Community pharmacist collaboration with a primary care clinic to improve diabetes care.

OBJECTIVE: The objective of this pilot project was to evaluate a model of care that consisted of a community pharmacist and registered nurse collaborating in a primary care clinic to improve guideline-directed therapy. SETTING: A regional grocery chain pharmacy partnered with a primary care clinic associated with a large academic medical center. PRACTICE INNOVATION: A community pharmacist was granted access to the electronic medical record and paired with a registered nurse care manager at a primary care office. EVALUATION: Forty-one patients were included and assessed for diabetes guidelines directed care. The pharmacist completed chart reviews and sent recommendations to a registered nurse care manager and the patient's primary care provider. The nurse facilitated lab orders, discussed the pharmacist's recommendations, and scheduled appointments as necessary for the patient. RESULTS: This intervention resulted in initial improvement in glycemic control followed by a decline at 3 months. Surrogate markers for prevention of micro- and macrovascular complications improved at 3 months. Optimization of medications for glycemic control and complication prevention also improved. CONCLUSION: The collaboration between a community pharmacist and primary care clinic led to improved adherence to guideline-directed diabetes care. Access to electronic medical records was necessary for pharmacist recommendations and communication. Pharmacist involvement in clinical recommendations at a primary care clinic in addition to standard duties at a community pharmacy may further improve care for patients with diabetes and requires further evaluation.

An Introductory Over-the-Counter Simulation for First-Year Pharmacy Students Using a Virtual Pharmacy.

Objective. First-year pharmacy students at two institutions were required to complete a virtual over-the-counter (OTC) simulation during their community pharmacy practice skills laboratory course. The simulation was designed to introduce first-year pharmacy students to OTC product selection and consultation prior to didactic coursework and community introductory pharmacy practice experiences. The objective of this study was to assess the impact of the OTC simulation on students' knowledge and confidence of OTC medications and overall perceptions of the activity.Methods. Patient simulation cases in the virtual community pharmacy setting were developed and delivered to students using the MyDispense platform. Students concurrently completed a Google Form that provided directions for the virtual activity, including a combination of didactic and active learning strategies within the online platform. Student surveys assessed knowledge and confidence before and after the activity, with perceptions added to the postsurvey.Results. Total knowledge scores for the 142 students from two institutions who completed both the pre- and postsurvey significantly improved and, when assessed individually, improved for seven out of 10 individual knowledge questions. All five confidence statements significantly increased after students completed the OTC simulation. Student perceptions were overall very positive.Conclusion. Introduction of OTC counseling processes to first-year pharmacy students through a virtual pharmacy simulation resulted in increased student knowledge and confidence in providing OTC recommendations. Students perceived the activity favorably.

The use of aloe vera in cancer radiation: An updated comprehensive review.

INTRODUCTION: Many cancer patients require radiation therapy and often experience adverse effects including erythema, itching, and pain. Aloe vera has been studied for its potential use in the prevention and treatment of radiation related adverse effects as it possesses a variety of properties and is considered an antioxidant and anti-inflammatory agent. Multiple controlled trials have been performed in order to evaluate the efficacy of aloe vera for the prevention and treatment of radiation side effects. Previous systematic reviews have examined the use of aloe vera for radiation-induced skin reactions, however updated literature now includes the use of aloe vera in proctitis. OBJECTIVES: The aim of this comprehensive review is to summarize and evaluate the use of aloe vera in patients who have undergone radiation therapy for the treatment of cancer. RESULTS: Aloe vera may not be effective for prophylaxis or treatment of radiation adverse effects in breast cancer patients. Moderate efficacy was seen when aloe vera was used in combination with mild soap versus soap as monotherapy for the treatment of radiation skin reactions. Aloe vera may be effective when cumulative radiation doses are greater than 2,700 cGy and for acute radiation proctitis. CONCLUSIONS: There is contradictory evidence for the use of aloe vera in the setting of radiation in regards to its efficacy in the prevention and treatment of radiation-induced adverse effects.

The Report of the 2016-2017 Professional Affairs Standing Committee: Formally Embracing and Engaging Preceptors in the Academy - The Time Has Come.

The 2016-2017 AACP Professional Affairs Committee (PAC) was charged to examine strategies to include adjunct/affiliate preceptors as AACP members and to determine the value proposition of AACP membership for this group of educators. The PAC defined adjunct/affiliate preceptors as preceptors who are neither full-time employees nor have a primary employment commitment (≥50% of the preceptor's work salary) at a school/college of pharmacy. Specific charges to the PAC included: recommend an approach to increase the number of adjunct/affiliate preceptors as AACP members, examine AACP membership from an adjunct/affiliate preceptor value perspective, and prepare a concise summary of available literature describing value-added contributions of student pharmacists and pharmacy preceptors to pharmacy practice models, interprofessional education (IPE) and interprofessional practice (IPP). The summary of the plan developed by the PAC to address the charges is presented in the following report, which includes three sections: the value proposition of AACP membership for adjunct/affiliate preceptors, expansion of the presence of adjunct/affiliate preceptors in AACP, and the value of student pharmacists in experiential education settings. The value proposition of AACP membership for adjunct/affiliate preceptors section describes results of surveys and focus groups conducted by the PAC. The PAC surveyed experiential education directors at schools/colleges of pharmacy, adjunct/affiliate preceptors (from a request via the experiential education directors), and new pharmacy practice faculty members in order to determine current resources available for adjunct/affiliate preceptor development, as well as explore potential resources AACP could provide for adjunct/affiliate preceptor development. Focus groups were held with adjunct/affiliate preceptors and experiential education faculty/staff to explore some of the results and concepts generated from the surveys. The PAC developed three recommendations for AACP as a result of the surveys and focus groups. The report also describes various factors that should be considered by AACP in developing a membership category for adjunct/affiliate preceptors, including potential membership models, establishment of an advisory board, and collaboration with other stakeholder groups. The final section of the report provides an executive summary and detailed table, which summarizes available literature on the value of student pharmacists in experiential education. The brief literature review reinforces that there are many different practice settings where student pharmacists add value to patient care and the practice site. This information is significant for experiential education faculty/staff, as well as adjunct/affiliate preceptors, and serves as an example of best practices which document the value experiential education provides to patient care and practice sites. The final section of the report provides a policy statement that was adopted by the 2017 AACP House of Delegates and one suggestion to schools/colleges of pharmacy. The report concludes with a call to action regarding the formal involvement of adjunct/affiliate preceptors by AACP and the academy.