PharmD Degree Research Articles

Chain community pharmacists’ requests for patient information during routine care

BackgroundTo optimize service provision, community pharmacists need information (e.g., laboratory values and updated medication lists), which can be difficult to obtain. Contacting prescriber offices is a common approach to obtain information but is often ineffective. Health information exchange (HIE) is one potential solution to this problem, and recent survey research has identified the information needs of independent pharmacists that could be addressed through HIE. However, the information needs of chain community pharmacists are unknown. ObjectivesThe objective of this study was to characterize the patient information requests made by chain community pharmacists during routine practice. MethodsThis electronic card study captured cross-sectional observational data on patient information requests made by chain pharmacists in central Indiana during routine practice. Only one pharmacist meeting eligibility criteria per pharmacy could submit data. Pharmacists were randomized to a two-week data collection period. In real-time, pharmacists recorded the following: type of information requested, reason for request, information source, whether initial or follow up request, modality of communication, and the time required to make the request. Data analysis occurred via descriptive statistics. The Indiana University Institutional Review Board approved all study procedures. ResultsNineteen of the 33 eligible pharmacists (57.6%) consented to the study. Most participants held a PharmD degree (78.9%) and were the pharmacy manager (89.5%) at their location. Updated medication orders/lists (41.3%) and insurance (33.3%) were the most common type of requested information and was primarily used for prescription clarification/filling (93.4%). The prescriber office (53.6%), as well as the patient/caregiver (39.8%), were the most frequent source of this information. Requests were largely completed by telephone (61.2%) and averaged 6.0 minutes (SD: 4.8). ConclusionCommunity pharmacists require key patient data during routine practice. There is a need to develop mechanisms, like HIE, to address gaps in needed information in the community pharmacy setting, regardless of the offered services.

Evaluating Curriculum Differences in US PharmD Programs: A Peer Evaluation

ObjectiveTo evaluate the differences in curriculum structure and content and observe commonalities across various Doctor of Pharmacy (PharmD) programs in the United States. MethodsThis research involves the collection of course content and credit hour data from the curricula and course descriptions, course catalogs, and student handbooks of all the PharmD programs available on their websites and categorization based on the content areas outlined in the Accreditation Council of Pharmacy Education. The core courses, elective offerings, and experiential education (eg, Introductory and Advanced Pharmacy Practice Experience) were evaluated using Excel® for credit hours, integration, non-integration, program duration (3-year vs 4-year), and online offerings. ResultsOf 142 accredited schools/colleges, 135 were included in the study, which met the inclusion criteria. In total, 85 of these schools have an integrated curriculum, 19 have a 3-year curriculum, and 15 offer a distance learning pathway for a PharmD degree. Fourteen of the 37 required content areas from the Accreditation Council of Pharmacy Education Appendix 1 were identified, with more than 50% of schools listing no credit hours allocated. Only 9 areas had 90% or more of pharmacy schools allocating credit hours. On average, biomedical, pharmaceutical, social/administrative/behavioral, clinical sciences, experiential education, and electives allocate 10.6, 25.3, 17.1, 40.5, 45.5, and 7.0 credit hours, respectively. ConclusionEach school’s curriculum has a significant variation in credit hours, and there is an opportunity to simplify the curricular structure and content by reducing redundancy and increasing flexibility based on health care needs.

Improving Drug Therapy for Pediatric Patients: Unfinished History of Pediatric Drug Development.

Improving Drug Therapy for Pediatric Patients: Unfinished History of Pediatric Drug Development.

Capacity-building and collaborative curriculum development: A transition from BPharm to PharmD degree at Nnamdi Azikiwe university in Nigeria

Introduction: The Nnamdi Azikiwe University (NAU) started its Bachelor of Pharmacy (BPharm) programme in the 2006-2007 academic year. However, NAU’s BPharm curriculum was not clinically focused, and NAU lacked expertise in implementing the clinical pharmacy focus of a Doctor of Pharmacy (PharmD) programme. The NAU pharmacy programme set out to transition from the BPharm curriculum to a new PharmD curriculum. Purpose: The purpose of this article is to describe the capacity-building and collaborative development of the new PharmD curriculum at NAU. In consultation and collaboration with an expert Carnegie African Diaspora. Description: During a six-week visit, the collaborators co-designed a model didactic and experiential PharmD curriculum, harmonised course syllabi and content, and revised the Clinical Clerkship Logbook. Conclusion: The Faculty of Pharmaceutical Sciences applied for and obtained University approval for the PharmD degree as a graduate degree. The National University Commission approved the PharmD programme.

Using the Theory of Planned Behavior to assess community pharmacists’ intention to prescribe using the Formulary and Protocol Compendia

BackgroundOregon pharmacists can autonomously prescribe hormonal contraception, naloxone, and various medications and devices from a Formulary and Protocol Compendia (FPC). Prescribing using the FPC has seen limited uptake. Objectives(1) Assess Oregon community pharmacists' intention to prescribe using the FPC; (2) Determine the impact that attitudes, subjective norms (SN), perceived behavioral control (PBC), perceived obligation, and past prescribing behavior have on pharmacists' intention to prescribe; (3) Examine the relationship between beliefs and pharmacists’ attitudes, subjective norms, and perceived behavioral control. MethodsThis study was conducted as a cross sectional survey, which was developed based on the results of a previously conducted research project. A modified version of the Theory of Planned Behavior (TPB) was the study framework. All Oregon community pharmacists with a public email address were invited to participate. The questionnaire collected information on TPB constructs as well as demographic and practice information. TPB constructs were measured directly (intention, attitudes, SN, PBC, perceived obligation, and past prescribing behavior) and indirectly (attitudes, SN, and PBC). Descriptive statistics were used for all items. Multiple linear regression was used to assess Objectives 2 and 3. ResultsThere were 175 useable responses included in the analysis of the estimated 1015 community pharmacists that received the survey invitation (17%). Respondents had 16.5 ± 13.3 years in practice, 60% held a PharmD degree, and 69% had prescribed in some manner before. Mean intention to prescribe using the FPC was 5.0 ± 1.5 (7-point scale with 7 indicating higher intention). Attitudes, SN, PBC, and PO were significant predictors of intention to prescribe, while past prescribing behavior was not (Adj R2 = 0.741, p < .0001). Attitudes were explained by beliefs about increasing patient access (p = .0179). PBC was explained by beliefs about having policies and procedures in place (p = .004) and feeling comfortable prescribing (p = .008). ConclusionsOregon community pharmacists have a positive intention to prescribe using the FPC, but actual uptake remains low. Efforts to increase uptake should focus on the beliefs that contribute most strongly to pharmacist intention.

Mapping Course Assessments to Canadian Pharmacy Educational Outcomes to Ensure Pharmacy Students’ Practice Readiness

Objective. The entry-to-practice PharmD degree is designed to meet the Educational Outcomes of the Association of Faculties of Pharmacy of Canada (AFPC). We set out to evaluate how assessment strategies in a "capstone" course align with AFPC educational outcomes, their respective key and enabling competencies, and whether enough assessments exist for students to demonstrate achievement of competencies prior to embarking on advanced pharmacy practice experiences.Methods. We mapped each assessment's objectives, content, and methods to the key and enabling competencies of each role of a pharmacist. The number of enabling competencies mapped represents the extent to which the assessment addressed the associated key competency and broader role. Deidentified student performance data were analyzed to identify achievement of competencies despite failed assessments.Results. Of the seven role descriptions, the roles care provider, communicator, and collaborator were the most comprehensively assessed. The roles leader-manager and health advocate were assessed to a limited extent. The role scholar was not covered to a great depth across assessments. The role professional was not represented in most assessments except for the final examination. Students with failed assessments generally had ample opportunity to demonstrate competencies through other assessments.Conclusion. Mapping assessments to AFPC educational outcomes is an essential step to demonstrate direct evidence that students have achieved the intended learning outcomes. Our map revealed that the assessments sufficiently overlapped with most AFPC educational outcomes with a few exceptions. It is important to create multiple opportunities within a course for students to demonstrate achievement of competencies to ensure practice readiness.

From Culture Shock to Cross-cultural Adaptation: Narrative inquiry of a Kenyan student’s journey in Pakistan

Travelling to a foreign country for higher education has its own challenges, as apart from dealing with academic stress, international students have to overcome various obstacles mainly because of linguistic and cultural differences between their native and the host country.The study explores a series of narratives shared by a Kenyan male student who had been in Karachi for the last five and a half years for earning a Pharm-D degree from a public sector university in Karachi. The aim of this qualitative narrative inquiry was to conduct an in-depth study of the challenges the Kenyan student faced during his five and a half years in Pakistan along with exploring how he succeeded in dealing with culture shock and adapting to the new academic, linguistic, and sociocultural environment in the host country.The data for this study were collected through a series of conversations with the participant collected in the form of stories, spanning over a period of 16 months. The collected data were analyzed through ‘a critical events approach’ based on highlighting critical events contained in the stories of experience. Although the findings of the study provide insights into the life experiences of only one international student, many international students, particularly the Kenyans can relate to it, as they pass through somewhat similar experiences during their academic journey in Pakistan. The findings of this study call for the need to facilitate international students irrespective of their race, religion, and nationality so that they do not feel marginalized in the host country.&#x0D;

The ethical challenges in pharmacy practice in community Pharmacies: A qualitative study

BackgroundPharmacists as a group of health care professionals, face different types of ethical challenges in their everyday routine that may impede pharmaceutical care. ObjectivesIn this study, we aimed at evaluation and recognition of the ethical challenges of pharmacy practice in community pharmacies. MethodsThis exploratory study was conducted as a qualitative study consisting of open-ended in-depth interviews and focus group discussions followed by content analysis. The study participants were chosen from pharmacists with PharmD degree who had at least 4 years work experience and were the founders or technical managers of community pharmacies, either as governmental or private. Interviews continued until data saturation and transcribed verbatim. The content analysis was done by Graneheim and Lundman method. The codes were generated, and categorized. After assessment and final modifications, the results of the study were discussed and confirmed in a focus group discussion conducted by 7 experts who teach medical ethics and/or pharmacy ethics. ResultsOverall, 40 pharmacists were interviewed (mean age 46 ± 11.3 years). The extracted ethical challenges of pharmacy practice were categorized into 3 main themes, 11 subthemes and 102 codes. The themes were achieved as challenges related to professionalism and professional practice, challenges related to professional communications and challenges related to regulations and policies. ConclusionTaken together, it seems that most of the challenges of pharmacy practice are related to professionalism and professional commitment; however, the regulations and policies provide serious obstacles for pharmacy practice and pharmaceutical care. More efforts towards teaching professionalism and modification of regulations and policies are recommended.

Knowledge, attitude, perceived barriers, and practices among pharmacists regarding risk assessment of cardiovascular disease: a cross-sectional study in Yemen

Background Risk evaluation of atherosclerotic cardiovascular diseases can guide the decision-making on various preventive measures, such as initiating or deferring statin therapy. Pharmacists can play an active part in the risk evaluation and primary prevention of atherosclerotic cardiovascular diseases. Thus, our study aimed to assess the pharmacists’ knowledge, attitude, perceived barriers, and practices regarding risk assessment of atherosclerotic cardiovascular disease. Materials and methods A cross-sectional study was conducted among 500 pharmacists using a structured validated questionnaire between November 2020 and February 2021. The Mann–Whitney and Kruskal–Wallis tests were used to analyze the data. Results A total of 456 pharmacists completed the questionnaire out of 500 distributed (91.2% response rate). Over 60% of participants responded with never or rarely for two out of five cardiovascular diseases (CVD) prevention practices. The lowest pharmacist-patient counseling practices were for side effects of statin medication (14.5%) and reviewing the patient’s medications to avoid potential statin-drug interactions (31.8%). Participants had a high positive attitude (median = 34 out of 40). The three major barriers for risk assessment were the lack of support (74.8%), the lack of resources (70.6%), and inadequate training (48.7%). Interestingly, having ≤75 customers a day, community pharmacies, PharmD degree, age ≥30 years, and experience ≥6 years were significantly associated (p < .05) with higher CVD prevention activities and counseling practices. Conclusion Pharmacists have a high positive attitude toward CVD risk assessment. However, they had insufficient knowledge and only provided limited activities and counseling services for CVD prevention and statin therapy. Participants perceived several barriers to CVD risk assessment services in pharmacies. Therefore, it is necessary to remove these impediments for pharmacists to be more involved in CVD risk assessment and prevention. Also, continuing medical education and adequate training for pharmacists are required.

Trends in gender and race/ethnicity of PharmD students and faculty in US pharmacy schools

IntroductionThis study described and compared trends in the distribution of gender and race/ethnicity for doctor of pharmacy (PharmD) students and faculty in schools and colleges of pharmacy in the United States. MethodsInstitution-level gender (male and female) and racial/ethnic (White, Black/African American, Hispanic/Latino) data for full-time faculty were obtained from the American Association of Colleges of Pharmacy institutional database for 2009–2019. PharmD students' demographic data during the same study period were collected separately for applications, enrollments, and degrees conferred. Generalized linear regression models were applied to examine trends in proportion of PharmD students and faculty distribution in subgroups of different gender and race/ethnicity at P < .05. All analyses were conducted using SAS, version 9.4 (SAS Institute). ResultsSignificantly increasing trends in female full-time faculty, PharmD applications, and enrollments were observed; however, the trend in female PharmD degrees conferred remained stable from 2009 to 2019. While the trends in proportion of PharmD applications, enrollments, and degrees conferred for Black/African American and Hispanic/Latino students increased significantly, declines and stable trends in the proportion of Black/African American and Hispanic/Latino faculty, respectively, were identified during the same time. ConclusionsUpward trends in proportions of Black/African American and Hispanic/Latino PharmD applications, enrollments, and degrees conferred were not mirrored by trends in proportions of underrepresented faculty. Implementation of effective faculty diversity and inclusion strategies is warranted to better meet the educational needs of PharmD students.

Adventures in getting paid

Adventures in getting paid

National Pharmacist Workforce Study (NPWS): Description of 2019 Survey Methods and Assessment of Nonresponse Bias.

National Pharmacist Workforce Studies (NPWS) have been conducted in the U.S. every five years since 2000. This article describes the online survey methods used for the latest NPWS conducted in 2019 and provides an assessment for nonresponse bias. Three waves of emails containing a link to the online survey were sent to a random sample of about 96,000 pharmacists licensed in the United States. The survey asked about pharmacist employment, work activities, work–life balance, practice characteristics, pharmacist demographics and training. A total of 5467 usable responses were received, for a usable response rate of 5.8%. To assess for nonresponse bias, respondent characteristics were compared to the population of U.S. pharmacists and a benchmark, while a wave analysis compared early and late respondents. The pharmacist sample–population comparison and the benchmark comparison showed that the NPWS respondents had a higher percentage of female pharmacists and a lower proportion of young pharmacists compared to the population of U.S. pharmacists and the benchmark sample. In some contrast, the wave analysis showed that the early respondents had a higher percentage of males and older pharmacists compared to the late respondents. Both the wave analysis and the benchmark comparison showed that the NPWS respondents (and early respondents) had a lower percent of pharmacists with a PharmD degree than did the late respondents and the benchmark group. These differences should be considered when interpreting the findings from the 2019 NPWS.

Perceived Value of Teaching and Learning Curriculum Programs Among Pharmacy Practice Department Chairs

Objective. To determine the perceived value that pharmacy practice department chairs ascribe to pharmacy faculty candidates having completed a teaching and learning curriculum (TLC) program and related activities.Methods. An 18-item survey instrument was created that was intended to capture the overall impressions of pharmacy practice chairs regarding the value of TLC programs, relative importance compared to other accomplishments (eg, residency completion, board certification), and importance of specific activities. Following pilot testing and establishment of intra-rater reliability, invitations to complete the electronic survey instrument were sent to pharmacy practice chairs (or their equivalent) at accredited Doctor of Pharmacy (PharmD) programs in the United States.Results. Of the 127 pharmacy practice chairs invited, 53 completed the survey (response rate of 41.7%). The majority of respondents held a PharmD degree (90.6%), had been in their role of chair for zero to five years (60.4%), and represented a private institution (54.7%). The majority of respondents who answered the question (32 of 49) felt it was very important or important (16.3% and 49.0%, respectively) that teaching experiences be completed within a formal teaching and learning curriculum program. These programs were believed to be most important for candidates with less than five years of professional experience. Teaching and learning curriculum programs were not deemed to be more important than other accomplishments by most responders. The perceived most important TLC program activities were instruction on didactic and experiential teaching strategies, and experience developing learning objectives, developing examination items, evaluating examination results, and facilitating case conferences or practice laboratory activities.Conclusion. Teaching and learning curriculum programs may provide the foundational experiences needed for pharmacy graduates to stand out among other candidates, although department chairs' perceptions of the value of teaching and learning curriculum experiences varied.

Challenges to Pharmacy School Enrollment Management Caused by a Global Pandemic

Academic institutions work diligently each year to recruit, retain, and graduate Doctor of Pharmacy (PharmD) students who will be positive contributors to our healthcare system. The immergence of a novel coronavirus in 2019 (COVID-19) has threatened these systems. This commentary is a discussion of the effects of the COVID-19 pandemic on the enrollment management processes of PharmD degree programs, including recruitment, admissions, orientation, retention, and graduation. The authors highlight enrollment management processes that may forever be changed by the COVID-19 pandemic. This commentary is intended to assist pharmacy administrators as they reflect on the impact of the COVID-19 pandemic on their own programs and develop strategies to minimize the negative effects.

A transition from the BPharm to the PharmD degree in five selected countries.

This review focuses on the studies and opinions around issues of transition from the BPharm to the PharmD degree in the U.S., Japan, South Korea, Pakistan and Thailand.The transition to the clinically orientated PharmD degree in many countries was seen to be a means of developing the profession. However, some countries have both clinically-oriented and pharmaceutical sciences-oriented PharmD programme that are designed to meet the needs of their countries. Each country created a different process to handle the transition to an all-PharmD programme, but mostly had the process of school accreditation mandated by the regulatory bodies. The main barrier to the transition in most of the countries was the issue of educational quality. A set of indicators is needed to measure and monitor the impact/outcome of the PharmD degree.Each country has different needs due to the different contexts of health care systems and the scope of pharmacy practice. In order to increase their chances of benefiting from the new programme, academic leaders should critically assess their countries’ needs before deciding to adopt a PharmD programme.

Bachelor of Pharmacy Programs in United Arab Emirates

The United Arab Emirates (UAE) pharmacy education has undergone significant reform in recent years to introduce more clinical and social pharmacy courses to replace many traditional pharmaceutical sciences courses that were typically dominate pharmacy curricula. The aim of this work was to carry out a comprehensive comparative analysis on all Bachelor of Pharmacy (BPharm) programs in the UAE and to describe the developments of BPharm curricula offered by UAE colleges of pharmacy after increasing the number of credit hours allocated for clinical and social pharmacy courses. BPharm curricula offered by all pharmacy colleges in the UAE were retrieved from their official websites. A comparative study on different curricula was carried out to investigate the structure of BPharm curricula after incorporating more patient-centered courses. Clinical and social pharmacy courses represent between 22% and 51% of the total BPharm credit hours. Non-clinical/social courses are no longer representing the majority of BPharm courses. PharmD degree program is offered by only one university. The course credit hour distribution of different BPharm programs is varied from one program to another. More clinical and social pharmacy courses are increasingly replacing the traditional pharmaceutical sciences subjects such as pharmaceutics, chemistry, biomedical, and basic sciences.

Community Pharmacy Practices in Timergara City Dir, Khyber Pakhtunkhwa, Pakistan

OBJECTIVES: To assess the community pharmacy practices in Timergara City in view of the standards set by the Drug Regulatory Authorities of Pakistan (DRAP).&#x0D; METHODOLOGY: A cross-sectional survey of community pharmacies, Timergara city, was conducted from 2nd October to 28th November 2016. Out of 155 community pharmacies 149 community pharmacies participated in the study. The data was collected on structured questionnaire. Face to face interview technique was used for data collection.&#x0D; RESULTS: Among these pharmacies only 02 (01%) dispensers were qualified pharmacist with a Pharm-D degree, 08 (05%) had B-Pharm degree, 80 (54%) had diploma in pharmacy and 59 (40%) had passed the pharmacy examination. Majority of community pharmacies 141 (95%) were selling medicines without prescription. In 140 (94%) of pharmacies, there were no arrangements for the control of insects, rodents and birds to prevent and eliminate possible infestation. In 140 (94%) pharmacies the medicines were stored on the floor, stairs and passageways due to lack of space. Only one pharmacy had temperature monitoring device and 19 (13%) pharmacies had refrigerators. Majority of the pharmacies 113 (76%) were using register for keeping record of the sale and purchase medicines. In 128 (86%) pharmacies the entrance was not accessible to the peoples with physical disabilities.&#x0D; CONCLUSION: The community pharmacy practices in Timergara City was ineffectual with inexperienced staff, lack of prescription and security, and medicines were not stored according to the Drug Regulatory Authorities of Pakistan.

Predictive validity of a Uniform Entrance Test for the health professionals.

Objective:To investigate the predictive validity of Uniform Entrance Test for academic performance in the first two years in various health science degree programs.Methods:A retrospective analysis of admissions data and academic performance of students admitted in under-graduate programs of medicine, dentistry and pharmacy of three cohorts was taken. The independent and dependent variables were entry test scores and semester scores respectively. Spearman’s Correlation co-efficient was computed to determine the association between entrance test scores and semester scores for three groups.Results:Majority of the students were from the MBBS degree program (61%) with majority of female students (65%) in all three programs. In MBBS the highest correlation coefficient between entry test and semester scores was observed for semester one rs = 0.334 and lowest in semester four rs= 0.208. In BDS degree program both highest and lowest correlations were in semester one. In the Pharm-D degree program, a significant correlation was only seen in cohort 1 but not in the subsequent cohorts.Conclusion:The uniform entrance test has an incremental predictive validity for the MBBS and BDS programs as compared to Pharm-D. Better performance in the entrance test predicts higher semester scores and more likelihood of achieving higher scores in the first year as compared to the second year.

It’s Time to Broaden the Conversation About the Student Debt Crisis Beyond Rising Tuition Costs

We all have heard the news about the rising student loan debt and the negative impact this has had on graduates trying to enter the workforce. This student loan debt crisis is a subject of increasing consideration, research, and analysis by federal government agencies, nonprofit organizations,

Break-Even Income Analysis of Pharmacy Graduates Compared to High School and College Graduates

Objective. To project the net cumulative income break-even point between practicing pharmacists and those who enter the workforce directly after high school graduation or after obtaining a bachelor's degree. Methods. Markov modeling and break-even analysis were conducted. Estimated costs of education were used in calculating net early career earnings of high school graduates, bachelor's degree holders, pharmacists without residency training, and pharmacists with residency training. Results. Models indicate that over the first 10 years of a pharmacist's career, they accumulate net earnings of $716 345 to $1 064 840, depending on cost of obtaining the PharmD degree and career path followed. In the break-even analysis, all pharmacy career tracks surpassed net cumulative earnings of high school graduates by age 33 and bachelor's degree holders by age 34. Conclusion. Regardless of the chosen pharmacy career track and the typical cost of obtaining a PharmD degree, the model under study assumptions demonstrates that pharmacy education has a positive financial return on investment, with a projected break-even point of less than 10 years upon career entry.