Education and training in nutrition support pharmacy practice

Abstract

The contributions of nutrition support teams are well established in the United States.1–5 Pharmacists have been intimately involved since the inception of these teams, especially with the provision of parenteral nutrition.1,6 The first documentation of the pharmacist’s role on the nutrition support team was published nearly three decades ago.1 As technology advanced, nutrition support therapy became exceedingly more complex, and pharmacy nutrition support training became more formalized, the role of the pharmacist has continued to evolve into more diverse clinical roles.7–10 The University of Tennessee was among the first institutions in the country where a pharmacist was intimately involved in a clinical role on the nutrition support service. At first, the team was comprised of a physician and pharmacist, and only patients using parenteral nutrition were seen.1 They subsequently added a nurse and a dietitian to complete the multidisciplinary service. Due to the complexity of providing safe and effective metabolic support in patient care, the current role of the multidisciplinary members of the nutrition support team necessitates advanced education and training. There is some published information regarding educational efforts by dietitians11,12 and physicians13,14 for advanced nutrition support education and training, but data regarding specialized nutrition support education and training for pharmacists are lacking. This editorial highlights our approach at the University of Tennessee Health Science Center to provide an individual with the appropriate skills and knowledge to function as a clinical pharmacy practitioner, educator, and researcher. Elements of the education and training pathway, illustrated in Figure 1, are described in this report. Although it is our opinion that this figure reflects the optimal training pathways, the availability of specialized residencies and fellowships in pharmacy nutrition support unfortunately is limited. In a national survey of 166 individuals practicing in pharmacy nutrition support in 1990 and 1991, only 40% had a doctor of pharmacy degree, 35% had completed a general or pharmacy practice residency, and 16% completed a specialty residency or fellowship in nutrition support.15 With the adoption of a 6-y Doctor of Pharmacy program by all colleges of pharmacy and the continued growth of pharmacy practice residencies, these demographics have likely changed since that initial survey from over a decade ago.