Managed Care Pharmacy Research on Inappropriate Opioid Use Interventions.

DISCLOSURES: No funding contributed to the writing of this commentary. The authors have nothing to disclose.

Trends in Research and Graduate Affairs in Schools and Colleges of Pharmacy, Part 3: Underrepresented Minorities.

Objective. To examine the landscape of research and graduate affairs nationally and within schools and colleges of pharmacy. This report, part 3 of a three-part series, focuses on underrepresented minority (URM) faculty members and students, with a focus on recruitment and retention. Findings. There has been a substantial increase in recruitment of Asian faculty members by schools of pharmacy over the last 10 years, but there has been only minimal changes in the numbers of Black and Hispanic faculty numbers, which reflects the challenges in recruitment and retention of URM faculty members. Consistently low enrollment of Black and Hispanic graduate students over a 10-year period demonstrates that pharmacy schools could improve their stated diversity initiatives and goals. Despite an overall increase in PhDs conferred over the last 10 years, international students continue to receive the majority of degrees conferred. Graduation rates of Black and Hispanic students have remained low, suggesting that continued and sustained efforts are needed to recruit, support, and graduate URM students. Summary. Pharmacy schools must make a focused investment and effort toward increasing the diversity of their graduate enrollees by modeling their recruitment, enrollment, and retention strategies after national programs and best practices. Because there is a direct link between the number of faculty role models and the recruitment of students, pharmacy schools must enhance the recruitment, retention, and success of URM faculty members. Further, pharmacy schools should provide inclusion training to encourage better communication with URM advisees.

Trends in Research and Graduate Affairs in Schools and Colleges of Pharmacy, Part 2: Students.

Objective. To examine the landscape of research and graduate affairs nationally and within schools and colleges of pharmacy. This report, part 2 of a three-part series, focuses on characteristics of full-time PhD enrollees and graduates in schools and colleges of pharmacy, and career planning and preparation in graduate programs. Findings. Despite a 41% increase in funding awarded by the National Institutes of Health (NIH) to schools and colleges of pharmacy over the last 10 years, NIH funding per principal investigator only increased 14% and graduate student enrollment increased just 6% during the period. However, there was a 15% increase in PhD degrees conferred in the 10-year period, which is evidence that degree completion time decreased. The number of female graduates from pharmacy schools consistently increased, and outpaced growth in the number of male graduates by more than 10%. Most graduate programs do not include training for industry-specific skills, abilities, and experiences to better prepare graduates for nonacademic careers, although national programs have been recognized as vital to graduate student career preparation. Summary. Graduate biomedical science programs and faculty members must recognize that academia is an "alternative" career choice for their trainees, and provide job skills training to support the majority of nonacademic career choices, without compromising the rigorous training in basic biomedical disciplines.

Trends in Research and Graduate Programs in Schools and Colleges of Pharmacy, Part 1: Programs.

Objective. To examine the landscape of research and graduate education nationally and within schools and colleges of pharmacy. This report is part 1 of a three-part series and focuses on graduate programs' research funding and science faculty composition and diversity. Findings. Between FY2008 and FY2017, the number of full-time faculty members in schools and colleges of pharmacy increased 36%. The number of pharmacy schools with National Institutes of Health (NIH) awards increased by 15%, while NIH grants per faculty principal investigator (PI) increased by 31%. However, unadjusted for inflation, the mean NIH dollar amount per-faculty member PI increased just 14% and the mean NIH dollar amount per-school declined 7%, indicating that number of funded faculty outpaced dollars available. Proportionately, the percentage of science faculty members at pharmacy schools decreased from 47% to 43%. Only 15 public, research-intensive schools and colleges of pharmacy received more than half of the combined FY2017 NIH funding and total funding, while all other public and private schools and colleges of pharmacy shared the remaining funds. Interdisciplinary programs are developing slowly, and may help to diversify and increase future funding. Proportions of tenured and tenure-track positions are declining, but biological sciences and social and administrative sciences disciplines are growing and women faculty are making significant gains in these fields and at the assistant professor rank. Summary. Research-intensive schools and colleges of pharmacy are best-positioned to lead the academy to reframe graduate education to build interdisciplinary team skills and attract more diverse funding and science faculty members.

Characterization of pharmacy practice research centers across the United States.

BACKGROUND: Schools of Pharmacy are important contributors to pharmacy practice research and several have created research centers focusing on this area. OBJECTIVES: To identify and characterize pharmacy practice research centers in the United States. METHODS: A comprehensive list of research centers was gathered using three sources: 1) websites of Schools of Pharmacy obtained from the American Association of Colleges of Pharmacy website; 2) Google; and 3) department chairs. Two independent reviewers applied the following exclusion criteria to the list: 1) no affiliation with a School of Pharmacy; 2) no focus on research; 3) not an independent unit recognized at the school or university levels; and 4) research not focused on advancing pharmacy practice. Inter-rater reliability was calculated using a prevalence-adjusted bias-adjusted kappa (PABAK). A questionnaire was developed comprising 24 questions grouped into three sections - overall structure of the center, research and educational activities - and disseminated through center directors. Descriptive statistics of survey data were obtained. RESULTS: Twenty centers across 20 different states were identified. Survey response rate was 100%. Three-quarters of centers were at public institutions and half had an advisory board. Full-time equivalents ranged from 0.2 to 21. Areas of research primarily focused on medication and disease-state management and interprofessional collaboration in the ambulatory/outpatient setting. Few centers (35%) conducted experimental studies. Despite 85% centers conducting multi-site studies, the median number of sites engaged was low (range 1-3). Seven centers received over USD 1 million in total funding since inception. A majority of centers (90%) offered educational activities for both students and professionals. CONCLUSIONS: Pharmacy practice research centers are relatively small, received low funding and few conduct multi-site experimental studies. Collaboration among centers could be a means to overcome these issues.

Outcomes of Student-Driven, Faculty-Mentored Research and Impact on Postgraduate Training and Career Selection.

Objective. To evaluate scholarly deliverables from student-driven research and explore the impact on postgraduate training placement rates, pharmacy faculty appointments and lifetime publications. Methods. A retrospective analysis of Doctor of Pharmacy graduates who conducted student research between the academic years of 2002 and 2015 was performed. Data were collected on research participation, abstracts, presentations, postgraduate training, full-time faculty appointments, and publications. Results. Of 1229 graduates, 300 participated in research during pharmacy school. Fifty-six percent (n=167) submitted at least one abstract and 68 students (23%) published their research. Research participation was associated with a significantly higher likelihood of postgraduate training and specialty training. Research participation positively affected the likelihood of faculty appointment and lifetime publication rate. Conclusion. Students who engaged in elective research had significant scholarly deliverables, including peer-reviewed publications, and were more likely to successfully match in a postgraduate position and achieve full-time academic appointments.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

BACKGROUND: Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. METHOD: Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. RESULTS: These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. CONCLUSION: Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business.

A Program to Increase Research Productivity Among Hospital Pharmacists.

OBJECTIVE: To describe the development, implementation, and outcomes of a structured research training program that aimed to increase the research productivity among hospital pharmacists. METHODS: The program was conducted in a step-wise approach and started with educational sessions on evidence-based medicine and research methods. After about a year, pharmacists were trained and mentored on how to conduct and publish a research project. We evaluated the number of research projects and publications for the pharmacy department before and after the implementation of the program. RESULTS: In the 5 years prior to implementing the program, there were a total of 4 institutional review board (IRB) proposals, 4 abstracts, and 2 manuscripts, which had pharmacists as primary investigators. After 5 years of running the program, there were 24 pharmacist-initiated research proposals submitted to the IRB, 29 abstracts, and 11 published manuscripts. The major challenges were the lack of sufficient time and the extensive training and mentorship required. CONCLUSION: Implementing a structured pharmacy research program at a hospital setting was feasible and was associated with an increase in the pharmacist-led research and publications. The success of such a program requires training and mentorship, strong commitment, and administrative support.

Using Social Cognitive Theory to Explain the Intention of Final-year Pharmacy Students to Undertake a Higher Degree in Pharmacy Practice Research.

Objective. To develop and test a conceptual model that hypothesized student intention to undertake a higher degree in pharmacy practice research (PPR) would be increased by self-efficacy, outcome expectancy, and the social influence of faculty members. Methods. Cross-sectional surveys were completed by 387 final-year pharmacy undergraduates enrolled in 2012 and 2013. Structural equation modeling was used to explore relationships between variables and intention. Results. Fit indices were good. The model explained 55% of the variation in intention. As hypothesized, faculty social influence increased self-efficacy and indirectly increased outcome expectancy and intention. Conclusion. To increase pharmacy students' orientation towards a career in PPR, faculty members could use their social influence by highlighting PPR in their teaching.

A Systematic Review of Extramural Presentations and Publications from Pharmacy Student Research Programs.

Objective. To conduct a systematic review of reports of pharmacy student research programs that describes the programs and resulting publications or presentations. Methods. To be eligible for the review, reports had to be in English and indicate that students were required to collect, analyze data, and report or present findings. The outcome variables were extramural posters/presentations and publications. Results. Database searches resulted in identification of 13 reports for 12 programs. Two-thirds were reports of projects required for a course or for graduation, and the remaining third were elective (participation was optional). Extramural posters resulted from 75% of the programs and publications from 67%. Conclusion. Although reporting on the outcomes of student research programs is limited, three-quarters of the programs indicated that extramural presentations, publications, or both resulted from student research. Additional research is needed to identify relevant outcomes of student research programs in pharmacy.

A change in behaviour: getting the balance right for research and policy.

Behaviour change interventions offer clinical pharmacists many opportunities to optimise the use of medicines. 'MINDSPACE' is a framework used by a Government-affiliated organisation in the United Kingdom to communicate an approach to changing behaviour through policy. The Theoretical Domains Framework (TDF) organises constructs of psychological theories that are most relevant to behaviour change into 14 domains. Both frameworks offer a way of identifying what drives a change in behaviour, providing a target for an intervention. This article aims to compare and contrast MINDSPACE and the TDF, and serves to inform pharmacy practitioners about the potential strengths and weaknesses of using either framework in a clinical pharmacy context. It appears that neither framework can deliver evidence-based interventions that can be developed and implemented with the pace demanded by policy and practice-based settings. A collaborative approach would ensure timely development of acceptable behaviour change interventions that are grounded in evidence.

Future methods in pharmacy practice research.

This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging information technology users on healthcare, understanding and responding to cultural and social disparities, implementing multidisciplinary initiatives to improve health care, medicines optimization and predictive risk analysis, and pharmacy as business and health care institution. Finally, implications of the trends for pharmacy practice research methods are discussed.

Improving pharmaceutical innovation by building a more comprehensive database on drug development and use.

New drugs and biologics have had a tremendous impact on the treatment of many diseases. However, available measures suggest that pharmaceutical innovation has remained relatively flat, despite substantial growth in research and development spending. We review recent literature on pharmaceutical innovation to identify limitations in measuring and assessing innovation, and we describe the framework and collaborative approach we are using to develop more comprehensive, publicly available metrics for innovation. Our research teams at the Brookings Institution and Deerfield Institute are collaborating with experts from multiple areas of drug development and regulatory review to identify and collect comprehensive data elements related to key development and regulatory characteristics for each new molecular entity approved over the past several decades in the United States and the European Union. Subsequent phases of our effort will add data on downstream product use and patient outcomes and will also include drugs that have failed or been abandoned in development. Such a database will enable researchers to better analyze the drivers of drug innovation, trends in the output of new medicines, and the effect of policy efforts designed to improve innovation.