A survey of South Carolina pharmacists' readiness to prescribe human immunodeficiency virus pre-exposure prophylaxis.

Introduction: HIV pre-exposure prophylaxis (PrEP) is largely underutilized in the Southern United States. Given their community presence, pharmacists are well positioned to provide PrEP within rural, Southern regions. However, pharmacists' readiness to prescribe PrEP in these communities remains unknown. Objective: To determine the perceived feasibility and acceptability of prescribing PrEP by pharmacists in South Carolina (SC). Methods: We distributed a 43-question online descriptive survey through the University of SC Kennedy Pharmacy Innovation Center's listerv of licensed SC pharmacists. We assessed pharmacists' comfort, knowledge, and readiness to provide PrEP. Results: A total of 150 pharmacists responded to the survey. The majority were White (73%, n=110), female (62%, n=93), and non-Hispanic (83%, n=125). Pharmacists practiced in retail (25%, n=37), hospital (22%, n=33), independent (17%, n=25), community (13%, n=19), specialty (6%, n=9), and academic settings (3%, n=4); 11% (n=17) practiced in rural locales. Pharmacists viewed PrEP as both effective (97%, n=122/125) and beneficial (74% n=97/131) for their clients. Many pharmacists reported being ready (60% n=79/130) and willing (86% n=111/129) to prescribe PrEP, although over half (62% n=73/118) cited lack of PrEP knowledge as a barrier. Pharmacists described pharmacies as an appropriate location to prescribe PrEP (72% n=97/134). Conclusions: Most SC pharmacists surveyed considered PrEP to be effective and beneficial for individuals who frequent their pharmacy and are willing to prescribe this therapy if statewide statutes allow. Many felt that pharmacies are an appropriate location to prescribe PrEP but lack a complete understanding of required protocols to manage these patients. Further investigation into facilitators and barriers of pharmacy-driven PrEP are needed to enhance utilization within communities.

Assessment of a Faculty and Preceptor Development Intervention to Foster Self-Awareness and Self-Confidence.

Objective. To conduct and evaluate the outcomes of a pharmacy faculty and preceptor development program to foster self-awareness and self-confidence. Methods. A faculty and preceptor development intervention was implemented in a multi-campus college of pharmacy to promote and assess for improvements in self-awareness and self-confidence. Faculty members and preceptors were surveyed regarding their self-perceptions and confidence at baseline and following an intervention in which they completed the Birkman Method self-assessment and participated in a training program with an active-learning component. A longitudinal follow-up survey was conducted to assess the long-term impacts of the intervention. Results. Faculty members and preceptors experienced significant improvements in self-awareness from baseline following the development intervention. They also experienced increases in self-confidence related to coaching. A survey evaluating the longitudinal impact of the intervention indicated a positive association between receiving a sufficient level of Birkman Method training and improved ability of both faculty members and preceptors to manage professional relationships. Similarly, a positive association was identified between the sufficiency of training and preceptors' confidence in their ability to manage personal relationships and stress following the intervention. Conclusion. Faculty members and preceptors teach students to be more self-aware and confident, yet both groups often need to grow in these areas themselves. A faculty and preceptor development intervention using the Birkman Method self-assessment is one approach to facilitating growth in these educators' self-awareness and self-confidence.

A sustainable business model for comprehensive medication management in a patient-centered medical home.

OBJECTIVES: To develop a sustainable business model for pharmacist-provided comprehensive medication management services in a patient-centered medical home. Secondarily, to evaluate the impact that the pharmacist had on clinical (glycosylated hemoglobin [A1C], low-density lipoprotein [LDL], and blood pressure) and economic (physician productivity and cost avoidance) outcomes. PRACTICE DESCRIPTION: This pilot project took place at the Palmetto Primary Care Physicians Trident office in North Charleston, South Carolina, from October 2013 to September 2014. At the time, the practice employed 5 physicians and 2 nurse practitioners and served more than 20,000 patients. PRACTICE INNOVATION: The pharmacist targeted patients with diabetes, lipid disorders, hypertension, congestive heart failure, obesity, polypharmacy, and treatment regimen nonadherence for his comprehensive medication management services. The pharmacist was available for immediate consultation or referrals by appointment 5 days per week. Services provided by the pharmacist were billed as medication therapy management or "incident to" physician evaluation and management services codes. EVALUATION: Number of patients seen per day, revenue collected from services rendered by the pharmacist, physician productivity and payment, cost avoidance, and health quality metrics (A1C, LDL, and blood pressure) were measured to determine the financial sustainability and clinical impact of the project. RESULTS AND IMPLICATIONS: The pharmacist was able to see an average of 11 patients per day, which was 72% of his capacity. The practice collected about $7400 per month for services rendered by the pharmacist. The average daily payment for services rendered by the physicians in the practice increased by 20.6%. More than 70% of uncontrolled patients had an improvement in clinical outcomes, such as A1C, LDL, and blood pressure. CONCLUSION: This project demonstrates the sustainable business model for embedding a pharmacist into a patient-centered medical home.

Massive open online courses in U.S. healthcare education: Practical considerations and lessons learned from implementation.

BACKGROUND AND PURPOSE: Massive Open Online Courses (MOOCs) offer an innovative approach to pharmacy education and are expected to challenge traditional pedagogy and foundational knowledge acquisition practices. A survey of the literature reveals no current publications describing implementation of MOOCs in pharmacy education and limited information about MOOC implementation in other healthcare disciplines in the United States. EDUCATIONAL ACTIVITY AND SETTING: A few colleges of pharmacy (COPs) and other health professions' educational programs have recently started offering MOOCs. FINDINGS: Herein we provide an overview of MOOCs and describe the early implementation stages of MOOCs being conducted at two COPs, an interprofessional MOOC, and a variety of MOOCs offered by a public health program. This overview and the four case studies on MOOC implementation in healthcare education provide practical information about course development, descriptions of selected course engagement outcomes, insight into lessons learned by the institutions, and practical considerations for development of future MOOCs. DISCUSSION: MOOCs prompt diversification of models of teaching and learning, transformation of pedagogical frameworks, and innovation in the scholarship of teaching and learning. SUMMARY: MOOCs offer exciting opportunities to distribute knowledge on a massive and global scale to a diverse population of learners.

Community pharmacist-delivered Medicare Annual Wellness Visits within a family medicine practice.

OBJECTIVE: To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). SETTING: Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, SC, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. PRACTICE INNOVATION: A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice. EVALUATION: The pharmacy team contacted each office and obtained information about the physician practices and their willingness to participate in the program. Two financial models were created and evaluated to determine budget implications. RESULTS: Many patients were seen at the physician offices; they were eligible for AWV, but had not received them. Meetings were scheduled with 3 of the 6 offices; however, none of the offices moved forward with the proposed program. CONCLUSION: Integrating a pharmacist into the AWV role may be profitable to both the pharmacy and the medical office with persistence and time to have a successful collaboration.

What are the latest recommendations for pneumococcal vaccines?

The Advisory Committee on Immunization Practices recently updated its guidelines on pneumococcal pneumonia vaccines for older adults. The new guidelines recommend that patients age 65 years and older receive the PCV13 vaccine in a series along with the PPSV23 vaccine. This article summarizes these changes along with a review of when to vaccinate other key adult populations.

Impact of the Birkman Method Assessment on Pharmacy Student Self-Confidence, Self-Perceptions, and Self-Awareness.

Objective. To identify changes in pharmacy student self-confidence, self-perceptions, and self-awareness after completing the Birkman Method assessment and training program. Methods. Survey tools were developed to evaluate students at baseline and following the co-curricular Birkman Method program. Following IRB approval, students participating in the Birkman Method program were recruited for enrollment in this survey-based study. Results. Student self-confidence was high at baseline (mean=4 out of 5) and did not significantly change after Birkman Method testing and training. Self-perceptions regarding usual and stressed communication style and behaviors and behavioral needs under stress changed significantly after Birkman Method testing and training for these endpoints. The Birkman Method intervention resulted in a significant improvement in self-awareness, as indicated by a mean self-perception accuracy score increase of 1.6 points (95% CI: 1.3-1.9). Conclusions. A Birkman Method assessment and training program is an effective self-assessment tool for students, and may be useful for accomplishing Accreditation Council for Pharmacy Education (ACPE) 2016 Standard 4 affective domain elements, particularly self-awareness.