ABSTRACT
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used medications due to their prescription and nonprescription availability, various dosage formulations, and therapeutic efficacy. Although NSAIDs have many known benefits, their effects on gastrointestinal, cardiovascular, bone, and renal physiology limit their widespread and long-term use. This article provides an update on dosage formulations, product availability, and pertinent adverse effects and warnings regarding the use of NSAIDs, with an emphasis on nonaspirin NSAIDs.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cardiovascular System/drug effects , Nonprescription Drugs/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , HumansABSTRACT
Shared decision-making is the process by which health care providers and patients work collaboratively to evaluate and select treatment options. In June 2019, this approach was included in the Advisory Committee on Immunization Practices' (ACIP's) updated recommendations for the 9-valent human papillomavirus (9vHPV) and 13-valent pneumococcal conjugate (PCV13) vaccines. Using shared decision-making, 9vHPV may be administered to individuals aged 27 years through 45 years who are not adequately vaccinated, and PCV13 may be administered to adults aged 65 years or older who do not have an immunocompromising condition, cochlear implants, or cerebrospinal fluid leak, and who have not previously received PCV13. Although not a new concept for physicians and providers in clinical practice, shared decision-making for vaccines presents additional opportunities for pharmacists and student pharmacists to actively engage patients in determining what vaccines they need and which ones to consider. In addition to the new 9vHPV and PCV13 recommendations, this approach should be applied to other vaccines that may benefit non-high-risk individuals based on guidance from ACIP and the Centers for Disease Control and Prevention immunization schedules.
Subject(s)
Pneumococcal Infections , Pneumococcal Vaccines , Adult , Humans , Immunization Schedule , Pneumococcal Infections/prevention & control , Vaccination , Vaccines, ConjugateABSTRACT
Although the use of a professional dress code is standard practice across colleges and schools of pharmacy during introductory and advanced pharmacy practice experiences, requiring professional attire is not applied consistently during the didactic portion of students' education. There are arguments for and against the adoption of a professional dress code throughout the entire doctor of pharmacy program, including the classroom setting. Given uncertainty regarding the potential benefits and challenges that may arise from adopting a professional dress code in the didactic portion of a student pharmacist's education, it is perhaps not surprising that programs adopt disparate policies regarding its use. This exploration was conducted as part of a series of debates held in conjunction with the American Association of Colleges of Pharmacy's (AACP) Academic Leadership Fellows Program (ALFP) and was presented at the 2015 AACP Interim Meeting on February 7, 2015.
Subject(s)
Clothing/standards , Codes of Ethics , Education, Pharmacy/standards , Schools, Pharmacy/standards , Students, Pharmacy , Codes of Ethics/trends , Humans , Professional Role , Schools, Pharmacy/trendsSubject(s)
Communicable Diseases/immunology , Immunocompetence , Immunocompromised Host , Vaccination , Adolescent , Adult , Child , Child, Preschool , Communicable Diseases/transmission , Humans , Infant , Patient Selection , Pneumococcal Vaccines/adverse effects , Pneumococcal Vaccines/immunology , Risk Assessment , Risk Factors , Vaccination/adverse effects , Vaccines, Attenuated/adverse effects , Vaccines, Attenuated/immunology , Vaccines, Inactivated/adverse effects , Vaccines, Inactivated/immunology , Young AdultABSTRACT
There are many local and global volunteer opportunities for pharmacists to contribute to public health initiatives that help promote health, prevent disease and improve access to care. This article provides perspective and guidance for pharmacists and student pharmacists who desire to take part in volunteer initiatives related to local and global public health needs. The case examples provided are limited to activities that occurred strictly in a volunteer capacity. Pharmacists serving in a volunteer capacity have an opportunity to broaden their depth of practice and patient care responsibilities. Their skills sets and knowledge can be applied in a variety of public health settings to help meet the health care needs of the communities and patients they serve. Emergency response and caring for the underserved are recurring themes within the volunteer opportunities afforded to pharmacists. Examples include, but are not limited to, the US Medical Reserve Corps, health departments, health centres and clinics, medical service trips and disaster relief. Regardless of setting, the volunteer pharmacist will need to consider scope of practice limitations and certain legal protections. An array of volunteer opportunities exists for pharmacists and student pharmacists in the public health arena. Participating in these events allows pharmacists to expand their practice experiences while contributing to public health needs and outreach.
Subject(s)
Pharmacists , Public Health , Volunteers , HumansABSTRACT
OBJECTIVE: To provide experiential rotation students with educational activities to enhance learning and patient communication skills with respect to nonprescription drug therapy. DESIGN: A longitudinal project, a consultation guide, and a list of mini-projects were developed for a 4-week community pharmacy rotation experience. The longitudinal project was a nonprescription pocket formulary consisting of 4 disease states and their respective treatment options. The consultation guide was a 1-page data collection form intended to capture patient information regarding the use of nonprescription products in a thorough and brief manner. The mini-projects were questions to be answered while spending time in the nonprescription medication aisles. ASSESSMENT: Students were very creative in developing their formularies. They also became more familiar with using nonprescription product references and package labeling information. The consultation guide taught students to apply the "PQRSTA" mnemonic. It prompted discussion of self-care issues and served as a useful educational tool for the preceptor. The list of mini-projects forced students to become familiar with the many nonprescription products available, as well as product line extensions and duplication. CONCLUSION: Students were able to apply and build upon what was learned during their didactic education. The activities provided an excellent means of enhancing patient counseling and problem-solving skills. Additionally, the preceptor relied on these activities to engage students in conversation pertaining to nonprescription products and self-care related issues.
Subject(s)
Community Pharmacy Services , Education, Pharmacy/methods , Self Care/methods , Students, Pharmacy , HumansABSTRACT
OBJECTIVE: To compare workload productivity, workflow efficiency, and pharmacist-patient interaction in automated and nonautomated community pharmacies. DESIGN: Observational study. SETTING: Four community pharmacy sites within a regional pharmacy chain. STUDY PARTICIPANTS: 173 patients and 11 pharmacists. INTERVENTIONS: Patient surveys, pharmacist surveys, and direct observation. MAIN OUTCOME MEASURES: Patient satisfaction, frequency of pharmacist-patient interactions, and prescription dispensing productivity and efficiency. RESULTS: Results from the three nonautomated pharmacies were averaged and compared with results from the automated pharmacy. Patient satisfaction was generally favorable for both automated and nonautomated pharmacies, but scores for the automated site were significantly better on items measuring one domain, technical competence of pharmacy staff. No association was found between patient counseling and prescription workload in automated or nonautomated sites. Personnel at the automated site made significantly more offers to counsel patients, but the number of patients who received counseling did not differ significantly. Automation was associated with a higher number of prescriptions dispensed per full-time equivalent pharmacist and fewer technical dispensing tasks performed by pharmacists. CONCLUSION: Patient satisfaction was not related to the presence of an automated dispensing system. Automation was associated with higher prescription productivity, but actual counseling rates were no different from those observed in nonautomated pharmacies. The likelihood that a patient would receive counseling was not related to staffing levels, automation, or workload. Whether counseling occurred appeared to depend on factors other than automation.
Subject(s)
Automation/methods , Community Pharmacy Services/statistics & numerical data , Professional-Patient Relations , Workload/statistics & numerical data , Community Pharmacy Services/standards , Community Pharmacy Services/trends , Humans , Patient Education as Topic/methods , Patient Education as Topic/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Pharmacy Technicians/education , Pharmacy Technicians/standardsABSTRACT
OBJECTIVE: To assess the effect that workflow enhancements have on dispensing responsibilities and pharmacist-patient interaction in the community pharmacy setting. DESIGN: Pre-post comparison. Pre-assessment data were obtained from a multisite observational study. SETTING: Pharmacy within a regional pharmacy chain. STUDY PARTICIPANTS: 3 pharmacists and 110 patients. INTERVENTION: The pharmacy was physically remodeled to enable workflow changes, including defining dispensing responsibilities with an emphasis on patient counseling, providing an additional 6 feet of counter space, upgrading technology, installing a third computer, implementing tools to augment the filling process, and requesting that cashiers rephrase the offer to counsel to encourage patient acceptance. Patients and pharmacists were surveyed about the experiences and beliefs, and pharmacy activities were observed directly. MAIN OUTCOME MEASURES: Patient counseling and prescription dispensing. activities. RESULTS: The number of pharmacists who perceived that they had adequate time to counsel patients increased as a result of the intervention (0 of 3 responding pharmacists before the intervention, compared with 2 of 2 afterward). Patient satisfaction scores both before and after the intervention were predominantly favorable and did not differ significantly. The most relevant change in dispensing activities was pharmacist involvement with data entry into the computer, which decreased from 61% to 10%. Oral counseling offers to patients increased significantly, from 5% to 85%, but counseling rates remained low throughout the study and were not measurably affected by workload. CONCLUSION: Workflow redesign has positively affected the dispensing activities at the study site. Technicians took more responsibility for dispensing tasks. Given the drastic increase in counseling offers but lack of effect on counseling rates, patient behavior and expectations with regard to counseling likely need to change to further improve dynamics in the community pharmacy.