Personality and Academic Performance During Years Two and Three of a Doctor of Pharmacy Curriculum.

OBJECTIVE: To evaluate academic success among students with different dominant personality styles as determined by DiSC (dominance, influence, steadiness, and conscientiousness) assessment via a comparison of grade point average (GPA) during the 3-year didactic portion of a PharmD curriculum. METHODS: This was a prospective evaluation of students admitted to the PharmD program as part of the graduating classes of 2019-2022 who provided written informed consent, completed an online DiSC assessment, and forwarded their personality style results to study investigators. Participant demographics were collected upon enrollment and individual course grades, semester, and cumulative GPA, and any academic standards penalties imposed were collected at the end of each semester. RESULTS: The overall participation rate for the student cohort studied was 96%. No significant differences were seen when evaluating the primary objective by comparing GPA of each of the 4 individual dominant personality styles. However, significant differences were found when evaluating the secondary objective comparing conscientiousness vs all other dominant personality styles regarding both individual semester and cumulative GPA. Students with conscientiousness as a dominant personality style also had significantly higher pharmacotherapeutics-focused systems-based therapy cumulative GPA during the second and third years of the PharmD didactic curriculum. CONCLUSION: Students with a dominant personality style of conscientiousness on DiSC assessment performed significantly better within the more clinically focused systems-based therapy courses in a PharmD curriculum. This ultimately culminated in higher cumulative GPA at the end of both the second and third professional years in those with a dominant personality style of conscientiousness.

Student Personality Style and First-Year Academic Performance in a Doctor of Pharmacy Program.

Objective. To evaluate whether the personality styles of Doctor of Pharmacy (PharmD) students as determined by the DiSC assessment are associated with students' cumulative grade point average (GPA) or with academic penalties imposed in the first year of a PharmD program. Methods. All incoming PharmD students that provided informed consent and completed the DiSC personality assessment were included in the study. Participants provided demographic data and forwarded their electronic DiSC assessment results to study investigators upon completion. Relevant academic data were collected at the end of each semester. Results. The overall response rate for the classes of 2019-2022 was 95.6%. No significant associations were found when comparing personality styles as defined by the DiSC assessment and cumulative GPA at the end of the first year. Additionally, no associations were noted when comparing students' personality style and semester GPA or academic penalties received. Conclusion. Understanding factors that contribute to students' academic success can aid in early identification of students who are likely to succeed and of students who may benefit from early academic intervention. While no significant associations were found in the first-year of the curriculum, continued evaluation will be conducted to determine the impact of personality style on students' overall academic performance beyond the first year of the PharmD curriculum.

Crushing deutetrabenazine for treatment of tardive dyskinesia in a patient with severe orofacial symptoms: A case report.

PURPOSE: Tardive dyskinesia (TD) is a hyperkinetic movement disorder that results from exposure to dopamine receptor antagonists and/or first- and second-generation antipsychotics. While cessation of the offending agent(s) through early detection is recommended, TD symptoms may be irreversible and require further treatment. Deutetrabenazine is approved by the Food and Drug Administration for treatment of persistent TD. Irreversible orofacial dyskinesia, a common affliction in TD, can progress to severe oropharyngeal dysphagia requiring alternate means of nutrition and medication delivery. Enteral administration of crushed deutetrabenazine has not been studied, and its use to treat TD in patients who cannot take medications by mouth has not been reported previously. SUMMARY: A 38-year-old female patient with a history of bipolar I disorder and TD secondary to atypical antipsychotic exposure developed worsening athetosis, hyperkinesia, and severe orofacial dyskinesia after initiation of ziprasidone. The patient had no improvement after discontinuation of atypical antipsychotics and required percutaneous endoscopic gastrostomy (PEG) placement for nutrition due to persistent aspiration and inability to tolerate oral nutrition. Despite a lack of information regarding administration of crushed deutetrabenazine tablets via PEG, that form of therapy was initiated and resulted in improvement of TD symptoms without noticeable adverse effects. CONCLUSION: TD can result in significant orofacial dyskinesia with impaired delivery of needed medications and nutrition. We describe a case in which a patient with severe TD and orofacial dyskinesia experienced improvement of symptoms with use of crushed deutetrabenazine. Larger studies to further evaluate use of crushed deutetrabenazine for treatment of TD are needed.

Antibiotic de-escalation on internal medicine services with rounding pharmacists compared to services without.

Background Antimicrobial stewardship programs ensure antibiotic therapy is used appropriately and includes de-escalation when clinical status or culture data indicates broad-spectrum agents are no longer needed. Although the impact of infectious diseases clinical pharmacists has been well documented, there is limited research evaluating the impact of adult internal medicine clinical pharmacists on broad-spectrum antibiotic de-escalation while rounding on internal medicine teams. Objective To determine if broad-spectrum antibiotics were de-escalated more regularly and more rapidly in patients on internal medicine services with a rounding pharmacist at the bedside compared to internal medicine services without rounding pharmacists. Setting A single 700 bed academic medical center in the United States of America. Method This was a prospective observational cohort chart review. Main outcome measure The primary endpoint was appropriate broad-spectrum antibiotic de-escalation within 72 h or upon return of culture results. Result A total of 64 patients were included in this study with 39 in the pharmacist group and 25 in the no pharmacist group. De-escalation occurred in 35/39 patients on services with pharmacists and in 13/25 patients on services without pharmacists (p = 0.001). In terms of mean days of broad-spectrum antibiotic therapy, services with rounding pharmacists saw patients on Methicillin-resistant Staphylococcus aureus coverage for an average of 2.12 days of their duration of therapy compared to 2.8 days in those without pharmacists (p = 0.821). Services with rounding pharmacists saw patients on Pseudomonas aeruginosa coverage for 2 days of their length of stay compared to 3 days in those without pharmacists (0.398). Conclusion This data shows that broad-spectrum antibiotics were de-escalated more frequently on medicine services with rounding pharmacists compared to services without pharmacists.

The perceived value of clinical pharmacy service provision by pharmacists and physicians: an initial assessment of family medicine and internal medicine providers.

BACKGROUND: Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. OBJECTIVES: The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists. The secondary objective was to evaluate perceived differences of clinical pharmacist benefit between IM and FM physicians. METHODS: An eight-item questionnaire assessed the attitudes and beliefs of pharmacists and physicians regarding the value of clinical pharmacy services. Surveys were emailed and participants marked their responses using a 7-point Likert scale for each item. Demographic data and overall comments were collected from each participant. KEY FINDINGS: Overall, 167 surveys were completed. When comparing cumulative physician and pharmacist responses, none of the eight questions showed significant differences. Statistically significant differences were noted when comparing IM and FM clinical pharmacists on five of the eight survey items; for each of these items, FM pharmacists had more favourable perceptions than their IM counterparts. No statistically significant differences were noted when comparing responses of IM and FM physicians. CONCLUSIONS: This study found that FM pharmacists perceived a greater benefit regarding participation in inpatient acute care rounds when compared to their IM pharmacist counterparts. Future studies are necessary to determine if other medical specialties' perceptions of clinical pharmacy provision differ from our findings and to evaluate the rationale behind specific attitudes and behaviours.