INNOVATIONS in pharmacy (Iip - E-Journal)
Not a member yet
600 research outputs found
Sort by
The Science of Safety – An Emerging Concept in Medication Use and Research
Get PDFMost published reports of patient safety in clinical practice focus largely on the culture of safety in complex health systems, separate from pre-approval and postmarketing research-related safety considerations for drugs, biologics, and other medical products. The science of safety requires a linked integrated perspective, i.e., an iterative process examining and relating safety concerns from drug or biologic discovery and development in preclinical stages, clinical trials and post-market use, research, surveillance, and potential regulatory changes. This commentary addresses the science of safety across the lifecycle of drug and biological products, regulatory considerations, barriers, and research needs. This paper provides a brief overview on how the functioning of healthcare systems affects the safety environment and describes how stakeholder involvement, research participation, and targeted education and training can help facilitate better safety measures and practices, provide improved quality of care to patients, and contribute to the science of safety.
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: Commentar
Pharmacist Prescriptive Authority for Epinephrine Auto-Injectors in Idaho
Get PDFObjective: To describe recent legislation in Idaho that granted pharmacists autonomous prescriptive authority for epinephrine auto-injectors.
Practice Innovation: States have taken action to increase access to epinephrine auto-injectors by allowing them to be stocked and prepositioned at locations where individuals may encounter allergens. All 50 states have allowed schools to maintain stock supplies of epinephrine auto-injectors and 26 states have allowed other entities, such as summer camps, daycare centers, gymnasiums, and restaurants to begin stocking product as well. In 2016, legislation in Idaho pursued entity stocking while simultaneously granting pharmacists autonomous prescriptive authority for epinephrine auto-injectors.
Results: Idaho legislation granted prescriptive authority for pharmacists for epinephrine auto-injectors not just for individual patients, but also for authorized entities. No collaborative practice agreement is necessary. To receive an epinephrine auto-injector, an agent or employee of an authorized entity must present proof that they have completed an appropriate training program. Pharmacists are provided liability protections when prescribing in good faith to an authorized entity.
Conclusion: Idaho’s legislation provides a potential model for pharmacist prescriptive authority for epinephrine auto-injectors that other states may consider pursuing in the years ahead.
Type: Commentar
Impact of Pharmacists’ Religious and Personal Beliefs in Dispensing Contraceptives
Get PDFBackground: Until recently, pharmacies were not permitted to dispense any emergency contraceptives to women to prevent pregnancy. No legal statutes existed under which pharmacists with religious, moral or ethical objections could refuse to fill a prescription for contraceptives, nor were there direct guidelines describing the pharmacist’s professional obligations.
Objectives: The purpose of this study is to explore the frequency of cases in which pharmacists have refused, due to their personal beliefs, to provide counsel regarding contraceptives or have refused to refer to a patient to a different pharmacist or healthcare provider. This study will compare and contrast the differences between independent pharmacies and chain pharmacies (i.e. time spent, location, most common recommended contraception). Finally, this study will compare the results evident between male pharmacists and female pharmacists.
Method: Quantitative method employed uses two interview questions directed to pharmacists:
(1) “I am moving in with my fiancée/boyfriend next month and I have never used contraceptives. What are my options?”
(2) “If I use a condom and it breaks, do I have any choices to prevent pregnancy after the fact?”
The survey was conducted in two locations, the greater Philadelphia area and Hershey, PA. The survey was conducted through face-to-face interactions with pharmacists, either employed at independent pharmacy or at a chain pharmacy. Data collected from each pharmacist included number of approximate age/gender; minutes spent in each consultation with a patient; the kind of privacy provided during the consultation; and the referrals given, if any.
Results: Fifty (50) pharmacists were interviewed. No pharmacist indicated that counseling would be denied, although one (1) pharmacist refused to counsel on Plan B and four (4) pharmacists referred the interviewer to a doctor immediately, indicating that all medications require a prescription. Two (2) pharmacists spent more than 10 minutes providing the best possible counseling.
Type: Student Projec
Policy Matters: Development of a Legislative Advocacy Week to Engage Student Pharmacists in Policy Discussions
Get PDFPolicy and advocacy discussions and activities are generally topics that student pharmacists are less excited to engage in during their PharmD curriculum. These can also be challenging to integrate within a curriculum in a meaningful, impactful, and engaging manner. At a college of pharmacy, two student organization chapters (American Pharmacists Association-Academy of Student Pharmacists and National Community Pharmacists Association) partnered together to host a Legislative Advocacy Week centered on the primary elections for the 2016 presidential race. This Note discusses the conceptualization, planning, events, impact, and analysis of this week.
Conflict of Interest
At the time of this activity, Dr. Mospan was a faculty member at East Tennessee State University Bill Gatton College of Pharmacy.
Type: Not
Preceptors' Need For Support In Tutoring Pharmacy Students in Finnish Community Pharmacies
Get PDFA pharmacy degree in Finland includes a six-month obligatory internship. The internship is integrated with theoretical studies and adds up to 30 European Credit Transfer and Accumulation System (ECTS) credits of the BSc (Pharm) degree. Learning is supported by reflective assignments from the university. The preceptors have an important role in organizing the internship and tutoring students successfully in community pharmacy settings.
Objective: to assess whether the preceptors of University of Helsinki’s teaching pharmacies need pedagogic support in tutoring and if so, in which core pharmaceutical tasks or tutoring skills.
Methods: The survey was sent to all preceptors of University of Helsinki´s teaching pharmacies (n=326) in 2011 (response rate 58%, n=190). The data was analyzed statistically using Excel (version 12.3.6). The open-ended questions were analyzed by qualitative content analysis.
Results: The majority of preceptors found their skills in tutoring the students mainly good. However, assessment of learning (27% of the respondents), giving feedback (23%) and organizing the learning situations supportive for learning (23%) were the areas in which the preceptors mostly indicated a need for support. Teaching current care guidelines and pharmaceutical care (36%) and multi-professional collaboration (28%) were the areas in which the preceptors expressed that they needed to update their skills.
Conclusions: The faculty should focus the support on the pedagogic skills of preceptors, particularly in improving their skills in assessment of learning and in reflective dialogue. In addition, their skills in teaching clinical and patient care aspects of pharmacy practice should be enhanced.
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: Original Research
 
Combining Chalk Talk with PowerPoint to Increase In-class Student Engagement
Get PDFIn striving to attain a higher degree of in-class student engagement, and target a larger number of preferred student-learning styles, this case study describes a multimodal teaching approach. PowerPoint slides have gradually gained popularity over the more traditional chalk and talk lecture design. The student population in today’s age seeks more non-passive modes of information delivery. Numerous novel approaches to enhance active learning, such as flipped classroom and problem-based learning, have recently been explored. While working well for therapeutic and lab-based courses, these formats may not be best-suited for all basic science topics. The importance of basic science in a pharmacy curriculum is well emphasized in the 2016 ACPE Standards. To actively involve students in a pharmacology lecture on diuretics, a session was designed to combine the PowerPoint and chalk talk approaches. Students created 10 concept diagrams following an instructor, who explained each step in the process using a document camera. For visual learners, these diagrams provided a layered representation of the information, gradually increasing in complexity. For learners with a preference for the reading learning style, the information was also available in corresponding PowerPoint slides. Scores from pre- and post-session quizzes indicated a high level of concept understanding and recall (median 1 [IQR 0 – 2] vs 4 [IQR 3 – 5]; p<0.001). The student perception survey data reported higher in-class attention levels (76%), an appreciation for the utility of self-created concept diagrams (88%), and a call for additional sessions being presented in this format (73%). Targeting a variety of student learning styles by using the active development of concept diagrams, in addition to traditional PowerPoint slides, can promote student engagement and enhance content understanding.
Type: Case Stud
Four Themes to Enhanced Interprofessional Education Integration: Lessons Learned from Early Implementation and Curricular Redesign
Get PDFWith the release of the Accreditation Council for Pharmacy Education (ACPE) Standards 2016, interprofessional education (IPE) has become more formalized and needs to be embedded into the curricula of colleges and schools of pharmacy. While IPE is not new to the practice and training of pharmacists, the call for IPE has become more robust over the last several years creating challenges to widespread implementation. The purpose of this Case Study Report is to describe a twelve-year progression of IPE implementation at a college of pharmacy without an academic medical center. Focused strategies for the development, integration, and expansion of IPE are provided through the context of four themes: working through program differences; collaborators and effective collaboration; attention to implementation planning; and prebriefing and debriefing. Each theme is defined and reviewed using specific examples and lessons learned. Finally, in consideration of the ACPE Standards 2016, potential next steps are discussed.
Type: Case Stud
Access to Breathing Medications in an Uninsured and Underinsured Patient Population
Get PDFThe purpose of this study was to explore access to breathing medications in an uninsured and underinsured patient population and identify needs for additional medication access resources. Quantitative data were collected from a dispensing report, financial database, and medical records review of patients who filled prescription medications at a charitable pharmacy in Ohio between December 11, 2014 and March 11, 2015, and qualitative data were collected from five semi-structured interviews with patients regarding breathing medication access. A total of 181 patients filled a breathing medication during the study period, which is nearly a quarter of the pharmacy’s patient population. The majority of patients were African American or Caucasian, and almost half were uninsured. Ultimately, the pharmacy had to purchase nearly half of breathing medications provided despite utilizing several medication access routes. Thus, access remains a significant challenge. Efforts are needed to ensure that vulnerable populations can consistently access breathing medications.
Type: Clinical Experienc
Sunlit Uplands: The Genius of the NICE Reference Case
Get PDFThe NICE reference case has received widespread acceptance in health technology assessment. The lifetime cost-per-QALY model and constructed claims for product impact have been widely emulated in country-specific guidelines for formulary submission as well as in publications in the leading health technology journals. Unfortunately, from the perspective of the standards of normal science, adherence to the reference case standard means that the claims made are typically non-evaluable. They have to be taken at face value. They may suggest potential evaluable hypotheses for clinical and cost-effectiveness claims, but there is no requirement in the reference case for claims to be put in an evaluable form and for manufacturers to suggest possible protocols for product impact assessment. This is not an acceptable situation. Absent the standards for falsification and replication, which are at the core of the scientific method, we have no idea whether the claims accepted by NICE are right or even if they are wrong. If we accept the reference case paradigm should we conclude that the sunlit uplands of formulary decisions based on non-evaluable simulated claims for cost-effectiveness has been reached? Have we rejected natural selection in favor of intelligent design?
Conflict of Interest
None
Type: Commentar
Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals
Get PDFThe objectives of this study were to measure the incidence and types of medication prescribing errors (MPEs) in Iraqi hospitals, to calculate for the first time the percentage of physician agreement with pharmacist medication regimen review (MRR) recommendations regarding MPEs, and to identify the factors influencing the physician agreement rate with these recommendations. Methods: Fourteen pharmacists (10 females and 4 males) reviewed each hand-written physician order for 1506 patients who were admitted to two public hospitals in Al-Najaf, Iraq during August 2015. The pharmacists identified medication prescribing errors using the Medscape WebMD, LCC phone application as a reference. The pharmacists contacted the physicians (2 females and 34 males) in-person to address MPEs that were identified. Results: The pharmacists identified 78 physician orders containing 99 MPEs with an incidence of 6.57 percent of all the physician orders reviewed. The patients with MPEs were taking 4.8 medications on average. The MPEs included drug-drug interactions (65.7%), incorrect doses (16.2%), unnecessary medications (8.1%), contra-indications (7.1%), incorrect drug duration (2%), and untreated conditions (1%). The physicians implemented 37 (37.4%) pharmacist recommendations. Three factors were significantly related to physician acceptance of pharmacist recommendations. These were physician specialty, pharmacist gender, and patient gender. Pediatricians were less likely (OR= 0.1) to accept pharmacist recommendations compared to internal medicine physicians. Male pharmacists received more positive responses from physicians (OR=7.11) than female pharmacists. Lastly, the recommendations were significantly more likely to be accepted (OR= 3.72) when the patients were females. Conclusions: The incidence of MPEs is higher in Iraqi hospitalized patients than in the U.S. and U.K, but lower than in Brazil, Ethiopia, India, and Croatia. Drug-drug interactions were the most common type of MPEs in hospitals. Physician specialty and pharmacist gender and patient gender significantly influenced physician agreement with the pharmacist comments. Only one-third of the pharmacist recommendations were implemented. Phone drug applications would be helpful for daily hospital pharmacy practice. More pharmacist-physician collaboration is needed to address MPEs. Pharmacist-led MRR can identify and address MPEs to improve patient safety.
Type: Original Researc