Research

11 pages, 243 KiB

Open AccessArticle

Lessons Learned from a Shared Curriculum on Tobacco Cessation Using a Mixed-Methods Approach

by Nervana Elkhadragy, Robin L. Corelli, Noll L. Campbell, Alan J. Zillich and Karen Suchanek Hudmon

Pharmacy 2023, 11(4), 123; https://doi.org/10.3390/pharmacy11040123 - 02 Aug 2023

Viewed by 1015

Abstract

Although the sharing of curricular content between health professional schools can reduce faculty burden, the literature provides little guidance to support these efforts. The objective of this investigation was to synthesize data from two prior studies to delineate recommendations guiding the future development [...] Read more.

Although the sharing of curricular content between health professional schools can reduce faculty burden, the literature provides little guidance to support these efforts. The objective of this investigation was to synthesize data from two prior studies to delineate recommendations guiding the future development of shared curricula in health professional education. Applying Rogers’ Diffusion of Innovations Theory as a guiding framework, relevant data were extracted from a two-phase mixed-methods study evaluating the long-term impact of the shared Rx for Change: Clinician-Assisted Tobacco Cessation program. Phase 1, a qualitative study, involved telephone interviews with faculty participants of train-the-trainer workshops conducted between 2003 and 2005. These results informed the development of a phase 2 national survey, administered electronically as a long-term follow-up (13 to 15 years later) with train-the-trainer workshop participants. Results from the two studies were synthesized and summarized, producing seven key recommendations to guide development of shared curricula: (1) appeal to attendees, (2) relate content to clinical practice, (3) deliver live, in-person training, (4) develop high-quality materials, delivered by experts, (5) provide support, (6) meet accreditation standards, and (7) demonstrate effectiveness. Future program developers should consider these recommendations to enhance dissemination, adoption, and long-term sustainability of shared curricular content. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

13 pages, 910 KiB

Open AccessArticle

Subjective Perceptions of Occupational Fatigue in Community Pharmacists

by Taylor L. Watterson and Michelle A. Chui

Pharmacy 2023, 11(3), 84; https://doi.org/10.3390/pharmacy11030084 - 09 May 2023

Cited by 2 | Viewed by 1782

Abstract

Introduction: Community retail pharmacists are experiencing unsafe levels of stress and excessive demands within the workplace. One aspect of workload stress that has been overlooked among pharmacists is occupational fatigue. Occupational fatigue is a characteristic of excessive workload including increased work demands and [...] Read more.

Introduction: Community retail pharmacists are experiencing unsafe levels of stress and excessive demands within the workplace. One aspect of workload stress that has been overlooked among pharmacists is occupational fatigue. Occupational fatigue is a characteristic of excessive workload including increased work demands and reduced capacity and resources to complete the work. The goal of this study is to describe the subjective perceptions of occupational fatigue in community pharmacists by using (Aim 1) a previously developed Pharmacist Fatigue Instrument and (Aim 2) semi-structured interviews. Methods: Wisconsin community pharmacists were eligible to participate in the study and recruited via a practice-based research network. Participants were asked to complete a demographic questionnaire, a Pharmacist Fatigue Instrument, and semi-structured interview. Survey data were analyzed using descriptive statistics. Interview transcripts were analyzed using qualitative deductive content analysis. Results: Totally, 39 pharmacists participated in the study. From the Pharmacist Fatigue Instrument, 50% of the participants stated they had times where they were not able to go above and beyond standard patient care on more than half of the days they worked. A total of 30% of the participants reported that they found it necessary to take short-cuts when providing patient care on more than half of the days they worked. Pharmacist interviews were separated into overarching themes including mental fatigue, physical fatigue, active fatigue, and passive fatigue. Conclusions: The findings highlighted the pharmacists’ feelings of despair and mental fatigue, fatigue’s connectedness to interpersonal relationships, and the complex nature of pharmacy work systems. Interventions aimed at improving occupational fatigue in community pharmacies should consider key themes of fatigue that pharmacists are experiencing. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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9 pages, 249 KiB

Open AccessArticle

Impact of Clinical Pharmacy Expansion within a Rural Federally Qualified Health Center through Implementation of Pharmacist-Led Medicare Annual Wellness Visits

by Carrington Royals, Reagan K. Barfield, Mary Francis Newman, Lori Mor, Tammy H. Cummings and P. Brandon Bookstaver

Pharmacy 2022, 10(6), 160; https://doi.org/10.3390/pharmacy10060160 - 29 Nov 2022

Cited by 1 | Viewed by 1717

Abstract

Medicare Annual Wellness Visits (AWVs) are annual appointments with the primary care team to prepare personalized prevention plans and focus on gaps in care. Although beneficial, AWVs are often difficult for providers to schedule and complete due to the increased time commitments compared [...] Read more.

Medicare Annual Wellness Visits (AWVs) are annual appointments with the primary care team to prepare personalized prevention plans and focus on gaps in care. Although beneficial, AWVs are often difficult for providers to schedule and complete due to the increased time commitments compared to other visits. The purpose of this study was to assess the clinical, economic and patient-level value of newly implemented pharmacist-led AWVs within a rural Federally Qualified Health Center (FQHC). This retrospective, cohort study included patients who completed an AWV between 1 October 2021, and 14 February 2022. The primary objective was to compare the per clinician rate of completed AWVs between pharmacists and providers. The secondary objectives were to compare revenue generated, interventions made, and patient satisfaction between pharmacist- and provider-led AWVs. During the study period, nine providers completed 139 AWVs (15.4/provider) and two pharmacists completed 116 AWVs (58/pharmacist). Proportions of interventions ordered among those due in eligible patients were similar between pharmacists and providers (47.6% vs. 44.5%; p = 0.356). Patient satisfaction was overall positive with no difference between groups. Pharmacist-led AWVs increased completion of AWVs by 83% over a 20-week period, including significantly more initial, compared to subsequent, AWVs than providers. Sustainability of pharmacist-led AWVs at this FQHC is supported by study outcomes. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

12 pages, 1251 KiB

Open AccessArticle

Birth Control Use and Access Including Pharmacist-Prescribed Contraception Services during COVID-19

by Karli Pelaccio, David Bright, Heather Dillaway and Mary Beth O’Connell

Pharmacy 2022, 10(6), 142; https://doi.org/10.3390/pharmacy10060142 - 28 Oct 2022

Viewed by 2440

Abstract

The COVID-19 pandemic influenced health care with effects on contraception access emerging. The study objectives were to analyze pandemic impacts on birth control (BC) use and access; and evaluate perceptions of pharmacist-prescribed BC. A 50-item survey was distributed by 31 Michigan community pharmacies [...] Read more.

The COVID-19 pandemic influenced health care with effects on contraception access emerging. The study objectives were to analyze pandemic impacts on birth control (BC) use and access; and evaluate perceptions of pharmacist-prescribed BC. A 50-item survey was distributed by 31 Michigan community pharmacies to women aged 18–45 over a three-month period. The survey link was also posted on two websites. 147 surveys were analyzed. Respondents were 29 ± 7.9 years old, primarily white (77%) and straight (81%). Fifty-eight percent of respondents used prescription BC, mostly to prevent pregnancy (84%) with oral pills (76%) being the most common formulation. Some BC users (25%) were worried about BC access and 27% had difficulty taking BC regularly. Half of the respondents (50%) would likely use pharmacist-prescribed BC if available, with advantages being more convenient than visiting a doctor’s office (71%) and easier access (69%). The major concern about pharmacist-prescribed BC was women not receiving PAP smears and screenings (61%). Respondents reported high confidence (72%) in pharmacist-prescribed BC and believe it would help prevent unintended pregnancies (69%). Some respondents experienced altered BC use and access. Half of the respondents supported pharmacist-prescribed BC. Pharmacist-prescribed BC could help solve pandemic-related access problems. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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8 pages, 232 KiB

Open AccessArticle

An Assessment of Student Pharmacists’ Knowledge of Electronic Cigarettes or Vapes—A Cross Sectional Study at One College of Pharmacy

by Ibrahim Alfayoumi, Osama Aqel and David R. Axon

Pharmacy 2022, 10(5), 131; https://doi.org/10.3390/pharmacy10050131 - 11 Oct 2022

Viewed by 2349

Abstract

This study assessed the knowledge of e-cigarettes/vapes among a sample of student pharmacists. A 22-item cross-sectional electronic questionnaire was administered to all third- and fourth-year student pharmacists enrolled at one college of pharmacy in the United States (N = 256). Data were collected [...] Read more.

This study assessed the knowledge of e-cigarettes/vapes among a sample of student pharmacists. A 22-item cross-sectional electronic questionnaire was administered to all third- and fourth-year student pharmacists enrolled at one college of pharmacy in the United States (N = 256). Data were collected over six weeks in March/April 2022. One point was assigned for each correct knowledge item; points were then summed to create a total knowledge score for each person. Differences in the proportion of students who correctly answered each knowledge item were compared between year groups using a chi-square test, while differences between year groups for total knowledge score were compared using a two-sample t-test. The a priori alpha level was 0.05. Fifty students (third year = 30, fourth year = 20; female = 60%) completed the survey. Students’ e-cigarettes/vapes knowledge varied depending on the item. There was no statistically significant difference between third- and fourth-year students for total mean knowledge scores (third year = 12.5 ± 3.3, fourth year = 11.2 ± 3.1, p = 0.1780) or for each knowledge item, except for items 10 and 20. In conclusion, the findings from this survey of student pharmacists at one college of pharmacy in the United States indicate a need for more education around e-cigarettes/vapes for student pharmacists so that they are better able to counsel patients on their use. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

7 pages, 499 KiB

Open AccessCommunication

Development and Implementation of a Healthcare Database Analysis Course for Graduate Students

by David R. Axon

Pharmacy 2022, 10(5), 119; https://doi.org/10.3390/pharmacy10050119 - 22 Sep 2022

Viewed by 1396

Abstract

There emerged a need to develop and implement a new healthcare database analysis course for Health Economics and Outcomes Research (HEOR) graduate students, which would allow students to apply their biostatistics and study design skills to answer healthcare-related research questions using large datasets. [...] Read more.

There emerged a need to develop and implement a new healthcare database analysis course for Health Economics and Outcomes Research (HEOR) graduate students, which would allow students to apply their biostatistics and study design skills to answer healthcare-related research questions using large datasets. This communication establishes the need for this course, describes how the course was conceptualized, provides an overview of the course content, course cohort, and course outcomes, and discusses lessons learned from this process. This course was developed to meet the need of HEOR graduates to perform real-world data studies. The course required students to conceptualize a study, apply their data analysis skills to analyze the data, and develop their scientific writing skills by preparing a conference abstract and research report that should be submitted for publication. Lessons learned include focusing more on developing advanced research methodologies and less time on preparing dissemination materials, which can instead be done in subsequent courses or for independent study credit. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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Review

Jump to: Research, Other

11 pages, 288 KiB

Open AccessReview

Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors Use among Heart Failure Patients and the Role of Pharmacists in Early Initiation of Therapy

by Mohammed Aldhaeefi, Brandon Beers, Jenny Shah, Saba Saeidi Rizi, Dhakrit Rungkitwattanakul, Oliver Nimoh, Victoria Frimpong, Jackie Gonzalez, Sanaa Belrhiti, Fatima Urooj and Deborah Williams

Pharmacy 2023, 11(2), 58; https://doi.org/10.3390/pharmacy11020058 - 17 Mar 2023

Viewed by 2084

Abstract

Heart failure (HF) is a growing major public health and economic concern in the United States and worldwide. Heart failure mortality rates can be as high as 75% despite advances in therapies. HF is expected to be the fastest growing among all cardiovascular [...] Read more.

Heart failure (HF) is a growing major public health and economic concern in the United States and worldwide. Heart failure mortality rates can be as high as 75% despite advances in therapies. HF is expected to be the fastest growing among all cardiovascular diseases, with HF-associated direct medical costs projected to nearly double over the next 10 years. Hospital admissions, re-admission, and medical cost are a huge burden to the healthcare system, and this is estimated to have increased gradually over the past decades despite the available advances in HF treatment and prevention. Many heart failure therapies have shown improvement in terms of mortality, morbidity, and symptomatic management. Guideline-directed medical therapy (GDMT) for heart failure has proven its ability to reduce morbidity and mortality by 66%. GDMT is recommended to be used among all HF patients when appropriate. In recent years, two new drug classes, angiotensin receptor-neprilysin inhibitor (ARNi) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, were approved by the United States Food and Drug Administration (US FDA) for the management of heart failure. The exact mechanism by which the SGLT-2 inhibitors attenuate the inflammatory process remains unclear. Several mechanisms have been suggested related to the cardiovascular benefit of SGLT-2 inhibitors, including a reduction in inflammation, improvement in natriuresis/diuresis, and promotion of the use of ketones as a secondary energy source. Clinical data showed that SGLT-2 inhibitors have morbidity and mortality benefits within 30 days of initiation. Studies have proven that clinical pharmacists practicing in HF inpatient and outpatient settings resulted in a reduction of HF hospitalization and an increase in the uptake of GDMT by initiating or up-titrating GDMT agents as well as providing patient education. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

11 pages, 1055 KiB

Open AccessReview

Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice

by Mohammed Aldhaeefi, Hisham A. Badreldin, Faisal Alsuwayyid, Tariq Alqahtani, Omar Alshaya, Majed S. Al Yami, Khalid Bin Saleh, Shmeylan A. Al Harbi and Abdulrahman I. Alshaya

Pharmacy 2023, 11(1), 34; https://doi.org/10.3390/pharmacy11010034 - 11 Feb 2023

Cited by 2 | Viewed by 14808

Abstract

In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the [...] Read more.

In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the primary concern among patients using antithrombotics. Direct oral anticoagulants (DOACs) include rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors (DTIs) include argatroban, bivalirudin, and dabigatran. DOACs are associated with lower rates of fatal, life-threatening, and significant bleeding risks compared to those of warfarin. The immediate reversal of these agents can be indicated in an emergency setting. Antithrombotic reversal recommendations are still in development. Vitamin K and prothrombin complex concentrate (PCCs) can be used for warfarin reversal. Andexanet alfa and idarucizumab are specific reversal agents for DOACs and DTIs, respectively. Protamine sulfate is the solely approved reversal agent for unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). However, there are no specific reversal agents for antiplatelets. This article aims to provide a practical guide for clinicians regarding the reversal of anticoagulants and antiplatelets in clinical practice based on the most recent studies. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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Other

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6 pages, 308 KiB

Open AccessCommentary

How Well Are Pharmacists Represented in National Institutes of Health R01 Funding to United States Schools of Pharmacy?

by Duong Nguyen, Ashley R. Selby and Ronald G. Hall 2nd

Pharmacy 2022, 10(6), 165; https://doi.org/10.3390/pharmacy10060165 - 30 Nov 2022

Cited by 2 | Viewed by 1768

Abstract

Pharmacists are essential healthcare providers but historically are not well represented as principal investigators (PIs) of R01 grants by the United States (US) National Institutes of Health (NIH). Pharmacy organizations have taken steps to provide pharmacists with research training to improve their chances [...] Read more.

Pharmacists are essential healthcare providers but historically are not well represented as principal investigators (PIs) of R01 grants by the United States (US) National Institutes of Health (NIH). Pharmacy organizations have taken steps to provide pharmacists with research training to improve their chances of achieving PI status. We conducted a retrospective cohort study using data from the NIH RePORTER website about R01 grants awarded to PIs affiliated with US Schools of Pharmacy (SOPs) for the fiscal years 2005–2019. Information regarding professional degrees was supplemented using data from the PIs’ institutional website profiles and other internet-based sources. Only doctorate degrees obtained within the US were included for clinically related degrees. Data regarding more than one year of funding for the same project, equipment supplements, and diversity supplements were excluded to focus on unique projects in year one of funding. PhDs were the primary unique PIs of R01 grants at US SOPs (>90%). Pharmacist representation as unique PIs increased over the 15 years but was still only 10.1% for the years 2015–2019. There was a higher percentage of female pharmacists as unique PIs than female non-pharmacists. Pharmacists are currently underrepresented as unique PIs for NIH R01 grants. This conclusion is limited by not knowing how many pharmacist R01 applications were submitted. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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