Pharmacy Practice Faculty Research Articles

Comparison of full-time faculty preceptor and volunteer preceptor evaluations of experiential students

IntroductionOftentimes, students believe that faculty preceptors have different expectations than volunteer preceptors during experiential rotations. Despite this perception, there is no published data reporting the actual differences in volunteer and faculty evaluations. This study determined if students placed with volunteer preceptors experience a different level of evaluation rigor than students placed with full-time faculty preceptors on advanced pharmacy practice experiences (APPEs). MethodsA retrospective analysis of preceptor evaluations of student pharmacists enrolled in acute care or ambulatory care APPEs from June 2016 to May 2019 was completed to determine differences between full-time faculty preceptors and volunteer preceptors. Results were analyzed using Fisher's exact testing. ResultsWhen comparing evaluation results from volunteer and full-time faculty preceptors, a statistically significant difference was demonstrated in both acute care and ambulatory care for two of ten questions on APPE formative evaluations. No difference was observed when comparing faculty and volunteer preceptor ratings across five summative assessments. ConclusionsPreceptor evaluations of APPE students in acute care and ambulatory care settings revealed limited statistically significant differences on formative assessment over three years, while required summative assessments showed no statistically significant differences between pharmacy practice faculty and volunteer preceptors. This indicates that any difference in rigor regarding APPE student performance between volunteer and faculty preceptors is limited.

Exploring factors associated with scholarly writing among US pharmacy practice faculty.

This study explored intrinsic facilitators (i.e., grit, self-efficacy, and writing motivation) and barriers associated with scholarly output as measured by self-reported publications among US pharmacy practice faculty. A cross-sectional study design was used to gather information regarding scholarly writing output and intrinsic facilitators and barriers among US pharmacy practice faculty using an online self-reported survey. The survey link was distributed via email between October and November 2017. The Grit-S, New Generalized Self-Efficacy Scale (NGSE), and Scholarly Writing Motivation Scale (SWMS) were used to measure grit, self-efficacy, and writing motivation, respectively. Perceived barriers, self-reported quantity of publications, and demographics were also collected. A structural equation modeling (SEM) approach was used to determine effects of perceived barriers and each intrinsic factor on self-reported total publications. N=208 participants were included in the analyses. The average number of self-reported annual publications was 1.88. Participants who reported having higher than average numbers of annual publications (n=85, 40.9%) more frequently held a PhD degree and were more frequently in the tenure track, compared to those with annual publications less than the average (n=123, 59.1%). The majority of both groups reported being employed in public institutions. Lack of time for scholarly writing was the highest perceived barrier and lack of knowledge about technical writing/English mastery was the lowest. All three SEM models consistently showed that perceived barriers were negatively associated with numbers of self-reported publications. However, only scholarly writing motivation according to SWMS was positively associated with the numbers of self-reported publications. Writing motivation and barriers to scholarly writing are shown to have a significant impact on scholarly output. These factors can be identified and should be appropriately addressed by colleges/schools of pharmacy to enhance scholarly activities among pharmacy practice faculty.

A cross-sectional analysis of self-reported scholarly publications among United States pharmacy practice faculty

IntroductionThe objectives of this study were to provide an estimate of self-reported peer-reviewed publications and evaluate characteristics associated with publication rates among pharmacy practice faculty within United States (US)-based colleges and schools of pharmacy. MethodsAn online survey instrument was distributed to pharmacy practice faculty via email listserv. Information regarding faculty members' publication histories, faculty position, institutional characteristics, and faculty demographic characteristics was gathered. Descriptive statistics were used to characterize participants, and t-tests and analysis of variance were used for comparisons among groups. ResultsTwo hundred and nine pharmacy practice faculty were included. The majority were female (67%), white (81%), and from public institutions (66%). Academic ranks were well-represented. Reporting higher percent time spent in research, employment at public institutions, and having earned a doctor of philosophy (PhD) degree were all significantly associated with higher total number of publications and a higher annualized publication rate. Tenure track faculty who were not yet tenured had higher annual publication rates than faculty who were tenured or in non-tenure track positions. The overall annual publication rate was 2.0 ± 2.1 publications per year. ConclusionsCharacteristics such as being in a tenure track position, holding a PhD, spending more time in research, and employment within a public institution were all associated with a higher publication rate. These self-reported data from pharmacy practice faculty also indicate an increase in the average number of scholarly publications per year from previously reported estimates.

Pharmacy practice faculty and preceptor development

AbstractFaculty development is a priority for colleges and schools of pharmacy for both corporate and individual success. Recommendations in the 2008 American College of Clinical Pharmacy (ACCP) position statement and white paper on faculty development remain relevant today. However, changes in educational standards, delivery of pharmacy education, and faculty and learners have prompted an update of the 2008 documents. This 2020 white paper focuses on three components: preceptor development, updates in pharmacy practice faculty development, and program formation and implementation. The paper provides evidence and recommendations for preceptor development and summarizes the literature updates related to pharmacy practice faculty development in several areas, including teaching, practice, and research. This update explores additional topics not emphasized in the previous paper, including faculty well‐being, holistic career‐long development, and challenges with implementing and assessing development programs.

Item analysis of emotional exhaustion in pharmacy practice faculty

IntroductionThe primary objective of this study was to identify the single question on the Maslach Burnout Inventory – Educator Survey (MBI-ES) that correlated with high emotional exhaustion (EE) among pharmacy practice faculty. MethodsWe analyzed data collected from the electronic administration of the MBI-ES to faculty at United States (US) colleges and schools of pharmacy in 2014. For our primary outcome, we used Spearman's rho correlation (rs) to identify a single question on the MBI-ES that was highly correlated with high EE (one of three subscales of MBI-ES). We calculated likelihood ratio statistics for each level of the item with the largest rs with total EE, then converted those to adjusted predicted probabilities of high EE. De-identified data were collected via Qualtrics version 60949 (Provo, Utah) and analyzed using IBM SPSS Statistics, Version 22.0 (Armonk, NY). ResultsThe single item, “I feel emotionally drained from my work” (rs = 0.833, p = 0.01), was most correlated with high EE score on the MBI-ES. Faculty who reported “I feel emotionally drained from my work” once per week and few times per week had 62.8% and 93% chance of having high EE, respectively. ConclusionThe single item that was most highly correlated with EE may be used for further evaluation of faculty who may be at risk for burnout. Interventions for reducing burnout among pharmacy practice faculty are critically needed for sustaining our pool of faculty.

Impact of Achieved Tenure and Promotion on Faculty Research Productivity at a School of Pharmacy.

Critics of the promotion and tenure system contend that promotion and tenure may lead to a decline in research productivity ("dead wood phenomena") by those faculty. To assess this perception, we compiled the publications and grants at the time of application for promotion, and again through 2017 for the same faculty following promotion and/or tenure. Promotion documents at a school of pharmacy at a public Midwestern university were assessed. Mean publication rates and grant dollars per year per faculty member were compared to the same group of faculty (n=13) pre and post-promotion. At the time of promotion to associate professor, mean numbers of total publications per year per faculty in the pharmacy practice department were 1.1, compared to 1.4 post-promotion. For pharmaceutical sciences department faculty, corresponding means were 5.0 and 4.1, respectively. At the time of promotion to full professor, mean numbers of total publications per year for pharmacy practice faculty were 7.0, compared to 7.2 post-promotion. For pharmaceutical sciences faculty, corresponding means were 3.5 and 4.7, respectively. For grant activity, both associate professors and full professors increased the mean total dollars per year from pre-promotion to post-promotion for both departments. Research productivity at this school of pharmacy continues to be either maintained or increased since promotion for the collective group of faculty. This evidence runs counter to the perception that promotion and tenure may lead to decreased scholarly productivity. The study provides a roadmap for other schools/colleges to quantify research productivity and make comparisons to national mean levels reported in the literature.

Gagné’s 9 Events of Instruction With Active Learning: Teaching Student Pharmacists How to Measure Blood Pressure

As the scope of practice for pharmacists expands to include rendering physical assessment procedures, colleges and schools of pharmacy are increasingly incorporating various assessment skills into the curriculum. Pharmacy practice faculty are increasingly tasked with teaching and assessing learners on professional competency in entrustable professional activities and skills such as manual blood pressure measurement. Manual measurement using a sphygmomanometer and a stethoscope is considered the gold standard with regard to evaluating blood pressure. As pharmacy faculty begin to develop courses on physical assessment, a step-by-step, evidence-based andragogic/pedagogic method for designing, planning, instructing, and assessing learner proficiency is essential. The principles and techniques of active learning are frequently discussed and increasingly incorporated into the curricular and teaching philosophies of colleges and schools of pharmacy. However, the practical application of andragogic/pedagogic principles toward lesson planning and curation of active learning is infrequently discussed. In this article, we aim to illustrate a deliberate approach to designing and operationalizing active learning for auscultatory manual blood pressure measurement within the framework of Gagné’s 9 events of instruction. For each design and instruction step, we propose user-friendly, high-impact operational practices derived empirically from education science, experience, and observations. Schematically, the approach described is intended to also facilitate instructor metacognition and knowledge building of applied andragogy/pedagogy through pre hoc, ad hoc, and post hoc reflection. Pragmatically, the approach accommodates active learning lesson planning, promotes transparency of teaching and learning, and is generalizable and applicable toward the instruction of various physical assessment procedures within the health professions.

Faculty insights regarding incorporation of gender- and sex-related differences in the PharmD curriculum: Phase 2

BackgroundWhile pharmacists should be aware of gender and sex-related differences in treatment related decisions, this is not a required doctor of pharmacy curricular component. A regional pilot study demonstrated that approximately half of pharmacy practice faculty discussed these differences in their content area. The aim of this study was to evaluate the extent of inclusion of gender and sex-related differences on a national level in doctor of pharmacy curricula and to determine if faculty are comfortable teaching the topic. MethodsAn electronic message with a link to an online survey was distributed to 7250 faculty members at 139 colleges of pharmacy. The survey remained open for three weeks and potential participants received weekly email reminders. The survey was voluntary, and responses were de-identified. ResultsOverall, 641 faculty participated in the survey (8.8% response rate). Most respondents indicated that they do not teach about gender or sex-related differences (54.9%). Of those faculty reporting teaching gender and/or sex-related differences, 28% indicated that it was addressed in one clinical topic, while some (7.7%) indicated that the content was included in up to five topics. Half of faculty (53.6%) indicated that they believe this topic is somewhat important. ConclusionsResults of this study suggest that gender and sex-related differences are not adequately addressed in current pharmacy curricula.

Overview and Preparation Guide for Academic Careers in Pediatric Pharmacy, Part 1: Career as a Pediatric Pharmacy Practice Faculty Member.

Pediatric clinical pharmacy is a growing and evolving field with an increasing number of pediatric clinical pharmacists in academia. In 2017, pediatric practice faculty members represented approximately 7.6% of all pharmacy practice faculty in the United States. The benefits of practicing in an academic environment are many, including, but not limited to, the ability to shape the future of pharmacy practice through the training of the next generation of pharmacists, contributing to science through research and scholarly activities for the care of pediatric patients, and positively impacting patient care for the most vulnerable of patients. Part one of this two-part series describes careers in academic pediatric pharmacy, as well as faculty roles and responsibilities, and provides information and advice related to the preparation and transition into careers in academic pediatric pharmacy.

When a patient talks about suicide: Adding a social worker led session on the pharmacist's role in suicide prevention to the PharmD curriculum

Background and purposeSuicide is the tenth leading cause of death in the US. Frontline health professionals like pharmacists can be trained to intervene with patients displaying warning signs of suicide. The purpose of this activity was to introduce student pharmacists to suicide prevention concepts. Educational activity and settingA social worker on faculty at the school of social work and a pharmacy practice faculty member collaborated to deliver a 50-min didactic session to first year students on the role of pharmacists in suicide prevention. The session included: (1) suicide statistics and public health signiifcance, (2) protective factors, risk factors, and warning signs of suicidal ideation, (3) strategies for asking about suicidal ideation, including practice asking about suicide, (4) resources and referrals, and (5) brief case scenarios and student questions. FindingsAn electronic survey was administered to 108 students and 83 responses (76.9%) were received. The results suggested the topic was new to most students and was relevant to their role as pharmacists. Most students (91%) reported that the session increased their confidence in asking about suicide for someone displaying warning signs. Student comments on the survey were generally positive with students requesting additional exposure to scenarios. Pharmacy programs may benefit from collaborating with social work or mental health professionals to deliver basic suicide intervention training tailored to pharmacy. SummaryA social worker-led session about suicide prevention was positively received by first year student pharmacists.

Interdisciplinary pharmaceutical sciences activity within a pharmacy practice skills course

Background and purposeTo help students develop a more integrated mindset, an integrated curricular model can facilitate the building of connections between the foundational and clinical sciences by presenting multi-disciplinary material within a cohesive framework in a single course. The main objective of this research was to assess the impact of interdisciplinary teaching on student performance in a skills course. Educational activity and settingA case study was presented and questions were embedded through an audience response system. Each of three groups of students (approximately 32 students per group) were divided into teams, and the scores were shown periodically to produce an atmosphere of friendly competition. The entire exercise lasted approximately 50 min. FindingsStudents found the pharmaceutical science and pharmacy practice faculty collaboration helpful in regards to reviewing for integrated exams. Student pharmacists were asked to provide one positive aspect of the course and one area for improvement. Twenty-two of 96 responders indicated that the integrated class session was the highlight of the course. Student pharmacists noted that they were able to recognize the integration between the basic and applied sciences. Students clearly favored this learning style over the didactic approach, as evidenced by the feedback. In the future, we plan to implement longer integrated cases more frequently to train future pharmacists as critical and integrative thinkers. SummaryThis integrated case study appeared to be effective in helping student pharmacists apply knowledge of various basic science disciplines to the applied sciences.

Establishing a New Ambulatory Care Practice Site as a Pharmacy Practice Faculty.

There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will be able to provide adequate resources and support to establish a successful practice. This may be challenging to pharmacy practice faculty in settings where clinical pharmacy services have never been utilized. Topics include the pre-work needed prior to approaching a new practice site, assessing the need for physical requirements, meeting key personnel, marketing clinical skills and services, implementing, and evaluating practice site. Preparation includes having a clear vision of the pharmacist services, ensuring that stakeholders have an understanding of the pharmacy services inquiring the site support and resources for the pharmacist, and regularly communicating.

Design and Evaluation of a Longitudinal Faculty Development Program to Advance Scholarly Writing Among Pharmacy Practice Faculty

Objective. To describe the design and evaluation of a six-month longitudinal faculty development program designed to promote experience and skills in scholarly writing among pharmacy practice faculty. Methods. Writer's Block uses a scheduled weekly writing time, peer support, and multiple accountability measures to promote progress in manuscript writing. Faculty participation, satisfaction, and manuscript writing progress were used to evaluate the program's success. Demographic data describing faculty participation in at least one of three cohorts of Writer's Block were collected. Satisfaction was determined using an anonymous online survey. Writing progress was determined through reporting of weekly manuscript word counts and submission to a peer-reviewed journal. Results. Twelve assistant professors participated in one or more program cohorts to develop 20 manuscripts. Twelve (60%) manuscripts were submitted to a peer-reviewed journal. Of these, 10 (83%) have been published or accepted for publication, and one (8%) is undergoing peer review. The majority of participants agreed or strongly agreed that the program was helpful in starting and advancing manuscript writing. Specific program components meant to encourage writing accountability, such as monthly meetings, reporting word counts, and setting a weekly writing schedule, were highly valued. Conclusion. This program is the first described writing-focused faculty development program among pharmacy practice faculty. It successfully engaged pharmacy practice faculty members in the scholarly writing process, evidenced by participation in the program, participant satisfaction, and documented progress in manuscript development.

Identifying student learning competencies for urban underserved practice using a Delphi process

IntroductionThe pharmacy profession has a growing opportunity to provide high-quality patient care to urban underserved patients. The Accreditation Council for Pharmacy Education (ACPE) has also recognized the necessity of training pharmacy students to care for underserved patients within Standard 3.5 in Standards 2016. Despite this recognized need to train students to care for urban underserved patients, there is limited literature to guide schools and colleges of pharmacy in developing learning activities and curricula to meet this need. MethodsThis study utilized a three-round modified Delphi process to develop learning competencies. Participation was solicited from pharmacy practice faculty members of the American Association of Colleges of Pharmacy (AACP) Health Disparities and Cultural Competency Special Interest Group (SIG). This study used a proportion of experts rating agree or strongly agree at 80% to determine consensus. ResultsThe expert pool had a combined 235 years of pharmacy practice experience in urban underserved settings. Ten learning competencies were developed and finalized: Identified learning competencies related to the development of pharmaceutical and social knowledge base; development of pharmaceutical care and social skills; and building awareness of benefits and disadvantages of working with urban underserved patient populations. DiscussionThe learning competencies described in this study provide schools and colleges of pharmacy a tool to help guide learning activity and curricular development to educate students to provide high-quality and compassionate care to urban underserved patients. ConclusionsThis study is the first description of practice-based student learning competencies for urban underserved pharmacy practice in the literature.

Clinical pharmacy academic career transitions: Viewpoints from the field part 3: Learning when and how to say yes

The six authors of this commentary series, who have recently transitioned into or within an academic career, discuss challenging aspects of an academic career change. This is Part 3 of a three-part commentary series that focuses on when and how to say yes to the multitude of opportunities available to pharmacy practice faculty. Part 1 discusses feedback, evaluation, and advancement. Part 2 explains distribution of effort (DOE) and how to marry the different components of teaching, research, and service. While the entire series is intended to be read in continuity, faculty, or those interested in pursuing a career in pharmacy academia, can refer to Part 3 as a reference on how to screen opportunities within academia to maximize professional and personal growth and minimize career burnout. Schools of pharmacy may utilize this as a tool for new faculty members during orientation to help ensure faculty success.

The Report of the 2016-2017 Professional Affairs Standing Committee: Formally Embracing and Engaging Preceptors in the Academy — The Time Has Come

The 2016-2017 AACP Professional Affairs Committee (PAC) was charged to examine strategies to include adjunct/affiliate preceptors as AACP members and to determine the value proposition of AACP membership for this group of educators. The PAC defined adjunct/affiliate preceptors as preceptors who are neither full-time employees nor have a primary employment commitment (≥50% of the preceptor's work salary) at a school/college of pharmacy. Specific charges to the PAC included: recommend an approach to increase the number of adjunct/affiliate preceptors as AACP members, examine AACP membership from an adjunct/affiliate preceptor value perspective, and prepare a concise summary of available literature describing value-added contributions of student pharmacists and pharmacy preceptors to pharmacy practice models, interprofessional education (IPE) and interprofessional practice (IPP). The summary of the plan developed by the PAC to address the charges is presented in the following report, which includes three sections: the value proposition of AACP membership for adjunct/affiliate preceptors, expansion of the presence of adjunct/affiliate preceptors in AACP, and the value of student pharmacists in experiential education settings. The value proposition of AACP membership for adjunct/affiliate preceptors section describes results of surveys and focus groups conducted by the PAC. The PAC surveyed experiential education directors at schools/colleges of pharmacy, adjunct/affiliate preceptors (from a request via the experiential education directors), and new pharmacy practice faculty members in order to determine current resources available for adjunct/affiliate preceptor development, as well as explore potential resources AACP could provide for adjunct/affiliate preceptor development. Focus groups were held with adjunct/affiliate preceptors and experiential education faculty/staff to explore some of the results and concepts generated from the surveys. The PAC developed three recommendations for AACP as a result of the surveys and focus groups. The report also describes various factors that should be considered by AACP in developing a membership category for adjunct/affiliate preceptors, including potential membership models, establishment of an advisory board, and collaboration with other stakeholder groups. The final section of the report provides an executive summary and detailed table, which summarizes available literature on the value of student pharmacists in experiential education. The brief literature review reinforces that there are many different practice settings where student pharmacists add value to patient care and the practice site. This information is significant for experiential education faculty/staff, as well as adjunct/affiliate preceptors, and serves as an example of best practices which document the value experiential education provides to patient care and practice sites. The final section of the report provides a policy statement that was adopted by the 2017 AACP House of Delegates and one suggestion to schools/colleges of pharmacy. The report concludes with a call to action regarding the formal involvement of adjunct/affiliate preceptors by AACP and the academy.

Essential Training, Resources, and Skills of First-Year and Junior Pharmacy Practice Faculty Needed in the Development of an Individual Research Program

Objective: To describe types of current training/support received and elicit opinions on the level of importance of specific skills and resources needed to build confidence in conducting research for early-career pharmacy practice faculty. Methods: A survey instrument regarding available resources, levels of importance of resources, and skills needed to improve research confidence was sent to all new early-career practice faculty members with 3 or less years of experience in academia at 129 US colleges and schools of pharmacy. Results: Few respondents indicated a formal research training existed at their institution. Overall, a majority of respondents identified at least 14 specific developmental areas as moderately to very important in building confidence. Over 75% of respondents rated 15 basic skills as moderately to very important in successfully starting an individual research program. Conclusion: Although different types of research training programs are available, confidence in conducting research in both informal and formal ones is low. Both groups of respondents identified similar important developmental research areas that would increase their confidence and skills in achieving their early research goals.

A course for developing interprofessional skills in pre-professional honor students using humanities and media

Background and purposeTo design and implement an undergraduate honors course for pre-health professional students that develops interpersonal skills through use of a variety of humanities. Educational activity and settingA three credit hour course in an honors seminar sequence was developed by pharmacy practice faculty and with input from faculty in mass communications, philosophy, applied communication studies and history. The course utilized a variety of media such as literature, film, and podcasts to foster student discussion about a variety of health-related topics. Topics included public health, stigmatization, portrayals of health care providers, patient experiences, health care ethics, aging, and death and dying. Students were assessed using pre-class assignments and reflective writings as well as a formal written and oral presentation on a selected health-related book. A quasi-experimental design was used to assess the impact of the course on desired course outcomes. FindingsThe first course offering was to 22 undergraduate pre-health professional honors students. Pre- and post-course surveys on students’ perceptions and students’ reflective writings revealed achievement of desired course outcomes. Post-course evaluations also revealed positive perceptions about the course. DiscussionThe design of this course provided an outlet for students to read and enjoy various forms of media, while also meeting its goal of exposing students to a variety of humanities. The course allowed students to think critically about various health care issues, and to begin to develop interpersonal skills. SummaryThe course could be adapted for pharmacy by developing affective domains of the Accreditation Council for Pharmacy Education (ACPE) Standards.

Assessment of Burnout and Associated Risk Factors Among Pharmacy Practice Faculty in the United States

Objectives. To measure the level of burnout among pharmacy practice faculty members at US colleges and schools of pharmacy and to identify factors associated with burnout. Methods. Using a cross-sectional, electronic, anonymous survey-design, we measured faculty burnout (n=2318) at US colleges and schools of pharmacy using the Maslach Burnout Inventory-Educators Survey (MBI-ES), which measures burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. We assessed MBI-ES scores, demographics and possible predictors of burnout. Results. The response rate was 32.7% (n=758). Emotional exhaustion was identified in 41.3% and was higher in women, assistant professors, and those without a hobby. Participants without a mentor had higher scores of depersonalization. Those with children ages 1-12 years had higher emotional exhaustion and depersonalization compared to those with older children. Conclusion. Pharmacy practice faculty members at US colleges and schools of pharmacy are suffering from burnout, exhibited mainly through emotional exhaustion.

Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.

The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care. Pharmacist-provided care has been shown to reduce drug expenditures, hospital readmissions, length of stay, and emergency department visits. Although pharmacists have become key team members of interdisciplinary teams within traditional care settings, their role has often been overlooked in the primary care-based ACO. In 2015, Nova Southeastern University College of Pharmacy founded the Accountable Care Organization Research Network, Services, and Education (ACORN SEED), a team of pharmacy practice faculty dedicated to using innovative approaches to patient care, while providing unique learning experiences for pharmacy students by partnering with ACOs in the South Florida region. Five opportunities are presented for pharmacists to improve medication use specifically in primary care-based ACOs: medication therapy management, annual wellness visits, chronic disease state management, chronic care management, and transitions of care. Several challenges and barriers that prevent the full integration of pharmacists into primary care-based ACOs include lack of awareness of pharmacist roles in primary care; complex laws and regulations surrounding clinical protocols, such as collaborative practice agreements; provider status that allows compensation for pharmacist services; and limited access to medical records. By understanding and maximizing the role of pharmacists, several opportunities exist to better manage the medication-use process in value-based care settings. As more organizations realize benefits and overcome barriers to the integration of pharmacists into patient care, programs involve pharmacists will become an increasingly common approach to improve outcomes and reduce the total cost of care and will improve the financial viability of primary care-based ACOs. No outside funding supported this research. The authors report no conflicts of interest related to this manuscript. Study concept and design were contributed by Joseph, Hale, and Eltaki, with assistance from the other authors. Prados and Jones took the lead in data collection and data interpretation and analysis, with assistance from the other authors. The manuscript was written primarily by Joseph and Hale, along with the other authors, and revised primarily by Seamon and Gernant, along with the other authors.