Working environment for historically marginalized faculty, administrators, and librarians in pharmacy education.

INTRODUCTION: Promoting diversity among faculty, administrators, and librarians in schools and colleges of pharmacy (SCOP) would be beneficial for the recruitment and retention of students from diverse backgrounds. Graduating such diverse pharmacists could assist in reducing healthcare disparities. Promoting diversity requires a climate that is inclusive of people from all backgrounds. The goal of this study was to examine the working environment of historically marginalized faculty, administrators, and librarians within pharmacy education. METHODS: An electronic survey was administered to all faculty, administrators, and librarians listed in the American Association of Colleges of Pharmacy roster. RESULTS: Responses from 339 participants were analyzed. Twenty-seven percent of these participants either observed or personally experienced misconduct during the previous five years. When action was taken, it resulted in the cessation of the misconduct only 38% of the time. Respondents most frequently identified the following as ways to make it easier to address misconduct: support from supervisors, support from peers, and education on how to address misconduct. CONCLUSIONS: Exclusionary, intimidating, offensive, and/or hostile communication/behaviors towards historically marginalized faculty, administrators, and librarians do exist in SCOP. The academy should work towards promoting diversity, equity, and inclusion in SCOP through education and provide administrative and peer support for reporting and managing professional misconduct.

Students' Reflections on Learning Experiences in Federally Qualified Health Centers.

Introduction: Final year pharmacy students participate in advanced pharmacy practice experiences in multiple settings. Each practice setting offers different opportunities for student learning and growth. Experiences at Federally Qualified Health Centers (FQHCs) allow student pharmacists to work with patients with unique health and socioeconomic challenges. Objective: The objective of this study was to examine the impact of an ambulatory care rotation at an FQHC on pharmacy students' learning. Methods: Final year pharmacy students submitted weekly reflections about their experiences at an FQHC using the Driscoll method of reflection. They reflected on activities, examined their effects on learning and growth, and discussed the impact the experiences would have on future practice. Qualitative analysis of students' reflections was conducted to identify themes related to learning and professional growth. Results: Pharmacy students (N = 11) reflected upon a variety of topics during their rotations at an FQHC. Fifteen themes and 11 sub-themes were identified by the reviewers within 43 reflections. Reflections covered three general areas: types of experiences students participate in at an FQHC, current and future effects of those experiences on student learning or patients' health, and students' emotional reactions during the experiences. Conclusions: Student reflections demonstrated that rotation experiences contributed to their growth and learning in communication, collaboration, and empathy. Additionally, students indicated that they gained confidence and skills throughout the rotation. By identifying the meaning students attributed to their learning experiences, reflections can be used to assess rotation activities for modification or continued inclusion.

Utilization of an implementation framework to obtain provider perspectives of pharmacist-led clinical services.

BACKGROUND: Pharmacist integration into health care teams has been shown to improve patients' clinical outcomes and satisfaction with care. Medication therapy management (MTM) has been implemented in a variety of pharmacy practice settings. Pharmacist-provided medication reviews, a core element of MTM, have been shown to optimize therapeutic outcomes for patients and identify medication-related problems in a patient's current regimen. Patients receiving care at Federally Qualified Health Centers (FQHCs) often face a number of challenges, such as multiple health conditions, transportation, and medication costs. Pharmacist-provided services can play an important role in providing patient-centered care in FQHCs. Seeking stakeholder input can be valuable to ensure services will benefit both patients and providers. OBJECTIVE: The objective of this study was to obtain provider perspectives of psychological, socioeconomic, and practice-based factors to consider before implementing a pharmacist-led medication review services in an FQHC in north central Indiana. METHODS: Five nurse practitioners employed by an FQHC in north central Indiana were interviewed. Thirty-four questions within 5 general domains were developed using the Consolidated Framework for Implementation Research. Responses were manually transcribed, coded by 3 reviewers, and then summarized using thematic analysis. RESULTS: Within the 5 interviews, a total of 97 codes were identified. The 251 mentions of the 97 codes were then thematically analyzed into 16 different themes. The 5 most referenced themes were feelings (N = 36), roles (N = 28), logistics (N = 26), benefits (N = 25), and communication (N = 21). Study participants noted that team roles, communication of information about the service, team or stakeholder concerns, and logistics should all be kept in mind when designing a new service. CONCLUSION: Semistructured interviews with providers at an FQHC in north central Indiana revealed multiple factors to consider before implementing a new pharmacist-led service in the clinic. Using a systematic approach to seek provider input can be beneficial in the design and implementation of pharmacist-led services.

Patient education interventions for prescription opioids: A systematic review.

OBJECTIVE: The objective of this systematic review is to evaluate the impact of prescription opioid-related education provided to a patient by a health care provider on patient outcomes. DATA SOURCES: The databases searched were PubMed, Cumulative Index of Nursing and Allied Health Literature (EBSCO), Academic Search Premier (EBSCO), Health Source: Nursing/Academic Edition (EBSCO), and International Pharmaceutical Abstracts (OVID). STUDY SELECTION: Studies were included if they were in English, peer-reviewed, and published between 1996 and October 22, 2018. Patient educational approaches initiated by health care providers for opioid medications in adults older than 18 years of age were evaluated. Studies were excluded if the full articles were unavailable or duplicates, or if they involved studies that did not explore provider-initiated patient educational interventions targeting opioid medications. Studies taking place outside the United States were excluded, as well. DATA EXTRACTION: Titles and abstracts of 4863 manuscripts were screened for inclusion in this review. Of these, 4794 were removed because they did not meet the inclusion criteria. The full texts of the remaining 69 documents were evaluated for inclusion. RESULTS: Ten articles were identified for inclusion in this review. Studies explored the impact of prescription opioid-related education on mortality, adherence, self-efficacy, self-care, quality of life, or knowledge. A variety of educational methods were used, including face-to-face follow-up, multimedia tools, predischarge counseling, and written information complementing verbal information. The interventions yielded inconsistent results, with improvements in patient outcomes seen in some studies, but not all. CONCLUSION: There are several well-documented interventions identifying methods to manage opioid-use disorder, but less about providing education to patients before they receive opioid prescriptions. Future research should explore the type of education and information being shared with patients, as this could inform pharmacists on how they should educate their patients.

Pharmacists' impact on older adults' access to vaccines in the United States.

OBJECTIVE: The purpose of this systematic review was to explore pharmacists' impact on older adults' access to vaccines in terms of realized accessibility, financial accessibility, and vaccine availability. METHODS: Five databases were searched using a search strategy developed in PubMed and translated to other databases. Included studies were English-language, United States-based primary literature published between 1994 to present day. Studies were excluded if they were incomplete studies or did not focus on at least one of three dimensions of access to immunizations: realized accessibility, availability, and financial accessibility. The following data were gathered: title, authors, year published, sub-dimension of accessibility, health care setting, intervention or data source, pharmacist role, type of immunization, duration of study, sample size, and main outcome measures. RESULTS: Twenty-five studies met the inclusion criteria. Of those, the majority evaluated realized accessibility (n = 22, 88%). Eleven studies evaluated vaccine availability, and one study addressed financial accessibility. Pharmacists had a variety of roles in the immunization process, including screener, educator, immunizer, or documenter, and often played more than one role (n = 10, 40%). Pharmacists participated in the vaccination process across multiple health care settings, including in community pharmacies (n = 8, 32%) and hospitals (n = 7, 28%). In the majority (n = 21, 84%) of studies, pharmacists positively impacted older adults' access to vaccines. The most common vaccinations studied were pneumococcal and influenza vaccinations (n = 20, 80%). CONCLUSION: Vaccinations are important in protecting and maintaining the health of older adults. Pharmacists improved access to vaccinations and served many roles in the vaccination process. Future research should explore how pharmacists impact access to vaccines beyond vaccination rates, especially regarding the financial impact on patients.