Using Team Innovation and Networking to Respond to Rapid Changes in the Academy.

When COVID-19 shuttered schools across the nation, it propelled higher education institutions into uncharted territories. Institutions had to make rapid decisions in a short period of time with limited information or direction. In these uncertain and challenging times, pharmacy academics in the United States and around the world reached out to one another to discuss, share, and learn. What began with a few members of the Student Services Personnel Special Interest Group (SIG) grew to many members who banded together as a team through open discussions to innovative problem-solving. Working together through open discussions created a setting that promoted diverse ideas, multiple perspectives, and a depth of knowledge to address some of the most challenging issues faced by pharmacy education. When partnering together, institutions had a much greater resource of knowledge and support that could be leveraged to broadly benefit the Academy.

Appetite Stimulants for Treatment of Protein Energy Wasting of Chronic Kidney Disease.

Nutritional and metabolic abnormalities, or protein energy wasting, is a common complication of chronic kidney disease, leading to significant morbidity and mortality. The cause of these abnormalities is multifactorial, and therefore, difficult to treat. The International Society of Renal Nutrition and Metabolism suggests appetite stimulants, including megestrol, dronabinol, mirtazapine, and cyproheptadine, as adjunctive treatment options in addition to parenteral or oral nutritional supplementation. This article reviews the evidence for use of these drugs as appetite stimulants and discusses their use in patients with chronic kidney disease.

Pathways to Improve Student Pharmacists' Experience in Research.

OBJECTIVE: To describe the implementation of a student research program and to provide outcomes from the initial 4 years' experience. DESIGN: Students conducted individual research projects in a 4-year longitudinal program (known as Pathway), with faculty member advising and peer mentoring. A prospective assessment compared perceptions of those who completed the Pathway program with those of students who did not. Descriptive statistics, t tests, and analysis of variance (ANOVA) were used. ASSESSMENT: The class of 2013 was the first to complete the Pathway program. In the Pathway assessment project, 59% (n=47) of students who responded reached self-set goals. Pathway students agreed that this research experience improved their ability to work/think independently, evaluate literature, and distinguish themselves from other students. CONCLUSION: The Pathway program helped students understand the research process and reach other self-set goals.

Teaching and learning curriculum programs: recommendations for postgraduate pharmacy experiences in education.

PURPOSE: Recommendations for the development and support of teaching and learning curriculum (TLC) experiences within postgraduate pharmacy training programs are discussed. SUMMARY: Recent attention has turned toward meeting teaching- and learning-related educational outcomes through a programmatic process during the first or second year of postgraduate education. These programs are usually coordinated by schools and colleges of pharmacy and often referred to as "teaching certificate programs," though no national standards or regulation of these programs currently exists. In an effort to describe the landscape of these programs and to develop a framework for their basic design and content, the American Association of Colleges of Pharmacy Pharmacy Practice Section's Task Force on Student Engagement and Involvement, with input from the American Society of Health-System Pharmacists, reviewed evidence from the literature and conference proceedings and considered author experience and expertise over a two-year period. The members of the task force created and reached consensus on a policy statement and 12 recommendations to guide the development of best practices of TLC programs. The recommendations address topics such as the value of TLC programs, program content, teaching and learning experiences, feedback for participants, the development of a teaching portfolio, the provision of adequate resources for TLC programs, programmatic assessment and improvement, program transparency, and accreditation. CONCLUSION: TLC programs provide postgraduate participants with valuable knowledge and skills in teaching applicable to the practitioner and academician. Postgraduate programs should be transparent to candidates and seek to ensure the best experiences for participants through systematic program implementation and assessments.

Roles of the pharmacist in the use of safe and highly effective long-acting reversible contraception: an opinion of the women's health practice and research network of the American College of Clinical Pharmacy.

The U.S. population continues to experience an alarmingly high rate of unintended pregnancies that have an impact on individual families and society alike. Lack of effective contraception accounts for most unintended pregnancies, along with incorrect use of contraceptives. The most common reversible contraceptive method used in the United States is the oral contraceptive pill, which has significant failure and discontinuation rates. Use of long-acting reversible contraceptive (LARC) methods has been increasing in recent years after efforts to educate providers and patients. Women are more likely to use LARC methods when barriers such as access and cost are removed. An uptake in the use of LARC methods would allow for markedly reduced contraception failure rates and higher user satisfaction and thus higher continuation rates than those seen with current contraception use. Promoting the use of LARC methods is an important strategy in improving both individual and public health outcomes by reducing unintended pregnancies. The pharmacist's role in family planning is expanding and can contribute to these efforts. Although knowledge regarding LARC has not been studied among pharmacists, a knowledge deficit exists among health care professionals in general. Thus pharmacist education and training should include LARC methods along with other contraceptives. The American College of Clinical Pharmacy Women's Health Practice and Research Network advocates for the pharmacist's role in the use of safe and highly effective LARC methods. These roles include educating patients, informing providers, facilitating access by providing referrals, and modifying institutional procedures to encourage provision of LARC methods.

A multipreceptor approach to ambulatory care topic discussions.

OBJECTIVE: To assess the impact of a multipreceptor approach to facilitating topic discussions on students' knowledge and confidence in clinical decision-making during an ambulatory care advanced pharmacy practice experiences (APPEs). DESIGN: Faculty members with relevant expertise and experience facilitated discussions with fourth-year doctor of pharmacy (PharmD) students regarding 7 ambulatory care topics. A student self-assessment survey and knowledge-assessment instrument was administered before and after discussions. ASSESSMENT: Students' examination scores increased significantly from 59.1% ± 13.9% at baseline to 76.5% ± 12.6% at the end of the 5-week experience (p<0.001). The majority of participants were comfortable making therapeutic decisions regarding medication use as it related to all discussion topics except heart failure. CONCLUSIONS: Participation in topic discussions led by faculty members with expertise and experience for each ambulatory care topic was associated with a significant improvement in knowledge-assessment scores.

New obesity agents: lorcaserin and phentermine/topiramate.

OBJECTIVE: To evaluate the evidence for lorcaserin and phentermine/topiramate in the treatment of obesity. DATA SOURCES: Literature was accessed through PubMed (June 1975-March 2013) using the search terms lorcaserin, phentermine, topiramate, or phenter mine/topiramate. Additionally, reference citations from publications identified were reviewed. Additional information was obtained from the Food and Drug Administration (FDA)-approved prescribing information and FDA briefing documents. STUDY SELECTION AND DATA EXTRACTION: English-language articles focusing on Phase 3 clinical trials for obesity were critiqued. Data from preclinical and Phase 1 and/or 2 trials are reported when appropriate. Six prospective Phase 3 trials were reviewed. DATA SYNTHESIS: Obesity has reached epidemic proportions, affecting more than one third of adults in the US. Two medication products, lorcaserin and phenter mine/topiramate, have recently received FDA approval as adjuncts to a reduced-calorie diet and increased physical activity among individuals with a body mass index greater than or equal to 30 kg/m(2) or greater than or equal to 27 kg/m(2) with an obesity-related comorbidity, such as hypertension, dyslipidemia, or diabetes. Lorcaserin is a selective serotonin 5-HT2C agonist that regulates food intake, while the combination of phentermine/topiramate causes appetite suppression and enhanced satiety. Three Phase 3 randomized, placebo-controlled trials reported approximately 75% and 45% of patients achieved greater than or equal to 5% weight loss with phentermine/topiramate and lorcaserin, respectively. CONCLUSIONS: With lifestyle modification, phentermine/topiramate appears most effective in terms of weight loss. Lorcaserin demonstrates moderate efficacy. Long-term cardiovascular outcomes studies are needed to confirm the safety and benefit of these new obesity agents.

Orlistat: current status in clinical therapeutics.

BACKGROUND: Obesity has rapidly become a life-threatening epidemic worldwide. There are a plethora of obesity-related co-morbidities and complications that increase morbidity, mortality and cost of care associated with obesity. Orlistat is approved for the treatment of obesity and has been evaluated both in obesity and in the several obesity-related co-morbidities. OBJECTIVE: The purpose of this article is to provide detail of the pharmacotherapeutic role of orlistat in obesity, describe orlistat and its pharmacological properties, critique the evidence for orlistat's use in obesity and obesity related co-morbidities, and define the role of orlistat in clinical practice. METHODS: A thorough, all-inclusive literature search was conducted to isolate clinical trials, case reports and meta-analyses evaluating the safety and efficacy of orlistat in various patient populations. RESULTS: Orlistat's unique mechanism of action, beneficial effects on multiple co-morbidity surrogates and relatively mild adverse effect and drug interaction profile position it favorably as the first option for pharmacotherapy in comprehensive obesity management of adults and children.

Role of statins for the primary prevention of cardiovascular disease in patients with type 2 diabetes mellitus.

PURPOSE: The major statin trials that included a significant number of patients with diabetes without preexisting coronary heart disease (CHD) are reviewed and evaluated, and the role statins should play in primary prevention is discussed. SUMMARY: Cardiovascular (CV) disease risk is increased in patients with type 2 diabetes mellitus, and diabetes is considered a CHD risk equivalent in current treatment guidelines. The American Diabetes Association (ADA) guidelines recommend statin therapy in the majority of patients with diabetes. Four large studies (which included a significant number of patients with diabetes and no history of CHD) have affected treatment guidelines, despite various flaws in their designs and some nonsignificant results. The most recent trial evaluating the primary prevention of CHD in diabetes patients (the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in Non-Insulin-Dependent Diabetes Mellitus [ASPEN]) has been published since these guidelines. ASPEN found that in patients with diabetes at lower CHD risk, atorvastatin 10 mg was not superior to placebo in reducing time to the first major CV event or procedure. The nonsignificant results of ASPEN may be because of the moderate reduction in low-density-lipoprotein cholesterol, or it may be that patients with type 2 diabetes mellitus and no additional CV risk factors do not benefit significantly from statin therapy. CONCLUSION: Current ADA recommendations may be too aggressive as available evidence suggests that the decision to initiate pharmacotherapy with a statin in patients with type 2 diabetes mellitus who do not have preexisting CHD should be individualized rather than based solely on the diagnosis of type 2 diabetes mellitus.