ABSTRACT
The ideas and philosophies of preservice secondary music teachers (PSMTs) are formalized in their tertiary education years. In these years, PSMTs must reconcile the expectations, beliefs, and values espoused by their lecturers, tutors, and other significant people from their past. PSMTs have accumulated various musical experiences through prior interactions with their primary and secondary school teachers and private tutors, which nurture and shape the kind of teachers they anticipate becoming. This research focuses on a group of six PSMTs who face a very different future, teaching in the COVID-19 world of digital delivery amid a time of curriculum change in New South Wales (NSW), Australia. Thirty-minute Zoom interviews with the six participants took place over the two semesters of 2020, beginning before the COVID-19 outbreak in Australia and investigating how prepared PSMTs felt they were for classroom teaching. Their most positive responses regarding online learning provided evidence that their music lecturers had built PSMTs? understanding of the curriculum, which increased their confidence in their musical ability during practicum. The findings in this article provide an informed NSW perspective about PSMTs? tertiary education, adding to research about classroom music pedagogy. Finally, the opinions of PSMTs on their current learning and future careers are of importance and interest for both tertiary education institutions and curriculum designers.
ABSTRACT
PURPOSE: Adherence to self-administered biologic disease-modifying antirheumatic drugs (bDMARDs) is necessary for therapeutic benefit. Health-system specialty pharmacies (HSSPs) have reported high adherence rates across several disease states; however, adherence outcomes in rheumatoid arthritis (RA) populations have not yet been established. METHODS: We performed a multisite retrospective cohort study including patients with RA and 3 or more documented dispenses of bDMARDs from January through December 2018. Pharmacy claims were used to calculate proportion of days covered (PDC). Electronic health records of patients with a PDC of <0.8 were reviewed to identify reasons for gaps in pharmacy claims (true nonadherence or appropriate treatment holds). Outcomes included median PDC across sites, reasons for treatment gaps in patients with a PDC of <0.8, and the impact of adjusting PDC when accounting for appropriate therapy gaps. RESULTS: There were 29,994 prescriptions for 3,530 patients across 20 sites. The patient cohort was mostly female (75%), with a median age of 55 years (interquartile range [IQR], 42-63 years). The median PDC prior to chart review was 0.94 (IQR, 0.83-0.99). Upon review, 327 patients had no appropriate treatment gaps identified, 6 patients were excluded due to multiple unquantifiable appropriate gaps, and 420 patients had an adjustment in the PDC denominator due to appropriate treatment gaps (43 instances of days' supply adjusted based on discordant days' supply information between prescriptions and physician administration instructions, 11 instances of missing fills added, and 421 instances of clinically appropriate treatment gaps). The final median PDC after accounting for appropriate gaps in therapy was 0.95 (IQR, 0.87-0.99). CONCLUSION: This large, multisite retrospective cohort study was the first to demonstrate adherence rates across several HSSPs and provided novel insights into rates and reasons for appropriate gaps in therapy.