US Pharmacy Research Articles

Pharmacogenomics courses in pharmacy school curricula.

Aim: The appropriate use and integration of pharmacogenetic (PGx) testing will pivot on provider preparation and training. Pharmacists have been recognized as one of the key providers in the delivery of PGx testing and as such, professional organizations have recommended inclusion of PGx content in pharmacy curricula. Methods: We reviewed the curriculum of 132 US pharmacy schools for information about PGx courses. Results: A total of 70 core curriculum courses were identified. 55 (42%) pharmacy schools included at least one PGx course as part of the core curriculum, and ten (8%) schools that offered a PGx course elective. Conclusion: While many pharmacy schools have responded to the accreditation standards to include PGx, less than half of the schools have developed a standalone course.

Institutional factors associated with global health education across US pharmacy schools

IntroductionThe objective of this study is to explore the relationship between institutional factors and offerings of global health education opportunities in pharmacy schools. MethodsData for this project came from a review of international advanced pharmacy practice experiences (APPEs) and global course offerings for US pharmacy schools conducted between February 1 and March 31, 2014. These data were merged with data on institutional factors which may influence a school's offering of APPEs or courses. Institutional factors included tuition, class size, academic medical center affiliation, year established, and others. Multivariable regression models were used to evaluate the relationship between individual institutional factors and APPEs and global courses. ResultsIn multivariable adjusted models, older and more established schools had a larger percent of the graduating class with an international APPE (9.5% vs. 2.6%, p < 0.01) and a larger number of international APPEs (3.8 vs. 1.4, p < 0.01) than schools founded after 1980. Schools with higher tuition (>$25,000/year) had, on average, a larger percent of their graduating class with an international APPE (7.9% vs. 3.1%, p < 0.05), a larger number of international APPEs (3.7 vs. 1.5, p < 0.01), and more interprofessional international APPEs (3.1 vs. 0.7, p < 0.001). There were more course offerings at older schools (1.1 vs. 0.4, p < 0.05) and those with higher tuition (1.3 vs. 0.4, p < 0.01). ConclusionsMore established schools and those with higher tuition appeared to have more robust global offerings. Schools can consider local opportunities to provide global experiential and didactic experiences, which may reduce the financial burden of global programs.

1308. Predictors of Career Interest in Infectious Diseases Among US Pharmacy Students

BackgroundPharmacists have a central role in infectious diseases (ID) and antibiotic stewardship efforts across multiple healthcare settings. The demand for pharmacist to fill ID and stewardship-related careers will likely increase as institutions create antibiotic stewardship programs in response to the 2016 Joint Commission standard. The objective of this study was to compare students’ perceptions of their school’s ID curriculum between students interested in an ID career and those who are not.MethodsA cross-sectional survey study of students graduating from US pharmacy schools was conducted in September 2017. Students received the survey link from the ID faculty at participating schools.ResultsFive hundred thirty-seven students from 28 pharmacy schools completed surveys. Quality of ID didactic education was rated as Very Good by 220 (41%), Good by 219 (40%), Acceptable by 76 (14%), and Poor by 22 (4%) respondents. The most common career interests were ambulatory care (44%), community practice (38%), and infectious diseases (29%). The most common preferred practice settings for students with an interest in ID (n = 157) were inpatient/hospital (86%), inpatient stewardship (70%), and inpatient ID consult service (66%). Differences in responses about didactic ID education between students interested in an ID career and those not interested included: perception of education as Very Good (52% vs. 37%, P = 0.005), faculty providing handouts and/or worksheets (89% vs. 82%, P = 0.009), and the desire for more time allocated to antibiotic stewardship (47% vs. 31%, P < 0.001). Multivariate logistic regression found variables to be predictive of pharmacy student interest in an ID career including: pharmacy school curriculum (OR 2.5, 95% CI 1.5–4.0), perception of a Very Good didactic ID education (OR 1.5, 95% CI 1.0–2.3), and faculty mentor(s) (OR 1.8, 95% CI 1.2–2.7).ConclusionPharmacy students expressing interest in ID as a career had positive views of their didactic ID education, were more likely to report faculty mentorship, and desired more time for antibiotic stewardship in the curriculum. These results can inform efforts to encourage pharmacy students to pursue careers in ID.Disclosures All authors: No reported disclosures.

981. A Comprehensive Survey of Infectious Diseases Curriculum Among US Pharmacy Schools

BackgroundPharmacists are key partners in institutional antimicrobial stewardship and require adequate knowledge and skills in antimicrobial pharmacotherapy to fulfill this role, whether or not they have specialized postgraduate training in infectious diseases (ID). The objective of this study was to describe ID topics and teaching strategies across US schools of pharmacy.MethodsA 23-question electronic survey was sent to ID faculty or curricular deans at all 137 US pharmacy schools.ResultsSurveys were collected from 106 schools (77% response rate). ID curriculum was allotted 60 (IQR 40–80) hours of classroom time and primarily taught in the third year. Respondents dedicated 33% of curriculum hours to ID fundamentals and 66% to disease states. Content was primarily delivered through traditional lectures compared with active learning (75% and 25%, respectively). Greater than 94% of schools taught all tier 1 ID topics from the 2016 American College of Clinical Pharmacy Pharmacotherapy Didactic Curriculum Toolkit. Utilization of active learning methods and time allocated to ID fundamentals differed across schools. Public schools dedicated more time to antimicrobial fundamentals than private schools (40 vs. 30 hours, P = 0.023). Schools using a block schedule allotted more classroom hours to ID content than schools using semester or quarter schedules (77.5 vs. 60 vs. 50 hours, P = 0.001). Schools established less than 5 years ago devoted more classroom hours to active learning than schools established 5 to 10, 11 to 20, and greater than 20 years ago (65 vs. 25 vs. 25 vs. 20, P = 0.012). Private schools were more likely to consistently or frequently use audience response systems (86% vs. 68%, P = 0.037) and concept maps (27% vs. 6%, P = 0.005) compared with public schools. Public schools were more likely to use debates (18% vs. 2%, P = 0.006). Schools established 10 or less years ago were more likely to use concept maps (28% vs. 12%, P = 0.050), games (38% vs. 19%, P = 0.050), and simulation (41% vs. 18%, P = 0.015).ConclusionIncreased communication and collaboration between ID pharmacotherapy educators is warranted to increase consistency of ID education and distribution of educational innovations.Disclosures All authors: No reported disclosures.

Assessing the quality of Objective Structured Clinical Examination (OSCE) reports in pharmacy education: A review of the literature

This article was migrated. The article was not marked as recommended. Objective: The purpose of this systematic review was to identify and assess the quality of published reports of objective structured clinical examinations (OSCEs) in pharmacy education. Methods: English-language articles published between 2000-2015 describing OSCEs in pharmacy education were included. Search terms included ‘pharmacy education’, ‘objective structured clinical examination’, ‘clinical skills assessment’, and ‘clinical skills examination’. A previously published checklist of reporting standards for OSCEs in medical education was used to assess the quality of published OSCE reports in specific areas: encounter characteristics, standardized participant (SPs) characteristics, training methods, and behavioral methods. Results: Forty-two articles were identified for inclusion. Forty (95%) articles reported the number of encounters with the median being 3.0 (SD=4.7). All articles reported the level of learner participating, with most US pharmacy schools conducting OSCEs with third year pharmacy students. Most articles reported training for SPs prior to the OSCE (n=23, 55%), however most did not report if training was provided to OSCE raters (n=22, 52%). Thirty-six (86%) articles reported the type of behavior measure used during OSCEs, however almost half (n=18, 42%) did not report the scale used. Few articles (n=19, 45%) reported if psychometric properties had been obtained for the specific behavior measures used. Conclusions: Overall, published descriptions of OSCEs are varied and inconsistent. Most OSCEs conducted in US pharmacy schools were in third year pharmacy students. Just over half of published articles reported OSCE training. The lack of published psychometric properties may make implementation of valid OSCEs difficult.

Predicting drug-resistant epilepsy — A machine learning approach based on administrative claims data

Patients with drug-resistant epilepsy (DRE) are at high risk of morbidity and mortality, yet their referral to specialist care is frequently delayed. The ability to identify patients at high risk of DRE at the time of treatment initiation, and to subsequently steer their treatment pathway toward more personalized interventions, has high clinical utility. Here, we aim to demonstrate the feasibility of developing algorithms for predicting DRE using machine learning methods. Longitudinal, intersected data sourced from US pharmacy, medical, and adjudicated hospital claims from 1,376,756 patients from 2006 to 2015 were analyzed; 292,892 met inclusion criteria for epilepsy, and 38,382 were classified as having DRE using a proxy measure for drug resistance. Patients were characterized using 1270 features reflecting demographics, comorbidities, medications, procedures, epilepsy status, and payer status. Data from 175,735 randomly selected patients were used to train three algorithms and from the remainder to assess the trained models' predictive power. A model with only age and sex was used as a benchmark. The best model, random forest, achieved an area under the receiver operating characteristic curve (95% confidence interval [CI]) of 0.764 (0.759, 0.770), compared with 0.657 (0.651, 0.663) for the benchmark model. Moreover, predicted probabilities for DRE were well-calibrated with the observed frequencies in the data. The model predicted drug resistance approximately 2 years before patients in the test dataset had failed two antiepileptic drugs (AEDs). Machine learning models constructed using claims data predicted which patients are likely to fail ≥3 AEDs and are at risk of developing DRE at the time of the first AED prescription. The use of such models can ensure that patients with predicted DRE receive specialist care with potentially more aggressive therapeutic interventions from diagnosis, to help reduce the serious sequelae of DRE.

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.

2018 cancer concerns of United States health plans

Background: Cancer care is shifting from chemotherapy to more effective targeted immunotherapies with fewer side-effects. New therapies, some existing therapies with expanded indications (including maintenance) and many therapies with price increases require re-evaluation.Objectives: To identify the cancers most concerning to managed care plans.Methods: A survey invitation was sent to senior officers of US health plans and pharmacy benefit managers (PBMs). Respondents completed an online interactive survey. Topics included: officer + plan information, cancer ranking (lowest = 1-to-13 = highest), copays, benefit design, cancer management, concerns today and in 5 years from budgetary and medical points of view (POV) and compare current results with prior surveys.Results: The survey was completed by 77 respondents; 57% were MDs and 43% were the senior officer, 19% were payor specific, 9.9% regional, 1.3% therapeutic area specific. 40.5% of respondents worked for health plans, 11.4% for PBMs, 8.9% for integrated delivery networks (IDNs), 3.8% for preferred provider organizations (PPOs)/independent physician associations (IPAs), 1.3% for government. Plans cover multiple types of members: commercial (68.8% = fee for service [FFS], 76.5% = health maintenance organization [HMO]/PPO), Medicaid (Traditional = 36.4%, HMO/PPO = 67.9%), Medicare (71.2%, PDP-only = 50%), Employer/Self-funded = 77.1% and IDN (47.7%, 340B = 43.5%). Oncology was tied for the 3rd highest ranked Specialty Pharmacy condition covered 81.8% (64.3% in 2016) and 47.5% of respondents reported they participated in Oncology accountable care/disease management organizations (34.1% last year). Genomic tests for Oncology were covered by 87.7% of plans. The cancers ranked most concerning were: Lung = 11.1, Breast = 11.0, Colon + Rectal = 9.6, Non-Hodgkins Lymphoma (NHL) = 7.7, Prostate = 7.4, Leukemia = 7.0, Myeloma = 6.9, Melanoma = 6.8, Pancreatic = 6.5, Kidney = 5.1, Bladder = 4.7, Endometrial = 4.5 and Thyroid = 11.38. NHL increased in rank to 4 (from 9 last year), myeloma decreased to 7 (from 5). When asked about cancer management 68.9% (increased from 48.7%) of the sometimes leave oncology specialists alone, 58.7% (decreased from 65%) always follow NCCN guidelines, 61.4% (increased from 56.4%) sometimes follow other guidelines or pathways, and 52.3% (increased from 38.5%) sometimes follow internal protocols. Cancer/oncology was consistently reported the top concern from medical care (47.2% today, 50% in 5 years) and budgetary (50% today, 60.9% in 5 years) POVs.Conclusions: The shift from chemotherapies toward targeted immunotherapies and the cost implications requires plans to focus on, evaluate and adapt to newer agents and pathways. New maintenance indications are causing plans to evaluate long-term coverage.

A Progress Report on the State of Pharmacy Informatics Education in US Pharmacy Schools and Colleges

Objective. To characterize informatics education opportunities in US colleges and schools of pharmacy curricula. Methods. Informatics curricular information online was catalogued via publicly available websites. Website content was searched via domain-specific keywords. Online course descriptions were reviewed. Website searches were also conducted for informatics-related opportunities. Results. Of 132 pharmacy curricula found online, 47 (36%) included an informatics course. Of those, 64% (n=30) were required while 47% (n=22) were elective courses. Additionally, 20% (n=26) provided informatics advanced and/or introductory pharmacy practice experiences, 20% (n=27) offered an informatics residency, and 17% (n=22) listed certificate and/or graduate degree programs in informatics. Conclusion. Over the past 10 years, little observable progress has been made in pharmacy school curricula in response to the increasing importance of informatics to the profession. Pharmacy programs can address this educational gap by internal (eg, course development) and external (eg, open source curriculum) solutions.

Work Preferences and General Abilities Among US Pharmacy Technicians and Danish Pharmaconomists

Introduction: The importance of pharmacy support personnel is increasingly recognized. Studies have evaluated workplace issues and evolving roles; however, needed information from technicians themselves is scarce. The purpose of this study was to examine preferences for work activities and the general abilities of US pharmacy technicians and Danish pharmaconomists. Methods: Surveys were administered to random samples of US technicians in 8 states and the general population of Danish pharmaconomists. Respondents indicated their preference for involvement in a set of work activities in community or hospital pharmacy on numeric scales. They also self-assessed their level of ability on facets associated with professional practice, in general. Descriptive results were tabulated, and bivariate tests were conducted on total general abilities ratings. Results: The 494 technicians and 313 pharmaconomists provided similar ratings on many activities. In community pharmacy, US technician ratings for performance of activities were generally higher than those of pharmaconomists; however, pharmaconomists rated certain “higher order” communication activities quite highly, such as discussing lifestyle changes with the patient. In hospital practice, Danish pharmaconomists provided low preferences for medication handling but high preferences for communication activities. General ability ratings were given high self-evaluations, but lower on some components, such as keeping up with the profession. Employer commitment was a strong correlate for both. Conclusions: Evaluation of preferred work activities and general abilities were likely reflected in different scopes of practice between the two and could be insightful for education and work redesign in both countries, particularly the United States, as leaders evaluate shifts in technician professionalization.

Pharmacy resident teaching in psychiatry and neurology for pharmacy programs in the United States.

Introduction:The American Society of Health-System Pharmacists' Postgraduate Year 1 and Year 2 Residency Accreditation Standards require that residents demonstrate effective teaching skills. The College of Psychiatric and Neurologic Pharmacists' survey of pharmacy program curricula assessed resident teaching in psychiatry and neurology, however, results were not published. The objective of this article is to describe resident teaching in psychiatry and neurology curricula as reported by responses to the college's survey.Methods:An electronic survey was sent to a curricular representative from each of 133 US pharmacy programs accredited as of July 2015. Programs were asked to report on psychiatry and neurology curricular content, faculty credentials, and types of teaching activities, including resident teaching.Results:Fifty-six percent (75/133) of programs responded to the survey. Fifty out of 75 (67%) distinct pharmacy programs reported utilizing residents for teaching topics in psychiatry and neurology. Residents were twice as likely to teach didactic topics in psychiatry (n = 44) compared to neurology (n = 22). Three times as many residents were involved in precepting psychiatric Advanced Pharmacy Practice Experiences (n = 37) compared to neurology Advanced Pharmacy Practice Experiences (n = 12).Discussion:Residents are involved in both didactic and experiential teaching with more residents teaching psychiatry content compared to neurology content. Authors recommend utilizing the American Society of Health-System Pharmacists' electronic resident assessment tool, PharmAcademic®, to capture the quantity and quality of resident teaching across accredited programs.

Pharmaceutical industry in a global context elective course: implementation and preliminary outcomes.

To describe the implementation of 'Pharmaceutical Industry in a Global Context' elective in a 4-year US pharmacy programme. An anonymous questionnaire regarding student experiences with the course content and intention to pursue pharmaceutical industry summer internships and/or postgraduation fellowships was distributed to students at the end of the course. Fifty per cent of the students (n=13) reported intention to apply for a pharmaceutical industry summer internships and/or industry fellowship postgraduation. The described industry course may be adopted by other educators to encourage pharmacy students' exploration into industry careers.

Surveys of substance use disorders education in US pharmacy programs.

Introduction:Substance use disorders (SUDs) are a significant US health problem affecting roughly 20 million Americans, but there continues to be limited access to SUD treatment and inadequate addiction medicine training. Therefore, it is important to understand how SUD education is being delivered to US health professionals, including pharmacists.Methods:A recent survey of US pharmacy programs' neuropsychiatry curricula was evaluated to identify any progress made toward increasing SUD education since the last national survey in 2004 and determine any remaining gaps between what is currently being taught and American Association of Colleges of Pharmacy (AACP) curricular guidelines for SUD education updated in 2010. A survey of psychiatric pharmacists, regarding what they thought should be taught, was also evaluated and compared with the 2010 AACP curricular guidelines.Results:Our survey of US pharmacy programs demonstrated that 94% of programs reported teaching SUD content in 2014-15, which has increased from 81% reported in a survey study from 2004. There was also an increase for average hours of SUD didactic instruction, which increased from 2.2 hours in 2004 to 2.7 hours in 2015. The majority of members (84%) recommended at least 2 hours of SUD instruction, and 27% recommended teaching ≥4 hours.Discussion:There was an overall increase in SUD instruction, but the average hours taught still falls short of 2010 AACP curricular guideline recommendation suggesting ≥4 hours. Furthermore, a majority of the psychiatric pharmacists we surveyed did not agree with the AACP curricular guideline recommendation because only 27% of members recommended ≥4 hours of SUD instruction, and the average hours recommended was only 2.7 hours.

A review of mastery learning: The roseman model as an illustrative case.

An educational method gaining acceptance in health profession's training is mastery learning. Mastery learning requires learners to demonstrate essential knowledge and skills measured against rigorously set standards without regard to time. The key elements of mastery learning include focus on a single subject, short curricular blocks, setting specific objectives, using frequent feedback, deliberative practice, and demonstrating mastery before moving onto the next subject. Roseman University of the Health Sciences College of Pharmacy (COP) developed and delivered an accelerated mastery learning curriculum designed to develop knowledge and skills through active learning. The COP uses a mastery model for its PharmD program. The didactic curriculum is divided into 2-week assessment blocks focusing on a single subject. Students must demonstrate mastery, defined as ≥90% on an assessment, to pass a block. Students failing a block assessment receive feedback and a second opportunity to pass. Students failing their repeat assessment continue onto the next block, but require summer remediation before moving onto the next year. National pass rates for the US pharmacy board examination ranged between 92.6% and 96.9% during the 2010-2015 period, while the COP scores ranged from 93.0% to 99.0% and fell below national pass rates on only one occasion. The attrition rate was 6.5%, below the national rate of 10.8%. Students reported an overall satisfaction with their education of 3.82 (Likert scale 1-5) and 4.04 for the block system. Overall, the Roseman University mastery model is successful. Students report high levels of satisfaction and outcomes on examinations and attrition compares favorably to national averages.

Preceptor's grading scale preference for student pharmacy practice experience and assessment of the common grading scale among US schools of pharmacy

IntroductionThe objective of this study was to gain an understanding of preceptors’ grading scale preferences for introductory and advanced pharmacy practice experiences (IPPE/APPE). Secondarily, assess if there is a common grading scale for IPPE/APPE rotations among US pharmacy programs. MethodsAn online, 22-item survey questionnaire was sent to all preceptors at a fully accredited school of pharmacy. The survey instrument assessed preceptor attitudes toward the effectiveness of the primary grading scales, letter or pass/no pass. Demographic variables were also assessed, including gender, age, practice setting, years as a preceptor, and annual number of students precepted. In addition, a phone survey was conducted with all pharmacy programs in the United States at the time to assess grading scales used for introductory and advanced pharmacy practice experiences (IPPE/APPEs). ResultsThree hundred sixty-five preceptors responded to the survey questionnaire. Overall, preceptors had more favorable attitudes toward the letter grade system as opposed to the pass/no pass system, and when asked specifically which they preferred, approximately 70% preferred the letter grading system. The phone survey of different pharmacy programs grading systems revealed most use the letter grading system. Fifty-six of 87 responding schools (64%) reported use of a letter grading system, compared to 26 of 87 (30%) using a pass/no pass system and five using ‘other variations’ (6%). ConclusionThe majority of preceptors preferred the letter grading system over the pass/no pass system. Familiarity with this system was a contributing factor, as a significant number of preceptors preferred the grading scale they had as a pharmacy student – the letter grade system. This trend mimics current pharmacy school's grading system, as approximately 2/3 currently use a letter grading system to evaluate IPPE/APPEs.

Educational Attainment and Academic Profile of Deans and Chairs at US Pharmacy Schools

Objective. To characterize educational attainment and experiences of current US pharmacy school deans and chairs. Methods. A cross-sectional study using a publicly available listing of accredited schools and information. Results. Among 134 deans and 301 chairs, 79.9% and 65.5% held a professional degree (BSPharm and/or PharmD), 33.6% and 26.2% completed PGY-1 residencies, 12.7% and 15.6% completed post-PharmD fellowships, 23.1% and 33.9% completed post-doctoral fellowships, and 13.4% and 18.3% held BPS certification, respectively. Fewer than 1 in 5 were employed at an alma mater. Ninety (20.7%) deans and chairs completed AACP's Academic Leadership Fellows Program. Average current tenure was 5.7 and 5.1 years for deans and chairs, respectively. Conclusion. The majority of deans and chairs held a pharmacy professional degree and the prevalence of post-graduate educational and leadership training is increasing. Future research should apply mixed methods to investigate educational attainment and employment experience of deans and chairs, institutional hiring trends, and how these characteristics compare between newer and established programs.

Simulation of Lipid-Lowering Therapy Intensification in a Population With Atherosclerotic Cardiovascular Disease

In patients with atherosclerotic cardiovascular disease (ASCVD), guidelines recommend optimizing statin treatment, and consensus pathways suggest use of ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with persistently elevated low-density lipoprotein cholesterol (LDL-C) levels despite use of statins. Recent trials have provided evidence of benefit in reduction of cardiovascular events with these agents. To estimate the percentage of patients with ASCVD who would require a PCSK9 inhibitor when oral lipid-lowering therapy (LLT) is intensified first. This simulation model study used a large administrative database of US medical and pharmacy claims to identify a cohort of 105 269 patients with ASCVD enrolled from January 1, 2012, through December 31, 2013, who met the inclusion criteria (database cohort). Patients were sampled with replacement (bootstrapping) to match the US epidemiologic distribution and entered into a Monte Carlo simulation (simulation cohort) that applied stepwise treatment intensification algorithms in those with LDL-C levels of at least 70 mg/dL. All patients not initially receiving a statin were given atorvastatin, 20 mg, and the following LLT intensification steps were applied: uptitration to atorvastatin, 80 mg; add-on ezetimibe therapy; add-on alirocumab therapy, 75 mg (a PCSK9 inhibitor); and uptitration to alirocumab, 150 mg. Sensitivity analyses included evolocumab as a PCSK9 inhibitor. Efficacy was estimated from published studies and incorporated patient-level variation. Data were analyzed from December 2015 to May 2017. Treatment intensification strategies with LLT. Use of LLT among the population with ASCVD and distributions of LDL-C levels under various treatment intensification scenarios. Inclusion criteria were met by 105 269 individuals in the database cohort (57.2% male and 42.8% female; mean [SD] age, 65.1 [12.1] years). In the simulation cohort (1 million patients; 54.8% male and 45.2% female; mean [SD] age, 66.4 [12.2] years), before treatment intensification, 51.5% used statin monotherapy and 1.7% used statins plus ezetimibe. Only 25.2% achieved an LDL-C level of less than 70 mg/dL. After treatment intensification, 99.3% could achieve an LDL-C level of less than 70 mg/dL, including 67.3% with statin monotherapy, 18.7% with statins plus ezetimibe, and 14% with add-on PCSK9 inhibitor. Large gaps exist between recommendations and current practice regarding LLT in the population with ASCVD. In our model that assumes no LLT intolerance and full adherence, intensification of oral LLT could achieve an LDL-C level of less than 70 mg/dL in most patients, with only a modest percentage requiring a PCSK9 inhibitor.

Update on sunscreens distributed by major US retailers that meet American Academy of Dermatology recommendations

Update on sunscreens distributed by major US retailers that meet American Academy of Dermatology recommendations

An Analysis of Quality Improvement Education at US Colleges of Pharmacy

Objective. Analyze quality improvement (QI) education across US pharmacy programs. Methods. This was a two stage cross-sectional study that inspected each accredited school website for published QI curriculum or related content, and e-mailed a questionnaire to each school asking about QI curriculum or content. T-test and chi square were used for analysis with an alpha a priori set at .05. Results. Sixty responses (47% response rate) revealed the least-covered QI topics: quality dashboards /sentinel systems (30%); six-sigma or other QI methodologies (45%); safety and quality measures (57%); Medicare Star measures and payment incentives (58%); and how to implement changes to improve quality (60%). More private institutions covered Adverse Drug Events than public institutions and required a dedicated QI class; however, required QI projects were more often reported by public institutions. Conclusion. Despite the need for pharmacists to understand QI, it is not covered well in school curricula.

Tone and style in pharmacy course syllabi

ObjectiveSyllabi are a part of the teaching and learning experience in pharmacy curricula. Yet, little has been done to understand the effects of these documents. Studies in Psychology and Social Work report important effects of style and tone of syllabi on student perceptions and performance. We sought to describe a cross-sectional pattern in the tone and style of pharmacy course syllabi. MethodsWe retrieved syllabi via US pharmacy institutions and association website searches. The tone was characterized as “warm” or “cold” based on the publications in Psychology and Social Work higher education. QSR NVivo® software was used to code syllabi. Subsequently, categories of style and tone were quantified in a descriptive manner. ResultsWe retrieved 416 pharmacy course syllabi from 30 public universities (69.8%) and 13 private universities (30.2%) across curricular disciplines. After observing saturation where no new patterns arose, 141 syllabi were analyzed. ConclusionsPharmacy course syllabi were rarely warm in tone and did not fully employ the components of the syllabus as a potential learning tool. This may have important implications on student-teacher interactions, professional development, and student perceptions and academic performance. More work should be done to determine whether and in what manner style and tone may affect pharmacy student learning and engagement.