Evaluation of an ambulatory care elective to improve practice readiness perceptions utilizing entry-level competencies.

BACKGROUND AND PURPOSE: The objectives of this study are to (1) describe the impact of an ambulatory care elective on students' future interests in ambulatory care careers and (2) evaluate students' perception of practice readiness using entry-level competencies. EDUCATIONAL ACTIVITY AND SETTING: This study employed a mixed methods approach to provide a comprehensive evaluation of a newly designed ambulatory care elective. A pre-post survey was developed to evaluate students' career plans and perceptions of practice readiness in an ambulatory care setting. The primary outcome analyzed the change in students' career plans and pre-post changes in self-perceptions using the institutional advanced pharmacy practice experience (APPE) ambulatory care rotation assessment and key skills from the American Society of Health-System Pharmacists entry-level readiness objectives. A qualitative analysis was also conducted to analyze open-ended response questions within the post-survey as well as the overall course reflections from the students. FINDINGS: There was no significant difference in career plans; however, students' perception of practice readiness for the ambulatory care setting significantly improved following the elective course. SUMMARY: This elective course improved students' perception of practice readiness for the ambulatory care setting. Future research is required to assess the impact of student performance in APPE and post-graduate pursuits.

Systemic-Sclerosis-Related Interstitial Lung Disease: A Review of the Literature and Recommended Approach for Clinical Pharmacists.

OBJECTIVE: To describe the efficacy, safety, and clinical utility of pharmacologic agents in the treatment of systemic sclerosis-related interstitial lung disease (SSc-ILD). DATA SOURCES: A review of the literature was performed using the terms lung diseases, (interstitial/therapy) AND (scleroderma, systemic/therapy) OR (scleroderma, systemic) AND (lung diseases, interstitial/therapy) in PubMed, Ovid MEDLINE, CINAHL, and Web of Science. ClinicalTrials.gov was also searched to identify ongoing studies. The initial search was performed in October 2022, with follow-up searches performed in October 2023. STUDY SELECTION AND DATA ABSTRACTION: Articles reviewed were limited to those written in the English language, human studies, and adult populations. DATA SYNTHESIS: A variety of therapeutic agents, including mycophenolate, azathioprine, cyclophosphamide (CYC), rituximab (RTX), nintedanib, and tocilizumab (TCZ) have slowed the rate of decline in forced vital capacity (FVC) and disease progression. Only nintedanib and TCZ have a labeled indication for SSc-ILD. Two agents, belimumab and pirfenidone, have shown encouraging results in smaller phase II and phase III studies, but have yet to be approved by the Food and Drug Administration. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Patients with pulmonary manifestations of SSc-ILD have worse outcomes and lower survival rates compared with those without. It is imperative that disease management be individualized to achieve optimal patient-centered care. Pharmacists are uniquely suited to support this individualized management. CONCLUSION: Numerous pharmacologic agents have been studied and repurposed in the treatment of SSc-ILD, with nintedanib and TCZ gaining approval to slow the rate of decline in pulmonary function in SSc-ILD. Other agents, including belimumab and pirfenidone, are on the horizon as potential treatment options; but further studies are needed to compare their efficacy and safety with the current standard of care.

Evaluation of adverse drug reaction formatting in drug information mobile phone applications.

OBJECTIVE: To evaluate the differences in presentation (formatting) of adverse drug reaction (ADR) information within drug monographs in commonly used drug information (DI) mobile device applications. METHODS: A cross-sectional analysis of ADR formatting of twenty commonly prescribed oral medications within seven DI mobile applications was performed. Databases were assessed for ADR information, including presence of placebo comparisons, severity of ADR, onset of ADR, formatting of ADRs in percentile (quantitative) format or qualitative format, whether references were used to cite information, and whether ADRs are grouped by organ system. Data was collected by two study investigators and discrepancies were resolved via consensus. RESULTS: The seven DI mobile applications varied significantly on every analyzed ADR variable with the exception of ADR onset, which was absent in all databases. Significant differences were found for variables known to impact clinical judgment such as placebo comparisons and qualitative versus quantitative formatting. Placebo comparisons were most common among monographs in Lexicomp (30%) but were absent among monographs within other applications. Quantitative information was commonly used in most databases but was absent in Epocrates. Qualitative formatting was present in all Epocrates and Micromedex applications but absent in the majority of other applications. Substantial variations were also found in severity and grouping information. CONCLUSION: Substantial variation in ADR formatting exists among the most common DI mobile applications. These differences may translate into alternative interpretations of medical information and thus impact clinical judgment. Health care librarians and clinicians should consider ADR formatting when choosing between DI applications.