An Exploratory Analysis of PharmD Program Value Using the Tuition: Licensure Index.

Objective. To assess the value of a Doctor of Pharmacy (PharmD) program using the Tuition: Licensure Index (TLI), a de novo metric combining tuition and licensure pass rates. Methods. The TLI is a ratio of program tuition and licensure pass rates, where separate indices are derived for the North American Pharmacist Licensure Examination or NAPLEX (ie, TLI-N) and the Multistate Pharmacy Jurisprudence Examination (ie, TLI-M). The TLI can be further nuanced depending on use of in-state (ie, TLI-Ni and TLI-Mi) or out-of-state (ie, TLI-No and TLI-Mo) tuition. The TLI-N for the 2018 cohort was used in this analysis. Total program tuition and NAPLEX pass rates were obtained from publicly available sources. Differences in traditional vs accelerated and public vs private programs were examined using the TLI-N categories "one or less" and "greater than one." Results. While differences in TLI-Ni category (ie, "one or less" and "greater than one") for traditional vs accelerated PharmD programs were not significant, a major difference was found in the TLI-Ni category for public vs private programs. No differences in the TLI-No category for public vs private or for traditional vs accelerated programs were found. Conclusion. In-state public (vs private) PharmD programs may be preferable for optimizing value. Prospective students are encouraged to consider a school's tuition and licensure pass rates when selecting a PharmD program.

Assessment of the effect of communication skills training on communication apprehension in first year pharmacy students - A two-year study.

INTRODUCTION: The purpose of the study is to assess the impact of a communication skills course on communication apprehension (CA) in two cohorts of first-year (P1), first quarter pharmacy students over a consecutive two-year span. METHODS: The personal report of CA (PCRA-24) was administered at the beginning and completion (pre-post) of a skills-centered communication course to two cohorts of P1, first quarter pharmacy students over a consecutive two-year period. The delivery of the communications course was redesigned during this timeframe based on post-course analysis data and student feedback to incorporate opportunities for students to engage in active learning activities throughout the course. RESULTS: Results of the study revealed a statistically significant reduction of total CA in both cohorts. Cohort 1 had significant reduction of CA in all four measured domains: group discussion meetings, interpersonal communication, and public speaking. Cohort 2 had significant reduction in two of the domains (group and meeting). CONCLUSIONS: Overall, this study indicated that the format of this P1, first quarter communications course had a positive effect on student CA. In addition to the data collected for this research project, post-course evaluations and student comments indicated an overall positive reaction to the design and delivery of the course material, active learning assignments, and assessments.

Neuroleptic Malignant Syndrome Secondary to Metoclopramide Use in an Elderly Gastroenterologic Surgery Patient.

An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed. She was then transferred to a general medical-surgical unit in a stable condition where she received a total of four 10-mg oral doses of metoclopramide administered every 8 hours. Approximately 32 hours after receiving the first dose of metoclopramide, the patient was subsequently transferred back to the ICU because of fever and inability to maintain respirations. Neuroleptic malignant syndrome was suspected, and the patient was intubated and received supportive care. After a week in the ICU, she was discharged back to the medical-surgical unit in a stable condition and recovered completely. The patient was later discharged home.

Pharmacy services after a tank car derailment and toxic chemical release in Blount County, Tennessee.

OBJECTIVES: To assess the impact of an accidental release of volatilized acrylonitrile on pharmacy services in Blount County, Tennessee. METHODS: A paper questionnaire was mailed to all pharmacies located in Blount County, Tennessee. The questionnaire assessed 5 domains relevant to pharmacy services after the derailment disaster: (1) disaster preparedness, (2) disaster response, (3) disaster information source awareness, (4) Pharmacy Practice Act amendment preference, and (5) pharmacy impact. Continuous (ratio-level), binary, and free-text data were collected and evaluated with the use of multiple correspondence analysis, tetrachoric correlations, and multiple regression modeling. RESULTS: The data suggested that geographic proximity to and duration of the disaster and the number of patients presenting for 72-hour emergency prescription refills significantly influenced the overall impact on pharmacy service delivery. The increase in 72-hour prescription refill requests was strongly correlated with blood pressure and diabetes medications, with all respondents in favor of amending state law to allow pharmacists to dispense 30-day prescription refills in times of disaster. Pharmacy respondents are also largely unaware of online disaster-related information sources. CONCLUSION: Disasters have the potential to affect all pharmacies in a locality but appear to have a significant impact on those located close to the scene. The number of patients presenting to pharmacies and the total duration of the disaster also appear to influence the overall impact of disasters on pharmacies. Pharmacists would be benefited by an awareness of current disaster information sources and legal supports pertinent to pharmacy practice in times of disaster.

An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness.

Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy's (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts.

Pharmacists' Roles in Post-September 11th Disasters: A Content Analysis of Pharmacy Literature.

PURPOSE: To characterize the roles pharmacists have assumed in disasters and clarify the types of roles and disasters that may be less well-documented in the pharmacy literature. METHODS: This research examines how balanced or equally proportioned role categories are in the pharmacy literature, whether pharmacy journals differ in the proportion of role categories reported, and whether journals significantly differ in the proportion of reported chemical, biological, radiological, nuclear (CBRN), and natural disasters. Data coding was performed solely by the lead author using Concordance (Harvard University, Cambridge, Massachusetts), a Web-based content analysis software, and Minitab(®) (version 15; Minitab, Inc; State College, Pennsylvania) for descriptive and inferential statistical analysis. Pharmacy journals publishing at least 2 articles about pharmacist disaster roles from September 11, 2001 to September 30, 2011 were used in the study and were available electronically. RESULTS: Chi-square analyses reveal significant differences in the weighted counts of roles, roles categorized by journal, and CBRN disasters categorized by journal. CONCLUSIONS: Data suggest that pharmacists may be prepared to respond to hurricanes and biological and chemical disasters in pharmaceutical supply and patient management roles. Future research should highlight efforts to prepare health systems for the effects of nuclear, radiological, and chemical disasters.

Examining roles pharmacists assume in disasters: a content analytic approach.

OBJECTIVE: Numerous practice reports recommend roles pharmacists may adopt during disasters. This study examines the peer-reviewed literature for factors that explain the roles pharmacists assume in disasters and the differences in roles and disasters when stratified by time. METHODS: Quantitative content analysis was used to gather data consisting of words and phrases from peer-reviewed pharmacy literature regarding pharmacists' roles in disasters. Negative binomial regression and Kruskal-Wallis nonparametric models were applied to the data. RESULTS: Pharmacists' roles in disasters have not changed significantly since the 1960s. Pharmaceutical supply remains their preferred role, while patient management and response integration roles decrease in context of common, geographically widespread disasters. Policy coordination roles, however, significantly increase in nuclear terrorism planning. CONCLUSIONS: Pharmacists' adoption of nonpharmaceutical supply roles may represent a problem of accepting a paradigm shift in nontraditional roles. Possible shortages of personnel in future disasters may change the pharmacists' approach to disaster management.