Report of the 2019-2020 Strategic Engagement Standing Committee.

For the American Association of Colleges of Pharmacy (AACP) strategic engagement is critical to the success of colleges and schools of pharmacy in expanding pharmacy and public health practice, meeting programmatic needs, and fulfilling institutional missions. The 2019-2020 Strategic Engagement Committee was charged with exploring the collaborative relationships colleges and schools have within their state to advance pharmacy practice. More specifically, this committee was tasked to examine those relationships with current state pharmacy and medical associations. This report seeks to provide insights from this work and share recommendations to assist AACP in facilitating practice transformation. To uncover current schools' relationships with state and medical associations, the committee utilized AACP's ability in convening members to conduct focus groups at INsight 2020 and one-on-one interviews with key faculty members. Overall, partnerships with state pharmacy associations are successful or growing, whereas there is still work to be done in developing relationships and collaborating with medical and health care societies. We found that there are several schools with "best practices" related to state association collaborations and look to highlight exemplar practices in this report as they are critical towards practice transformations.

Pathway to pharmacist medical provider status in Washington State.

OBJECTIVES: To describe Washington State's successful legal and legislative efforts to gain pharmacist medical provider status and major medical compensation and to compare those efforts with similar efforts in other states to identify key lessons learned. SUMMARY: Washington State Engrossed Substitute Senate Bill 5557 was enacted in 2015, securing pharmacists as medical providers and requiring compensation under major medical insurance for pharmacists providing health services (Revised Code of Washington 48.43.715). Other states have passed, or attempted to pass, pharmacist provider status bills, but none have achieved both pharmacist medical provider status and mandatory major medical compensation. CONCLUSION: Pharmacist medical provider status ideally should include recognition as a medical provider and compensation through major medical health insurance as a clinical decision maker rather than an "incident-to" provider. Both elements should be sought as part of a complete legislative package to ensure sustainable patient access to needed health care services.

Oral health in patients taking psychotropic medications: Results from a pharmacy-based pilot study.

OBJECTIVES: Individuals with mental illness face an increased risk of oral disease compared with those without mental illness. The goals of this study were to examine the self-reported oral health and dental access of individuals filling psychotropic medication prescriptions and to determine whether pharmacy patients would choose to speak with a pharmacist about their oral health if given the option to do so. DESIGN: Pharmacists across 6 community pharmacies within a local chain identified and surveyed adult patients filling prescriptions for psychotropic medications. Surveys included questions about oral health, dry mouth, and dental care utilization. SETTING: Six community pharmacy locations. PARTICIPANTS: Adults (≥18 years of age) filling prescriptions for psychotropic medications. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Self-reported oral health, dental utilization, desire to discuss oral health with a pharmacist. RESULTS: Participants (N = 178) filling prescriptions were mostly (65.9%) female with a mean age of 48.2 years (SD 14.3, range 19-82 years). One in 4 (24.9%) said their mouths "always" or "frequently" felt dry; these individuals were significantly more likely to have last seen a dentist for emergency (rather than routine) treatment (P <0.01) and rated their oral health as significantly worse (P <0.001) than participants whose mouths "never" or "occasionally" feel dry. A small percentage (5.7%) requested to speak with pharmacists about oral health; they reported poorer oral health than those who opted not to speak with a pharmacist (P <0.05). CONCLUSION: One in 4 patients reported having dry mouth, and those with dry mouth reported significantly worse oral health than patients without dry mouth. Although dry mouth and poor oral health were common in this sample of individuals taking psychotropic medications, this did not consistently translate into seeking information regarding oral health. Future research will focus on pharmacist-initiated oral health interventions with high-risk patients.

Coming of age: pharmacy practice in the 21st century.

Individuals, families, health plans and governments are struggling with the growing importance of managing chronic, non-communicable diseases. People in many countries are living longer and thus are facing many years of managing hypertension, diabetes and hyperlipidemia - often complicated by obesity, declining physical activity and changing diets. The financial burden this places on governments, employers, and individuals purchasing health care services is growing and solutions are being sought on how to both finance this care and deliver the best care possible. New ideas are emerging that look to newfound resources, and one untapped resource increasingly being utilized is the clinical pharmacist. After many years being primarily involved in medication supply-chain management, the assistance that highly skilled pharmacists can provide medical providers and their patients is now being recognized. In order to realize fully the benefits of clinical pharmacists, governments, health plans and medical providers are taking a second look at the wisdom of maintaining the long-standing policy of compensating pharmacists only for filling prescriptions.

Pharmacist prescribing of hormonal contraceptives: results of the Direct Access study.

OBJECTIVE: To describe implementation of a collaborative drug therapy protocol to screen and counsel women for safe use of hormonal contraceptives prescribed by community pharmacists. DESIGN: Community-based intervention study. SETTING: Metropolitan Seattle, Wash., from June 2003 to December 2005. PARTICIPANTS: 26 community pharmacists and 214 women enrollees. INTERVENTION: Pharmacists identified women at risk of unintended pregnancy and offered to evaluate them to determine whether they could safely use oral contraceptives, contraceptive patches, or the contraceptive vaginal ring. Interested women self-administered medical and contraceptive history questionnaires. Pharmacists measured weight and blood pressure and prescribed hormonal contraceptives according to the protocol guidelines. Study interviewers followed up with women via telephone at 1, 6, and 12 months. MAIN OUTCOME MEASURES: Effectiveness of pharmacist interventions was measured by continuation of hormonal methods by women. Feasibility was determined by measuring acceptability and sustainability. Acceptability was measured by interviewing women and pharmacists. Sustainability was measured by evidence of willingness to pay for the services. RESULTS: 195 women (91%) were prescribed hormonal contraceptives by participating pharmacists. A self-administered screening tool and physical measurement of weight and blood pressure enabled pharmacists to evaluate women for safe use of contraceptives. Most women (87%) were experienced users of hormonal contraceptives. More than 80% of women paid for the pharmacists' services out of pocket. After 12 months, 70% of women responding to an interview reported continuing use of hormonal contraceptives. Women reported that they would want to obtain a gynecologic exam within 3-year intervals while taking hormonal contraceptives. Both women and pharmacists were satisfied with the experience. Nearly all respondents expressed willingness to continue to see pharmacist prescribers and to receive other services from them. CONCLUSION: Community pharmacists can efficiently screen women for safe use of hormonal contraceptives and select appropriate products. Women and pharmacists were satisfied with the services, and women were willing to pay for them.