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Cytotoxics in the pipeline: carrier-mediated anticancer agents in development
Suphat Subongkot, PharmD, BCPS, BCOP
European Journal of Oncology Pharmacy , 2011,
Abstract: Novel cancer pharmacotherapeutics are progressing speedily and are being implemented to solve several limitations of conventional chemotherapy. In this review, we will focus on the types and characteristics of carriermediated anticancer agents, how they are being used as drug delivery, and possible future advances.
Comparison of Traditional Versus Evidence-Based Journal Club Formats
Kathleen Packard, PharmD, MS, BCPS,Megan Herink, PharmD, BCPS,Thomas L. Lenz, PharmD, MA, PAPHS
INNOVATIONS in Pharmacy , 2011,
Abstract: Purpose: The objective of the study was to compare a traditionally structured journal club with an evidence based structured journal club during an advanced clinical pharmacy rotation and to determine the best utilization that aligns with recent changes to the pharmacy school accreditation standards.Methods: The study included 21 students who completed journal club utilizing the traditional journal club format and 24 students who utilized an evidence based journal club format. Background characteristics, student reported beliefs, and mean critical evaluation skills scores were evaluated and compared in each group.Results: There were no statistically significant differences between the two cohorts in mean overall percentage grade for the activity. Students in the traditional cohort received significantly higher grades for the Study Analysis and Critique section (90.97 + 12.18 versus 81.25 + 11.18, P=0.01) as well as for the Preparedness section (96.11 + 8.03 versus 85.0 + 17.13, P=0.002). Students in the evidence based cohort received statistically superior grades for the Presentation Skills section (96.43 + 6.39 versus 82.47 + 14.12, P=0.0004).Conclusion: An evidence based journal club is a reasonable and effective alternative to the traditionally structured journal club when the primary objective is to assist students in understanding evidence based concepts and to apply current literature to clinical practice.
Impact of Pharmacists and Student Pharmacists in Educating and Screening Low-Income Women for Cardiovascular Disease
Natalie A. DiPietro, PharmD, MPH,Kristen Finley Sobota, PharmD, BCPS,Martin R. Giannamore, PharmD, BCPS
INNOVATIONS in Pharmacy , 2012,
Abstract: Objectives: To evaluate the effectiveness of an educational intervention on knowledge of cardiovascular disease (CVD) and to increase awareness of risk factors among female patients of a community health center with an on-site 340B pharmacy.Methods: The program consisted of a 10-minute educational intervention and brief pre-test, post-test, and participant satisfaction survey. Adult female patients at the clinic for any provider visit or prescription fill were eligible to participate. Participants met individually with a student pharmacist or faculty member and verbally completed the pre-test. The participant received education regarding CVD, risk factors, and symptoms of myocardial infarction and were screened for hypertension and/or hyperlipidemia. The post-test was then verbally administered. Participants answered the satisfaction survey privately. Based on individual needs, educational materials and information on available pharmacy clinical services were provided. The university IRB deemed the study exempt. Results: Eighty-four individuals received educational materials and/or a screening test. Of those, 30 women (mean age 46.9 years) completed the educational intervention. Thirteen (43%) reported smoking; 22 (73%) identified themselves as overweight. Fourteen (47%) indicated a preexisting diagnosis of hypertension. Correct responses for 6 of 8 knowledge-based questions were statistically significantly improved from pre-test to post-test (p<0.05). Twenty-nine patients (97%) rated the program as “useful” or “very useful”. Conclusion: CVD is the leading cause of death in U.S. women. Data from this program indicate that through screening and education, pharmacists and student pharmacists can impact female patients’ knowledge of CVD risk factors. Continued efforts in this area may help to reduce the public health burden of CVD.
Using Multiple Choice Questions Written at Various Bloom’s Taxonomy Levels to Evaluate Student Performance across a Therapeutics Sequence
Amy M. Tiemeier, Pharm.D., BCPS,Zachary A. Stacy, Pharm.D., BCPS,John M. Burke, Pharm.D., FCCP, BCPS
INNOVATIONS in Pharmacy , 2011,
Abstract: Objective: To evaluate the results of a prospectively developed plan for using multiple choice questions (MCQs) developed at defined Bloom’s levels to assess student performance across a Therapeutics sequence.Methods: Faculty were prospectively instructed to prepare a specific number of MCQs for exams in a Therapeutics sequence. Questions were distributed into one of three cognitive levels based on a modified Bloom’s taxonomy, including recall, application, and analysis. Student performance on MCQs was compared between and within each Bloom’s level throughout the Therapeutics sequence. In addition, correlations between MCQ performance and case performance were assessed.Results: A total of 168 pharmacy students were prospectively followed in a Therapeutics sequence over two years. The overall average MCQ score on 10 exams was 68.8%. A significant difference in student performance was observed between recall, application, and analysis domain averages (73.1%, 70.2% and 60.1%; p<0.001). Student performance within each Bloom’s level across the three courses was significantly different for recall (p<0.001), application (p<0.001), and analysis (p<0.001) MCQs. A significant correlation was observed between the recall domain and the case (0.67; p<0.01), application domain and the case (0.62; p<0.01), and analysis domain and the case (0.64; p<0.01).Conclusions: As students progress through the curriculum, faculty may need to find ways to promote recall knowledge for more advanced topics while continuing to develop their ability to apply and analyze information. Exams with well-designed MCQs that prospectively target various cognitive levels can facilitate assessment of student performance.
Perspectives from the Hmong Population on Type 2 Diabetes
Phoua Xiong, Pharm.D.,Sarah M. Westberg, PharmD, BCPS
INNOVATIONS in Pharmacy , 2012,
Abstract: The primary goal of the study was to determine perceptions the Hmong population has about Type 2 diabetes. Specific information to be gathered from the Hmong participants were: reactions after being diagnosed with Type 2 diabetes, knowledge and beliefs about medications, and how pharmacists can help them with their diabetes care. Learning the beliefs of this population related to Type 2 diabetes will help identify methods to improve diabetes care and education for Hmong patients. A focus group was conducted with Hmong participants with Type 2 diabetes to explore their perceptions and experiences with diabetes. There were 9 participants in the focus group which lasted approximately 90 minutes. The major themes were a misunderstanding of diabetes and its treatment, a reluctance to adhere to medications, a reluctance to change cultural diet, and the need for clear education from pharmacists. Participant recommendations for pharmacists were to improve their diabetes care by educating them about the condition, medication, and available treatments.
Medication Adherence of Patient Assistance Program Recipients: A Pilot Study
Christian S. Conley, PharmD,Peter J. Hughes, PharmD, BCPS
INNOVATIONS in Pharmacy , 2012,
Abstract: Purpose: Evaluate medication adherence of prescription assistance program recipients at an inner-city clinic.Methods: Surveys were administered at enrollment and 6 months following enrollment to patients who were either recipients of at least one patient assistance program (PAP) or had prescription benefits through Alabama Medicaid. Data on patient demographics, Morisky Medication Adherence Survey (MMAS) scores, mean possession ratio (MPR), and drug classes were collected for 6 months.Results: The baseline MMAS score concluded that both the PAP group and Alabama Medicaid group were highly motivated and highly knowledgeable regarding adherence to prescribed medications. After 6 months, administration of the same MMAS instrument resulted in a category change in the PAP group from highly motivated and knowledgeable to low motivation and high knowledge. The Medicaid MMAS adherence category did not change from baseline after 6 months. The 6-month mean MPR for the PAP and Medicaid groups were 0.542 and 0.823, respectively.Conclusion: Providing free or low-cost medication plus customary counseling should not be the sole interventions for the uninsured patient. In this study, PAP recipient MMAS score change and low mean MPR suggest that additional interventions are needed to ensure that PAP recipients adhere to prescribed therapies.
Patient-perceived value of Medication Therapy Management (MTM) services: a series of focus groups
Heidi Schultz, PharmD,Sarah M. Westberg, PharmD, BCPS,Djenane Ramalho de Oliveira, PhD,Amanda Brummel, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i) patients who paid out-of-pocket to receive MTM services; (ii) insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii) patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.
The Effect of a Novel Proactive First Day Prescription Counseling Program on Adherence to Select Cardiovascular Medications
Jamie L. McConaha, Pharm.D., CGP,Kevin Lynch, Pharm.D., BCPS, MBA
INNOVATIONS in Pharmacy , 2011,
Abstract: Objective: To determine the impact of a proactive first day prescription counseling program on medication adherence to new cardiovascular maintenance medicationsDesign: Cross-sectional studySetting: Regional chain community pharmacy in Pittsburgh, Pennsylvania; August 2009 through November 2010Patients: Data was collected from all patients aged 18-89 presenting with a new or transferred prescription or change in dosage within the study dates at four study locationsInterventions: Patients presenting with a new or transferred prescription or change in dosage were identified to receive pharmacist or student pharmacist counseling. Data from the counseling session was tracked weekly to determine if the program increased adherence to statins, ACEIs and/or ARBs.Main Outcome Measured: Adherence to statins, ACEIs and/or ARBs was determined by differences in proportion of days covered (PDC) at six months and medication persistence to therapy.Results: Analysis was conducted using IDNA sm software. Results of the 6,916 prescriptions included in the study revealed that persistence rates for statins was 32.5% (intervention) and 34.2% (control) (p<0.001); ACEI/ARBs persistence was 37.3% (intervention) and 43.2% (control) (p<0.001). PDC was nonsignificant with respect to statins; 43.2% (intervention) and 45.1% (control); and 50.2% (intervention) and 57.1% (control) (p<0.001) for the ACEI/ARBs.Conclusion: Results from this study showed no improvement in adherence of statins or ACEIs/ARBs with the D1TC program versus control pharmacies, although several important limitations were identified. It is clear that a variety of methods and programs are needed to consistently improve adherence to maintenance medications.
Adopting an Advanced Community Pharmacy Practice Experiential Educational Model Across Colleges of Pharmacy
Jennifer L. Rodis, Pharm.D., BCPS,Brandon T. Jennings, Pharm.D.
INNOVATIONS in Pharmacy , 2011,
Abstract: Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration.Case Study: The Ohio State University College of Pharmacy (OSU COP) Partner for Promotion (PFP) program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP). Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed.Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.
Design and Implementation of Antidepressant Decision Making Aids
Beth DeJongh, Pharm.D., BCPS,Robert Haight, Pharm.D., BCPP
INNOVATIONS in Pharmacy , 2012,
Abstract: Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness.Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient’s medication adherence needs to be addressed in future studies.
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