe principal objective in introducing Version 2 of the proposed Minnesota Guidelines for Formulary Evaluation is to recognize the challenges faced by formulary committees and other health care decision makers with the introduction of next generation sequencing (NGS) in therapy choice across a range of disease areas. The adoption of NGS promises to disrupt accepted standards in product development and formulary assessment. Although the standards expected in presenting, evaluating and replications clinical and cost-effective claims will still be central to the assessment process, the application of NGS platforms to link therapy choices to identified mutation clusters will require a robust evidence base. These Guidelines are intended to provide the framework for that evidence base by setting protocol driven standards for (i) choosing the appropriate NGS platform and (ii) evaluating NGS platforms in the identification of therapy pathways for target populations in disease states.
Type: Commentar
Potential Rx-to-OTC Switch Drug Candidates
Get PDFThe purpose of this study was to gain insight in what Rx legend drugs pharmacists think have a good enough safety profile to sell as OTC and, if any, what OTC drugs pharmacists think should be legend only. This study was performed as a non-directional survey asking the 2 following questions: “What are some prescription only medications that you think would be okay to sell as nonprescription (over-the-counter and behind the counter)” and following that “If any, what are some OTC/BTC medications that you think should be prescription only?” Pharmacists who were surveyed were those in the Philadelphia area within convenient traveling distance or whose contact information was available or accessible. There were three modes of collecting data. The first method was traveling to pharmacies in person and giving the pharmacist a physical survey to complete. The second method was the creation of a survey monkey, identical to the physical survey, which was sent electronically via email, text, or Facebook. The third method was telephoning pharmacies and conducting the survey over the phone. Demographics of respondents’ age range, education, area of work, and gender were collected. All methods were done as similarly as possible; with the same greeting and wording of questions, etc. Data analysis was done based on noticeable trends of answers and tallying frequencies of responses. In all, 101 pharmacists were contacted. The most common suggestion for Rx-to-OTC switch was oral contraceptives.
Type: Student Projec
An Innovative Approach to Pharmacy Law Education Utilizing a Mock Board of Pharmacy Meeting
Get PDFA thorough understanding of pharmacy law by students is important in the molding of future pharmacy practitioners, but a standardized template for the best way to educate students in this area has not been created. A mock Board of Pharmacy meeting was designed and incorporated into the Pharmacy Law course at the University of Tennessee College of Pharmacy. Students acted as Board of Pharmacy members and utilized technology to decide outcomes of cases and requests addressed in a typical 2 day Tennessee Board of Pharmacy meeting. The actual responses to those cases, as well as similar cases and requests addressed over a 5 year period, were revealed to students after they made motions on mock scenarios. The mock Board of Pharmacy meeting engages the students in a way that lectures alone often fail to achieve with some initial evidence of successful student learning. Utilizing this teaching format as a law education tool challenges the status quo of pharmacy education and may serve as an impetus and catalyst for future innovations.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents, and royalties. Dr. Wang’s time was partly supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG040146 and R01AG049696. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Type: Idea Pape
Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)
Get PDFPharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management.
Type: Original Researc
From Drug Literature Evaluation to Evidence-Based Medicine: Transforming the Focus of a First Year Pharmacy Curriculum
Get PDFThis case study describes a longitudinal curricular sequence implemented to teach evidence-based medicine (EBM) skills. The longitudinal sequence is innovative in its approach, design, and assessment of EBM. This approach moves away from the conventional strategy of teaching drug information and drug literature evaluation as stand-alone courses and instead embraces the EBM Framework and its use in the context of authentic problem solving. The EBM Framework—Ask, Acquire, Appraise, and Apply—was used as the basis for defining seven EBM skills. These skills were targeted in the evidence-based, integrated design of 17 learning episodes delivered with eight faculty members through six courses in the first year. Student perceptions of relevance of EBM and performance on assessments and learning activities throughout the sequence suggest that integrating EBM across the first year of the curriculum is an effective strategy for teaching EBM skills. Three themes emerged from analysis of the data and experience, including the need for: a strong teaching team, a whole task approach with a focus on solving authentic problems, and care in interpreting the progression of assessments and patterns of student performance. Through instructor observations and peer review, the longitudinal sequence has been refined and has had an impact on the rest of the curriculum.
Type: Case Stud
Engagement in a Diverse Urban Community to Describe Community Residents’ Perceptions of Pharmacists as Immunizers
Get PDFObjective: To describe the perceptions of pharmacist-delivered vaccination services among community members that live in a diverse urban metropolitan area and to identify potential strategies to improve the use of vaccines provided by pharmacists.
Design: Qualitative study. Setting: Metropolitan urban diverse community in Wayne County, MI. Participants: Individuals 50 years of age and older that reside in a defined urban metropolitan community. Intervention: Four, 45-minute, focus group discussions were conducted to gather the experiences and perceptions of participants around pharmacists that immunize. A focus group guide was developed to facilitate focus group sessions. Main Outcome Measures: Focus group discussions were audio-recorded and transcribed. Content analysis was used to analyze data and identify relevant themes. Results: Three main themes were identified related to the use of pharmacist-delivered vaccination services: trust with vaccine providers, interaction with pharmacy personnel, and the factor of accessibility. Conclusion: Study participants expressed views that will guide the development of interventions aimed to reduce disparities in vaccine utilization. It is suggested that future efforts improve accessibility to pharmacy-delivered vaccines in this community and enhance the interaction between patients and pharmacists.
Type: Original Researc
Nullius in verba: The University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations
Get PDFThe University of Minnesota Social and Administrative Pharmacy Program proposed Guidelines for Formulary Evaluations (GFE) are designed to focus on the credibility of clinical and cost-outcomes claims in formulary decision making. The last few years have witnessed increasing concern over the credibility of trial based efficacy claims, with a surprisingly high proportion of claims falling short. At the same time cost-outcomes claims, where comparative clinical claims are a key input, have been presented where the claims made are not open to experimental or observational assessment. This follows from standards recommended for modeled and simulated claims. In the absence of cost-outcomes claims being presented in an evaluable form, it is impossible not only to replicate the claim or to judge whether or not it is credible. Claims for product value based on such claims are unacceptable. The guidelines proposed here are designed to overcome these limitations and support an evidence base that is both credible and replicable for formulary decisions. This is achieved by focusing on short-term modeled or simulated claims for cost-effectiveness. The requirement for modeled or simulated claims that are evaluable within a time frame that is meaningful for formulary decisions marks a major departure from format submissions already in play, not only in the US but in other developed economies. Rather than subscribing to the gold standard of long term or lifetime cost-per-QALY claims a short-term time horizon of no more than 2-years is recommended. This allows products to be provisionally placed on formulary but subject to a protocol that supports an evaluation to be reported back to a formulary committee as part of ongoing disease area or therapeutic class reviews. The place of the product and its contracted price can then be reviewed.
Conflict of Interest
None
Type: Commentar
Imaginary Worlds: The Status of Modeled Economic Evaluation Claims Published in Value in Health January 2015 to December 2015
Get PDFThe purpose of this paper is to assess the extent to which modeled or simulated cost-effectiveness claims published in Value in Health in 2015 meet the standards of normal science. To meet these standards, modeled or simulated claims must be credible. They must be capable of empirical evaluation and replication. If these standards are not met then such claims run the risk of being labeled as pseudoscience. Following a systematic review of all publications in Value in Health, 16 papers were identified. Of these 14 presented a cost-per-QALY analysis, with 9 presenting their claims for comparative effectiveness in a lifetime cost-per-QALY framework. With the focus of the assessment on whether or not these studies generated testable claims, none of the studies met this standard. They were best seen as thought experiments or imaginary worlds. Recipients of such claims can of course, on the one hand, reject them outright as not meeting accepted standards in normal science. After all, QALYs are never collected by health care systems and are unlikely to be collected. This means that the outcome metrics are untestable and may never have been intended to be tested. On the other hand, if the recipient believes that the model or simulation provides a sufficient correspondence to reality then the claims made are necessarily entailed. The issue of testing is irrelevant to the belief in the credibility of the claims. The modeled or simulated claims are immune to failure. The review concluded that none of the claims presented were in a testable form and that while 7 (at most) of the studies had the potential to generate testable claims, the rest were immune to failure. In the absence of testable claims, the studies reviewed are most appropriately characterized as imaginary worlds or thought experiments.
Type: Commentar