Implementation of academic detailing for pharmacists on opioid use disorder and harm reduction.

BACKGROUND: The United States is experiencing an opioid crisis, substantially worsened by the pandemic. Pharmacists play a critical role in expanding access to care through harm reduction efforts and medications to treat opioid use disorder (mOUD), yet lack necessary education and resources. Academic detailing is a one-on-one technique, which can effectively address educational gaps. OBJECTIVE: The purpose was to assess needs and equip pharmacy staff to address the health of people with substance use disorders (SUD). PRACTICE DESCRIPTION: Community pharmacists provide ongoing care for patients with SUD. PRACTICE INNOVATION: Based on needs' assessment findings, an academic detailing program was designed to provide education and resources for community pharmacies. The project sought to assess current practice and needs and address pharmacists' skills in managing patients with opioid use disorder (OUD) and/or at risk for overdose (OD). Visits were scheduled in high-risk regions. Coaching and materials were provided. EVALUATION METHODS: Detailers completed visits reports. Discrete variables were reported using descriptive statistics. Associations between discrete variables were detected with Chi-square or Fisher's exact test. RESULTS: Detailers visited 136 pharmacies. Most stocked naloxone (86.8%), mOUD (94.9%) and would sell syringes (64%) per state law. Fifty-seven percent of pharmacies provided all of these services. However, additional education and resources were needed. Only 27.9% had naloxone signage and/or handouts; 22.1% had supplemental materials; and 25% had referral information. When asked to explain barriers, frequently cited themes included providing resources/help, financial issues, stigma, and transportation. CONCLUSION: Pharmacists routinely care for patients at risk for OD and diagnosed with OUD. Academic detailing is a well-received strategy to disseminate education and materials, while gathering information about pharmacist needs and barriers. However, there remains room for expansion of services and opportunities for improved care. Further efforts should incorporate ongoing training and access to materials with visual cues, as well as referral and cost savings information.

Salary and entry-level requirements for pharmacy technicians compared with other health technologist and technician occupations in Maryland.

OBJECTIVES: Pharmacy technician programs are experiencing important transitions to new educational standards, an enhanced accreditation framework, and changing requirements by state boards of pharmacy. The requirements are highly variable from state to state and have practical consequences for the pharmacy workforce in terms of technician recruitment, retention, and satisfaction. Using the state of Maryland as a case report, the purpose of this analysis was to compare the requirements necessary to become either a pharmacy technician or another type of health technologist, including board licensure or registration; training, education or certification or both; and 2016 median salary as reported by the Bureau of Labor Statistics. DATA SOURCES: This analysis of salaries and job requirements for health technologists and technicians in the state of Maryland was conducted using the Standard Occupational Classification system and the Bureau of Labor Statistics wage data. SUMMARY: Nuclear medicine technologists have the highest median salary at $38.50 per hour. No relationship between increasing entry-level qualifications and salary was identified, but pharmacy technicians were found to have the lowest median salary at $15.10 per hour. Although 5 occupations have median salaries greater than $30, 9 have median hourly salaries less than $20, of which 5 have minimum qualifications mandated by statute and regulation. CONCLUSION: Pharmacy technicians have the lowest median salary compared with other health technologists and technicians in Maryland. With pharmacy technicians reporting low satisfaction with salary as a reason for intending to leave an employer, implementing mandatory minimum entry-level requirements without a corresponding increase in salary could lead to a reduction in applicants for positions.

Recommitting to AACP Engaged Governance for the Common Good: Report of the 50th Anniversary Commission to Reimagine the AACP House of Delegates.

The 50th Anniversary Commission to Reimagine the American Association of Colleges of Pharmacy (AACP) House of Delegates (HOD Commission) was charged to consider and recommend changes to the AACP Board of Directors and AACP HOD regarding a broad range of issues related to the HOD. The 2021-2022 HOD Commission met virtually many times throughout the year as 2 sub-groups and a full commission, using Basecamp for shared documents and timelines, and it provided interim reports to the Board of Directors in November and February. A survey of 2022 delegates was developed and administered; responses from 163 delegates informed final recommendations as described in the report. The HOD Commission affirms the need for and purpose of AACP's HOD and urges that all schools/colleges of pharmacy recommit to engaged governance for the common good.

Overcoming Past Perceptions and a Profession-Wide Identity Crisis to Reflect Pharmacy's Future.

The profession of pharmacy has come to encompass myriad identities, including apothecary, dispenser, merchandiser, expert advisor, and health care provider. While these identities have changed over time, the responsibilities and scope of practice have not evolved to keep up with the goals of the profession and the level of education of practicing pharmacists in the United States. By assuming that the roles of the aforementioned identities involve both product-centric and patient-centric responsibilities, our true professional identity is unclear, which can be linked to the prevalence of the impostor phenomenon within the profession. For pharmacy to truly move forward, a unified definition for the profession is needed by either letting go of past identities or separating these identities from each other by altering standards within professional degree programs and practice models. Without substantial changes to the way we approach this challenge as a profession, the problems described will only persist and deepen.

Adaptability, Agency, and Association to Influence Change: The Report of the 2020-21 AACP Argus Commission.

EXECUTIVE SUMMARY The 2020-21 AACP Argus Commission was charged to 1) review the 2019-2020 standing committee reports; 2) describe the impact of COVID-19 on healthcare delivery with an emphasis on health equity and social justice, 3) identify strategies to work with other health professions associations to advance interprofessional education and practice, and 4) offer recommendations for activities for the Center to Accelerate Pharmacy Practice Transformation and Academic Innovation (CAPT). Two work groups divided charges 2 and 3 and provided assessments of how health care and education might change due to all we have experienced over the 12-plus months of the pandemic. A review of plans for the first year of the CAPT activities and recommendations for additional activities are included in report. The Commission has proposed two new policy statements on digital health, five recommendations for AACP and five suggestions for colleges and schools of pharmacy. The Argus Commission affirms academic pharmacy's adaptability, agency, and association to influence changes in healthcare delivery and interprofessional education and practice.

Advancing Our Pharmacy Reformation - Accelerating Education and Practice Transformation: Report of the 2019-2020 Argus Commission.

The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.

Reexamining the Academic Partnerships with Federal Pharmacy: 2018-19 Argus Commission Report.

The Argus Commission examined the history and current status of progressive pharmacy patient care services across several federal branches of government, including the Veterans Administration, Department of Defense, and the U.S. Public Health Service where officers and civilian pharmacists practice in the Indian Health Service, Bureau of Prisons, Area Health Education Centers and other locations. The engagement of pharmacy faculty, students and residents in these practices was assessed. Colleges and schools of pharmacy advocate for the expansion of the capacity for placement of learners in these progressive practices. AACP is encouraged to establish on going collaborations with federal pharmacy leaders to create new opportunities for partnerships that advance patient care, especially for special populations served in these federal programs.

Vital Directions for Pharmacy Education and Practice: Report of the 2017-18 Argus Commission.

The Argus Commission examined the National Academy of Medicine's publication "Vital Directions for Health and Health Care" and engaged with six guests from outside academic pharmacy to identify the salience of the key issues and recommendations for pharmacy education and practice. To be part of the changing health care system we must prepare graduates and faculty to be patient- and community-centered, to command electronic systems of communication with members of interprofessional teams and to create and apply real-world evidence. Sustainable practice models will depend upon the measurement of performance and the assessment of the value produced by clinicians. To that end, the Commission advances a proposed policy related to the knowledge graduates must possess in key areas, including informatics, data analytics, genomics and value-based payment schemes. This will require new forms of faculty development and engagement between AACP members and their communities.

Adapting Leadership Styles to Reflect Generational Differences in the Academy.

The topic of adapting one's leadership style is controversial and can generate great debate. When one considers adapting one's leadership style, the question of authenticity often bubbles to the surface. This is even more compelling in the context of generational differences in our society and workforce. How can faculty members be effective if they refuse to adapt their leadership style to students' learning styles and generational characteristics? Leadership development is an ongoing focus for the American Association of Colleges of Pharmacy (AACP) to prepare faculty for roles as future leaders in higher education while a major redistribution of generations is occurring within the workforce. These generations are molded by many factors, including the economy, significant events, technology, and education. As experienced leaders, we affirm that one's leadership styles must be honed over time and adapted to reflect generational differences in academic pharmacy among colleagues, students, alumni, and stakeholders, including patients. Current and future leaders need further education and development so that their awareness of generational characteristics prepares them to adapt their leadership styles to more effectively engage and lead people of any generation.

Aligning the AACP Strategic Engagement Agenda with Key Federal Priorities in Health: Report of the 2016-17 Argus Commission.

The Argus Commission identified three major federal priorities related to health care, including the precision medicine initiative, the Cancer Moonshot and the opioid abuse epidemic. Current activities at the federal level were summarized and an analysis of activities within the profession, and academic pharmacy specifically, was prepared. The implications for pharmacy education, research and practice are compelling in all three areas. Recommendations, suggestions and two policy statements aim to optimize the attention to these priorities by the academy. Further, aligning the AACP Strategic Engagement agenda with the opportunities and threats acknowledged in the analysis is essential.

Guiding principles for student leadership development in the doctor of pharmacy program to assist administrators and faculty members in implementing or refining curricula.

OBJECTIVE: To assist administrators and faculty members in colleges and schools of pharmacy by gathering expert opinion to frame, direct, and support investments in student leadership development. METHODS: Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define doctor of pharmacy (PharmD) student leadership instruction. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes to begin the generation of student leadership development guiding principles and competencies. Statements were identified as guiding principles when they were perceived as foundational to the instructional approach. Round 2 grouped responses for agreement rating and comment. Group consensus with a statement as a guiding principle was set prospectively at 80%. Round 3 allowed rating and comment on guidelines, modified from feedback in round 2, that did not meet consensus. The principles were verified by identifying common contemporary leadership development approaches in the literature. RESULTS: Twelve guiding principles, related to concepts of leadership and educational philosophy, were defined and could be linked to contemporary leadership development thought. These guiding principles describe the motivation for teaching leadership, the fundamental precepts of student leadership development, and the core tenets for leadership instruction. CONCLUSIONS: Expert opinion gathered using a Delphi process resulted in guiding principles that help to address many of the fundamental questions that arise when implementing or refining leadership curricula. The principles identified are supported by common contemporary leadership development thought.

Competencies for student leadership development in doctor of pharmacy curricula to assist curriculum committees and leadership instructors.

OBJECTIVE: To assist curriculum committees and leadership instructors by gathering expert opinion to define student leadership development competencies for pharmacy curricula. METHODS: Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define competencies for student leadership development in pharmacy curricula. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes. Round 2 grouped responses for agreement rating and comment. Round 3 allowed rating and comment on competencies not yet meeting consensus, which was prospectively set at 80%. RESULTS: Eleven competencies attained 80% consensus or higher and were grouped into 3 areas: leadership knowledge, personal leadership commitment, and leadership skill development. Connections to contemporary leadership development literature were outlined for each competency as a means of verifying the panel's work. CONCLUSIONS: The leadership competencies will aid students in addressing: What is leadership? Who am I as a leader? What skills and abilities do I need to be effective? The competencies will help curriculum committees and leadership instructors to focus leadership development opportunities, identify learning assessments, and define program evaluation.

Preparation of faculty members and students to be citizen leaders and pharmacy advocates.

To identify characteristics and quality indicators of best practices for leadership and advocacy development in pharmacy education, a national task force on leadership development in pharmacy invited colleges and schools to complete a phone survey to characterize the courses, processes, and noteworthy practices for leadership and advocacy development at their institution. The literature was consulted to corroborate survey findings and identify additional best practices. Recommendations were derived from the survey results and literature review, as well as from the experience and expertise of task force members. Fifty-four institutions provided information about lecture-based and experiential curricular and noncurricular components of leadership and advocacy development. Successful programs have a supportive institutional culture, faculty and alumni role models, administrative and/or financial support, and a cocurricular thread of activities. Leadership and advocacy development for student pharmacists is increasingly important. The recommendations and suggestions provided can facilitate leadership and advocacy development at other colleges and schools of pharmacy.

Planning and implementation of a student-led immunization clinic.

Students and faculty planned and implemented a pharmacist-led influenza clinic on election day. A needs assessment was conducted, and a core team was convened for planning and reaching out to health departments. Stakeholders helped to identify polling sites and obtain sponsorship for vaccinations. Standing orders and a protocol were considered and university legal counsel addressed potential liability issues. Volunteers were trained, and the event was promoted through media outlets. This pharmacist-led immunization clinic provided 153 vaccinations; 42 individuals received an influenza vaccination for the first time. Over 30 students and faculty members were involved in the clinic. Lessons learned, including challenges, opportunities, and practical recommendations, are provided for students and faculty pharmacists who wish to conduct similar programs.