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Exploring performance predictors among employees in a pharmacist-led medication management center
No full textObjective: Health care companies are increasingly interested in developing and maintaining employee motivation. However, this can be challenging with different professions working together in delivering telephonic medication therapy management services. The purpose of the study is to assess employees’ perceptions of performance metrics, strategies to achieve those metrics, motivational work factors, and barriers to achievement at a medication management center (MMC). Design: Focus group using purposive sampling. Setting: Six in-person focus groups were conducted with the MMC employees. Participants: Separate focus groups were conducted for pharmacists, student pharmacist interns, and pharmacy technicians. Each group consisted of approximately 5 participants, lasted roughly 1 hour, and was facilitated by trained qualitative researchers. Outcome measures: The semistructured sessions involved participants responding to open-ended, predetermined questions introduced by a facilitator. The sessions were audio-recorded and transcribed for analysis. Two independent reviewers analyzed the transcripts; a third independent reviewer facilitated a consensus to resolve discrepancies. Results: Thirty MMC employees, with an average age of 32.1 ± 10.5 years, participated; most of them (73.3%) were women and had worked at the MMC for an average of 2.8 ± 2.2 years. Six themes were identified: (1) awareness and understanding of performance measures; (2) perceptions of performance measures; (3) suggested changes to make the performance measures more reflective of their roles; (4) motivating factors to improve performance; (5) performance barriers; and (6) strategies to achieve performance goals. The intrinsic motivational factors included providing patient care, helping change patients’ lives, and meeting work goals. The extrinsic motivational factors included remuneration, management, teamwork, work environment, and feedback. The performance barriers were unrealistic goals, lack of feedback, ineffective communication, and inconsistent operational procedures. Conclusions: These study findings contribute to a growing body of research surrounding employee motivation within organizations with diverse workforces. Future work is warranted to investigate employee motivation in similar pharmacy-related settings
Geographic variation in the prevalence of high-risk medication use among medicare part d beneficiaries by hospital referral region
No full textBACKGROUND: Understanding geographic patterns of high-risk medication (HRM) prescribed and dispensed among older adults may help the Centers for Medicare & Medicaid Services and their partners develop and tailor prevention strategies. OBJECTIVE: To compare the geographic variation in the prevalence of HRM use among Medicare Part D beneficiaries from 2011 to 2013, for Medicare Advantage Prescription Drug (MA-PD) plans and stand-alone Prescription Drug Plans (PDPs). METHODS: This retrospective study used the data of a 5% national Medicare sample (2011-2013). Beneficiaries were included in the study if they were aged ≥65 years, continuously enrolled in MA-PDs or PDPs (~1.3 million each year), and had ≥2 prescriptions for the same HRM (e.g., amitriptyline) prescribed and dispensed during the year based on the Pharmacy Quality Alliance\u27s (PQA) quality measures for HRM use. Multivariable logistic regression was used to estimate adjusted annual HRM use rates (i.e., adjusted predictions, average marginal predictions, or model-adjusted risk) across 306 Dartmouth Atlas of Health Care hospital referral regions (HRRs), controlling for sociodemographic, health-status, and access-to-care factors. RESULTS: Among eligible beneficiaries each year (1,161,076 in 2011, 1,237,653 in 2012, and 1,402,861 in 2013), nearly 40% were enrolled in MA-PD plans, whereas the remaining 60% were in PDP plans. The adjusted prevalence of HRM use significantly decreased among Medicare beneficiaries enrolled in MA-PD (13.1%-8.4%, P\u3c0.001) and PDP (16.2%-12.2%, P\u3c0.001) plans from 2011 to 2013. For MA-PD and PDP beneficiaries, HRM users were more likely to be (all P\u3c0.001) the following: female (MA-PD: 70.4% vs. 59.9%; PDP: 72.8% vs. 62.5%); White (MA-PD: 84.6% vs. 81.4%; PDP: 86.6% vs. 85.3%); with low-income subsidy or dual eligibility for Medicaid (MA-PD: 22.3% vs. 16.6%; PDP: 29.2% vs. 23.3%); and disabled (MA-PD: 15.6% vs. 8.7%; PDP: 15.4% vs. 8.5%) compared with non-HRM users in 2013. In 2013, significant geographic variation existed, with the ratios of 75th-25th percentiles of HRM use rates across HRRs as 1.42 for MA-PDs and 1.31 for PDPs. For MA-PDs, the top 5 HRRs with the highest HRM use rates in 2013 were Casper, WY (20.4%), Waco, TX (16.7%), Lubbock, TX (15.7%), Santa Barbara, CA (15.2%), and Temple, TX (15.1%); for PDPs, they were Lawton, OK (18.8%), Alexandria, LA (18.8%), Lake Charles, LA (18.6%), Oklahoma City, OK (18.0%), and Slidell, LA (18.0%). CONCLUSIONS: Substantial geographic variation exists in the prevalence of HRM use among older adults in Medicare, regardless of prescription drug plan. Areas with high prevalence of HRM use may benefit from targeted interventions (e.g., medication therapy management monitoring or alternative medication substitutions) to prevent potential adverse consequences
Naming of Biological Products
No full textBiological products are rapidly expanding in the United States, and they are currently the fastest-growing class of therapeutic products. Biological products are being developed for rare, difficult-to-treat disease states and disease states with no treatment options, as well as creating new options for treatable conditions. The FDA has identified potential safety concerns for patients using biological products. These concerns include inappropriate or unintended biological-product substitution, along with pitfalls in pharmacovigilance monitoring for biological products. Recent FDA guidance discusses concerns, proposes solutions, and describes nomenclature for naming biological products
ACCP clinical pharmacist competencies: Advocating alignment between student, resident, and practitioner competencies
No full textCompetency standards in pharmacy education and training have been formulated by different organizations to focus on various stages in the development of students, residents, and clinical pharmacists. This commentary advocates a deliberate alignment of educational outcomes, goals, and competencies across the developmental continuum of students, residents, and pharmacy practitioners. Consistent use of terminology and appropriate sequencing of expectations will help develop pharmacists who can meet the demands of the profession in the changing health care landscape. Progressive development is needed for the pharmacist\u27s abilities, from student to resident to new practitioner to experienced professional. Consistency will ensure that educational and training programs optimally prepare individuals for board certification and professional roles. Specific recommendations include developing a common taxonomy that aligns within the pharmacy profession and across health care professions
Biological Toxin Use and Disposal Policy
No full textBiological toxins are poisonous substances produced by certain microorganisms, animals, and plants. Examples of toxins of biological origin include Diphtheria Toxin, Tetrodotoxin, Pertussis Toxin, Botulinum Toxin, Snake Venom Toxins, Conotoxin and Ricin. Although toxins are derived from biological materials, they do not replicate and are therefore not considered infectious.
However, they may be extremely toxic in very small quantities and must be managed like hazardous chemicals in the workplace. Controls must be in place to ensure staff is protected from exposure. The routes of exposure include inhalation, eye, nose and mucous membrane contact, percutaneous, and skin absorption depending on the diluents used. The main issues of concern in the laboratory are accidental exposures to toxin caused by contact with the mouth, eye, skin and mucous membranes, inhalation of toxin powder or aerosol inadvertently generated, or by needlestick incidents.
Work with toxins of biological origin must be included in your laboratory-specific Chemical Hygiene Plan. Documented toxin-specific hazard training and training on the laboratory-specific standard operating procedures (SOP) is required for all laboratory personnel prior to starting work. The training must include but is not limited to the health and physical hazards of the toxin, signs and symptoms associated with exposure, appropriate work practices, personal protective equipment, and emergency procedures.
Some toxins of biological origin are considered Select Toxins, which the US Departments of Health and Human Services (HHS) and Agriculture (USDA) have determined to have the potential to pose a severe threat to public health and safety, to animal or plant health, or to animal or plant products. The Centers for Disease Control and Prevention (CDC) in their Select Agent Program regulates the possession, use, and transfer of these specific biological agents and toxins. Research work with CDC listed Select Toxins may have additional safety and security requirements including registration with UHSP EH&S and the CDC
Policy Against Sex-Based Discrimination in Educational Programs and Activities (Title IX)
No full textTitle IX of the Higher Education Act Amendments of 1972 (“Title IX”) prohibits discrimination on the basis of sex in educational programs or activities and employment. Discrimination on the bases of sex includes sex discrimination, sexual harassment and certain relationship violence. University of Health Sciences and Pharmacy in St. Louis (“UHSP” or “University”) is committed to preventing sexual discrimination in its programs and activities and complying with the requirements for handling reports of sex-based discrimination under Title IX. The University takes the safety and well-being of its students, faculty and staff seriously and offers many forms of educational and support services to prevent and address issues of sex-based discrimination or sexual harassment that may occur.
The University takes care to support reporters and educate them on their options including filing Formal Complaints to investigate and adjudicate sex-based discrimination or harassment covered by this policy. The University will take steps to promptly investigate Complaints of policy violations, to initiate supportive measures to protect individuals involved and minimize disruption on campus, to provide a fair and impartial hearing and appeal process, to impose sanctions or discipline reasonably calculated to prevent future violations, and to correct the discriminatory effects of a violation on individuals filing Complaints and other members of the University community. University personnel and students who violate this policy are subject to the grievance and disciplinary procedures outlined in this policy and any civil and criminal laws that may apply. The University will impose sanctions against individuals for violations of this policy including, but not limited to, suspension, involuntary separation and referral to appropriate law enforcement authorities. The University may notify third parties, such as other employers and educational institutions, and initiate appropriate action for violations by outside persons, representatives, or students under their control. Whenever a report of sexual harassment does not involve conduct governed by this policy (Title IX), the University will refer the report to another office to review for potential violation of other policies and procedures, such as its non-discrimination policies, to protect members of the University community
Library Asset Management Policy
No full textThe policy allows the library to ensure that library budgets are spent on electronic resources (e-resources) that support the mission and objectives of the institution and are relevant and cost effective. This policy will establish procedures to evaluate both requested new resources and existing resources.
To establish if a new e-resource is appropriate for the library’s collection and to help determine the true and hidden cost implications of acquisition, storage, maintenance, preservation and other issues, detailed information regarding the item is reviewed.
Established e-resources will be reviewed closely to identify legacy resources that are no longer providing adequate value.
The University\u27s Contract Administration and Signature Authority Policy identifies those positions which are allowed to enter into an agreement on behalf of the University. Individual faculty and staff may not enter into an agreement to purchase or lease library information resources on behalf of the University
American College of Clinical Pharmacy Global Health Practice and Research Network\u27s opinion paper: Pillars for global health engagement and key engagement strategies for pharmacists
No full textThe scope of pharmacy practice in global health has expanded over the past decade creating additional education and training opportunities for students, residents and pharmacists. There has also been a shift from short-term educational and clinical experiences to more sustainable bidirectional partnerships between high-income countries (HICs) and low- to middle-income countries (LMICs). As more institutional and individual partnerships between HICs and LMICs begin to form, it is clear that there is a lack of guidance for pharmacists on how to build meaningful, sustainable, and mutually beneficial programs. The aim of this paper is to provide guidance for pharmacists in HICs to make informed decisions on global health partnerships and identify opportunities for engagement in LMICs that yield mutually beneficial collaborations. This paper uses the foundations of global health principles to identify five pillars of global health engagement when developing partnerships: (a) sustainability, (b) shared leadership, (c) mutually beneficial partnerships, (d) local needs-based care and (e) host-driven experiential and didactic education. Finally, this paper highlights ways pharmacists can use the pillars as a framework to engage and support health care systems, collaborate with academic institutions, conduct research, and interface with governments to improve health policy
An ethics-based approach to global health research part 1: Building partnerships in global health
No full textGlobal health partnerships (GHPs) can be the cornerstone for advancing research and public health. The steps to build a global research partnership focus on sharing a common research agenda, identifying key partners in the community, and establishing goals and expectations for partnerships. Moreover, upholding important values, such as communication, trust, and transparency is essential for building successful partnerships. Ethical dilemmas can propose challenges to researchers in global health. These challenges can be overcome by creating a shared vision for a research agenda, maintaining communication, and providing bidirectional training
Permeation-Enhancing Nanoparticle Formulation to Enable Oral Absorption of Enoxaparin
No full textThis study tests the hypothesis that association complexes formed between enoxaparin and cetyltrimethylammonium bromide (CTAB) augment permeation across the gastrointestinal mucosa due to improved encapsulation of this hydrophilic macromolecule within biocompatible poly (lactide-co-glycolide, PLGA RG 503) nanoparticles. When compared with free enoxaparin, association with CTAB increased drug encapsulation efficiency within PLGA nanoparticles from 40.3 ± 3.4 to 99.1 ± 1.0%. Drug release from enoxaparin/CTAB PLGA nanoparticles was assessed in HBSS, pH 7.4 and FASSIFV2, pH 6.5, suggesting effective protection of PLGA-encapsulated enoxaparin from unfavorable intestinal conditions. The stability of the enoxaparin/CTAB ion pair complex was pH-dependent, resulting in more rapid dissociation under simulated plasma conditions (i.e., pH 7.4) than in the presence of a mild acidic gastrointestinal environment (i.e., pH 6.5). The intestinal flux of enoxaparin complexes across in vitro Caco-2 cell monolayers was greater when encapsulated within PLGA nanoparticles. Limited changes in transepithelial transport of PLGA-encapsulated enoxaparin complexes in the presence of increasing CTAB concentrations suggest a significant contribution of size-dependent passive diffusion as the predominant transport mechanism facilitating intestinal absorption. [Figure not available: see fulltext.