Objective. To quantitatively determine scholarly activity among tenure-track faculty at US departments of pharmacy practice over a 10-year period. Methods. A search of PubMed was performed for ...articles by department of pharmacy practice tenure track (DPP-TT) faculty from January 1, 2010, through December 31, 2019. DPP-TT faculty working in departments of pharmacy practice were identified through faculty rosters published on the American Association Colleges of Pharmacy website or college or school internet sites. Tenure-track faculty listed as working in a department of pharmacy practice, clinical pharmacy, or pharmacotherapy were included. An objective third party confirmed the data obtained. Each publication was classified by scope (eg, clinical pharmacology, health economics/outcome research, biomedical informatics, basic science, review, editorial/letter, or case report). DPP-TT faculty productivity was calculated by dataset frequency distribution. Descriptive statistics and analysis of variance were used to compare data across demographic strata. Results. One hundred thirty-seven institutions employed 2147 pharmacy practice faculty. These faculty published 20,059 (9.3+ or -16.3/10 years/faculty member) papers. Six institutions had no tenure-track designation. There was a 2.5-fold increase in publication rates from 2010-2019 (P < .0001). Public vs private schools' productivity was 207.8 vs 69.0 publications per institution, respectively (P < .001). The ratio of male to female DPP-TT faculty per institution was 62% to 38%, with male faculty publishing an average of 12.1+ or -19.1 each, and female faculty publishing an average of 7.4+ or -13.8 each (P < .0001). Faculty ranks were 37% assistant professor; 36% associate professor; and 26% professor, with an average of 4.067.3, 8.6+ or -12.4, and 17.4+ or -24.6 publications per faculty, respectively. Regionally, US pharmacy practice faculty located in the West produced the most publications, followed by those in the Northeast, South, and Midwest (P < .0001). Conclusions. These national DPP-TT publication data demonstrate that scholarly productivity increased from 2010 through 2019, across a wide variety of publication scopes. Keywords: clinical research, outcomes research, outcomes analysis, pharmacometrics, pharmacy practice, tenure
Background: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high ...quality care. Objective: To gauge pharmacists’ demand for primary health care services delivered through community pharmacies. Methods: An online survey was administered to determine community pharmacists’ preferences for varying primary care services that could be offered in the community pharmacy setting. A Discrete Choice Experiment was employed to show pharmacists competing scenarios with varied primary care service offerings in the community pharmacy setting. Attributes evaluated were operation hours, service provider, medical records, service logistics, physical examinations, point-of-care diagnostic testing, preventative care, and drug prescribing. Respondents chose the scenario most likely to induce switching employment from base pharmacy to one providing advanced services. Results: The optimal service delivery model from 291 community pharmacists comprised: inclusion of patient prescriptions and health information into the patient’s medical record; provision of point of care testing and vital sign, including blood pressure, heart rate and breathing rate, and blood sugar and cholesterol measurement; and pharmacists prescribing (under physician oversight). Pharmacists were 4 times more likely to switch employment from their current pharmacy to their choice for advanced pharmacy services. Pharmacist demand was highest among those with a PharmD, less experience, working >40 hours per week, and in rural areas. Conclusions: This study provides empirical support for the model of pharmacists playing a greater role in the provision of primary care health services through community pharmacy settings.
The demographic shift towards an older population increases the public health burden. Two conditions, commonly occurring together, that contribute to this burden are hypertension and diabetes ...mellitus. Effective blood pressure (BP) control is particularly important in this patient population, with a recommended BP goal of <130/80 mmHg. Most of these patients will require treatment with a combination of antihypertensive agents to reach this goal. Polypharmacy can be defined as the use of two or more medications, and it is commonly seen in this patient population. The risks of polypharmacy and the potential for inappropriate therapy must be considered and balanced against the possible benefits of multiple drug therapies. An optimal approach to reducing the risks and maximizing the benefits of polypharmacy should include regular reviews of patients’ medication lists, which can be changed to include, where appropriate, combination therapy and the use of single-pill combinations. Combination therapy can achieve greater BP reductions than monotherapy and can also enhance the safety and tolerability of pharmacotherapy. The safety and efficacy of numerous anti-hypertensive combinations in elderly patients have been demonstrated in a number of clinical trials. Single-pill formulations can simplify the medication regimen, and specific combinations can offer further benefits, such as enhanced reduction of macrovascular and microvascular complications, independent of BP reductions. Rational combination therapy can maximize BP control along with glycaemic control and help maximize the benefits of polypharmacy on outcomes in elderly patients with hypertension and co-morbid diabetes.
Abstract
Introduction
Quality of life (QoL) deficits have been noted among patients with venous thromboembolism (VTE) but understanding of the drivers of that poorer QoL is limited. The objective of ...this study was to examine associations between a variety of factors and QoL in patients with VTE.
Methods
Adult patients who had experienced at least one VTE episode within the past 2 years completed an online survey between May and July 2016 with responses to a variety of questions designed to ascertain QoL scores, Optum Short Form-12, and potential factors associated with these scores.
Results
Most of the 907 patients were female (56.7%) and Caucasian (88.6%). Physical and mental QoL scores below the general population average were present in 76.0 and 56.7% of patients, respectively. Multiple regression modeling revealed several factors associated with below average physical QoL scores including unemployment (odds ratio OR 3.77, 95% confidence interval CI 1.76–8.05), gastrointestinal bleeding (OR 2.54, 95% CI 1.28–5.01), high depression scores (OR 4.02, 95% CI 1.88–8.58), or difficulty accessing VTE care (OR 4.24, 95% CI 1.77–10.17). Factors associated with below average mental QoL scores included experiencing VTE within the last month (OR 3.85, 95% CI 1.58–9.41), unemployment (OR 2.83, 95% CI 1.30–6.16), or high depression (OR 3.85, 95% CI 1.60–9.28) and/or anxiety (OR 9.17, 95% CI 4.81–17.47) scores.
Conclusion
Most patients with recently diagnosed VTE reported below average QoL. Many of the factors associated with below average QoL are modifiable, indicating that patients with VTE could potentially benefit from interventions aimed at improving QoL.
Objective. To assess the impact of a Doctor of Pharmacy (PharmD) capstone project on students’ ability to conduct research and quality improvement, and to assess the feasibility of requiring projects ...in the core curriculum.
Methods. Project proposals were solicited from faculty members and local colleagues, and students matched with an individual project and mentor. After developing a written research proposal in their third professional year, students completed the project with mentor oversight in their third and fourth professional years, culminating with a poster session and completion of a manuscript prior to graduation. Students’ knowledge of biostatistics, research confidence, and attitudes regarding research were evaluated using a validated survey instrument. Students and mentors were surveyed for feedback, and students’ publications and presentations were tracked.
Results. Sixty-one students (97%) completed their projects on time. Students’ confidence in their ability to understand and participate in research increased, but improvement in statistical knowledge and interest in conducting future research projects was minimal. Fifty-eight percent of students presented posters at national conferences. Thirteen (21%) published manuscripts in peer-reviewed journals. Students and mentors responded positively overall about the program and the associated time requirements.
Conclusion. Requiring PharmD students to complete a capstone project prior to graduation was feasible and increased student confidence in their ability to participate in research and the number of student and faculty poster presentations and peer-reviewed publications. These findings support the consideration of the Academy that analysis, synthesis, and creation of new knowledge can be successfully implemented into the core PharmD curricula.
Objective. To gauge multiple dimensions of pharmacy students’ professionalism, stress, and satisfaction with the Doctor of Pharmacy (PharmD) program.
Methods. An online survey of first- through ...fourth-year pharmacy students was conducted from 2015-2018 to gauge the degree of students’ professionalism (personal reflection, patient-centric care focus, cultural and interprofessional competencies), program stress (levels, sources, and burnout syndrome), and satisfaction. Multilevel structural equation modeling (SEM) determined the relationship between stress and satisfaction, and the degree to which these impacted levels of professionalism after adjusting for potential correlates (age, sex, financial stress, relationship status, race, and employment status).
Results. Seven hundred sixty-four responses to the survey were received across the four calendar years. Of the students in the sample, 51% were female with a mean (SD) age of 26.6 (3.4) years. The overall response rate to the surveys was 86.2%. Professionalism was most strongly indicated by the measures of community-centeredness, patient-centeredness, and perceived benefits of being part of a team-based environment. The SEM model demonstrated an inverse relationship between the two composite latent constructs of stress and satisfaction. When modeled simultaneously, program satisfaction was found to be the more significant predictor of professionalism than stress after adjusting for associations with age, sex, and relationship status.
Conclusion. Professionalism of pharmacy students is positively associated with students’ satisfaction with the program, but professionalism is not independently significantly predicted by stress. Students who have positive responses to community- and patient-centeredness and who feel they benefit from engaging in a team-based environment are most likely to have greater professionalism.
Background: The United States is spending an increasing share of its national income on health care while American citizens are not receiving the commensurate benefit of longer, healthier lives. ...Pharmacists are in a position to provide high-quality care; however, a paucity of data exists on payers’ perspectives on insurance reimbursement for pharmacist-provided, community-delivered clinical services. Objective: To understand payers’ perspectives toward pharmacist-provided community-delivered advanced clinical services. Methods: A 15-minute online survey was administered to determine payers’ preferences and attitudes of impact about care being provided in a community pharmacy setting by a pharmacist. Results: The study recruited 50 payers from a diverse set of US organizations. The likelihood for reimbursement for a suite of pharmacist-provided, community-delivered clinical services was likely/very likely (66%), neutral (22%), and unlikely/very unlikely (12%). Pharmacists were viewed positively by payers for the provision of these services. Payers think that more clinical services should be offered in the community pharmacy. Trust in pharmacist-provided information services on general health and medications, and pharmacist competency were strongly positive. Conclusions and Relevance: A quantitative assessment of payer attitudes for pharmacist-provided, community-delivered advanced clinical practice was positive. Payers were positive about pharmacist contributions to the provision of heath and medication information. Continued development and deployment of advanced clinical services at the community pharmacy appears to be a financially viable model.
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