Instruction on compounded sterile preparations at U.S. schools of pharmacy.

PURPOSE: The extent of didactic and laboratory instruction related to compounded sterile preparations (CSPs) provided by U.S. schools of pharmacy was studied. METHODS: A nine-item survey was developed and mailed to the deans of 82 U.S. schools of pharmacy in 2005. The survey instrument was designed to gather basic demographic information about the school of pharmacy, identify availability and characteristics of instruction offered on the compounding of sterile preparations, identify which of 20 topics were covered in either a didactic or laboratory setting, determine how students' skills in sterile preparation were assessed, and identify the compounding environment at the school of pharmacy. Data were analyzed using descriptive statistics. RESULTS: A total of 53 surveys were returned, yielding a response rate of 65%. All schools included some instruction on CSPs; however, only 70% required students to compound on their own (rather than in groups or not at all), and only 21% offered a stand alone course on this topic. Most schools (88%) taught students about U.S. Pharmacopeia chapter 797 standards for sterile compounding. Only 13% of schools felt that their students had adequate training in compounding sterile preparations before graduation; however, most (88.7%) believed that students could only become fully competent in these skills over time in actual practice. CONCLUSION: A survey sent to deans of pharmacy schools revealed that instruction provided to pharmacy students in preparing CSPs varied widely. Only about a sixth of respondents believed that their students were adequately trained in compounding sterile preparations before graduation.

Mental health and psychiatric pharmacy instruction in US colleges and schools of pharmacy.

OBJECTIVES: To describe the extent of psychiatric pharmacy instruction in US pharmacy curricula, including course and faculty characteristics and mental health topics taught in clinical therapeutics-based courses. METHODS: An 11-item survey instrument (54% response) was developed and mailed to 91 colleges and schools of pharmacy. RESULTS: Over 75% of colleges and schools employed a psychiatric pharmacist; however, less than 50% of faculty teaching psychiatric pharmacy content were psychiatric pharmacy specialists as defined in the study. All colleges and schools included psychiatric topics as part of a therapeutics-based course with an average of 9.5% of course content devoted to these topics. About 25% of colleges and schools offered elective didactic courses in psychiatric pharmacy. Only 2 schools required a psychiatric pharmacy advanced pharmacy practice experience (APPE), but about 92% offered elective APPEs. The mean number of hours spent on lecture- and case-based instruction across all colleges and schools was highest for depression and lowest for personality disorders. CONCLUSIONS: There is a need for colleges and schools of pharmacy to better identify and standardize the minimal acceptable level of didactic instruction in psychiatric pharmacy as well as the minimal level of specialty qualifications for faculty members who teach this subject.

Negotiating with third party payers: one community pharmacy's experience.

OBJECTIVES: To evaluate financial terms and legal wording in insurance contracts and negotiate their terms with companies to improve an independent pharmacy's financial position and to determine the time required to negotiate a contract and translate that time into a salary cost. SETTING: An independent pharmacy in a small town in Alabama with a population of approximately 6,000. PRACTICE DESCRIPTION: The prescription department accounts for two-thirds of the pharmacy's sales and dispenses approximately 70,000 prescriptions each year. Insurance companies paid for over 59% of these prescriptions in 2000. The pharmacy is open 7 days a week with one full-time pharmacist and a second pharmacist who works 2 days a month. PRACTICE INNOVATION: A contract negotiation form was developed that addressed factors that might affect a pharmacy's decision to accept or reject a contract; the form included an area for recording the time involved in negotiating each contract. INTERVENTIONS: Insurance companies selected by the pharmacy owner were faxed copies of an Insurer Demographics Collection Form. Upon collection of all data and finalization of proposed changes, a copy of the contract with the proposed changes marked, along with a letter explaining and justifying the changes, was sent to the insurance company. If no response was received from the company, the contact person was called and negotiations proceeded over the telephone. MAIN OUTCOME MEASURES: Primary end points were the percentage of companies that would negotiate and the average increase in reimbursement achieved. Secondary end points included the time involved in negotiations and the translation of that time into a salary cost. RESULTS: None of the nine participating companies accepted any of the changes proposed. The time to negotiate each contract ranged from 28 minutes to 74 minutes, taking an average of 48.4 minutes. Depending on the division of work between the pharmacist and the technician, the salary cost for the negotiations ranged from $14.68 to $18.73 per contract. CONCLUSION: This study provides a realistic description of attempts at contract negotiation between one pharmacy and nine third party payers. The difficulty of achieving successful results and the necessity of carefully considering the time and cost of contract negotiations underscore how important it is for independent pharmacists to concentrate their efforts on contracts and terms they have an opportunity to change.