Community Pharmacy Residency Program Research Articles

Pandemic shapes community pharmacy residency learning environment.

Lauren T. Le The COVID-19 pandemic brought about an unusual learning experience for Lauren T. Le, outgoing chief resident at the H-E-B Pharmacy–University of Texas at Austin community pharmacy residency program. “It’s been difficult but . . . rewarding,” Le said of the past year. “I’m very, very happy with my decision to do the residency.” The pandemic was in full swing when Le started her residency last summer, and she expected COVID-19 to shape the year’s activities. But she and her colleagues were surprised at the pace of vaccine development and the resultant need to quickly roll out a robust vaccination campaign. “We immunized upwards of 1,000 people per day,” Le recalled. “They even had us travel to surrounding areas like Waco and San Antonio to help with vaccination efforts.” Le said the biggest problem for her home-store pharmacy team was establishing a workflow for COVID-19 vaccination while managing normal pharmacy operations.

Perceived Stress, Stressors, and Coping Mechanisms Among PGY1 Pharmacy Residents

Objective. To evaluate perceived stress among postgraduate year 1 (PGY1) pharmacy residents and to examine relationships between perceived stress and certain demographic variables. Main stressors during residency training and coping mechanisms used were also determined. Methods. A link to a web-based survey was sent to 1128 pharmacy residency program directors who were asked to forward it to current PGY1 residents in their programs. The 22-item questionnaire included the 10-item Perceived Stress Scale (PSS-10), demographic information, number of working/sleeping hours, and major stressors and coping mechanisms. Results. There were 505 responses collected from PGY1 residents of community pharmacy, managed care, and pharmacy practice residency programs across the US. Females reported higher PSS-10 scores than males. Perceived stress scores were similar across age groups. Single residents and married residents exhibited similar PSS-10 scores. Residents with children had higher stress score compared to residents without children. Perceived stress scores were similar across types of PGY1 residency programs. A higher number of working hours was associated with a higher PSS-10 score. Time pressures, work overload, and fear of error were the top stressors reported. Spending time with family and friends, staying optimistic, and engaging in enjoyable activities were the top coping strategies employed by participants. Conclusion. Female gender, having children, working longer working hours, and desire to change residency program were associated with higher PSS-10 scores. Approximately a third of the participants associated perceived stress with activities related to residency training (time pressures, workload, fear of errors) and report the use of positive coping strategies to deal with stress.

RETRACTED: Beyond the PGY-1 community pharmacy residency: Characterizing career pathways of residency graduates

To characterize positions obtained upon graduation from Community Pharmacy Residency Programs (CPRPs). Descriptive nonexperimental study; online cross-sectional survey. United States, February to April2016. One hundred thirty-three community pharmacy residency program alumni. CPRP alumni identified by past program directors were surveyed using 3 contact attempts. Descriptive measures of demographics and information regarding post-CPRP employment including sex, region, degree status, number of positions offered, and further specialization were determined. Skills developed during CPRPs, such as research, teaching, management, advocacy, and clinical service provision during employment, were reported. E-mails were sent to 216 potential participants, and 133 useable survey responses were gathered from CPRP alumni. When asked how many positions were offered upon residency graduation, 57% were offered 2 positions and 26% were offered 3 positions. Of those employed, 50% of respondents indicated employment at the practice site at which they completed their CPRP. The amount of time spent on traditional dispensing decreased from the initial post-residency position to the current position. The time CPRP graduates spent in roles involving research, management, and advocacy activities in their current position was increased. Graduates of CPRPs spend approximately 34% of their time dispensing, which is less than the national average reported by the National Pharmacist Workforce Survey. A contributing factor to the expansion of CPRPs largely depends on the ability of employment opportunities that embrace the value this unique skill set brings. CPRPs foster clinical innovation and leadership in the community setting, thus creating additional opportunities for pharmacists to demonstrate their value to the health care system.

Evaluation of the impact of a residency in an independent pharmacy in rural Mississippi

ObjectivesTo evaluate the impact of a postgraduate year 1 (PGY1) community pharmacy residency program on clinical pharmacy service implementation and enhancement in a rural Mississippi community. SettingAn independent rural community pharmacy in Canton, MS. Practice description and innovationDelivery of clinical pharmacy services provided by PGY1 community residents 1 day a week to an underserved population during an 18-month period. EvaluationEconomic impact of a community pharmacy residency on the pharmacy's revenue stream determined by calculating an estimated dollar amount generated by clinical pharmacy services. ResultsBy providing services 1 day a week, the residents were able to directly contribute an estimated $8000 of revenue from vaccinations and medication therapy management services. In addition, residents provided point-of-care testing, facilitated group education, developed a medication synchronization program, and assisted with physician outreach. ConclusionOverall, community pharmacy residencies can contribute to the generation of revenue in rural independent settings and may also offer an opportunity to generate revenue in different areas that were not present before residency implementation, thereby improving access to care for patients.

Developing a process for expansion of community pharmacy residency sites

ObjectiveThe development of guidelines for community pharmacy residency site expansion is described. SummaryDuring the past 20 years, community pharmacy residency programs have grown in number. Most community residencies were initiated and accredited through schools of pharmacy with faculty members dedicated to the oversight and growth. Because of the interest in residency expansion from sites, a systematic process was needed to determine whether a site was resident ready. This need led to the development of a site-readiness tool for community residency expansion. This tool was developed by 2 faculty members serving as residency program directors at 2 schools of pharmacy in North Carolina. The development of this tool resulted in guidance and clarification of residency expectations for potential community sites. The tool also led to improved efficiency in the assessment of readiness for residency site expansion. ConclusionDevelopment of a tool for residency site readiness increased the overall knowledge of site requirements, resulting in a more efficient process for residency program directors, and aided in the ability to increase the number of community pharmacy residency sites in North Carolina. The tool described in this article can serve as a guide to sites that have an interest in establishing new programs but are uncertain of the site's readiness and next steps.

Valued characteristics of community pharmacy residency applicants

ObjectivesTo determine the attributes of postgraduate year 1 (PGY1) community pharmacy residency applicants and candidates that are most appealing to community residency program directors (CRPDs). DesignA 22-question online survey, designed to collect residency demographics, desirable characteristics for consideration for interview invitation (applicants), and characteristics that should be displayed during an interview (candidates). SettingAmerican Society of Health-System Pharmacists (ASHP)–recognized community pharmacy residency programs (CPRPs). ParticipantsThe CRPDs of 109 ASHP-recognized CPRPs throughout the United States. InterventionNot applicable. Main outcome measuresMinimum applicant requirements; rank order of valued characteristics at application and interview stage of hiring process. ResultsThe response rate was 71/109 (65.1%). Applicant work experience in chain pharmacy (90.1%) and independent pharmacy (77.5%) was most highly valued by CRPDs, with 85.9% preferring applicants with a minimum of 1 year or more of community pharmacy experience. A large majority of CPRPs (91.4%) indicated a preference for applicants who have been an officer of a student organization. Among CPRPs that required minimum grade point averages (GPAs), a mean GPA of 2.88 ± 0.34 was reported (range 2.0 to 3.5; mode 3.0). Pharmacy work experience (68.1%) and letters of recommendation (59.4%) were most frequently cited as top factors in the decision-making process for selecting candidates to interview. At the interview stage, CRPDs rated interest and knowledge about the residency (62.3%), time management and prioritization (50.7%), and self-awareness and commitment to improvement (43.5%) as the most important skills for candidates to demonstrate. ConclusionCommunity pharmacy work experience, organizational leadership experience, and positive letters of recommendation appear to be the most valued attributes of a community pharmacy residency applicant. Applicants should consider aligning themselves with these characteristics to successfully match to a community pharmacy residency.

Developing a vision and strategic action plan for future community-based residency training

ObjectivesThe Community Pharmacy Residency Program (CPRP) Planning Committee convened to develop a vision and a strategic action plan for the advancement of community pharmacy residency training. Aligned with the profession’s efforts to achieve provider status and expand access to care, the Future Vision and Action Plan for Community-based Residency Training will provide guidance, direction, and a strategic action plan for community-based residency training to ensure that the future needs of community-based pharmacist practitioners are met. Data SourcesNational thought leaders, selected because of their leadership in pharmacy practice, academia, and residency training, served on the planning committee. The committee conducted a series of conference calls and an in-person strategic planning meeting held on January 13-14, 2015. Outcomes from the discussions were supplemented with related information from the literature. Results of a survey of CPRP directors and preceptors also informed the planning process. SummaryThe vision and strategic action plan for community-based residency training is intended to advance training to meet the emerging needs of patients in communities that are served by the pharmacy profession. The group anticipated the advanced skills required of pharmacists serving as community-based pharmacist practitioners and the likely education, training and competencies required by future residency graduates in order to deliver these services. The vision reflects a transformation of community residency training, from CPRPs to community-based residency training, and embodies the concept that residency training should be primarily focused on training the individual pharmacist practitioner based on the needs of patients served within the community, and not on the physical location where pharmacy services are provided. ConclusionThe development of a vision statement, core values statements, and strategic action plan will provide support, guidance, and direction to the profession of pharmacy to continue the advancement and expansion of community-based residency training.

Establishing a community pharmacy residency at an independent pharmacy: Time allocation and valuation.

The value of a first-year community pharmacy residency program (CPRP) at an independent pharmacy was estimated based on time allocation for resident responsibilities. Predefined time allocation categories for the pharmacy resident were used to consistently classify and document time completing residency activities. Benefit-to-cost ratio was determined by tabulating total costs and total benefits of the residency program. A retrospective-prospective comparison of overall change in revenue, operating expense, and prescription volume was performed between the preresident time period (July 2012 to June 2013) and the postresident time period (July 2013 to June 2014). This comparison accounted for resident activities that did not directly generate revenue. Time allocations for the resident out of 2,221 total hours logged were dispensing (40%), clinical setup (16%), research (8%), professional meetings (7%), clinical activities (5%), resident education (5%), site precepting (4%), residency meetings (4%), didactic teaching (3%), miscellaneous (3%), marketing (2%), training (2%), and public health promotion (1%). Total costs were $77,422, and total benefits were $118,410. The benefit-to-cost ratio was 1.53. The postresident time interval had $172,451 more revenue and $6,622 more in operating expenses than the preresident time interval, and prescription volume decreased by 2,000 prescriptions compared to the previous year. The benefit-to-cost analysis indicated a $1.53 return for every $1.00 invested into a CPRP. An increase in revenue and operating expenses for the pharmacy was observed after implementation of the CPRP compared to the previous year.

Integrating a Patient Care Development Model to Enhance Community Pharmacy Residency Programs

Purpose: The purpose of this paper is to describe integration of a community-based patient care service development model, Partner for Promotion (PFP), within five community pharmacy residency programs (CPRPs) across the United States and provide insights and examples of methods for optimizing community pharmacy resident experiences, developing new patient care services, and achieving residency accreditation standards.
 Summary: Five community pharmacy residency programs have integrated PFP that affiliated with Midwestern University – Glendale, Northeast Ohio Medical University, Ohio State University, University of Utah, and West Virginia University. Each college and residency program has identified different strategies through which PFP enhances their residency training and service development including completion of training modules, reflections and discussion on application of the PFP service development model to practice, research, and teaching, use of assignments to guide service creation, and mentoring of PFP student-pharmacist teams. All five sites directly link these activities to objectives required in PGY1 CPRP accreditation standards. PFP has resulted in resident-facilitated service development of a variety of patient care programs.
 Conclusion: PFP applied to CPRPs enhances training on service development, builds new services within residency training sites, and assists programs with meeting residency accreditation standards. The experiences of five community pharmacy residency programs across the U.S. that have adopted the program has been positive, with creation of new services and residency sites, integration of novel teaching, practice, research, and learning opportunities for residents, and direct links from the PFP experience to achievement of residency objectives.
 
 Type: Idea Paper

Differences in career paths and attributes of pharmacists completing a community pharmacy residency program (CPRP)

Objective: To determine any differences in career paths and career attributes of pharmacists who have completed a PGY1 community pharmacy residency program (CPRP) as compared to those that have not completed a PGY1 CPRP.
 Methods: A web-based survey evaluating various aspects of community pharmacists' careers was distributed to 274 CPRP graduates in addition to a random sample of 7,376 community pharmacists. The survey contained 32 questions evaluating various career attributes. Questions that assessed level of agreement were on a 6-point Likert-type Scale (1=strongly disagree; 6=strongly agree).
 Results: A total of 353 participants completed the survey, with 224 indicating that they had not completed a CPRP. Pharmacists who completed a CPRP responded that they spend significantly more time on patient care services, teaching, and research, and spend less time dispensing medications compared to those that have not completed a CPRP. Compared to those that did not complete a CPRP, CPRP graduates were less likely to agree that current level of workload negatively impacts job performance, motivation to work, job satisfaction, mental/emotional health, and physical health.
 Conclusion: Pharmacists completing a CPRP noted significant differences in their current employment and job responsibilities. Additional expansion and education regarding the importance of CPRPs should be considered.
 
 Type: Original Research

Community pharmacy residency pioneer Rudenko dies at 38

Friends, family, and colleagues were shocked on May 25 when Rudenko, Associate Professor of Pharmacy at the Virginia Commonwealth University (VCU) School of Pharmacy, died suddenly of complications of breast cancer that had been diagnosed only a few days before. As noted in a memorial article on the VCU website, tributes to this leader in one of the nation’s most prominent community pharmacy residency programs soon filled her Facebook page: “I remember her as a student, and she went on to do great things for our profession.” “She was an amazing person with such excitement for life.” “She was such a good professor. Always happy and cheerful.” “Such a wonderful person who touched the lives of so many.” “She was awesome.” “[Amy] was a conscientious student, and the faculty respected and liked her due to her genuine interest in every facet of the pharmacy curriculum and her positive personality traits,” recalled Tom Reinders, Associate Dean for Admissions and Student Services at VCU. “She was a great student, a great professor and, above all, a great pharmacist. Most remarkable was her unwavering commitment to community pharmacy practice.” A native of Richmond, Amy Whitaker received her PharmD degree from VCU in 1998 and completed the community pharmacy residency there after graduation. Following a stint at the University of North Carolina, Whitaker returned to Richmond and VCU in 2001 and was involved in student and resident life, serving as faculty advisor to the VCU chapter of the APhA Academy of Student Pharmacists and as an expert in medication therapy management in big-box settings. Married less than 4 years before her untimely death, Rudenko is survived by her husband Mike Jr., daughters Olivia Lynn, 2, and Abigail Iryna, then 3 months, parents Barry and Linda Whitaker, and brother Barry Whitaker.

Team-based care and provider status

The health care system appears to be moving from fee for service to pay for performance with emerging models of care such as patientcentered medical homes and accountable care organizations (ACOs). Many pharmacists are providing medication therapy management (MTM) in these new models, based on data in the 2013 Medication Therapy Management Digest: Pharmacists Emerging as Interdisciplinary Health Care Team Members, released in March.

Incubator for new ideas: Patient care at community pharmacy residency sites

The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study. The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study. Findings of the study revealed variability in the types of services provided at CPRP practice sites and the experiences offered for residents. There also appeared to be collaboration with other practice sites to enhance residents' training and experiences.■ Community Pharmacy Residency Program practice sites offer residents opportunities for advanced and innovative direct patient care.■Resident experiences vary among sites, including collaboration with other sites. ■ Community Pharmacy Residency Program practice sites offer residents opportunities for advanced and innovative direct patient care.■Resident experiences vary among sites, including collaboration with other sites. "It’s innovative practice sites with very eager and well-trained pharmacists as residents coming in," Schommer, Professor and Associate Department Head at the University of Minnesota School of Pharmacy, told Pharmacy Today. "And a lot of times, that creates this innovation and [it’s] almost like a little incubator for trying new ideas." The resident—who is at a lower resident’s salary—can be there for a year and try new things; then the pharmacy can make go or no-go decisions to continue those new things. "The data that we collected are supporting that," Schommer said. Funded by APhA, the study, "Patient care services provided at primary community pharmacy residency sites," was published with the March/April 2013 Journal of the American Pharmacists Association, available online at www.japha.org. CPRP was established by APhA in 1986. In June 1999, APhA and the American Society of Health-System Pharmacists announced a partnership to accredit community pharmacy residency programs. When this study was conducted, there were 83 community pharmacy residency programs in 36 states and Puerto Rico. More information on CPRP is available online at www.pharmacist.com/residency. For this study, 120 CPRP directors/preceptors and residents responded to a survey using a Web-based data collection form. The responders came from varied practice settings and geographical locations. The survey asked questions about 11 patient care services provided at the primary practice site for each community pharmacy residency location during the 2011–12 residency year. At these residency sites, the most commonly provided patient care services were related to medication reviews and immunizations. These services are part of what the pharmacy does regularly. But residents were often deployed in other ways. Residents contributed to more than 50% of services related to interventions incorporated into the dispensing process (69%), medication reconciliation (64%), and patient education (52%). They contributed to between 40% and 50% of services related to comprehensive medication reviews (49%), chronic disease management (47%), health and wellness screenings (46%), pharmacotherapy consults (45%), and targeted medication therapy review (44%). And they contributed to less than one-third of services related to point-of-care testing with medication monitoring and adjustment (28%), specialty pharmacy (27%), and immunizations (25%). In addition to providing services at the primary community practice site, 65% of respondents said that residents provided patient care at other sites, including hospital-based ambulatory care clinics, community health centers, patient-centered medical homes within physician offices, and community outreach events. Several trends and goals characterize the environment for community pharmacy residency sites. One is that the number of residencies is growing. "It’s becoming more and more common for people say, look, after my PharmD, I need to do a residency," Schommer said. Another is that while an increasing number of the nation’s 250,000 pharmacists are moving from being medication providers to taking care of patients directly, "community pharmacy really is still tied to dispensing," he said. Then, at least in Schommer’s home state of Minnesota, the trend in the community pharmacy space is toward more large mass merchandisers, supermarket pharmacies, clinic and medical center chains, and specialty pharmacies. "As those types of pharmacies become more common, I think the residencies will follow," he said. Also relevant is the role of the community pharmacist in accountable care organizations as players like Walgreens start to participate. Finally, there’s having access to the electronic health record as community practitioners, and achieving provider status for pharmacists. "That would really help bring pharmacists into being full-fledged members of the health care team," Schommer said. The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study.

Patient care services provided at primary community pharmacy residency sites

ObjectiveTo describe the types of services provided at primary community pharmacy residency program (CPRP) sites and the levels of intensity devoted to different levels of patient care. DesignDescriptive nonexperimental study. SettingUnited States during May and June 2012. Participants120 key informants from CPRPs. InterventionKey informants from CPRPs were surveyed. Main outcome measuresProportion of residency sites providing selected patient care services, proportion of each service provided by residents, estimates for the number of repetitions needed for a typical resident to become proficient in each service, and services provided at other practice sites. ResultsOf the 120 respondents, 70 identified themselves as preceptors/directors, 45 identified themselves as residents, and 5 did not identify their position. Variation was achieved for representation from different practice settings and geographic locations. The findings revealed variability in the types of services provided at CPRP practice sites and the experiences offered for residents. Collaboration with other practice sites, in order to enhance residents' training and experiences, also appeared to be occurring. ConclusionThe results showed that the types and intensity of services provided at CPRP sites gave residents opportunities for advancing patient care services training, directing patient contact, and creating opportunities to be engaged in practice innovation.

Student pharmacists' perceptions of community pharmacy residency programs

ObjectivesTo compare penultimate-year (next-to-last) and final-year student pharmacists' perceptions of the educational value of community pharmacy residency programs (CPRPs) and to compare student pharmacists' perceptions of the educational value of CPRPs and health-system residency programs (HSRPs). MethodsA self-administered online survey was sent to administrators at 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy for ultimate distribution to penultimate- and final-year student pharmacists. The survey included demographic measures and a 20-item residency program “perceived value of skill development” scale developed for this study. Results1,722 completed surveys were received and analyzed. Penultimate-year students attributed greater value to CPRPs more frequently than final-year students. Students more often attributed higher value to CPRPs for skills related to business management, practice management, and medication therapy management, while they attributed higher value to HSRPs for skills related to teaching, research, and clinical knowledge. ConclusionThe results of this study suggest students' perceived value of CPRPs may be related to their year of pharmacy school and the pharmacy practice skill in question.

Comforter in chief in our towns

Comforter in chief in our towns

Student pharmacists’ perceptions and awareness of community pharmacy practice residency programs

To assess student exposure to types of pharmacy practice, evaluate awareness and perceptions of community pharmacy residencies, and identify areas of postgraduate training of interest to student pharmacists. Cross-sectional, descriptive, online survey study. United States, January to April 2008. Student pharmacists in the final 2 years of the doctor of pharmacy (PharmD) program. An online survey was administered to students in the final 2 years of the PharmD program at randomly selected schools of pharmacy by region throughout the United States. Awareness of student pharmacists regarding community pharmacy residencies and interest in postgraduate training. 254 surveys were completed during the study period. Of the respondents, 95% had previous experience working in a community pharmacy setting. Nearly 90% were aware of community pharmacy residencies. Students who indicated opportunities to publish (odds ratio 2.4 [95% CI 1.34-4.1]), teaching students (2.1 [1.36-3.14]), enjoying the job atmosphere (4.9 [1.54-15.60]), and clinically challenging (4.3 [2.15-8.67]) as desirable career attributes were more likely to be interested in postgraduate training. No significant differences existed in the information sources sought by students interested in community pharmacy residency programs (CPRPs) compared with those interested in other types of postgraduate training. The significant predicators of student pharmacists interested in pursuing postgraduate training are in alignment with CPRP training. Further research is needed to market the value of CPRPs through the identified information sources.

One to One awardees build relationships with patients

Pharmacy Today honored pharmacists for their outstanding counseling and patient care at last month’s 2012 APhA Annual Meeting & Exposition in New Orleans. Student pharmacists and pharmacists received round-trip airfare to APhA2012 and 2 nights’ hotel and were recognized at an awards dinner. A full list of the 2012 One to One Patient Counseling Recognition Program recipients appeared in the March issue of Today. The program was made possible through the generous support of McNeil Consumer Healthcare. Today will profile each of the top 10 One to One pharmacist awardees through the spring. This month features two pharmacists who establish long-term relationships with their patients by providing ongoing care with frequent follow-up counseling sessions. Traci Brooks, PharmD, a clinical pharmacist at the Wounded Warrior and Pain Clinics at Womack Army Medical Center in Fort Bragg, NC, provides medication management to active duty men and women who have been wounded or injured or are ill. She keeps her patients safe by monitoring for drug-drug interactions and adverse effects. Counseling this patient population can be challenging because of physical and emotional injuries that patients incur from training missions and deployments. Brooks recently met with a patient who requested a refill for rizatriptan (Maxalt—Merk); she noticed that the prescription had been filled within the past 10 days. After further discussion. Brooks learned that the patient was taking the medication daily to prevent headaches, rather than on an as-needed basis at the onset of a headache. Brooks provided medication education and counseling, and the patient learned about the appropriate use of his medication, decreasing the chance of worsening his condition from medication overuse. Brooks was instrumental in developing an outpatient detoxification program for active duty personnel. Pain and Behavioral Health clinic providers asked Brooks to provide expertise in opening a buprenorphine/naloxone (Suboxone— Reckitt Benckiser) clinic. She took the lead in creating criteria for patients to be seen at the clinic, including weekly screenings, safety checks, and medication counseling. Once patients are enrolled in the Suboxone clinic, Brooks counsels them about the role of the drug in their treatment and any adverse effects they can expect. Through weekly interactions, she builds a rapport with her patients and they feel comfortable disclosing issues that may affect their treatment plan. Through these ongoing relationships with her patients, Brooks ensures that they are following their treatment plan and are evaluated for dose adjustments. One Special Forces soldier sought out Brooks after completing his treatment with Suboxone. He thanked her for saving his life and said that the program she manages enabled him to be a better husband and father. The personal goal of Patrick Devereux. PharmD. is to provide one-on-one counseling services to every patient who fills prescriptions at FMS Pharmacy in Bessemer, AL. As the vice president of the pharmacy, Devereux believes in building long-term relationships with his patients. He recently added in-depth patient follow-up procedures to the pharmacy’s standard patient counseling sessions. When a new medication is initiated or when an existing medication is changed, the patient is counseled as usual, and counseling points are noted in the patient’s chart. The patient is contacted 5 to 7 days later to assess if there are any adverse effects. Through this process. Devereux identifies patients who have stopped taking their medications because of adverse effects and works with prescribers to find alternative options for these patients. Devereux uses the follow-up consultation to sync medication refills for his patients. Typically, within 3 months, Devereux is able to formulate a strategy that allows patients to make only one trip to the pharmacy to refill chronic medications. The system is also useful in determining nonadherence, because patients are able to receive refills on all chronic medications at the same time each month. When patients come in to get all of their medications refilled. Devereux takes this opportunity to talk to them about any medication adherence problems. He also strategizes with patients and prescribers to ensure optimal medication use. Devereux established the only accredited diabetes education program in a community pharmacy in Alabama. He completed a pilot program in his pharmacy and has since marketed the program to additional contracted payers. “Of all the pharmacists I have worked with, Patrick far exceeds all the expectations of normal patient counseling,” wrote Devereux’s nominator, Lindsey Elmore, PharmD, BCPS, Assistant Professor of Pharmacy Practice and Residency Program Director for the Community Pharmacy Residency Program at the Samford University McWhorter School of Pharmacy.

Value of community pharmacy residency programs: College of pharmacy and practice site perspectives

ObjectivesTo describe and compare perceptions of key informants representing U.S. colleges/schools of pharmacy and community pharmacy practice sites regarding (1) value associated with community pharmacy residency programs (CPRPs) and (2) barriers to offering CPRPs. DesignDescriptive, nonexperimental, cross-sectional study. SettingUnited States, June 13, 2009, through July 13, 2009. Participants554 respondents to a Web-based survey. InterventionKey informants representing the following four organizational groups were surveyed: (1) colleges/schools of pharmacy participating in CPRPs, (2) colleges/schools of pharmacy not participating in CPRPs, (3) CPRP community pharmacy practice sites, and (4) non-CPRP community pharmacy practice sites. Main outcome measuresValue of CPRPs to participating pharmacies, value of CPRPs to participating colleges/schools of pharmacy, and barriers to offering CPRPs. ResultsOverall, 267 key informants from colleges/schools of pharmacy and 287 key informants from pharmacy practice sites responded to the survey (n = 554 total respondents). Of these, 334 responders provided data that were usable for analysis. The most important types of value to the respondents were altruistic in nature (e.g., pharmacy education development, pharmacy profession development, community engagement). However, barriers to offering CPRPs were more practical and included challenges related to accreditation and operational issues. Further, evidence indicated that (1) lack of leadership, (2) lack of revenue generated from such programs, and (3) the cost of reimbursement for residents may be fundamental, multidimensional barriers to implementing CPRPs. ConclusionGuidelines for starting and continuing CPRPs, “industry norms” that would require CPRP training for certain types of employment, and creation of models for patient care revenue would help develop and position CPRPs in the future.

Assessment of factors influencing community pharmacy residents' pursuit of academic positions.

To determine the percentage of residents accepting faculty positions following completion of a community pharmacy residency program (CPRP) and identify influences to pursue/not pursue an academic career. CPRP directors and preceptors across the United States were contacted and 53 community pharmacy residents were identified. The residents were invited to participate in surveys at the beginning and end of the 2005-2006 residency year. Forty-five residents (85%) completed the preliminary survey instrument and 40 (75%) completed the follow-up survey instrument. Of these, 36 completed both survey instruments. Initially, 28 (62%) respondents indicated a faculty position as one of their potential job preferences. After completing their residency program, 3 (8%) residents accepted faculty positions; and 3 (8%) others were awaiting offers at follow-up. Reasons for accepting a faculty position were positive teaching experiences and the influence of a mentor or preceptor. Reasons for not pursuing a faculty position included lack of interest, geographic location, disliked teaching experiences, lack of preparedness, and non-competitive salary. Many community pharmacy residents consider faculty positions early in their residency but few pursue faculty positions. CPRPs and colleges of pharmacy should work together to enhance residents' experiences to foster interest in academia.