Scholarship of Drug Information and Library Sciences Instruction in North American Pharmacy Education: A Systematic Review of English-Language Research.

OBJECTIVES: This study aimed to characterize the scholarship of teaching and learning specific to drug information and library sciences (DILS) in pharmacy education and provide a comprehensive, evidence-based resource for faculty, detailing published practices for content delivery and scholarly research gaps. FINDINGS: Systematic searches of PubMed, Embase, International Pharmaceutical Abstracts, Educational Resources Information Center, Scopus, Library Literature & Information Science Full Text, and Library, Information Science & Technology Abstracts were conducted from January 1997 through early February 2022. Included studies were published in English, involved DILS content, were specific to pharmacy education, were original research, and were conducted in North America. The review excluded abstract-only records and studies that did not include learners (ie, pharmacy students and residents) as participants. Duplicate records were removed. After screening and review, 166 articles met the eligibility criteria, 60% of which (n = 100/166) were published in the last 10 years. Most studies focused on literature evaluation (45/166, 27%), fundamentals of drug information (43/166, 25%), evidence-based medicine (21/166, 13%), and resource utilization (21/166, 13%). Studied learners were mainly pharmacy students (77%), and 82% of research included authors who were pharmacists, whereas 14% included librarians. Assessment techniques used primarily focused on student perception (61/166, 37%), followed by summative assessment (46/166, 28%), other (25/166, 15%), and formative assessment (18/166, 11%). SUMMARY: This article presents a systematically identified collection of North American literature examining the education in DILS of pharmacy learners. Areas for continued research of DILS content include evaluating underrepresented educational domains (ie, systematic approach, response development and provision, literature searching, study design), using librarians more in scholarship of teaching and learning research, and using formative and summative assessments as outcomes.

A Review of Tapinarof: Novel Topical Treatment for Plaque Psoriasis in Adults.

Psoriasis is a chronic, immune-mediated, multisystem, inflammatory dermatological condition that is persistent and relapsing. Topical treatments are first line agents for mild to moderate plaque psoriasis. With proven efficacy and safety, topical corticosteroids are often used, although adverse effects and limitations for use exist. Tapinarof (Vtama®), a novel topical aryl hydrocarbon receptor modulating drug, was approved by the US Food and Drug Administration for the treatment of plaque psoriasis in adults in May 2022. A literature search of PubMed, MEDLINE, and ClinicalTrials.gov was conducted using the following keywords: tapinarof, psoriasis, GSK2894512. Articles published before January 2023 were included in this review. This review describes the preclinical and clinical studies demonstrating the efficacy and safety of tapinarof, its place in therapy, and relevance to patient care. Kalabalik-Hoganson J, Nogid A, Frey K. A review of tapinarof: novel topical treatment for plaque psoriasis in adults. J Drugs Dermatol. 2023;22(8):761-765. doi:10.36849/JDD.7481.

Focusing on cultural humility in pharmacy assessment tools.

INTRODUCTION: Many pharmacy programs have been reviewing their curricula to ensure that unconscious bias is not interwoven throughout. However, few programs have looked at their assessment tools to determine if unconscious bias exists in them. Since research on unconscious bias in assessment tools is currently limited, this study was developed to explore how race, ethnicity, age, and gender were used in multiple-choice item banks at one pharmacy program. METHODS: A total of 27 pharmacy test banks, including examinations from first-, second-, and third-year pharmacy curricula, were examined. The exams administered in the 27 courses provided 3621 questions for review and coding based on reference to race, ethnicity, age, and gender. RESULTS: Of the total 3621 exam items reviewed, 40 referenced race. Of those 40, it was determined that race was only applicable/relevant to two (5%) of the questions, linked to Whites. Gender breakdown was 56% male and 45% female, with no mention of transgender. Gender was central to 72 of the 426 questions. Age was mentioned in 381 of the questions and was central in only 46. Ethnicity was not mentioned in any of the questions. In none of the questions were these variables self-identified. CONCLUSIONS: The routine mention of race in preparation of materials such as question banks, with no specified goal, risks contributing to racial bias. The goal of all pharmacy educators is to graduate pharmacists that possess sound academic knowledge, clinical skills, and the cultural humility to provide quality care to their patients.

Call to Action: Addressing Social Determinants of Health in Pharmacy Practice.

Social determinants of health (SDOH) are conditions in which individuals are born, live, work, learn, play, and age that affect health, risks, functioning, and outcomes. SDOH are recognized barriers to care, risk factors for certain diseases, and associated with poorer health outcomes. Screening for SDOH in physician practices and hospitals is reportedly low. The accessibility of pharmacists and established relationships with patients make pharmacy settings ideal for identifying and mitigating social needs. An evaluation of the impact of SDOH on health outcomes and opportunities for pharmacists to embed screening into practice is warranted.

A Call to Action for Cultural Humility in Pharmacy Education Student Assessments.

An important topic in the conversation on the education of pharmacy students evolves around methods of pedagogy and assessment and attention to diversity and inclusion. Well-intentioned educators may introduce bias into their teachings and assessment tools by focusing on diseases with a higher rate of presentation in minorities without engaging in conversations about why these health disparities exist. When considering the content and structure of a curriculum, it is also important to review its assessment tools, with attention to cultural humility in multiple-choice examinations, case-based presentations, and even observed structured clinical examinations. Disregarding this component of the conversation may lead students to have an unconscious impression that social constructs are biological markers for a disease. Students may recall not only what they learned in a classroom setting, but often the content included in their assessments as well. By writing test items that are culturally responsible, unconscious bias can be reduced and test items can better measure the knowledge that educators intend to assess. As pharmacy educators perform programmatic reviews, attention should be directed toward unconscious bias, not only in the curricula but also in evaluation and assessment tools.

Vericiguat: A Novel Oral Soluble Guanylate Cyclase Stimulator for the Treatment of Heart Failure.

OBJECTIVE: To review the efficacy and safety of vericiguat indicated to reduce the risk of cardiovascular death and heart failure (HF) hospitalization following hospitalization or need for outpatient intravenous diuretics in adult patients with chronic symptomatic HF and ejection fraction (EF) less than 45%. DATA SOURCES: A literature search through MEDLINE with search terms MK1242, BAY 1021189, and vericiguat was conducted. Product labeling and English-language studies assessing pharmacokinetics, pharmacodynamics, efficacy, or safety of vericiguat were included. STUDY SELECTION AND DATA EXTRACTION: Preclinical and clinical studies describing the efficacy and safety of vericiguat were included. DATA SYNTHESIS: The phase 3 VICTORIA clinical trial demonstrated a lower composite primary outcome of death from cardiovascular causes or first hospitalization in the vericiguat group compared to placebo. Total hospitalizations for HF in the vericiguat group were significantly less compared to placebo. The composite secondary outcome of death from any cause or first HF hospitalization was significantly less in the vericiguat group. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: The addition of vericiguat offers a new treatment option for those in whom rehospitalization or recurrent outpatient intravenous diuretic treatment is a concern. Given high rates of nonadherence in HF patients, vericiguat represents an additional treatment option, especially for patients who do not tolerate available HF therapies. CONCLUSION: Vericiguat is a novel soluble guanylate cyclase stimulator that is safe and effective for reducing the risk of cardiovascular death and HF hospitalization in adults with symptomatic chronic HF and reduced EF.

Multicenter randomized comparative trial of Micromedex, Micromedex with Watson, or Google to answer drug information questions.

OBJECTIVE: The purpose of this study was to compare pharmacy students' ability to correctly answer drug information questions using Micromedex with Watson, Micromedex without Watson, or Google. METHODS: This multicenter randomized trial compared pharmacy student responses to drug information questions using Micromedex with Watson, Micromedex without Watson, or Google from January to March of 2020. First- to fourth-year pharmacy students at two institutions were included. The primary outcome was the number of correct answers. Secondary outcomes were the time taken to answer the questions and differences in number of correct answers by pharmacy student year and institution. RESULTS: The analysis included 162 participants: 52 students in the Micromedex group, 51 students in the Watson group, and 59 students in the Google group. There was a significant difference among groups in the total number of questions answered correctly (p=0.02). Post-hoc analysis revealed that participants in the Micromedex group answered more questions correctly than those in the Google group (p=0.015). There were no significant differences between Micromedex and Watson groups (p=0.52) or between Watson and Google groups (p=0.22). There was also no difference in time to complete the questions among groups (p=0.72). CONCLUSION: Utilizing Google did not save students time and led to more incorrect answers. These findings suggest that health care educators and health sciences librarians should further reinforce training on the appropriate use of drug information resources.

Clascoterone: A Novel Topical Androgen Receptor Inhibitor for the Treatment of Acne.

OBJECTIVE: To review the efficacy and safety of clascoterone 1% cream for the treatment of acne vulgaris in patients 12 years of age and older. DATA SOURCES: A literature search through PubMed, MEDLINE, and ClinicalTrials.gov was conducted using the following keywords: clascoterone, cream, acne, and CB-03-01. Articles published between 2004 and 2020 were included in this review. STUDY SELECTION AND DATA EXTRACTION: Preclinical and clinical studies describing the efficacy and safety of topical clascoterone cream were included. DATA SYNTHESIS: Early preclinical studies demonstrated that clascoterone exhibits local antiandrogenic effects without any systemic effects. Phase 2 and 3 trials demonstrated a statistically significant reduction in inflammatory and noninflammatory lesions and mild erythema with clascoterone use. Long-term studies confirmed the favorable safety profile of the drug in subjects for up to 9 months of use, with erythema being the most common treatment-emergent local skin reaction. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Pharmacological treatment options for acne vulgaris include topical and systemic agents. Systemic antiandrogen medications are associated with adverse effects and should be avoided in pregnancy and male patients. Clascoterone is a novel topical antiandrogen drug with no systemic adverse effects. This drug provides prescribers with an appealing treatment option for male and female patients 12 years of age and older, who are not candidates for systemic drugs because of contraindications or adverse effects or who have failed other topical therapies. CONCLUSION: Clascoterone, a novel topical androgen receptor inhibitor, is a safe and effective treatment option for patients with acne vulgaris.

Childhood Immunization and COVID-19: An Early Narrative Review.

The COVID-19 pandemic has evolved into arguably the largest global public health crisis in recent history-especially in the absence of a safe and effective vaccine or an effective anti-viral treatment. As reported, the virus seems to less commonly infect children and causing less severe symptoms among infected children. This narrative review provides an inclusive view of scientific hypotheses, logical derivation, and early analyses that substantiate or refute such conjectures. At the completion of a relatively less restrictive search of this evolving topic, 13 articles-all published in 2020, were included in this early narrative review. Directional themes arising from the identified literature imply the potential relationship between childhood vaccination and COVID-19-either based on the potential genomic and immunological protective effects of heterologous immunity, or based on observational associations of cross-immunity among vaccines and other prior endemic diseases. Our review suggests that immune response to the SARS-CoV-2 virus in children is different than in adults, resulting in differences in the levels of severity of symptoms and outcomes of the disease in different age groups. Further clinical investigations are warranted of at least three childhood vaccines: BCG, MMR, and HEP-A for their potential protective role against the SARS-CoV-2 virus.

Pre-Exposure Prophylaxis (PrEP) in the Prevention of HIV: Strategies, Target Populations and Upcoming Treatments.

Pre-exposure prophylaxis (PrEP) against HIV infection with tenofovir/emtricitabine is proven to be effective yet uptake of this preventive measure has been difficult due to several barriers such as cost, access, and misinformation. Certain subpopulations are disproportionately affected by this problem. Several methods have been developed to close the gap in care. New antiretroviral treatment strategies are being investigated for safety and efficacy in preventing HIV infection.

Insights from a capstone workshop: An investigation of soon-to-be pharmacists' readiness to provide culturally competent pharmaceutical care.

INTRODUCTION: This study investigated readiness of soon-to-be pharmacists to provide culturally sensitive patient-centered care through administration of a capstone workshop. METHODS: The workshop was delivered in 2017 and 2018 and consisted of a pre-survey, a didactic lecture followed by group discussions of Worlds Apart cases, and a post-survey. The surveys contained knowledge questions and perception statements. Results were analyzed using descriptive and inferential statistics. Group questions were aligned to constructs from Campinha-Bacote's Model of Cultural Competence. The percentage of groups with correct answers was calculated. RESULTS: Both cohorts significantly increased their knowledge by the end of the workshop (p = 0.007, 2017; p < 0.001, 2018). Significant increases in respondent agreement to perception statements were also observed post-workshop. The percent of correct group responses varied by construct within the cultural aspect, between the aspects for each year, and between years. The evaluation of overall cultural readiness yielded the lowest results. CONCLUSION: This research revealed the necessity and value of the capstone workshop. Significant improvements in meeting cultural competence standards were observed upon completion of the exercise. Alignment of group discussion questions to Campinha-Bacote's Model of Cultural Competence constructs was useful in augmentation of assessment armamentarium as it unearthed gaps in cultural competences of pharmacy graduates. Further multi-institutional research aimed to generalize the findings of this study is highly desired.

Procalcitonin in special patient populations: Guidance for antimicrobial therapy.

PURPOSE: Procalcitonin (PCT) is an endogenous hormone that increases reliably in response to bacterial infection, and measurement of serum PCT levels is recommended to help guide antimicrobial therapy. The utility of PCT assessment in special patient populations (eg, patients with renal dysfunction, cardiac compromise, or immunocompromised states and those undergoing acute care surgery) is less clear. The evidence for PCT-guided antimicrobial therapy in special populations is reviewed. SUMMARY: In the presence of bacterial infection, nonneuroendocrine PCT is produced in response to bacterial toxins and inflammatory cytokines, resulting in markedly elevated levels of serum PCT. Cytokine induction in nonbacterial inflammatory processes activated by acute care surgery may alter the interpretation of PCT levels. The reliability of PCT assessment has also been questioned in patients with renal dysfunction, cardiac compromise, or immunosuppression. In many special populations, serum PCT may be elevated at baseline and increase further in the presence of infection; thus, higher thresholds for diagnosing infection or de-escalating therapy should be considered, although the optimal threshold to use in a specific population is unclear. Procalcitonin-guided antimicrobial therapy may be recommended in certain clinical situations. CONCLUSION: Procalcitonin may be a reliable marker of infection even in special populations with baseline elevations in serum PCT. However, due to unclear threshold values and the limited inclusion of special populations in relevant clinical trials, PCT levels should be considered along with clinical criteria, and antibiotics should never be initiated or withheld based on PCT values alone. Procalcitonin measurement may have a role in guiding de-escalation of antibiotic therapy in special populations; however, the clinician should be aware of disease states and concomitant therapies that may affect interpretation of results.