Assessment of Postgraduate Year 2 Pharmacy Residency Programs Within the Veterans Affairs Healthcare System.

PURPOSE: Despite the increasing importance placed on advanced training for clinical pharmacists, literature describing postgraduate year 2 (PGY2) residency opportunities is limited. The objective of this study was to describe characteristics of PGY2 programs within the Veterans Affairs (VA) healthcare system. METHODS: An online survey addressing attributes of PGY2 residency programs was electronically distributed to VA residency program directors (RPDs). RESULTS: Responses from 27 (32.9%) VA PGY2 residency programs were included, representing 11 distinct PGY2 specialties. Growth and recruitment trends were similar across programs, with most programs projecting additional expansion. Staffing requirements were uncommon, but opportunities to precept and earn teaching certificates were prevalent. RPDs had been licensed pharmacists an average of 16.9 years, and most had at least 1 advanced certification. The majority of programs had a formal residency advisory committee and required preceptors to attend regular development meetings. CONCLUSION: Although multiple postgraduate specialties were represented, the requirements and opportunities available for PGY2 pharmacy residents were similar across VA facilities. By comparing residency programs in a nationally integrated health-care system, this study may promote growth of existing PGY2 programs, facilitate the establishment of new programs, and provide a framework for prospective residents to evaluate programs of interest.

Collaborative drug therapy management and comprehensive medication management-2015.

The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throughout the United States. CDTM is well suited to facilitate the delivery of comprehensive medication management (CMM) by clinical pharmacists. CMM, defined by ACCP as a core component of the standards of practice for clinical pharmacists, is designed to optimize medication-related outcomes in collaborative practice environments. New models of care delivery emphasize patient-centered, team-based care and increasingly link payment to the achievement of positive economic, clinical, and humanistic outcomes. Hence clinical pharmacists practicing under CDTM agreements or through other privileging processes are well positioned to provide CMM. The economic value of clinical pharmacists in team-based settings is well documented. However, patient access to CMM remains limited due to lack of payer recognition of the value of clinical pharmacists in collaborative care settings and current health care payment policy. Therefore, the clinical pharmacy discipline must continue to establish and expand its use of CDTM agreements and other collaborative privileging mechanisms to provide CMM. Continued growth in the provision of CMM by appropriately qualified clinical pharmacists in collaborative practice settings will enhance recognition of their positive impact on medication-related outcomes.

Characteristics of Postgraduate Year 1 Pharmacy Residency Programs at Veterans Affairs Medical Centers.

PURPOSE: Although the characteristics of pharmacy postgraduate year 1 (PGY1) residency programs have been examined among large academic medical centers, there are no identified studies comparing the attributes of individual programs in the Veterans Affairs (VA) Health Administration System. The primary objective of this study was to describe and contrast characteristics of VA PGY1 residency programs. METHODS: This was a cross-sectional survey of VA pharmacy residency programs. An online survey was distributed electronically to residency program directors of VA PGY1 residencies. RESULTS: Responses from 33 (33%) PGY1 programs were available for the analysis. Programs reported growth over the previous 2 years and expected continued expansion. There was a wide variety of learning opportunities, although experiences were customizable based on residents' interests. Notably, many programs allowed residents to seek rotations at other locations if specific experiences were not available on-site. Additionally, most programs had a mandatory staffing component and required residents to present the results of residency research projects. CONCLUSION: There is a high degree of variability among individual VA facilities with regard to the requirements and opportunities available to PGY1 pharmacy residents. This assessment is able to characterize the currently established residency programs and allows for an active comparison of programs in a nationally integrated health care system.

Prevalence of baseline lipid monitoring in patients prescribed second-generation antipsychotics during their index hospitalization: a retrospective cohort study.

BACKGROUND: Second-generation antipsychotics have been found to increase a patient's risk of dyslipidemia. Despite consensus statement recommendations for lipid monitoring, studies indicate that up to 90% of patients still do not have a baseline lipid panel prior to prescription of a second-generation antipsychotic. METHODS: This study retrospectively examined the prevalence of baseline lipid monitoring in patients prescribed second-generation antipsychotics during their index psychiatric hospitalization at Duke University Hospital between July 1, 2005, and July 1, 2010. RESULTS: Seventy patients were included in the study, with a mean age of 21.5±2.5 years. Of these patients, 22 (31.4%) had baseline lipid panels drawn during hospitalization. Lipid monitoring was statistically more frequent in males than in females (P=.01). Although not statistically significant, lipid monitoring was also more likely to occur among subjects who were African American (40%; P=.07) and with the prescription of olanzapine (50%; P=.07). About half of baseline lipid panels demonstrated either a low high-density lipoprotein or high triglycerides, indicating at least one risk factor for the metabolic syndrome. CONCLUSION: This study provides alarming evidence that, even in an academic setting with active discussions among psychiatrists regarding issues of metabolic risk and appropriate monitoring, adherence to American Psychiatric Association/American Diabetes Association consensus statement recommendations on rates of baseline lipid monitoring is disappointingly low in the absence of systems to encourage or automate best practice.