Pediatric Pharmacy Advocacy Group Research Articles

The Pediatric Pharmacy Association and Members Threaded Through a Career and the Impact on Pediatric Drug Development.

The Pediatric Pharmacy Association and Members Threaded Through a Career and the Impact on Pediatric Drug Development.

Improving pediatric pharmacy services in a primarily adult emergency department.

DisclaimerIn an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.PurposeThe American Society of Health-System Pharmacists (ASHP) and Pediatric Pharmacy Advocacy Group (PPAG) guidelines for providing pediatric pharmacy services in hospitals and health systems can be used to improve medication safety wherever pediatric patients receive care, including in the emergency department (ED). The purpose of this initiative was to improve compliance with these guidelines in a primarily adult ED.MethodsThis quality improvement initiative was conducted in a level 1 trauma center ED between October 2019 and March 2020. The ASHP-PPAG guidelines were used to create practice elements applicable to the ED. An initial compliance assessment defined elements as noncompliant, partially compliant, fully compliant, or not applicable. Investigators identified interventions to improve compliance for noncompliant or partially compliant elements and then reassessed compliance following implementation. Data were expressed using descriptive statistics. This initiative was exempt from institutional review board approval.ResultsNinety-three ED practice elements were identified within the 9 standards of the ASHP-PPAG guidelines. At the initial compliance assessment, the majority (59.8%) of practice elements were fully compliant; however, various service gaps were identified in 8 of the standards, and 16 interventions were implemented to improve compliance. At the final compliance assessment, there was a 19.5% increase in full compliance. Barriers to achieving full compliance included technology restrictions, time constraints, financial limitations, and influences external to pharmacy.ConclusionThis quality improvement initiative demonstrated that the ASHP-PPAG guidelines can be used to improve ED pediatric pharmacy services in a primarily adult institution. The initiative may serve as an example for other hospitals to improve compliance with the guidelines.

Opioid Use in Children.

Limited guidance on opioid use exists in the pediatric population, causing medication safety concerns for pain management in children and adolescents. Opioid misuse and use disorder continue to greatly affect adolescents and young adults in the United States, furthering the apprehension of their use. Pediatric Pharmacy Advocacy Group (PPAG) recommends pharmacists contribute their knowledge to pain management in children, including the discussion of appropriate use of non-opioid alternatives for pain and when to recommend coprescribing of naloxone. PPAG also supports the review of electronic prescription drug-monitoring programs prior to opioid prescribing and dispensing by both prescribers and pharmacists. Education by pharmacists of children and their families regarding proper administration, storage, and disposal, as well as the awareness of opioid misuse and use disorder among adolescents and young adults, is key to prevention. If opioid use disorder is diagnosed, PPAG encourages improved access among adolescents to evidence-based medications including methadone, buprenorphine, and naltrexone. Furthermore, pharmacists should assist in screening and referral to evidence-based treatment.

Identification of Factors Associated With the Desire to Participate in a Pediatric Pharmacy Practice-Based Research Network.

To evaluate the practice-based research network (PBRN) potential within the Pediatric Pharmacy Advocacy Group (PPAG) membership and to identify characteristics associated with member willingness to join a PPAG PBRN. In October 2016, a 21-question survey was sent by email to approximately 900 PPAG pharmacist members (excluding students) using contact information contained in the PPAG membership database. The survey elucidated information regarding training, clinical and research experience, practice site information, and willingness to participate in a PPAG PBRN. Descriptive statistics described the potential PBRN and multivariate logistic regression determined respondent characteristics associated with willingness to join the PBRN. Of 145 survey respondents (a 16% survey response rate), 92 selected "yes" regarding their willingness to participate in the PPAG PBRN. Acute care general pediatrics was the most common area where respondents desired to perform research (44.6% of "yes" respondents), with over 2500 patients/day collectively available. The most common selected limitations to research were time and size of available patient populations (59.8% and 47.8% of "yes" respondents, respectively). Cumulative hours/week members would be willing to devote to the PBRN was approximately 77 to 206. Publication of a retrospective study (OR 10.4, 95% CI 2.1-51.9, p = 0.004), research protected time (OR 4.9, 95% CI 1.4-17.8, p = 0.015), and affiliation with an academic medical center (OR 3.32, 95% CI 1.05-10.45, p = 0.04) were independently associated with willingness (a "yes" response) to join a PPAG PBRN. Within the PPAG membership, there is sufficient interest, expertise, patient exposure, and member time to develop a PBRN focused on pediatric pharmacotherapy. The identified characteristics associated with willingness to join the PBRN can help focus efforts for member involvement, education, and recruitment to ensure sustainability of the PPAG PBRN.

Pediatric Pharmacists' Participation in Cardiopulmonary Resuscitation Events.

The Pediatric Pharmacy Advocacy Group (PPAG) understands the dilemma and varying factors that many institutions face concerning the routine participation of pharmacists in emergency resuscitation events. Acknowledging these obstacles, the PPAG encourages all institutions to strongly consider creating, adopting, and upholding policies to address pharmacists' participation in cardiopulmonary resuscitation (CPR) as evidenced by the impact pharmacist participation has shown on the reduction of hospital medication error and mortality rates in children. The PPAG advocates that pharmacists be actively involved in the institution's CPR, medical emergency team committees, and preparation of emergency drug kits and resuscitation trays. The PPAG advocates that all institutions requiring a pharmacist's participation in CPR events consider adoption of preparatory training programs. Although the PPAG does not advocate any one specific program, consideration should be taken to ensure that pharmacists are educated on the pharmacotherapy of drugs used in the CPR process, including but not limited to basic life support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support algorithms; medication preparation and administration guidelines; medication compatibility; recommended dosing for emergency medications; and familiarity with the institutional emergency cart.

The Role of the Pediatric Pharmacist in Precision Medicine and Clinical Pharmacogenomics for Children.

With the initiatives by the National Institutes of Health and the US Food and Drug Administration, pharmacogenomics is transitioning from the laboratory to patient care. Nearly 200 drug products now contain pharmacogenomic information as part of their labeling; many of these products are commonly used in the pediatric population. Because pharmacogenomic testing can provide patient-specific predictors for drug response, pharmacists are positioned to assume a leadership role in pharmacogenomic testing, clinical interpretation of results, and recommendations for individualization of drug therapy. Opportunities for pharmacists exist in both inpatient and outpatient settings, such as pharmacist-managed clinical pharmacogenomics consultation services and educating patients and families about pharmacogenomic testing. Given the potential for genetic and age-dependent factors to influence drug selection and dosing, pediatric pharmacists should be involved in the development of dosing recommendations and interprofessional practice guidelines regarding pharmacogenomic testing in pediatric patients. Opportunities to become knowledgeable and competent in pharmacogenomics extend from coursework as part of the pharmacy curriculum to postgraduate education (e.g., residencies, fellowship, continuing education). The Pediatric Pharmacy Advocacy Group acknowledges a need for increased education of both students and practicing pharmacists with consideration for infants and children.

Position Paper: Pharmacists and Childhood Vaccines.

Vaccination rates of children in the United States remain below the target coverage levels identified in the Healthy People 2020 objectives. Given the success of pharmacists in providing adult vaccinations and the accessibility of pharmacists to the public, expanding pharmacists' authority to vaccinate children may improve vaccination rates of children, particularly in key disease states. This article serves as a Position Statement of the Pediatric Pharmacy Advocacy Group (PPAG), who supports the expansion of pharmacists' authority to vaccinate children. PPAG also believes that increased use of state vaccination registries by pharmacists will help improve communication and documentation of vaccines between providers. PPAG also recommends that continued education and maintaining current knowledge of vaccines and vaccine schedules are vital for pharmacist immunizers. Finally, PPAG believes that pharmacists should be advocates for childhood vaccinations.

Pediatric Antimicrobial Stewardship Programs.

The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events. This paper serves as a position statement of the Pediatric Pharmacy Advocacy Group (PPAG) who supports the implementation of antimicrobial stewardship programs for all pediatric patients. PPAG also believes that a pediatric pharmacy specialist should be included as part of that program and that services be covered by managed care organizations and government insurance entities. PPAG also recommends that states create legislation similar to that in existence in California and Missouri and that a federal Task Force for Combating Antibiotic-Resistant Bacteria be permanently established. PPAG also supports post-doctoral pharmacy training programs in antibiotic stewardship.

Duty to Advocate: Human Papillomavirus Vaccination.

Despite the excellent benefit-to-risk ratio for human papillomavirus (HPV) vaccination and recommendations for its routine use from the Advisory Committee on Immunization Practices (ACIP), significant controversy surrounding HPV vaccination continues to exist. In light of this controversy and continued low rates of vaccination among U.S. adolescents, the Pediatric Pharmacy Advocacy Group (PPAG) endorses the safety and efficacy of HPV vaccination and agrees with ACIP recommendations for protection of the U.S. population against the potentially severe consequences of HPV. The PPAG recommends that all eligible individuals undergo vaccination. We further recommend that pediatric pharmacists participate in the education of patients and their families and serve as advocates for HPV vaccination. This document serves as an update to the 2008 PPAG position statement.1.

Medication Dosage in Overweight and Obese Children.

Approximately 31.8% of U.S. children ages 2 to 19 years are considered overweight or obese. This creates significant challenges to dosing medications that are primarily weight based (mg/kg) and in predicting pharmacokinetics parameters in pediatric patients. Obese individuals generally have a larger volume of distribution for lipophilic medications. Conversely, the Vd of hydrophilic medications may be increased or decreased due to increased lean body mass, blood volume, and decrease percentage of total body water. They may also experience decreased hepatic clearance secondary to fatty infiltrates of the liver. Hence, obesity may affect loading dose, dosage interval, plasma half-life, and time to reach steady-state concentration for various medications. Weight-based dosing is also a cause for potential medication errors. This position statement of the Pediatric Pharmacy Advocacy Group recommends that weight-based dosing should be used in patients ages < 18 years who are < 40 kg; weight-based dosing should be used in patients ≥ 40 kg, unless, unless the recommended adult dose for the specific indication is exceeded; clinicians should use pharmacokinetic analysis for adjusting medications in overweight/obese children; and research efforts continue to evaluate dosing of medications in obese/overweight children.

Minimum Requirements for Core Competency in Pediatric Pharmacy Practice.

Colleges of pharmacy provide varying amounts of didactic and clinical hours in pediatrics resulting in variability in the knowledge, skills, and perceptions of new graduates toward pediatric pharmaceutical care. The Pediatric Pharmacy Advocacy Group (PPAG) endorses the application of a minimum set of core competencies for all pharmacists involved in the care of hospitalized children.

Drug shortages and implications for pediatric patients.

Drug shortages in the United States continue to be a significant problem that negatively impacts pediatric patients of all ages. These shortages have been associated with a higher rate of relapse among children with cancer, substitution of less effective agents, and greater risk for short- and long-term toxicity. Effective prevention and management of any drug shortage must include considerations for issues specific to pediatric patients; hence, the Pediatric Pharmacy Advocacy Group (PPAG) strongly supports the effective management of shortages by institutions caring for pediatric patients. Recommendations published by groups such as the American Society of Health-System Pharmacists and the American Society for Parenteral and Enteral Nutrition should be incorporated into drug shortage management policies. PPAG also supports the efforts of the Food and Drug Administration (FDA) to not only address but prevent drug shortages caused by manufacturing and quality problems, delays in production, and discontinuations. Prevention, mitigation, and effective management of drug shortages pose significant challenges that require effective communication; hence, PPAG encourages enhanced and early dialogue between the FDA, pharmaceutical manufacturers, professional organizations, and health care institutions.

Patient Safety in South Africa

Adverse event registration is a means to improve patient safety in a PICU. So far it has been used in European and North American countries mainly. We studied adverse events in a South African setting with the aims to 1) assess rates and types of adverse events with two different registration methods and 2) describe characteristics of patients experiencing adverse events. This study consisted of 1) a retrospective audit of randomly selected patient records and 2) a prospective observational study of real-time registration of AEs during ward rounds. Adverse events were identified using the Child Health Corporation of America - Pediatric Pharmacy Advocacy Group PICU trigger tool. A multidisciplinary 20 bed PICU at the Red Cross War Memorial Children's Hospital in Cape Town. The retrospective section of the study involved 80 randomly selected patients who had been discharged from the PICU, and the prospective study involved patients who were present in the PICU between March and June 2012. None. The retrospective audit identified 260 adverse events in 61 patients (50.8 per 100 patient days). Nineteen patients (24%) did not have any adverse events. Catheter complications, hypoglycemia, and endotracheal tube malpositioning requiring repositioning were most frequent. Prospective registration during 58 ward rounds revealed 272 adverse events in 236 patients (27.2 per 100 patient days), particularly catheter complications, nosocomial infection, and surgical complications. Hundred thirty-two patients of the total 236 patients (56%) did not experience an adverse event. Patients experiencing adverse events underwent mechanical ventilation significantly more frequently. Length of stay was significantly associated with number of adverse events. The trigger tool method identifies a higher adverse event rate compared with real-time registration. Each method has a unique contribution to yield types of adverse events.

Survey results: characterization of direct thrombin inhibitor use in pediatric patients.

The objective of this multicenter survey is to characterize the use of direct thrombin inhibitors (DTIs) in the pediatric population. The results of this survey may be used to design a prospective multicenter study with the ultimate goal of developing a dosing/titration recommendation for the use of DTIs in the pediatric population. This is a multicenter, descriptive study to survey hospitals around the country regarding the use of DTIs (argatroban, bivalirudin, and lepirudin) in the pediatic population. Institutional review board approval was obtained. The survey consisted of 42 questions and was designed utilizing Survey Monkey. The survey was emailed to members of the Pediatric Pharmacy Advocacy Group. Listserv members who responded to the survey within 4 weeks of when the survey was emailed were included in the study. Descriptive statistics were performed utilizing Microsoft Excel 2007. Responses were obtained from 56 institutions from 29 states in the United States. Multiple agents are available on formulary with argatroban being the most common (~80%). The large majority of institutions (41.1%) utilize DTIs 2 to 4 times a year with an additional 33.9% utilizing them less than twice a year. There is no consistent approach to dosing and titration amongst pediatric institutions. There are a wide variety of methods used by pediatric institutions with regard to dosing and titration of DTIs. Recently published prospective studies and package insert updates should help guide practitioners toward a more consistent approach to dosing of these high-risk medications.

Pediatric News

The Pediatric Pharmacy Advocacy Group presented the Lexi-Comp Best Practice Awards at the 22nd Annual PPAG Meeting and 2013 Pediatric Pharmacy Conference on May 4, 2013 in Indianapolis, Indiana. To be considered for the award, practitioners must submit a description of their program. Awards are evaluated based upon innovation, creativity, cost effectiveness, improvement in practice and leadership. All pediatric pharmacy practitioners are eligible and encouraged to apply.Shannon Manzi, PharmD, from Children’s Hospital Boston was recognized for her implementation of a pharmacist-led pharmacogenomics service. Shannon is currently the Director of the Clinical Pharmacogenomics Service at Children’s Hospital Boston. She is also the team leader for Emergency and Combined Services in the Department of Pharmacy. She graduated from the University of Rhode Island’s PharmD program in 1996. She has practiced pediatric pharmacy for over 15 years, and pediatric emergency pharmacy for 10 years. You can read more about this Best Practice here: http://www.ppag.org/22AM/Manzi_A.pdfJackie Magers, PharmD, BCPS, Kristen Gawronski, PharmD, and Lindsay Schray, PharmD received recognition for their work targeting higher Vancomycin Trough Concentrations in neonates. Jacqueline K. (Schneider) Magers graduated from Jamestown College, Jamestown, ND in 2001 with a BA in Biochemistry and Summa Cum Laude honors. She earned her Doctorate of Pharmacy from The Ohio State University in 2001 with Summa Cum Laude honors. She went on to complete a general practice pharmacy residency at The Nebraska Medical Center and a specialty residency in Neonatology and Women’s Health at The Ohio State University. Currently Jackie works at Nationwide Children’s Hospital in Columbus, Ohio as a NICU Clinical Pharmacy Specialist. Topics of interest include infectious disease, nutrition and pulmonary hypertension. To learn more, please click here: http://www.ppag.org/22AM/Magers.pdf“The Presidential Chairman's Citation' is chosen annually by the sitting president of the Pediatric Pharmacy Advocacy Group (PPAG) and is awarded to an individual that has made a significant and direct impact on the organization. This year’s president, Amy Potts, PharmD, selected Peter Johnson, PharmD an associate professor at the University of Oklahoma. Dr. Johnson received this accolade in recognition of his outstanding service as PPAG’s representative on the Taskforce that recognize Pediatric Pharmacy as a Pharmacy Specialty. The Taskforce was a joint effort of the American College of Clinical Pharmacy, American Society of Health-System Pharmacists and PPAG. Dr. Johnson received his doctor of pharmacy from the University of Mississippi School of Pharmacy in 2004 and completed a PGY1 and PGY2 residencies at the University of Kentucky Chandler Medical Center in Lexington, KY. He is currently an assistant professor in the College of Pharmacy and adjunct assistant professor in the Department of Pediatrics-Section of Critical Care at the University of Oklahoma. Dr. Johnsons is currently a Clinical Pharmacy Specialist-Pediatric Critical Care at the Children’s Hospital at Oklahoma University Medical Center. The Citation was presented on May 3, 2013 at the 22nd Annual PPAG Meeting in Indianapolis, Indiana.The American College of Clinical Pharmacy (ACCP), the American Pharmacists Association (APhA), the American Society of Health-System Pharmacists (ASHP), and the Pediatric Pharmacy Advocacy Group (PPAG) jointly submitted a petition to the Board of Pharmacy Specialties (BPS) requesting recognition of Pediatric Pharmacy Practice as a Specialty. In response to that petition the BPS Board of Directors has voted to recognize pediatric pharmacy as a BPS Specialty. Peter Johnson, PharmD from the University of Oklahoma represented PPAG on the joint task force. Others on the task force included Lea Eiland, PharmD (ASHP), Marcia Buck, PharmD (ACCP), and Chasity Shelton, PharmD (APhA).BPS issued a call for nominations to serve on the Pediatric Pharmacy Specialty Councils and will appoint a 9-member council, which will convene in the Fall of 2013. Examination item writing for the new specialty exam will begin between the fourth quarter of 2013 and the first quarter of 2014 with the first exam being administered in 2015.For more information from BPS, please direct your browser to: http://bpsweb.org/news/pr_041513.cfm.“The Spirit of PPAG Award” recognizes outstanding member contributions to the Association. The recipients of this Award embody and exemplify the values of PPAG and inspire action in others. The Award recognizes those “behind the scene” contributors that usually go unnoticed, but are not less important. Recipients are chosen by peers working on committees or on particular projects. Recipients are officially recognized at the “Town Hall Business Meeting” during the PPAG Annual Meeting each year. This year recipients are Drs. Crumby, Nichols and Whitmore.Ashley Crumby, PharmD, Assistant Clinical Professor at Purdue University, for her contributions to the Education Committee coordinating hospital tours of Riley Children’s Hospital. Kristen Nichols, PharmD, Assistant Professor at Butler University, for her contributions to the Education Committee coordinating hospital tours of Riley Children’s Hospital. Maria Whit-more, PharmD, Pediatric Critical Care Clinical Pharmacist at Peyton Manning Children’s Hospital, for her contributions to the Education Committee coordinating hospital tours of Peyton Manning Children’s Hospital at St. Vincent.

Recommendations for Meeting the Pediatric Patient's Need for a Clinical Pharmacist: A Joint Opinion of the Pediatrics Practice and Research Network of the American College of Clinical Pharmacy and the Pediatric Pharmacy Advocacy Group

Children warrant access to care from clinical pharmacists trained in pediatrics. The American College of Clinical Pharmacy Pediatrics Practice and Research Network (ACCP Pediatrics PRN) released an opinion paper in 2005 with recommendations for improving the quality and quantity of pediatric pharmacy education in colleges of pharmacy, residency programs, and fellowships. Although progress has been made in increasing the availability of pediatric residencies, there is still much to be done to meet the direct care needs of pediatric patients. The purpose of this joint opinion paper is to outline strategies and recommendations for expanding the quality and capacity of pediatric clinical pharmacy practitioners by elevating the minimum expectations for pharmacists entering pediatric practice, standardizing pediatric pharmacy education, expanding the current number of pediatric clinical pharmacists, and creating an infrastructure for development of pediatric clinical pharmacists and clinical scientists. These recommendations may be used to provide both a conceptual framework and action items for schools of pharmacy, health care systems, and policymakers to work together to increase the quality and quantity of pediatric training, practice, and research initiatives.

Pediatric News

Pediatric News

KRAUS NAMED HELMS AWARD RECIPIENT

Donna Kraus, PharmD has been named the PPAG 2013 recipient of the Richard A. Helms Award for Excellence in Pediatric Pharmacy Practice. Dr. Kraus received her Bachelor of Science in Pharmacy (‘77) and Doctor of Pharmacy (‘82) from the University of Illinois at Chicago. She completed a postdoctoral pediatric specialty residency at the University of Texas Health Science Center in San Antonio (‘83). Dr. Kraus served as a pediatric intensive care clinical pharmacist for 15 years and for the past 14 years has been an ambulatory care pediatric clinical pharmacist, specializing in pediatric HIV pharmacotherapy and patient/ parent medication adherence. Dr. Kraus has also served as a clinical pharmacist consultant to a pediatric long-term care facility for over 21 years. She currently holds the appointment of Associate Professor of Pharmacy Practice in both the Departments of Pharmacy Practice and Pediatrics at the University of Illinois in Chicago.Dr. Kraus is an active educator at UIC and has been a guest lecturer in China, Thailand, and Hong Kong. She has played a leading role in the advanced training of postgraduate pharmacists and has been the Director of the ASHP accredited Pediatric Residency Program at UIC for 25 years. Dr. Kraus’ research areas include pediatric drug dosing and developmental pharmacokinetics and pharmacodynamics. She has published 30 articles and 10 book chapters on various issues of pediatric pharmacy and pharmacotherapy. Dr. Kraus is co-author of the Pediatric &amp; Neonatal Dosage Handbook (previously called the Pediatric Dosage Handbook), which is currently in its 19th edition.Dr. Kraus has been an active member of numerous professional associations including the American Pharmacists Association (APhA), American Society of Health-System Pharmacists (ASHP), Illinois Pharmacists Association (IPhA), American College of Clinical Pharmacy (ACCP), and Illinois College of Clinical Pharmacy (ICCP). She has served as Chairperson of the ASHP Commission on Therapeutics; member of the Board of Directors of the Pediatric Pharmacy Advocacy Group (PPAG); Member-at-Large of the Academy of Pharmaceutical Research and Science (APhA); member of the ASHP, Commission on Credentialing, Design/Writing Group, Educational Outcomes, Goals and Objectives for Postgraduate Year Two (PGY2) Pediatric Pharmacy Residency Programs (2007); member of the Alliance for Pediatric Quality, Improve First Measures Task Force; and member of the PPAG Advisory Board. Dr. Kraus also served as an Editorial Board member of the American Journal of Health-System Pharmacy and the Journal of Pediatric Pharmacy Practice. Currently, she serves as an Editorial Board member of The Journal of Pediatric Pharmacology and Therapeutics.Dr. Kraus has been elected to Fellow status by the American Pharmacists Association, the Pediatric Pharmacy Advocacy Group, and the American College of Clinical Pharmacy.

Recommendations for Meeting the Pediatric Patient's Need for a Clinical Pharmacist: A Joint Opinion of the Pediatrics Practice and Research Network of the American College of Clinical Pharmacy and the Pediatric Pharmacy Advocacy Group

Children warrant access to care from clinical pharmacists trained in pediatrics. The American College of Clinical Pharmacy Pediatrics Practice and Research Network (ACCP Pediatrics PRN) released an opinion paper in 2005 with recommendations for improving the quality and quantity of pediatric pharmacy education in colleges of pharmacy, residency programs, and fellowships. While progress has been made in increasing the availability of pediatric residencies, there is still much to be done to meet the direct care needs of pediatric patients. The purpose of this Joint Opinion paper is to outline strategies and recommendations for expanding the quality and capacity of pediatric clinical pharmacy practitioners by 1) elevating the minimum expectations for pharmacists entering practice to provide pediatric care; 2) standardizing pediatric pharmacy education; 3) expanding the current number of pediatric clinical pharmacists; and 4) creating an infrastructure for development of pediatric clinical pharmacists and clinical scientists. These recommendations may be used to provide both a conceptual framework and action items for schools of pharmacy, health care systems, and policymakers to work together to increase the quality and quantity of pediatric training, practice, or research initiatives.

2012 PPAG Fellows

2012 PPAG Fellows