A Four-day Pharmacy Course Schedule.

OBJECTIVE: To discuss the results of implementing a 4-day student didactic course schedule. METHODS: The change from a 5-day to a 4-day course schedule was implemented in spring 2021. Students in the classes of 2023 and 2024 and faculty course coordinators were surveyed in fall 2021 regarding their experience with the new schedule format. Baseline data from fall 2020 were also collected for comparison. Quantitative data was described using frequencies, percentages, odds ratios, and 95% confidence intervals. Open-ended questions were evaluated using qualitative thematic analysis. RESULTS: Almost all students (n = 193, 97%) who responded to the course planning survey in fall 2021 wanted to continue the 4-day course schedule. Students perceived the benefits of the 4-day schedule, to include more time for studying/preparing for classes (69%), and for self-care and wellness activities (20%). Student survey responses showed increased odds of engagement outside of the class. Qualitative analysis found that students reported increased engagement and liked the improved course structure. Students disliked the longer time spent in class. Academic performance was reported as somewhat or significantly improved by 85% of respondents. Faculty (n = 31; response rate 80%) reported that the 4-day course schedule positively impacted (48%) or had no impact (42%) on their job responsibilities. Work-life balance (87%) was noted as the most positive effect from faculty respondents. CONCLUSION: A 4-day course schedule was well received by both students and faculty. Institutions may consider a similar approach to allow students the flexibility of this novel schedule so as to have more time to prepare for class and wellness activities.

Implementation of an interviewing skills workshop for pharmacy students.

BACKGROUND AND PURPOSE: To describe the implementation and effect of an interviewing skills workshop (ISW) on student confidence on various interviewing techniques. EDUCATIONAL ACTIVITY AND SETTING: A student directed ISW was offered to student pharmacists of all years within the doctor of pharmacy curriculum. There were five stations that student pharmacists rotated through every 12 min: a panel interview, group interview, teleconference interview, video conference interview, and a case station where student pharmacists were given a clinical or ethical case. Stations were staffed by faculty, alumni, and pharmacy residents. Student pharmacists completed a survey directly following the workshop to rate their confidence with the stations prior to and after the activity. Feedback on the activity was solicited from the student pharmacists and those who participated as interviewers. FINDINGS: Twenty-eight student pharmacists participated in the ISW with an 85.7% response rate to the survey (n = 24). All students reported wanting to pursue a career requiring a residency and found the ISW to be beneficial. Average student confidence improved significantly from neutral to confident. Students reported positive themes of feedback and practice while requesting more time for each session and practice with group interviews and ethical situations. Interviewers noted building positive relationships with students and other faculty members. Opportunities for improvement included timing and providing more background information about the student pharmacists. SUMMARY: A student-led ISW was found to be beneficial in improving confidence in student pharmacists. Student pharmacists' confidence increased in all types of interviews and with the clinical case.

New Drugs in the Pipeline for the Treatment of HIV: a Review.

PURPOSE OF REVIEW: The purpose of this paper is to review therapies with new mechanisms of action for the treatment of HIV that are at least in phase 2 clinical trials. RECENT FINDINGS: There are several new mechanisms of action being represented within clinical development, including histone deacetylase (HDAC) inhibitors, gene therapies, broadly neutralizing anti-HIV antibodies, immune modulation, and drugs with new mechanisms to block HIV entry. The new therapies are being developed for both as add-on therapy to existing combination antiretroviral therapy and as agents to be used during treatment interruption. The current drugs in development have had varying degrees of success in the early trials. Each of these new drugs may potentially fill a void in current antiretroviral therapy (ART) therapies, which will ultimately lead to improved outcomes in HIV-infected individuals.

Challenges in measuring antibiotic consumption.

The measurement of antibacterial consumption is important for tracking use over time, for assessing correlations between use and antibacterial resistance, and for serving as an outcome measure for antimicrobial stewardship programs. Accurate and consistent measures of use are important for meaningful inter- and intrainstitutional comparisons. The defined daily dose (DDD) and days of therapy methods are commonly used measures in the adult population; however, there is no one ideal measure of consumption that covers the breadth and depth of antibacterial prescribing. The use of the DDD and the prescribed daily dose methods, with further stratification of use by weight and age groups, aids in the evaluation of antimicrobial use in pediatric patients. Increasing availability of computerized pharmacy data should enhance the collection and analysis of data from hospitals.

Confirmed beta16 Arg/Arg polymorphism in a patient with uncontrolled asthma.

OBJECTIVE: To report a case of confirmed beta(16) Arg/Arg polymorphism (Arg/Arg) in a patient with uncontrolled asthma. CASE SUMMARY: A 49-year-old black female presented to the emergency department with acute shortness of breath with subsequent intubation. After extubation, she reported multiple hospitalizations for asthma with one prior intubation, adherence to asthma medications, and very frequent use of her short-acting beta(2)-agonist (SABA). Because of her asthma history, self-reported adherence, and race, she was tested for beta(2)-adrenoreceptor genotype, which revealed Arg/Arg. Based on these findings, beta(2)-agonists were discontinued and tiotropium (maintenance) and ipratropium (primary rescue) were initiated as part of her asthma regimen. Application of the Naranjo probability scale revealed probable causality between uncontrolled asthma in our patient and SABA use. The patient is followed in our outpatient pulmonary clinic and, at time of writing, had not been admitted to our hospital for asthma-related events. DISCUSSION: Approximately 15% of Americans with asthma are Arg/Arg, with an increased prevalence in black and Asian populations. It is hypothesized that changes in the degree of sensitivity or desensitization to the bronchodilator effect of beta(2)-agonists may occur in these individuals. Data exist, although they are conflicting, suggesting that inhaled beta(2)-agonists may worsen clinical outcomes. Trials have reported declines in peak expiratory flow rates plus increases in asthma symptoms and exacerbations when SABAs have been used regularly in patients with Arg/Arg. Studies evaluating long-acting beta(2)-agonists (LABAs) have inconsistent results. Preliminary data suggest that anticholinergics may serve as a beneficial primary rescue medication instead of beta(2)-agonists in patients with Arg/Arg. CONCLUSIONS: Clinicians should be aware of factors (eg, race and polymorphisms) that may predict unfavorable outcomes with regular SABA and possibly LABA use. Patients with poor asthma control despite adherence to asthma therapy may benefit from beta(2)-adrenoreceptor genotyping and, possibly, from anticholinergics.