Barriers to Medication Error Reporting in a federally qualified health center (Barriers to MEET in a FQHC).

Barriers to medication error reporting in inpatient settings and primary care clinics are well known and can be categorized as psychological, logistical, knowledge, and workplace. These barriers have not been explored well at Federally Qualified Health Centers (FQHC) where limited pharmacy services may exist. METHODS: This prospective, cross-sectional study surveyed 161 medical professionals at a large FQHC clinic with a small pharmacy team to explore their understanding of medication error categories and the influence of barriers to medication error reporting on their decision to report. RESULTS: Thirty-six (22.4%) respondents completed the survey. Nearly 40% of respondents would not report a near miss error and were influenced by workplace/environmental barriers significantly more than those who would report. Regardless of reporting experience or patient-care role, assessed barrier categories influence the decision to report similarly. CONCLUSION: Near miss medication errors are inconsistently reported. Efforts to improve reporting should emphasize addressing workplace/environmental barriers.

Future leaders in pharmacy (FLIP): Student perceptions of leadership development within pharmacy school.

INTRODUCTION: This study evaluated the perceptions of student pharmacists in their final year regarding leadership development and feelings of preparedness to assume their first leadership role after graduation. METHODS: This research was conducted using an anonymous, researcher developed, online instrument distributed to 21 institutions across the United States for students in their final semester. Data collected included demographics, the availability/benefit of leadership development activities, and perceptions of leadership skills a pharmacist needs. Student pharmacists' perceptions of their own leadership development and feelings of preparedness to be a leader upon graduation were also analyzed using descriptive statistics. RESULTS: Seventy-two percent of respondents agreed or strongly agreed that they felt prepared to assume their first leadership role after graduation. Students agreed (91.4%) that their school/college of pharmacy (S/COP) offered enough leadership development opportunities; however, common opportunities were not always identified as the most beneficial. Those most beneficial to student pharmacists' growth were in extracurriculars and experiential learning. Least beneficial were advocacy related activities and self-reflection. CONCLUSIONS: The majority of respondents felt they were prepared to be a leader in their first professional role. Student pharmacists did not perceive certain common activities related to advocacy and self-reflection as beneficial to their growth. S/COPs should explore strategies to improve such leadership development opportunities.

Are COVID-19 age-mortality curves for 2020 flatter in developing countries? Evidence from a cross-sectional observational study of population-level official death counts and excess deaths estimates.

OBJECTIVES: Previous studies have found a pattern of flatter COVID-19 age-mortality curves among low-income and middle-income countries (LMICs) using only official COVID-19 death counts. This study examines this question by comparing the age gradient of COVID-19 mortality in a broad set of countries using both official COVID-19 death counts and excess mortality estimates for 2020. DESIGN: This observational study uses official COVID-19 death counts for 76 countries and excess death estimates for 42 countries. A standardised population analysis was conducted to assess the extent to which variation across countries in the age distribution of COVID-19 deaths was driven by variation in the population age distribution. SETTING AND PRIMARY OUTCOMES: Officially reported COVID-19 deaths and excess deaths for 2020 for all countries where such data were available in the COVerAGE database and the short-term mortality fluctuations harmonised data series, respectively. RESULTS: A higher share of pandemic-related deaths in 2020 occurred at younger ages in middle-income countries compared with high-income countries. People under age 65 years constituted on average (1) 10% of official deaths and 11 % of excess deaths in high-income countries, (2) 34% of official deaths and 33% of excess deaths in upper-middle-income countries, and (3) 54% of official deaths in LMICs. These contrasting profiles are due only in part to differences in population age structure. CONCLUSIONS: These findings are driven by some combination of variation in age patterns of infection rates and infection fatality rates. They indicate that COVID-19 is not just a danger to older people in developing countries, where a large share of victims are people of working age, who are caregivers and breadwinners for their families.

Exploring strategies to increase college students' motivation to receive their annual influenza vaccine.

OBJECTIVE: To evaluate college students' awareness of an educational initiative to increase campus influenza vaccination rates and strategies to improve it. PARTICIPANTS: Students attending a large public comprehensive university. METHODS: An investigator-developed, online survey evaluated awareness of the initiative, the students' perception of incentives, and other motivations to receive seasonal influenza vaccine. RESULTS: The vaccination rate was 43%, despite low awareness of the initiative (28%). Awareness was significantly higher among vaccinated students (p = 0.0013). Having knowledge that appointments to receive vaccine were not needed increased the motivation of vaccinated students more than unvaccinated students (p = 0.0001). Personal influencers increased motivation of vaccinated students only when they were aware of the initiative (p = 0.04). Tangible incentives did not motivate students. CONCLUSIONS: Campus vaccination rates increased despite low initiative awareness. Improvements to the initiative should include strategies to increase emphasis on vaccination program conveniences like accessibility and perhaps engage personal influencers more.

Development, implementation and perceived benefits of student pharmacist learning experiences in transitions of care.

BACKGROUND: Experiential education designed around transitions of care (TOC) offers student pharmacists a variety of educational activities to build their skills and confidence related to direct patient care, communication, and practice management. The purpose of this paper is to describe the development, implementation, and student perceptions of introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs) that emphasize TOC. EDUCATIONAL ACTIVITY: Sixty students (22 IPPE and 38 APPE) completed the learning experience with the oversight of two faculty members in two, separate, large community hospitals providing pharmacy led TOC services. Each educational activity was mapped to the Pharmacists' Patient Care Process, which includes guided electronic medical record review, patient case discussions, and direct patient care (i.e. medication history collection, patient education). Other aspects of the learning experience include the use of layered learning, intention/reflection dialogues, and topic discussions. Evaluation of the learning experience occurred through review of student performance data and feedback. CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY: Student performance data demonstrated an increase in the mean score between midpoint and final evaluation of all TOC specific competencies. Students expressed a positive learning experience as demonstrated by an approximately 3.8 overall rating of the learning experience on a 4-point scale for both IPPEs and APPEs. Analysis of open comments from students demonstrated the most beneficial aspects of the learning experience as interprofessional communication, patient communication, and a variety of patient care opportunities.

APPE Evaluations are Positively Associated with MMI, Pre-pharmacy GPA and Pharmacy GPA.

Objective. To determine factors associated with advanced pharmacy practice experience (APPE) performance in the pre-pharmacy and Doctor of Pharmacy (PharmD) curriculum and establish whether performance on the multiple mini interview (MMI) independently predicts APPE evaluation scores. Methods. A multi-case MMI has been used in the admissions process since 2008. Students are scored anywhere from 1 to 7 (unsatisfactory to outstanding) on each interview. Traditional factors (GPA, PCAT, etc.) are also used in the admissions determination. Pearson product-moment correlation and ordinary least squares regression were used to explore the relationships between admissions data, pharmacy GPA, and APPE evaluation scores for the graduating classes of 2011-2014. These analyses identified which factors (pharmacy GPA, PCAT, MMI score, age, gender, rurality, resident status, degree, and underrepresented minority status) related to APPE performance. Results. Students (n=432) had a mean APPE score of 4.6; a mean MMI score of 5.5; mean pharmacy GPA, PCAT and age of 3.14, 73.2, 22.6 years, respectively. Pre-pharmacy GPA and pharmacy GPA positively correlated with mean APPE scores. MMI score demonstrated positive correlations with overall APPE score; including subcategories patient care, documentation, drug information/EBM, public health, and communication. MMI scores were positively related to overall APPE scores in the multivariable regression. Variables showing negative associations with APPE scores included a pre-pharmacy GPA of <3.0 (ref= GPA >3.5) and pharmacy school GPA of >3.0 - 3.5 and GPA 2.6 - 3.0 when compared to GPAs >3.5. Conclusion. GPA (pre-pharmacy and pharmacy) and MMI positively correlate with preceptor-rated performances in the APPE year.

Pharmacogenomics of triazole antifungal agents: implications for safety, tolerability and efficacy.

INTRODUCTION: Triazole antifungal agents are prescribed to treat invasive fungal infections in neutropenic and non-neutropenic patients. These antifungal agents are substrates and inhibitors of cytochrome P450 (CYP). Genetic polymorphisms in CYP2C9, CYP2C19 and CYP3A5 can lead to large population-specific variations in drug efficacy and safety, optimal dosing, or contribute to drug interactions associated with this class. Areas covered: This manuscript reviews the pharmacogenomics (i.e. the influence of genetics on drug disposition) of triazole antifungal agents related to their CYP-mediated metabolism and summarizes their implications on triazole efficacy, safety, and tolerability. A search of English language original research, and scholarly reviews describing the pharmacogenomics of triazole antifungal agents and their impact on drug efficacy, safety, and tolerability published from 1980 to present was undertaken using PubMed. Expert opinion: Currently studies demonstrating the pharmacogenomic influences on itraconazole, posaconazole and isavuconazole are minimal and limited to their inhibitory effects on CYP3A4 in expressors of CYP3A5 variants. Conversely, there are significant pharmacogenomic considerations for voriconazole because it interacts with several polymorphic CYPs, most notably CYP2C19. Pharmacogenomics of CYP2C9 do not appear to effect fluconazole safety and efficacy. However, genetic polymorphisms may influence its drug interactions but this needs further study.

Assessing the Medication Adherence App Marketplace From the Health Professional and Consumer Vantage Points.

BACKGROUND: Nonadherence produces considerable health consequences and economic burden to patients and payers. One approach to improve medication nonadherence that has gained interest in recent years is the use of smartphone adherence apps. The development of smartphone adherence apps has increased rapidly since 2012; however, literature evaluating the clinical app and effectiveness of smartphone adherence apps to improve medication adherence is generally lacking. OBJECTIVE: The aims of this study were to (1) provide an updated evaluation and comparison of medication adherence apps in the marketplace by assessing the features, functionality, and health literacy (HL) of the highest-ranking adherence apps and (2) indirectly measure the validity of our rating methodology by determining the relationship between our app evaluations and Web-based consumer ratings. METHODS: Two independent reviewers assessed the features and functionality using a 4-domain rating tool of all adherence apps identified based on developer claims. The same reviewers downloaded and tested the 100 highest-ranking apps including an additional domain for assessment of HL. Pearson product correlations were estimated between the consumer ratings and our domain and total scores. RESULTS: A total of 824 adherence apps were identified; of these, 645 unique apps were evaluated after applying exclusion criteria. The median initial score based on descriptions was 14 (max of 68; range 0-60). As a result, 100 of the highest-scoring unique apps underwent user testing. The median overall user-tested score was 31.5 (max of 73; range 0-60). The majority of the user tested the adherence apps that underwent user testing reported a consumer rating score in their respective online marketplace. The mean consumer rating was 3.93 (SD 0.84). The total user-tested score was positively correlated with consumer ratings (r=.1969, P=.04). CONCLUSIONS: More adherence apps are available in the Web-based marketplace, and the quality of these apps varies considerably. Consumer ratings are positively but weakly correlated with user-testing scores suggesting that our rating tool has some validity but that consumers and clinicians may assess adherence app quality differently.

Potential for Pharmacy-Public Health Collaborations Using Pharmacy-Based Point-of-Care Testing Services for Infectious Diseases.

CONTEXT: Health care professionals must continually identify collaborative ways to combat antibiotic resistance while improving community health and health care delivery. Clinical Laboratory Improvement Amendments of 1988 (CLIA)-waived point-of-care (POC) testing (POCT) services for infectious disease conducted in community pharmacies provide a means for pharmacists to collaborate with prescribers and/or public health officials combating antibiotic resistance while improving community health and health care delivery. OBJECTIVE: To provide a comprehensive literature review that explores the potential for pharmacists to collaborate with public health professionals and prescribers using pharmacy-based CLIA-waived POCT services for infectious diseases. DESIGN: Comprehensive literature review. SETTING: PubMed and Google Scholar were searched for manuscripts and meeting abstracts for the following key words: infectious disease, community pharmacy, rapid diagnostic tests, rapid assay, and POC tests. INTERVENTION: All relevant manuscripts and meeting abstracts utilizing POCT in community pharmacies for infectious disease were reviewed. OUTCOME MEASURE: Information regarding the most contemporary evidence regarding CLIA-waived POC infectious diseases tests for infectious diseases and their use in community pharmacies was synthesized to highlight and identify opportunities to develop future collaborations using community pharmacy-based models for such services. RESULTS: Evidence demonstrates that pharmacists in collaboration with other health care professionals can leverage their knowledge and accessibility to provide CLIA-waived POCT services for infectious diseases. Testing for influenza may augment health departments' surveillance efforts, help promote rationale antiviral use, and avoid unnecessary antimicrobial therapy. Services for human immunodeficiency virus infection raise infection status awareness, increase access to health care, and facilitate linkage to appropriate care. Testing for group A streptococcal pharyngitis may curb inappropriate outpatient antibiotic prescribing. However, variance in pharmacy practice statues and the application of CLIA across states stifle collaboration. CONCLUSION: CLIA-waived POCT services for infectious diseases are a means for pharmacists, public health professionals, and prescribers to collaboratively combat antibiotic resistance and improve community health.

Exploration of Methods Used by Pharmacy Professional Programs to Contract with Experiential Practice Sites.

Objective. To explore methods used by pharmacy programs to attract and sustain relationships with preceptors and experiential practice sites. Methods. Interviews with eight focus groups of pharmacy experiential education experts (n=35) were conducted at two national pharmacy meetings. A semi-structured interview guide was used. Focus group interviews were recorded, transcribed verbatim, and categorically coded independently by two researchers. Codes were compared, consensus was reached through discussion, and two experiential education experts assisted with interpretation of the coded data. Results. Six themes emerged consistently across focus groups: a perceived increase in preceptor compensation, intended vs actual use of payments by sites, concern over renegotiation of established compensation, costs and benefits of experiential students, territorialism, and motives. Conclusion. Fostering a culture of collaboration may counteract potentially competitive strategies to gain sites. Participants shared a common interest in providing high-quality experiential learning where sites and preceptors participated for altruistic reasons, rather than compensation.

Multiple Mini-Interview Performance Predicts Academic Difficulty in the PharmD Curriculum.

Objective. To identify admissions variable prognostics for academic difficulty in the PharmD curriculum to use for admissions determinations and early identification of at-risk students. Methods. Retrospective multivariate analysis of 2008-2012 admission data were linked with academic records to identify students with academic difficulty (ie, those with Ds, Fs, delayed progression). The influence of prepharmacy grade point average (GPA), composite Pharmacy College Admission Test (PCAT) score, multiple-mini interview (MMI) score, age, credit hours, state residence, and prior degree on academic difficulty was estimated using multivariate logistic regression. Results. Students' (n=587) prepharmacy GPA, composite PCAT score, mean MMI score, and age were 3.6, 72.0, 5.5, 22.8 (SD=4.14 years), respectively. Students having a GPA <3.25, PCAT score <60th percentile, or MMI score <4.5, were approximately 12-, 7-, and 3-times more likely, respectively, to experience academic difficulty than those with a GPA ≥ 3.75, PCAT score >90, or MMI score of 5-6. Conclusion. Using GPA, PCAT, and MMI performance can predict academic difficulty and assist in the early identification of academically at-risk PharmD students.

Assessment of medication adherence app features, functionality, and health literacy level and the creation of a searchable Web-based adherence app resource for health care professionals and patients.

OBJECTIVES: To assess the features and level of health literacy (HL) of available medication adherence apps and to create a searchable website to assist health care providers (HCP) and patients identify quality adherence apps. PRACTICE DESCRIPTION: Medication nonadherence continues to be a significant problem and leads to poor health outcomes and avoidable health care expense. The average adherence rate for chronic medications, regardless of disease state, is approximately 50% leaving significant room for improvement. PRACTICE INNOVATION: Smartphone adherence apps are a novel resource to address medication nonadherence. With widespread smartphone use and the growing number of adherence apps, both HCP and patients should be able to identify quality adherence apps to maximize potential benefits. INTERVENTIONS: Assess the features, functionality and level of HL of available adherence apps and create a searchable website to help both HCP and patients identify quality adherence apps. EVALUATION: Online marketplaces (iTunes, Google Play, Blackberry) were searched in June of 2014 to identify available adherence apps. Online descriptions were recorded and scored based on 28 author-identified features across 4 domains. The 100 highest-scoring apps were user-tested with a standardized regimen to evaluate their functionality and level of HL. RESULTS: 461 adherence apps were identified. 367 unique apps were evaluated after removing "Lite/Trial" versions. The median initial score based on descriptions was 15 (max of 68; range: 3 to 47). Only 77 apps of the top 100 highest-scoring apps completed user-testing and HL evaluations. The median overall user-testing score was 30 (max of 73; range: 16 to 55). CONCLUSION: App design, functionality, and level of HL varies widely among adherence apps. While no app is perfect, several apps scored highly across all domains. The website www.medappfinder.com is a searchable tool that helps HCP and patients identify quality apps in a crowded marketplace.

The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients.

Elderly are at high risk for hospitalization for community-acquired pneumonia (CAP), especially due to Streptococcus pneumoniae, and seasonal influenza viruses. Data suggest PPV23's influence on various CAP-related outcomes among the elderly may depend upon how many years have elapsed since they received this vaccine. PPV23's protection against invasive pneumococcal disease and CAP hospitalizations are often limited to moderately ill elderly, who are less than 75 years old, or female. PCV13 demonstrates broad protection against a variety of CAPs, but ultimately, its influence on their outcomes among the elderly may be limited by herd immunity from PCV7 use. Influenza vaccine's indirect protective effect against all-cause and non-invasive pneumococcal CAP in the elderly is difficult to ascertain. The use of both PPV23 and influenza vaccine shortens length of stay in hospitalized elderly with CAP, but whether that benefit would be realized in the presence of herd immunity is unknown.

Prior pneumococcal and influenza vaccinations and in-hospital outcomes for community-acquired pneumonia in elderly veterans.

BACKGROUND: Studies of adults hospitalized for community-acquired pneumonia (CAP) reported better outcomes associated with prior pneumococcal vaccination (PV), suggesting potential additional benefits of PV in hospitalized CAP patients. Influenza (flu) vaccination (FV) could independently/additively improve CAP outcomes in hospitalized patients. OBJECTIVE: To examine the effect of prior PV and FV on in-hospital outcomes in elderly veterans hospitalized for CAP. DESIGN: Retrospective cohort study. SETTING AND PATIENTS: A total of 6,723 elderly veterans who were admitted to Veterans Affairs hospitals for CAP between October 1, 2002 and September 30, 2003. INTERVENTION: PV in the 5 years and FV in the 1 year before admission. MEASUREMENTS: The association of prior PV and/or FV with inpatient mortality and length of stay (LOS) (primary) and risk of any bacteremia and respiratory complications (secondary) were assessed using logistic regressions and generalized linear model, controlling for patient demographic and clinical characteristics. RESULTS: Prior PV alone was not associated with shortened LOS, or reduced risk of inpatient mortality or respiratory complications. Lower risk of bacteremia was associated with prior PV (odds ratio: 0.66; 95% confidence interval [CI]: 0.48-0.90). After adjusting for patients' characteristics, risk of inpatient mortality was not statistically significantly different across the vaccination groups, but having had both PV and FV before CAP admission was associated with a 10% reduction in LOS (95% CI: 0.86-0.95) compared to having had neither vaccinations. CONCLUSION: Significant survival benefit and improved in-hospital outcomes may not be expected among CAP-hospitalized elderly patients with prior PV alone. However, having both PV and FV before CAP admission may reduce LOS.

Family Commitment and Work Characteristics among Pharmacists.

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse's family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants' mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Innovation in clinical pharmacy practice and opportunities for academic--practice partnership.

Clinical pharmacy has a rich history of advancing practice through innovation. These innovations helped to mold clinical pharmacy into a patient-centered discipline recognized for its contributions to improving medication therapy outcomes. However, innovations in clinical pharmacy practice have now waned. In our view, the growth of academic­practice partnerships could reverse this trend and stimulate innovation among the next generation of pioneering clinical pharmacists. Although collaboration facilitates innovation,academic institutions and health care systems/organizations are not taking full advantage of this opportunity. The academic­practice partnership can be optimized by making both partners accountable for the desired outcomes of their collaboration, fostering symbiotic relationships that promote value-added clinical pharmacy services and emphasizing continuous quality improvement in the delivery of these services. Optimizing academic­practice collaboration on a broader scale requires both partners to adopt a culture that provides for dedicated time to pursue innovation, establishes mechanisms to incubate ideas, recognizes where motivation and vision align, and supports the purpose of the partnership. With appropriate leadership and support, a shift in current professional education and training practices, and a commitment to cultivate future innovators, the academic­practice partnership can develop new and innovative practice advancements that will improve patient outcomes.

The need for PGY2-trained clinical pharmacy specialists.

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level.

Point-of-care testing for infectious diseases: opportunities, barriers, and considerations in community pharmacy.

OBJECTIVES To identify opportunities to perform point-of-care (POC) testing and/or screening for infectious diseases in community pharmacies, provide an overview of such tests and how they are used in current practice, discuss how the Clinical Laboratory Improvement Amendments of 1988 (CLIA) affect pharmacists performing POC testing, and identify and discuss barriers and provide recommendations for those wanting to establish POC testing for infectious diseases services in community pharmacies. DATA SOURCES PubMed and Google Scholar were searched from November 2012 through May 2013 and encompassed the years 2000 and beyond for the narrative review section of this article using the search terms rapid diagnostic tests, POC testing and infectious diseases, pharmacy services, CLIA waiver, and collaborative drug therapy management. All state boards of pharmacy in the United States were contacted and their regulatory and legislative websites accessed in 2012 and January 2013 to review relevant pharmacy practice laws. DATA SYNTHESIS POC testing for infectious diseases represents a significant opportunity to expand services in community pharmacies. Pharmacist education and training are addressing knowledge deficits in good laboratory practices and test performance and interpretation. Federal regulations do not define the qualifications for those who perform CLIA-waived tests, yet few pharmacists perform such services. Fewer than 20% of states address POC testing in their statutes and regulations governing pharmacy. CONCLUSION POC testing for infectious diseases could benefit patients and society and represents an opportunity to expand pharmacy services in community pharmacies. Existing barriers to the implementation of such services in community pharmacies, including deficits in pharmacist training and education along with state regulatory and legislative variance and vagueness in statutes governing pharmacy, are not insurmountable.

Factors associated with health-related quality of life of student pharmacists.

OBJECTIVE: To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university. METHODS: A survey instrument was administered to all student pharmacists in a PharmD program at a public university to evaluate differences and factors related to the HRQoL outcomes of first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) student pharmacists in the college. The survey instrument included attitudes and academic-related self-perception, a 12-item short form health survey, and personal information components. RESULTS: There were 304 students (68.6%) who completed the survey instrument. The average health state classification measure and mental health component scale (MCS-12) scores were significantly higher for P4 students when compared with the P1through P3 students. There was no difference observed in the physical component scale (PCS-12) scores among each of the 4 class years. Significant negative impact on HRQoL outcomes was observed in students with higher levels of confusion about how they should study (scale lack of regulation) and concern about not being negatively perceived by others (self-defeating ego orientation), while school satisfaction increased HRQoL outcomes (SF-6D, p<0.001; MCS-12, p=0.013). A greater desire to be judged capable (self-enhancing ego-orientation) and career satisfaction were positively associated with the PCS-12 scores (p<0.05). CONCLUSION: Factors associated with the HRQoL of student pharmacists were confusion regarding how to study, ego orientation, satisfaction with the chosen college of pharmacy, and career satisfaction. First-year through third-year student pharmacists had lower HRQoL as compared with P4 students and the US general population. Support programs may be helpful for students to maintain or improve their mental and overall health.