United States Pharmacy Research Articles

Faculty assessment of scholarship of teaching and learning among United States pharmacy programs

IntroductionPharmacy faculty understanding of the scholarship of teaching and learning (SoTL) and its recognition remain unclear. This study aimed to determine faculty SoTL perceptions and whether it should be recognized in promotion and tenure decisions. MethodsA survey instrument was developed and distributed to 6454 faculty in 139 United States pharmacy programs. The survey provided a list of scholarly activities and respondents were asked to select activities they perceived as SoTL and solicited faculty attitudes toward SoTL, its recognition and value in promotion and tenure, and SoTL engagement. Results were stratified based on SoTL participation, disciplines, and years of experience. ResultsSix hundred forty-three pharmacy faculty responded to the survey. Diverse scholarly works from teaching and learning practices to curriculum development, which lead to peer-reviewed public dissemination, were perceived as SoTL by most (78–98%) of the respondents. Participation in SoTL was reported by 74%. Pharmaceutical/biomedical science faculty were significantly less likely to accept the SoTL definition than pharmacy practice or social and administrative sciences faculty. Over 90% of participants indicated that college/school and departmental policies should encourage participation in SoTL activities. More than 70% of respondents strongly agreed that SoTL should be incorporated into criteria for promotion and tenure. Competing time commitments, lack of funding, interest, and institutional SoTL recognition were identified as challenges. ConclusionFindings demonstrate that pharmacy faculty perceive SoTL as a broad spectrum of scholarly activities, including classroom practices and beyond, that culminate into peer-reviewed public dissemination. Pharmacy faculty support the incorporation of SoTL into promotion and tenure criteria.

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.

Evaluation of human immunodeficiency virus curricular content in schools of pharmacy in the United States

IntroductionHuman immunodeficiency virus (HIV) is an important educational topic for student pharmacists given extended patient life expectancy and expanding pharmacist roles in HIV treatment and prevention. Data are lacking in regard to curricular content and type of training received by faculty to provide didactic and experiential HIV training. MethodsA cross-sectional, population-based survey of United States (US) pharmacy schools was conducted using a 15-item questionnaire. HIV content experts were surveyed at 135 four-year, accredited programs. ResultsThirty-seven responses were received from schools in the Midwestern (34%), Northeastern (26%), Southern (26%), and Western (14%) regions. Time devoted to didactic HIV education ranged from 0.5 to 60 hours. The majority of respondents (78%, n = 29) reported 10 or fewer hours of HIV-related content, with 41% (n = 15) reporting five or less hours of content. Experiential practice sites for HIV training were variable, with a majority (80%) including an outpatient infectious diseases/HIV clinic. Eighty percent of respondents also reported students receiving fewer than 25 encounters with people living with HIV (PLWH) throughout their entire experiential training. Over half (54%) of respondents reported that the primary HIV instructor devoted four hours per week or less to HIV care. ConclusionsDiversity in the amount of time devoted to HIV didactic education existed among reporting US pharmacy schools. Few schools have dedicated faculty spending a substantial amount of time in direct care of PLWH. Minimum standards for HIV education in schools of pharmacy should be established.

Three Commonly Utilized Scholarly Databases and a Social Network Site Provide Different, But Related, Metrics of Pharmacy Faculty Publication

Scholarly productivity is a critical component of pharmacy faculty effort and is used for promotion and tenure decisions. Several databases are available to measure scholarly productivity; however, comparisons amongst these databases are lacking for pharmacy faculty. The objective of this work was to compare scholarly metrics from three commonly utilized databases and a social networking site focused on data from research-intensive colleges of pharmacy and to identify factors associated with database differences. Scholarly metrics were obtained from Scopus, Web of Science, Google Scholar, and ResearchGate for faculty from research-intensive (Carnegie Rated R1, R2, or special focus) United States pharmacy schools with at least two million USD in funding from the National Institutes of Health. Metrics were compared and correlations were performed. Regression analyses were utilized to identify factors associated with database differences. Significant differences in scholarly metric values were observed between databases despite the high correlations, suggestive of systematic variation in database reporting. Time since first publication was the most common factor that was associated with database differences. Google Scholar tended to have higher metrics than all other databases, while Web of Science had lower metrics relative to other databases. Differences in reported metrics between databases are apparent, which may be attributable to the time since first publication and database coverage of pharmacy-specific journals. These differences should be considered by faculty, reviewers, and administrative staff when evaluating scholarly performance.

Strategies for inclusion of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) education throughout pharmacy school curricula.

Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others (LGBTQIA+) patients face stigma and barriers to health care, including a lack of health care professionals’ knowledge and confidence in treating this patient population. Pharmacists are in prime position to decrease this health disparity. United States pharmacy schools have limited LGBTQIA+ content, continuing the concern of recent graduates without knowledge and confidence. This commentary discusses potential barriers to introducing LGBTQIA+ content into school of pharmacy curricula and presents five strategies currently in use by nursing, medical, and pharmacy schools. Schools of Pharmacy should consider proactive incorporation of this content to graduate practitioners able to provide quality care to LGBTQIA+ patients.

Canadian Medication Cost Savings Associated with Combinatorial Pharmacogenomic Guidance for Psychiatric Medications.

ObjectiveTo estimate Canadian pharmacy cost savings associated with psychiatric medication prescribing that is guided by combinatorial pharmacogenomic testing in patients switching or augmenting their psychiatric medication.MethodsPharmacy claims data from a United States (US) pharmacy benefit manager were analyzed for 1662 patients who recently augmented or switched to a different antidepressant or antipsychotic medication and underwent combinatorial pharmacogenomic testing. Costs of prescription medications were translated to the Canadian healthcare system by matching drug names and doses using the Ontario Drug Benefit Formulary. One-year costs (2017 CAD) were compared between patients whose clinician prescribed antidepressants or antipsychotics that were consistent (congruent) or inconsistent (incongruent) with the combinatorial pharmacogenomic test recommendations.ResultsPatients whose psychiatric medication treatment was congruent with the combinatorial pharmacogenomic test report saved $1061 CAD per member per year (PMPY) on prescription medication costs relative to patients whose medications were incongruent with their test report (p<0.0001). For patients ages <65 and ≥65, prescription medication costs were $979 and $1178 CAD PMPY lower, respectively, for patients who followed the report recommendations (p=0.0004 and p=0.13). Prescription drug fills from the US pharmacy claims were concordant with the Canadian Formulary; 62% of fills matched at both the drug name and dose strength, 81% matched at drug name, and >99% matched at the therapeutic chapter.ConclusionsAntidepressant and antipsychotic prescribing that was congruent with combinatorial pharmacogenomic test guidance was associated with significant cost savings on Canadian prescription medications according to the Ontario Drug Benefit Formulary.

Student perceptions of the value they bring to APPE sites

IntroductionPartner institutions invest much time and effort into educating pharmacy students, and ideally students should be viewed as valuable to those sites. Prior studies have demonstrated the perceptions that preceptors and administrators have about the value of students at their sites. However, students' perceptions of their own value at practice sites have not been described. Students do have perceptions about their own value to sites, and such information could be useful in learning about potential areas in which students perceive they are making an impact on patient care. MethodsFive hundred qualitative student responses to an evaluation question regarding perceived value were analyzed from a United States pharmacy school. Nineteen categories of value were extracted. Responses fit into multiple categories, resulting in 783 data points for analysis. The categories were analyzed overall and with respect to advanced pharmacy practice experience (APPE) type (acute care, community, hospital, ambulatory care, and elective). Descriptive statistics were used. ResultsProviding patient counseling (15.7%) and therapeutic recommendations (14.7%) were the highest perceived values. In adult acute care and hospital APPEs, “providing therapeutic recommendations” (24.4% and 19.1% respectively) were rated highest. In community, ambulatory care, and elective APPEs, “providing patient counseling” (25%, 23%, and 13.8%, respectively) was highest rated. ConclusionsStudents perceive they are valuable to practice sites in several ways. These results demonstrate that students' self-reported perceptions of the value they bring to their sites are consistent with other literature reports based on perception of preceptors regarding student value to patient care.

A comparative study of the depth, breadth, and perception of pharmacogenomics instruction in a subgroup of US pharmacy curricula

IntroductionThis study was designed to assess the depth, breadth, and perception of pharmacogenomics education in pharmacy curricula in the United States (US). MethodsA modified, online questionnaire from previous studies was sent to all accredited US schools and colleges of pharmacy. The survey covered three distinct areas related to the schools' educational environments, the depth and the extent of pharmacogenomics core competencies and topics taught, and the institutions' perceptions of the importance of pharmacogenomics in the curriculum and future plans for expanded pharmacogenomics education. Multiple approaches were used to increase the response rate, and results were analyzed using descriptive statistics. ResultsOf the 133 eligible programs, 32 participated in the survey. Six invalid surveys were excluded from our study, resulting in a 19.6% response rate. Results revealed that all responding schools included pharmacogenomics in the curriculum. Interestingly, 76.9% of the respondents believed pharmacists do not have the appropriate knowledge of pharmacogenomics. However, only 30.7% indicated that their programs planned to expand pharmacogenomics in their curriculum. ConclusionsThe responding schools all included some pharmacogenomics in their curriculum. However, the depth and the extent of pharmacogenomics topics covered varied. Respondents perceived that pharmacists today do not possess the appropriate level of pharmacogenomics knowledge. Despite this, there is limited emphasis on expanding pharmacogenomics instruction in the responding schools' curriculums.

A cross-sectional survey evaluating transgender-related care education in United States pharmacy school curricula

IntroductionThe objectives of this study are to evaluate the extent of transgender-related care in current pharmacy school curricula, identify where transgender-related care is covered in the curriculum, describe how the content is delivered to pharmacy students, and review how student knowledge of transgender-related care is evaluated. MethodsThis cross-sectional study utilized an online survey of curricular contacts of 142 pharmacy schools in the United States. Survey questions regarding transgender-related care were presented as multiple choice, ranking, and free-response. The survey inquired about transgender-related care information taught, teaching methods, hours of education, and student assessment. ResultsOf the 66 schools that responded to the survey, 53% indicated that transgender-related education is a topic that is currently addressed somewhere within the curriculum. Twenty-two pharmacy schools incorporate this topic into the didactic curriculum, two into the experiential curriculum, and 10 into both didactic and experiential. Transgender-related care is only taught in the required curriculum of 41.2% of schools that responded to the survey. ConclusionTransgender-related care education is taught to variable degrees throughout US doctor of pharmacy programs. This study should serve as a call to action to incorporate this necessary transgender-related care education and training into pharmacy curricula to effectively reduce health disparities among this population that is increasingly seeking care.

Comprehensive Assessment of Didactic Curriculum and Career Interest in Infectious Diseases Among Graduating United States Pharmacy Students.

BackgroundThe growing need for clinicians with antimicrobial stewardship (AS) skills has resulted in an examination of educational methods for pharmacy and medical learners. This study explores characteristics associated with student assessment of didactic infectious diseases (ID) education quality and variables associated with a career interest in ID and/or AS.MethodsInfectious diseases faculty from US pharmacy schools were sent a 15-question survey in September 2017. Faculty members e-mailed the survey link to graduating pharmacy students.ResultsParticipants from 29 pharmacy schools, representing 21 states, resulted in 537 student responses. Quality of ID didactic education was rated as Very Good by 41%, Good by 40%, Acceptable by 14%, and Poor by 4% of participants. The mean number of faculty-provided learning resources differed by quality rating and was significantly associated with perceived educational needs. Infectious diseases was identified as a career interest by 29% of students. These students more frequently rated their ID didactic education as Very Good (52% vs 37%, P < .01) and were more likely to become interested in ID during or after it was taught in pharmacy school (39% vs 21%, P < .01).ConclusionsIn this cohort of graduating pharmacy students, the perceived quality of didactic ID education was associated with a career interest in ID and/or AS. Factors associated with quality of education were quantity and quality of faculty-provided resources. Increasing the quality of the didactic ID curriculum has potential to increase interest in ID/AS careers among pharmacy students.

Implementation of a virtual dispensing simulator to support US pharmacy education

IntroductionA key element for pharmacy practice defined by the Accreditation Council for Pharmacy Education (ACPE) is medication use systems management. A web-based community pharmacy simulation originally created for Australian pharmacy students was adapted for pharmacy students in the United States (US). The objective of this study was to collaboratively adapt an existing international simulation program for utility in the US and measure student perceptions of a web-based community pharmacy simulation program in three US schools of pharmacy. MethodsAn Australian development team in collaboration with US pharmacy school faculty modified the existing MyDispense software to create a virtual environment that accurately represented US community pharmacy practice. Students at three US schools of pharmacy used the newly adapted version of MyDispense and were surveyed on their prior experience in community pharmacy and their perceptions of MyDispense as a learning tool. ResultsOverall 241 (44%) students completed the satisfaction survey. Approximately 40% of these students worked in a community pharmacy before starting pharmacy school. Most students agreed or strongly agreed that MyDispense was straightforward to learn (76%), was more realistic than addressing similar paper cases (73%), and offered a learning opportunity to safely make errors (84%). Qualitative thematic analysis revealed that MyDispense allowed students to practice how to gather patient information and ask appropriate questions, counsel patients, and practice the dispensing process. Discussion and conclusionsResponse to the US version of My Dispense is positive and proves to be a viable option for introducing and reinforcing community pharmacy practice skills to students during in their pharmacy education

The impact of work-life balance on intention to stay in academia: Results from a national survey of pharmacy faculty.

Border-Crossing theory suggests work-life balance and career satisfaction are inter-related and disappointment in work-life balance may predict changes in one's career path. Application of this theory to health profession faculty is plausible but has not been fully explored. The purpose of this study is to examine factors related to reported career change intention among United States pharmacy school faculty and to determine if Border-Crossing theory fits these observations. Results from a national web-based survey administered via Qualtrics® to American Association of Colleges of Pharmacy (AACP) members were utilized. Bivariate analyses were conducted to compare differences among faculty stating an intention to stay or leave academia. A logistic multivariate model was used to determine if work-life balance remains significant when controlling for other variables and if survey results support the Border-Crossing theory. Nearly all (seven hundred of 811 responders, or 86.3%) stated a desire to stay in academia. Faculty with higher work-life balance were more likely to report an intent to remain in academia. Male, older, full-professor and non-pharmacy practice faculty (social or administrative science, pharmacology, medicinal chemistry and others) were more likely to state an intention to remain in academia relative to their counterparts. Lower stress, as measured by the validated Perceived Stress Scale (PSS) scores, was seen among faculty stating a desire to remain in academia. Work-life balance remained significantly inversely related to career change intention after controlling for all other factors. A significant factor related to pharmacy faculty's stated intention to remain in academia was work-life balance. Other factors such as gender, age, rank, stress level and department may also play a role. These results support the application of the Border-Crossing theory in health profession faculty and may provide pharmacy school administrators and stakeholders with insight to foster faculty retention and decrease faculty turnover.

A Shared Focus: Comparing the Australian, Canadian, United Kingdom and United States Pharmacy Learning Outcome Frameworks and the Global Competency Framework.

This paper presents an analysis of the end of degree expectations, expressed as learning outcomes, for pharmacy graduates from Australia, Canada, United Kingdom and United States. The authors compare the end of degree expectations, through mapping these requirements to the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF). The anticipated end of degree expectations are similar but also reveal some individual characteristics. Irrespective of degree title, achievement of learning outcomes specified in any one of the four jurisdictions should enable students to become pharmacists who are patient-orientated medicines experts. The mapping provides impetus for cross-border institutional networking to generate a dependable set of assessment tools across national borders developing a common metric for outcome assessment irrespective of different program delivery.

The prevalence of exercise prescription-related course offerings in United States pharmacy school curricula: Exercise is Medicine.

Exercise training has proven to be beneficial in the prevention of disease. In addition, exercise can improve the pathogenesis and symptoms associated with a variety of chronic disease states and can attenuate drug-induced adverse effects. Exercise is a drug-free polypill. Because the benefits of exercise are clear and profound, Exercise is Medicine, a joint initiative between the American Medical Association and American College of Sports Medicine, was launched in 2007 to call on all health care providers to counsel patients and prescribe exercise in the prevention and treatment of chronic disease states. Pharmacists play an increasing role in direct patient care and are the most accessible health care providers in the community. Thus, pharmacists should be knowledgeable in counseling patients on the frequency, intensity, time, and type of exercise that is appropriate for various conditions and disease states. The aim of the present study was to determine the prevalence of didactic course offerings in United States pharmacy school curricula regarding training in exercise prescription. School websites were accessed for information regarding course offerings in PharmD programs. No United States pharmacy schools offered courses that were dedicted to the role of exercise in disease prevention or exercise prescription in disease management. Ninety percent of pharmacy schools did not offer courses with the keywords "exercise," "fitness, or "physical activity" in the title or description. The data suggest that student pharmacists are not adequately trained to counsel patients on the benefits of exercise or exercise prescription.

AB0496 Tumor necrosis factor (TNF)-inhibitor dose escalation in rheumatoid arthritis (RA) patients in a united states (US) pharmacy benefits management (PBM) setting

BackgroundIn the US, Pharmacy Benefits Management (PBM) companies act as third-party administrators who manage prescription benefits for health insurance companies and self-insured entities. Research in commercial health plans has shown...

Emerging Roles of U.S. Pharmacists in Global Health and Africa

The transition from 20th to 21st century involved increasing global perspective to health and disease. Africa has reportedly accounted for 13% of the world’s population, 24% of the world’s disease and yet 3% of the world’s healthcare workforce; an imbalance creating vulnerability ranging from health disparities to terrorism. The public health system in Sub-Saharan Africa has been a significant focus of global health intervention, especially in tackling HIV/ AIDS, Tuberculosis and Malaria. The United States’ role has also increased for both humanitarian and security-related strategic interests. The purpose was primarily to explore and identify examples of key pharmaceutical-related public health problems in Africa, United States (U.S.) pharmacist and pharmacy school involvement in Africa; and secondly, to introduce and evaluate student interest in global health pharmaceutical issues, activities and potential careers. Access, affordability and safety of pharmaceuticals are among those important global health areas of interest; others are healthcare worker shortages, financial resource and allocation problems and challenges with indigenous health system leadership. The World Health Organization (WHO) estimates indicate marked imbalances or insufficiency in global workforce distribution, especially in Sub-Saharan Africa to tackle such problems. An overview of the literature and collaborative partnerships between U.S. and African Colleges of Pharmacy, and the incorporation of global health policy into pharmacy curricula illustrate examples of higher education contributing to shaping future health professional roles and career interests for new and expanding service opportunities in the global health workforce.

Prevalence of and Factors That Influence Board Certification Among Pharmacy Practice Faculty at United States Colleges and Schools of Pharmacy

Board certification is a means of demonstrating expertise above the minimum licensing standards. For many health care professionals, this credential is a necessity. As pharmacists become involved in more advanced patient care services, board certification becomes an essential component to ensuring quality care. The prevalence of United States pharmacy practice faculty members who are board certified, however, is unknown. In addition, to our knowledge, factors that serve to motivate or discourage faculty from obtaining board certification have not been previously described; thus, 900 pharmacy practice faculty members listed in the American Association of Colleges of Pharmacy (AACP) online directory were invited to complete an online survey regarding motivators and barriers for board certification. In addition, a list of board-certified pharmacists, obtained from the Board of Pharmacy Specialties, was used to check the board certification status of all pharmacy practice faculty members listed in the AACP directory. In 2011, the prevalence of board certification among the 2867 pharmacy practice faculty members was 37% (1063 pharmacists), with the highest prevalence found among assistant professors (39.4%).A total of 322 faculty members (36% response rate) completed the survey; of these, 308 self-identified as pharmacy practice faculty, and their responses were included in the analysis. Current board certification in pharmacy specialties was reported by 163 respondents (52.9%); 14 (4.5%) were previously certified. Among the 308 respondents, the most common perceived reason why pharmacy practice faculty become board certified was the desire to be recognized as an expert in the field (71.5%). Those who were currently board certified indicated personal growth as the most important reason (60.1%). Those previously certified indicated no perceived benefit as the most common reason for not recertifying (71.4%). Among those never certified, no perceived need (52.0%) or benefit (44.8%) were the most common reasons for not becoming certified; however, a majority of those never certified (68%) stated that they would become board certified if there was no associated cost and they were confident they would pass. To increase the prevalence of board certification in pharmacy practice faculty at U.S. schools and colleges of pharmacy, the benefits of this credential must be addressed at each institution. Steps should be taken to assist and encourage board certification.

The impact of initial statin treatment decisions on cardiovascular outcomes in clinical care settings: estimates using the Archimedes Model

PurposeMany patients treated for dyslipidemia do not achieve recommended cholesterol goals despite the widespread availability of effective statins. Pharmaceutical claims show a strong tendency for patients to remain on their initially assigned treatment. With computer simulations, the impact of initial statin treatment decisions on medium- and long-term cardiovascular outcomes were examined.Patients and methodsUsing the Archimedes Model, three treatment scenarios were simulated. Patients initiated treatment with simvastatin (20, 40, or 80 mg), atorvastatin (10, 20, 40, or 80 mg), or rosuvastatin (10, 20, or 40 mg), and periodically intensified treatment. The simulated population consisted of 50,025 patients, aged 45–70 years, with low-density lipoprotein cholesterol exceeding goal. The proportion of patients initiating each dose was calibrated to United States pharmacy claims. Patients not reaching goal intensified the dose of their current statin or switched to an appropriate dose of rosuvastatin at rates matching pharmacy claims. Biomarkers and major adverse cardiovascular events (MACE) were tracked for 10 years and several high-risk subpopulations were analyzed. Statin models used biomarker effects from the STELLAR (Statin Therapies for Elevated Lipid Levels Compared Across Doses to Rosuvastatin) trial and outcomes data from various trials.ResultsInitiating therapy with rosuvastatin reduced MACE more than simvastatin or atorvastatin. The 5- year relative risk of MACE was 0.906 (95% confidence interval: 0.888–0.923; P < 0.001) for initial treatment with atorvastatin rather than simvastatin, 0.831 (0.812–0.850; P < 0.001) for rosuvastatin rather than simvastatin, and 0.918 (0.898–0.938; P < 0.001) for rosuvastatin rather than atorvastatin. Subgroups with higher MACE incidence experienced greater absolute benefit.ConclusionConsidering observed rates of treatment intensification, initial treatment choices appear to significantly impact medium- and long-term cardiovascular risk. Patients at high cardiovascular risk are good candidates for aggressive initial therapy.

Twelve-Month Persistency with Oral 5-Aminosalicylic Acid Therapy for Ulcerative Colitis: Results from a Large Pharmacy Prescriptions Database

Patients receiving 5-aminosalicylic acid (5-ASA) require long-term therapy to achieve good outcomes. Persistency (duration of time from initiation to discontinuation of therapy) is therefore an important consideration. To evaluate persistency in patients receiving various oral 5-ASA formulations. This retrospective, 12-month, cohort study examined new-starter patients (any age and diagnosis) from a large United States pharmacy database who filled a prescription for oral 5-ASA [Lialda(®), Asacol(®), Pentasa(®) 250 or 500 mg, balsalazide (generic and Colazal(®)), and olsalazine (Dipentum(®))] between March and September 2007. Persistency was evaluated monthly on the basis of prescription refill rates. Prescription and refill records were identified for 44,191 patients receiving oral 5-ASA. After 1 year, 20% of patients receiving Lialda were considered persistent and classified as continuing (refilling within a timeframe of up to twice the duration of the prescription), compared with 9% receiving Asacol, 7 (250 mg) and 10% (500 mg) receiving Pentasa, 10% receiving balsalazide, and 10% receiving Dipentum. Overall persistency with oral 5-ASA therapy was low. However, patients receiving once-daily Lialda had significantly higher persistency after 1 year of treatment than patients receiving other oral 5-ASA therapies.

Open Access to the World – IncreasingJournalVisibility

With the first issue of 2004 the American Journal of Pharmaceutical Education will be “open access,” available to everyone at www.ajpe.org, free of charge and without need of a password. Also, the number of Journal issues will increase from 4 to 6 per year. The Board of Directors reached these decisions at the request of the Editor. Changing the Journal to open access is consistent with AACP’s strategic goal of enhancing its members’ influence and visibility beyond pharmacy education in the United States. Journal authors are leaders in health professions education by describing their innovative instructional methods, and these advances should be available to the larger pharmacy education community. The increase in the number of issues published per year is possible and necessary because the number of manuscripts submitted to the Journal has increased by almost 100% in the past 2 years. Open access will dramatically increase readership of the Journal. Increased readership will enhance the value of the Journal, attract more contributors, and expand the influence of authors and AACP in general. An open-access Journal will better serve the needs of authors as well as the United States and international pharmacy education community. The Journal will now be made available to thousands of full-time, part-time, and adjunct faculty members and preceptors throughout the United States. Also, open access allows electronic transmission of the Journal to organizations and pharmacy educators around the world. At the same time we can promote United States pharmacy education to schools and colleges developing around the world and increase our awareness of the best that international programs can offer to us. By now, most readers are aware of the open-access movement in journal publishing as well as the exploding costs to libraries for journals that are owned by some of the large publishing houses. The number of open-access journals is ~700 and is growing. The open-access movement is spearheaded by the Public Library of Science and BioMed Central, organizations that are attempting to create new systems for making academic information available to a wider audience. While the open-access movement is gaining ground, journals that require paid subscriptions will continue to exist for the foreseeable future. Advocates of the open access movement claim that it will “accelerate research in every discipline.” There are some indications that papers that appear free online are more frequently cited by other researchers than papers that have restricted distribution. Open access can enhance the attractiveness of the Journal to indexing services and Medline as well as increase Journal “impact” as measured by citation analysis. However, open access brings some challenges. Open access or not, print or online, journals are still expensive to produce and “open access” should not be confused with “free.” While readers would not pay for access, the costs are paid for in other ways. The financial support for the Journal comes from individual and institutional subscriptions and dues. While the Journal expense is lower than many comparable academic journals, we will continue to seek ways to increase value to readers (AACP members and nonmembers) in costeffective ways.