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1.
Artigo em Inglês | MEDLINE | ID: mdl-34366288

RESUMO

BACKGROUND: Although Kentucky pharmacists recently gained authority to provide protocol-driven care for 13 conditions, provision of prescription hormonal contraception (HC) services is not currently authorized. A board-approved protocol allowing for provision of nonprescription over-the-counter (OTC) emergency contraception (EC) was recently approved by the Kentucky Board of Pharmacy but has yet to be implemented. OBJECTIVES: The objectives of this study were (1) to assess Kentucky pharmacists' interest in providing prescription HC and OTC EC services via protocol and (2) to identify perceived benefits/barriers regarding provision of prescription HC. METHODS: An online questionnaire was disseminated electronically to a convenience sample of Kentucky pharmacists. The questionnaire collected (1) demographic information, (2) opinions regarding provision of prescription HC and OTC EC, and (3) perceived benefits and barriers regarding provision of prescription HC. For analysis, responses were limited to pharmacists in community-based practice. McNemar's test was used to identify statistically significant differences in support by dosage form. In addition, a multivariable logistic regression model was used to examine associations between demographic factors and support for pharmacist provision of prescription HC. RESULTS: We received 151 responses from community-based pharmacists. Support for provision of prescription HC was highest for oral (61%) and transdermal (54%) forms. We found no statistically significant differences in support among demographic factors other than number of years in practice, with more recent graduates being at higher odds of support. In addition, time, reimbursement, training, and belief in the need for pelvic exams were the most commonly cited barriers to implementation. With regard to OTC EC provision, pharmacists were largely supportive (62%) and confident in their abilities. CONCLUSIONS: Community-based pharmacists in Kentucky are supportive of provision of oral, vaginal, and transdermal prescription HC as well as OTC EC via protocol. Barriers, including time, reimbursement, training, and belief in the need for pelvic exams, should be addressed to increase support for prescription HC provision.

2.
Am J Pharm Educ ; : 8556, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34301548

RESUMO

Written by members of the 2021 AACP Professional Affairs Committee, this commentary describes the perspective on why pharmacists should not be classified as "mid-level" providers.  Beyond the connotation that this classification implies that there are different levels or a hierarchy of providers, it is important to recognize that all healthcare providers bring unique and essential knowledge and contributions to the healthcare team and to patients.  Timely issues germane to pharmacists, including dependent and independent practice, provider status, and professional identity also contribute to the rationale that pharmacists, just like all other healthcare providers, should be classified by their professional identity. While use of the term "mid-level" provider to identify various practitioners may not seem consequential in today's healthcare environment, it is important to recognize that words do matter in attributing value, and the contributions of all healthcare providers should be recognized as equally important to the patient care team.

3.
Am J Pharm Educ ; : 8720, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34301582

RESUMO

EXECUTIVE SUMMARYEXECUTIVE SUMMARYThe 2020-21 Professional Affairs Committee was charged to (1) Read all six reports from the 2019-20 AACP standing committees to identify elements of these reports that are relevant to the committee's work this year; (2) Identify opportunities and models of integration of pharmacist care services in physician and other health provider practices beyond primary care; (3) Differentiate and make the case for the integration of pharmacist care services from that of other mid-level providers; and (4) From the work on the aforementioned charges, identify salient activities for the Center To Accelerate Pharmacy Practice Transformation and Academic Innovation (CTAP) for consideration by the AACP Strategic Planning Committee and AACP staff. This report provides information on the committee's process to address the committee charges, describes the rationale for and the results from a call to colleges and schools of pharmacy to provide information on their integrating pharmacist care services in physician and other health provider practices beyond primary care practice, and discusses how pharmacist-provided patient care services differ from those provided by other healthcare providers. The committee offers a revision to a current association policy statement, a proposed policy statement as well as recommendations to CTAP and AACP and suggestions to colleges and schools of pharmacy pertaining to the committee charges.

4.
Curr Pharm Teach Learn ; 13(7): 739-742, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34074500

RESUMO

INTRODUCTION: One of the challenges of pharmacy schools worldwide is the need to link theoretical training with the mastery of practical skills. A virtual pharmacy simulation, MyDispense, developed by the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, enables students to practice the skills of a professional pharmacist, from novice to highly advanced, in a safe virtual environment that is web-based and highly accessible. The free online simulation allows students to undertake scenarios where patients can present with prescription or self-care requirements, and are also challenged with validation tasks requiring them to check the work of virtual colleagues for accuracy, legality, and medicine safety. COMMENTARY: This commentary describes the use of a virtual simulation, MyDispense, in enhancing didactic instruction, complementing experiential education, and the challenges of the virtual simulation to pharmacy educators. MyDispense is now deployed to 186 schools of pharmacy across 34 countries to over 25,000 students worldwide who have completed over 963,000 exercises globally. IMPLICATIONS: The severe acute respiratory syndrome 2 (aka COVID-19) pandemic presents challenges to pharmacy education requiring many educators to switch to remote online learning. Simulation programs, such as MyDispense, help to replicate aspects of pharmacy practice and can be used creatively to meet course needs. The use of MyDispense is an excellent example of pharmacy educators collaborating globally and learning from each other to improve student learning.


Assuntos
Simulação por Computador , Currículo , Educação à Distância/métodos , Educação em Farmácia/métodos , Aprendizagem Baseada em Problemas/métodos , Competência Profissional , Humanos
5.
Pharmacy (Basel) ; 9(1)2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33670595

RESUMO

(1) Background: The outbreak of the novel coronavirus, COVID-19, forced colleges of pharmacy to implement new online learning methodologies to ensure that students could complete required courses. This transition was especially acute for laboratory simulation courses that require students to practice professional skills. This study aims to compare student assessment performance within a simulation-based laboratory course for students who completed the module prior to and after the online transition. (2) Methods: This study was a retrospective cohort comparison of student outcome performance with two distinct content delivery methods. Students were organized into two tracks at the beginning of the semester to determine the order of the simulation module. The online learning transition occurred in-between the delivery of the same module, which allowed comparison of online versus in-person content delivery with consistent assessment. Remediation rates on each assessment were compared using chi-squared tests. (3) Results: Student pharmacists across the first and second professional year performed similarly despite in-person or online course formats, with no significant differences in remediation rates. (4) Conclusions: Pharmacy course content, including laboratory-based simulation activity, may produce similar assessment performance when using online content delivery. Further research into hybrid or mixed-delivery models may enhance learning without affecting assessment performance.

6.
Am J Pharm Educ ; 84(10): ajpe8199, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33149338

RESUMO

The 2019-2020 Professional Affairs Committee was charged to (1) Describe the leadership role of schools of pharmacy in advancing interprofessional practice, with an emphasis on physician-pharmacist collaborative relationships; (2) Establish an inventory of resources that can support school efforts to grow collaborative partnerships between pharmacists and physicians; (3) Determine gaps that exist in the resources required to support schools in efforts to facilitate expansion of interprofessional partnerships; and (4) Define strategies and draft an action plan for AACP's role in facilitating member school efforts to accelerate the development of interprofessional practices within their geography of influence. This report provides information on the committee's process to address the committee charges as well as background and resources pertaining to the charges, describes the rationale for and the results from the focus groups conducted at the 2020 AACP Interim Meeting, communicates the results of an initial inventory of models that integrate pharmacists with primary care practices, and provides an overview on issues to continue the work to integrate pharmacists with primary care practices. The committee offered several revisions to current association policy statements and provided a proposed policy statement and several recommendations to AACP pertaining to the committee charges.

7.
Pharmacy (Basel) ; 8(4)2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33036133

RESUMO

Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% of patients testing positive received a prescription as a result. While health insurance cannot be billed for the service due to current pharmacy reimbursement practices, this did not appear to negatively affect patient willingness to participate. As point-of-care testing services become more commonplace in community pharmacy settings, patient awareness will similarly increase and allow for more widespread access to acute outpatient care.

9.
Am J Pharm Educ ; 84(8): ajpe7531, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32934380

RESUMO

Objective. To assess student pharmacists' ability to impact the administration of complex prescription regimens using the universal medication schedule in a standardized laboratory exercise. Methods. First and third professional year (P1 and P3) student pharmacists at three colleges of pharmacy completed a required activity to simplify and organize a complex medication regimen. Using a medication box, students planned how and when they would advise a patient to take seven fictitious medications over a 24-hour period. Picture documentation of each students' activity was used for data analysis. Descriptive statistics were used to compare P1 and P3 students' performance, and an independent t test was used to assess the frequency of daily dosing. A chi-square analysis was used to compare differences between P1 and P3 students, and analysis of variance was used to compare differences among individual institutions. Results. Of 842 students invited, 459 P1 and 372 P3 students (98.7%) consented to participate. Student pharmacists recommended 5.1 (SD=1.0; Range=3-11) dosing intervals per 24 hours, with 27% of students successfully reducing the regimen to four total intervals. The P3 students were more effective than the P1 students in planning the number of dosing intervals (4.9 vs 5.4 per 24 hours). Conclusion. Student pharmacists may become more effective at organizing complex medication regimens as they proceed through the pharmacy curriculum and gain experience. Student pharmacists can translate what they learned from this exercise to potentially improve patients' self-organized medication regimens.

10.
Drugs Aging ; 36(7): 639-645, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31054113

RESUMO

INTRODUCTION: Overactive bladder (OAB) affects adults of all ages. The risk for medication-related adverse events (AEs) may differ between age groups, given age-related changes in pharmacokinetics and pharmacodynamics. No previous study has differentiated the risk of AEs between older and non-older adults with OAB. OBJECTIVE: Our objective was to assess the risk of AEs and treatment discontinuations between older and non-older adults with OAB initiated on an antimuscarinic. METHODS: We searched MEDLINE (PubMed interface), Embase, SCOPUS, and Cochrane Central Register for Controlled Trials in a previous analysis in February 2015 and repeated the search in August 2018, with no additional studies identified. Studies that delineated AEs or treatment discontinuations between the older and non-older (age <65 years) subjects were included. RESULTS: Six studies that made nine comparisons between older and non-older subjects met the inclusion criteria. The AEs of dry mouth (46.7%), constipation (10.3%), and headache (7.7%) were most frequently reported. Older subjects were more likely to experience dry mouth (relative risk [RR] 1.09; 95% confidence interval [CI] 1.00-1.19), constipation (RR 1.92; 95% CI 1.52-2.43), dizziness (RR 2.37; 95% CI 1.21-4.62), and urinary retention (RR 4.17; 95% CI 1.76-9.89) than were non-older subjects. Headache was less likely to occur in older subjects (RR 0.58; 95% CI 0.40-0.86). Treatment discontinuations due to AEs were more likely to occur in the older subjects (RR 1.59; 95% CI 1.20-2.11). CONCLUSION: Treatment of OAB with antimuscarinics in the older population resulted in significantly higher rates of AEs, barring headache, when compared with non-older subjects.


Assuntos
Antagonistas Muscarínicos/administração & dosagem , Antagonistas Muscarínicos/efeitos adversos , Bexiga Urinária Hiperativa/tratamento farmacológico , Adulto , Fatores Etários , Idoso , Constipação Intestinal/induzido quimicamente , Cefaleia/induzido quimicamente , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco , Xerostomia/induzido quimicamente
11.
J Am Pharm Assoc (2003) ; 59(2S): S13-S17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30448026

RESUMO

OBJECTIVE: Nonprescription or over-the-counter (OTC) medications play a crucial role in a patient's ability to make choices to manage his or her own health care. Often these nonprescription choices are unknown to health care practitioners and thus are often not included as part of patients' health records. The exclusion of these therapies can pose risks to patient safety. There is a significant need to address the capture of OTC medication use in both the physician and pharmacy electronic health records (EHRs) and during the practitioner-patient medication history and reconciliation process. DATA SOURCES: On October 26, 2016, the National Association of Chain Drug Stores Foundation hosted a forum for a select group of health care industry professionals to work on a series of recommendations to improve the documentation of OTC medication use by patients. This diverse group of more than a dozen stakeholders included community pharmacy leaders from multiple chain pharmacies, pharmacy system vendors, e-prescribing vendors, health information technology experts, and multiple industry representatives, including individuals from the public sector. This commentary is a summary of the insights and suggestions where the group was in general agreement. SUMMARY: Successful OTC medication EHR integration will require system-level buy-in across multiple layers of the health care industry to improve patient safety. Forum participants suggested incremental steps that could be taken by multiple stakeholders to lay the foundation for integration within an appropriate regulatory structure. CONCLUSION: Based on the results of the stakeholder forum, an agreement formed around one approach that the group supported as feasible: the creation of a consistent and uniform identification method for OTC medications in cooperation with government regulatory authorities.


Assuntos
Registros Eletrônicos de Saúde/organização & administração , Informática Médica/métodos , Documentação , Prescrições de Medicamentos , Registros Eletrônicos de Saúde/tendências , Prescrição Eletrônica , Humanos , Medicamentos sem Prescrição/uso terapêutico , Segurança do Paciente , Assistência Centrada no Paciente , Assistência Farmacêutica/legislação & jurisprudência , Farmácias , Farmácia , Automedicação
12.
Curr Pharm Teach Learn ; 9(6): 1010-1015, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29233368

RESUMO

INTRODUCTION: Perspectives from faculty regarding team-based learning (TBL) are not well understood. Previous studies describe faculty preference for TBL due to increased student interaction despite requiring increased time for design. The perception of changes in faculty workload over multiple semesters has not been measured. This research evaluates faculty workload and perceived student engagement after implementing TBL in a required non-prescription medication course over multiple semesters. METHODS: TBL was implemented in the non-prescription medication course and continued for three consecutive semesters. Faculty members' perception of TBL was captured using an anonymous survey. The survey was an 11 item questionnaire with five Likert-type response options to identify changes in workload, training, and student interaction using TBL. RESULTS: Twenty-eight total responses were collected from 10 faculty members who taught in at least one of the four semesters. Results were aggregated based on the number of semesters faculty continually taught in the course. More respondents agreed than disagreed that participation from and interactions with students increased with the TBL course compared to traditional lectures. However, more respondents believed the TBL course approach was more difficult and reported increased workload in the initial semester taught. Enjoyment of teaching increased for a majority of respondents. DISCUSSION AND CONCLUSIONS: This is the first study to explore the impact of TBL implementation over multiple semesters. These data can be used to help implement TBL in pharmacy school curricula.


Assuntos
Currículo/normas , Docentes de Farmácia/psicologia , Práticas Interdisciplinares/métodos , Percepção , Adulto , Currículo/tendências , Educação em Farmácia/métodos , Educação em Farmácia/normas , Feminino , Humanos , Práticas Interdisciplinares/tendências , Masculino , Missouri , Avaliação de Programas e Projetos de Saúde/métodos , Estudantes de Farmácia/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
13.
Curr Pharm Teach Learn ; 9(4): 511-520, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-29233422

RESUMO

INTRODUCTION: A key element for pharmacy practice defined by the Accreditation Council for Pharmacy Education (ACPE) is medication use systems management. A web-based community pharmacy simulation originally created for Australian pharmacy students was adapted for pharmacy students in the United States (US). The objective of this study was to collaboratively adapt an existing international simulation program for utility in the US and measure student perceptions of a web-based community pharmacy simulation program in three US schools of pharmacy. METHODS: An Australian development team in collaboration with US pharmacy school faculty modified the existing MyDispense software to create a virtual environment that accurately represented US community pharmacy practice. Students at three US schools of pharmacy used the newly adapted version of MyDispense and were surveyed on their prior experience in community pharmacy and their perceptions of MyDispense as a learning tool. RESULTS: Overall 241 (44%) students completed the satisfaction survey. Approximately 40% of these students worked in a community pharmacy before starting pharmacy school. Most students agreed or strongly agreed that MyDispense was straightforward to learn (76%), was more realistic than addressing similar paper cases (73%), and offered a learning opportunity to safely make errors (84%). Qualitative thematic analysis revealed that MyDispense allowed students to practice how to gather patient information and ask appropriate questions, counsel patients, and practice the dispensing process. DISCUSSION AND CONCLUSIONS: Response to the US version of My Dispense is positive and proves to be a viable option for introducing and reinforcing community pharmacy practice skills to students during in their pharmacy education.


Assuntos
Educação em Farmácia/métodos , Sistemas de Medicação/estatística & dados numéricos , Treinamento por Simulação/métodos , Currículo/tendências , Educação em Farmácia/normas , Desenho de Equipamento/normas , Humanos , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/normas , Design de Software , Inquéritos e Questionários , Tecnologia Farmacêutica/instrumentação , Tecnologia Farmacêutica/organização & administração , Estados Unidos
14.
Am J Pharm Educ ; 81(8): 5927, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29200447

RESUMO

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.


Assuntos
Comunicação , Educação em Farmácia/métodos , Relações Profissional-Paciente , Estudantes de Farmácia , Competência Clínica , Avaliação Educacional/métodos , Humanos , Reprodutibilidade dos Testes
15.
Arch Gerontol Geriatr ; 69: 77-96, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27889591

RESUMO

INTRODUCTION: Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB. METHODS: Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic were performed in February 2015. Studies assessing AEs or treatment discontinuations in a population of adults 65 or older were included. The Jadad Criteria and McHarm Tool were used to assess the quality of the trials. RESULTS: A total of 16 studies met the inclusion criteria. Eighty AEs and 27 reasons for treatment discontinuation were described in the included studies and further explored. Anticholinergic AEs were more common in antimuscarinics compared to placebo. Incidence of dizziness, dyspepsia, and urinary retention with fesoterodine, headache with darifenacin, and urinary tract infections with solifenacin were significantly higher compared to placebo. Treatment discontinuation due to AEs and dry mouth were higher in the antimuscarinics when compared to placebo in older adults. CONCLUSIONS: Treatment for overactive bladder using antimuscarinics in adults aged 65 or older resulted in significant increases in risk for several AEs compared to placebo including anticholinergic and non-anticholinergic AEs.


Assuntos
Antagonistas Muscarínicos/efeitos adversos , Bexiga Urinária Hiperativa/tratamento farmacológico , Suspensão de Tratamento , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Humanos , Antagonistas Muscarínicos/uso terapêutico , Fatores de Risco , Bexiga Urinária Hiperativa/fisiopatologia
16.
J Am Pharm Assoc (2003) ; 56(3): 242-247.e1, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27067553

RESUMO

OBJECTIVES: The objectives of the study were to identify patient expectations for prescription label content and formatting and to explore how United States Pharmacopeia Chapter 17 Standards for prescription container labeling meet patient expectations. DESIGN: Focus group. SETTING: St. Louis, Missouri, in July and August 2014. PARTICIPANTS: Patients 18 years and older who were taking at least 2 chronic prescription medications and managing their medications independently. MAIN OUTCOME MEASURE: Qualitative themes. INTERVENTION: Not applicable. METHODS: Five focus groups (17 total participants) were conducted in St. Louis in 2014. Focus groups were audio-recorded and consent was obtained from the participants. The audio files were professionally transcribed. Atlas.ti software (version 7.5.3) was used to analyze the transcript data, which were then coded to identify key themes. To ensure consistency of interpretation, a constant comparative analytic framework approach was used. RESULTS: Analysis produced 6 themes related to patient perceptions and expectations of prescription label content and formatting: importance of drug name, dose, and directions; lack of side effects on the label; improved organization and larger font size; using the color red; lack of familiarity with auxiliary labels; and the importance of pharmacy information. Themes focused on how patients use prescription labels and the relative value of different aspects of prescription container labeling. CONCLUSIONS: Patient-perceived prescription content and formatting expectations for prescription container labeling were generally consistent with published USP Chapter 17 guidelines. The importance of pharmacy phone numbers, white space, and highlighting were noteworthy.


Assuntos
Doença Crônica/tratamento farmacológico , Rotulagem de Medicamentos/métodos , Percepção , Assistência Farmacêutica , Medicamentos sob Prescrição/uso terapêutico , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Medicamentos sob Prescrição/administração & dosagem , Medicamentos sob Prescrição/efeitos adversos
17.
HIV AIDS (Auckl) ; 5: 263-74, 2013 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-24068878

RESUMO

The prevalence of human immunodeficiency virus (HIV) infection in older and elderly adults is significant worldwide. This population poses new challenges and opportunities in the management of HIV. In addition to the risks affecting HIV patients of all ages, including risk of opportunistic infection and medication resistance, age-related changes in physiology, higher comorbidity burdens, increased use of medications, and potential adverse drug reactions to HIV medications all factor into the care of older adults with HIV. The risk and progression of cardiovascular and renal comorbidities may be higher in the older adult HIV population and in patients taking specific HIV medications. Understanding these risks is essential when managing a new type of patient: the older adult with HIV.

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