The Role of Consumerism in Pharmacy Education.

The notion of consumerism and that students are customers of pharmacy colleges was explored by proponents and opponents of the idea. First, a working definition of a "customer" in pharmacy education is pondered with respect to the roles and responsibilities of students and schools/colleges of pharmacy. Second, the pros and cons of "student-centered" education are considered in the light of students and their families being consumers of the educational experience. Third, the duality of student-centered education is discussed including student engagement/disengagement in their learning, professional/unprofessional behaviors, and shared/individual responsibilities. Lastly, learning and teaching environment dynamics are discerned when higher education becomes more student-centric and how that may affect the overall outcome of the student and the goals of pharmacy educational programs.

Impact of COVID-19 on Pharmacy Education and Practice: Strategies to Boost Advocacy and Unity among Health Care Organizations.

The global COVID-19 pandemic impacted pharmacy education and changed the pharmacists' scope of practice at the federal and state levels. Based on the Amended Public Readiness and Emergency Preparedness Act, pharmacists were authorized to provide essential services, including testing, treatments, and immunizations at various practice settings. Specifically, the United States Food and Drug Administration issued emergency use authorization for several medications, vaccines, and medical devices. The pandemic also affected the regulatory landscape for pharmacists, pharmacy education, access to care, and delivery of pharmacy services in-person and through telehealth. The pandemic's specific impact on pharmacy education heightened awareness of the well-being of the Academy. This commentary will highlight the impact of COVID-19 on both pharmacy education and practice. It will also provide strategies that educators, researchers, and practitioners can take into future research and action to help promote advocacy and unity among pharmacy organizations.

An HBCU track-and-field student-athlete perspective on the role of the pharmacist and physical therapist in sports.

Background: Pharmacy is a profession with the capacity to provide services in a variety of venues, including sports and sporting events. The physical therapy profession is often involved in treating the injured athlete; however, direct interactions with collegiate sport teams is limited and inconsistent. A literature review showed a limited and inconsistent role of the pharmacist and physical therapist in sports, especially at Historically Black Colleges and Universities (HBCU). Objective: To examine collegiate track-and-field student-athlete perceptions related to the role of the pharmacist and physical therapist. Methods: A cross-sectional study using a convenience sample was conducted to assess the perceptions of NCAA track-and-field student-athletes from a HBCU. A survey utilizing modified Likert-scale and open-ended questions was administered electronically to fifty-four student-athletes via email. Inclusion criteria were age ≥ 18 years old and a current track-and-field student-athlete. Descriptive statistics were used for data analysis. Results: This study, one of the first to examine an HBCU student-athlete population, yielded a 100% response rate. About 80% want to discuss the directions for use and side effects of certain medications or dietary supplements with a team pharmacist. Over 75% of student-athletes desired to consult with a physical therapist about injury management and prevention. Overall, most respondents felt that pharmacists (81.5%) and physical therapists (78.8%) should have a role with NCAA sports to benefit student athletes. Conclusion: Interprofessional collaboration and communication among healthcare professionals is essential to improve student-athlete health knowledge and performance. The student-athletes expressed interests in receiving consultation and educational sessions from pharmacists and physical therapists.

Characteristics of Successful International Pharmacy Partnerships.

Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other's programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.

Taking Action Towards Equity, Diversity, and Inclusion in the Pharmacy Curriculum and Continuing Professional Development.

Increased awareness of social injustices and inequities highlight the relevance and importance of diversity, equity, inclusion, and accessibility (DEIA) in health care. Former and recent graduates of pharmacy schools remain deficient in their knowledge of DEIA topics such as unconscious bias, which can directly influence health outcomes in an undesirable manner. Particular DEIA areas that are pertinent to pharmacy practice include: race, gender, sexual orientation, gender identity, ability status, religion, socioeconomic status, and political beliefs. The American Association of Colleges of Pharmacy (AACP) affirmed its commitment to DEIA as a priority. However, existing gaps in knowledge of pharmacy graduates in this area have the potential to contribute to health disparities and inequities, which are significant public health issues. We call on academic pharmacy institutions and professional pharmacy organizations to elevate DEIA topics and to designate them as essential to both addressing health equity and improving care for underserved populations. We also implore licensing boards to require continuing education related to DEIA as a foundational step to closing the knowledge gap for pharmacists in this area.

Addressing the need for a telehealth readiness assessment tool as a digital health strategy.

Immediate public health interventions and solutions, including the virtual provision of patient care via telehealth, were exponentially employed in response to the coronavirus disease 2019 pandemic. As a result, the U.S. Department of Health and Human Services temporarily waived Medicare telehealth restrictions. Dramatic increases in the provision of care via telehealth were observed, beginning in March 2020. Yet, despite these changes, there was a deficit in relevant telehealth readiness assessment, resources, and training that incorporated critical elements brought forth by the pandemic. This article describes the need for and provides a telehealth readiness assessment tool as a digital health strategy for health professional students, clinicians, and organizations to be prepared for patient care engagement during and beyond the pandemic.

Exploring COVID-19 vaccine hesitancy at a rural historically black college and university.

OBJECTIVES: Minorities have been disproportionately affected by the coronavirus disease 2019 (COVID-19) yet have the lowest COVID-19 vaccine rate. Vaccine hesitancy has been reported at higher rates in African Americans (AAs) and young adults. This study aimed to assess COVID-19 vaccine hesitancy, determine the rationale for receiving or declining the COVID-19 vaccine, and propose strategies to address confidence in faculty, staff, and students at a rural historically black college and university (HBCU). METHODS: A study was conducted using an electronic survey administered to a convenient sample of 210 faculty, students, and staff at the University of Maryland Eastern Shore, an HBCU in a rural community. RESULTS: Most participants were 18 to 24 years old (69%), college students (73.89%), AA (70%), and identified as a woman (70%). Notably, 87% of participants were nonhesitant (received one dose or intended to be vaccinated). Approximately 54% had already received at least one dose of a COVID-19 vaccine. Only 13% of participants were hesitant and did not plan to receive the COVID-19 vaccine. The most common rationale for vaccine hesitancy was mistrust of the health care system or government toward AAs. CONCLUSION: The results show that vaccine hesitancy was low in the predominantly young-adult AA population at a rural HBCU. However, opportunities exist for pharmacists and other accessible health care professionals to contribute to efforts aimed at decreasing vaccine hesitancy and improving vaccine confidence.

Empowering Public Health Pharmacy Practice-Moving from Collaborative Practice Agreements to Provider Status in the U.S.

This article describes the history and evolution of pharmacist-physician collaborative practice agreements (CPAs) in the United States with future directions to support pharmacists' provider status as the profession continues to evolve from product-oriented to patient-centered care and population health. The pharmacy profession has a long history of dispensing and compounding, with the addition of clinical roles in the late 20th century. These clinical roles have continued to expand into diverse arenas such as communicable and non-communicable diseases, antimicrobial stewardship, emergency preparedness and response, public health education and health promotion, and critical and emergency care. Pharmacists continue to serve as integral members of interprofessional and interdisciplinary healthcare teams. In this context, CPAs allow pharmacists to expand their roles in patient care and may be considered as a step towards securing provider status. Moving beyond CPAs to a provider status would enable pharmacists to be reimbursed for cognitive services and promote integrated public health delivery models.

Pharmacy Emergency Preparedness and Response (PEPR): a proposed framework for expanding pharmacy professionals' roles and contributions to emergency preparedness and response during the COVID-19 pandemic and beyond.

Background: Pharmacists have long been involved in public health and emergency preparedness and response (EP&R), including through preventive measures such as screening, vaccinations, testing, medical and pharmaceutical countermeasures, as well as ensuring medication safety and access during natural disasters and pandemics. Pharmacy professionals are considered essential partners in response to the ongoing COVID-19 pandemic. Community and hospital pharmacies are expanding services and hours to provide essential services, putting pharmacists and their co-workers at the frontlines for patient care and safety to improve public health. In addition, pharmacy professionals are increasingly integrating into global, national, state and local EP&R efforts, including into interprofessional teams, such as Medical Reserve Corps (MRCs). However, lacunae exist for further integration of pharmacists into public health and safety initiatives. There are increasing opportunities and recommendations that should be expanded upon to provide improved patient care and population health interventions, and to ensure healthcare worker and public health safety. Objective: Develop a Pharmacy Emergency Preparedness and Response (PEPR) Framework and recommendations for pharmacy professional pathways towards full integration within public health EP&R efforts (such as the COVID-19 pandemic), and enhanced recognition of pharmacists' skills, roles and contributions as integral members of the interprofessional healthcare team. Methods: This paper draws on the American Society of Health-System Pharmacists (ASHP) 2003 Statement on the Role of Health-System Pharmacists in Emergency Preparedness and lessons learned from previous and current public health emergencies, such as the 2009 H1N1 pandemic and the current COVID-19 pandemic, to provide expanded guidance for pharmacists and pharmacy professionals across all practice settings in EP&R. The proposed PEPR framework also incorporates information and recommendations from The Pharmacy Organizations' Joint Policy Recommendations to Combat the COVID-19 Pandemic (March 2020), CDC-NIOSH, International Pharmaceutical Federation (FIP) Guidance, health departments and emergency preparedness guidance and resources, Boards of Pharmacy, and other pharmacy professional organizations and educational institutions. Results: Based on methods and resources utilized in developing this proposed PEPR Framework, five key focus areas were identified, as follows:1)Emergency preparedness and response2)Operations management3)Patient care and population health interventions4)Public health pharmacy education and continuing professional education5)Evaluation, research, and dissemination for impact and outcomes. Conclusion: Pharmacists and pharmacy professionals have been at the frontlines in responding to the COVID-19 pandemic. Yet, challenges remain, such as limited availability of personal protection equipment, high risk of infectious exposures inherent in healthcare professions, and legislative hurdles resulting in lack of provider status and related reimbursements. Recommendations to enhance pharmacy's scope as public health professionals involved in EP&R include targeted training and education on key framework areas and policymaking. Pharmacy professionals should further integrate with interdisciplinary public health teams. Additional research and dissemination on impacts and outcomes of EP&R can enhance recognition of pharmacy professionals' contribution and value during public health emergencies. The proposed PEPR Framework can be utilized to develop, implement, evaluate, and disseminate results in order to strengthen existing efforts and to establish new initiatives in EP&R.

An ethics-based approach to global health research part 1: Building partnerships in global health.

Global health partnerships (GHPs) can be the cornerstone for advancing research and public health. The steps to build a global research partnership focus on sharing a common research agenda, identifying key partners in the community, and establishing goals and expectations for partnerships. Moreover, upholding important values, such as communication, trust, and transparency is essential for building successful partnerships. Ethical dilemmas can propose challenges to researchers in global health. These challenges can be overcome by creating a shared vision for a research agenda, maintaining communication, and providing bidirectional training.

Report of the 2018-2019 Strategic Engagement Standing Committee.

EXECUTIVE SUMMARY. 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 AACP 2019-2020 Strategic Engagement Committee was charged with exploring faculty leadership and development as they relate to strategic engagement, considering challenges and barriers to faculty participation and identifying successes in faculty engagement and opportunities for professional development. The committee reviewed literature and examples regarding strategic engagement across academic pharmacy, with strategic engagement understood as being part of the service mission of academic institutions. The committee found faculty service is often not rewarded or recognized equally to efforts in research and education, including in promotion and tenure. The perceived low value often accorded to strategic engagement efforts, coupled with lack of time and low priority for the work, are barriers to faculty participation in strategic engagement. Service missions thrive when supported by institutional culture, faculty and alumni role models and administration priorities. The committee also found that there is no defined path to leadership in most national organizations, a limited number of leadership positions and a lack of awareness regarding these positions. However, strategic engagement with organizations can open doors and increase visibility for faculty, leading to enhanced opportunities and improved scholarship. Engagement efforts can be particularly successful when aligned with faculty interests and school and departmental priorities. Based on the committee's work, the following recommendations are provided to AACP for consideration.Recommendation #1 - AACP should create a pathway or exemplar stories of members who have become leaders within the Academy including institutional and volunteer leadership roles.Recommendation #2 - AACP should provide an organizational chart to outline the reporting structures, as well as the policy development process to help members understand how AACP works and points of entry for involvement.Recommendation #3 - AACP should develop an initiative to "groom" faculty for leadership roles including providing tools/training programs for emerging leaders within the Academy.Recommendation #4 - AACP should consider creating a community for targeted groups of faculty, eg, tenured/tenure-track and non-tenure track to address leadership development and engagement based on member interest.Recommendation #5 - AACP should establish a "service mentors" program to match current and past leaders with members interested in enhancing their involvement in the association.

Assessment of First-Year Student Pharmacists' Intercultural Competency Skills Using a Validated Scale and International Scenarios

Objective. To assess first-professional year student pharmacists' level of intercultural competency using international scenarios and a validated scale. Methods. The Wesleyan Intercultural Competence Scale (WICS), a validated questionnaire, was administered to student pharmacists to self-assess their intercultural skills based on their responses to various situations that students encounter in international settings. Student pharmacists rated 16 items on a 5-point Likert scale ranging from "very inaccurate" to "very accurate." Their responses allowed their intercultural competency skills to be ranked among six developmental stages. Results. The 48 participants had traveled outside of the United States an average of 2.6 times, and 34 (71%) of them spoke another language besides English. Students' average comfort level with working with culturally diverse health care students was 4.5 out of 5, and their average comfort level with working with patients of different cultures and background was 4.6 out of 5. The students' average overall score on the WICS was 21.9 out of 36, which indicated the majority of the students were in the acceptance phase of cultural competency. Conclusion. The results of this study can inform pharmacy school faculty and administrators regarding the importance of developing targeted and/or comprehensive cultural competency training for student pharmacists, in both the didactic and experiential settings, especially during global health experiences.

Implementation and lessons learned from a mock trial as a teaching-learning and assessment activity.

BACKGROUND AND PURPOSE: To describe implementation and lessons learned from use of a mock trial as a teaching-learning and assessment activity in a required evidence-based practice course. This innovative self-directed learning strategy reinforced evidence-based skills and affective domain competencies in Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Outcomes and Accreditation Council for Pharmacy Education (ACPE) Standards 2016. EDUCATIONAL ACTIVITY AND SETTING: During spring semesters 2015 and 2016, first professional year (P1) cohorts were divided into teams and assigned controversial topics to research and debate in mock trials. The activity provided opportunities for teaching-learning and assessment. Statistical analysis included inter-rater reliability (IRR), comparison of faculty-judge and student-juror evaluation of trial performance. FINDINGS: Two cohorts were divided into eight teams (four per cohort) to debate four issues. Students within each team were assigned individual scores. Mean individual scores are reported by trial/topic. Faculty-judges and student-jurors rated eight criteria including content/knowledge, critical thinking, application/discussion of federal/state law, citations/references, visual aids, delivery/style, and active listening. Analysis indicated students met competency expectations with overall judges' and jurors' mean scores above 54/60 points (90%) in 2015 and above 51/60 points (85%) in 2016. Judges' scores showed a wider distribution than jurors' scores. Peer evaluation mean scores were above 55/60 points in all four trials. Intra-class correlation was calculated. Judges' scores had excellent IRR in two trials, and good IRR in a third trial, whereas jurors had good IRR in one trial. SUMMARY: Evaluation scores demonstrated students successfully applied knowledge and skills from this and prior P1 courses, and met competency expectations for the mock trial.

The Eastern Shore Collaborative for Interprofessional Education's Implementation and Impact over Five Years.

Health care professionals working collaboratively on interprofessional teams are essential to optimize patient-centered care. Collaboration and teamwork can be best achieved if interprofessional education (IPE) starts early for health professions students. This commentary describes the formation, implementation, impact, and lessons learned from students' curricular and co-curricular activities and faculty collaboration over a five-year trajectory of the Eastern Shore Collaborative for Interprofessional Education (ESCIPE). This collaborative is an inter-institutional, interprofessional team and includes 18 faculty members from nine health disciplines with administrative support to prepare practice-ready graduates through effective IPE curricular and co-curricular activities. This collaborative also serves as a resource for interprofessional education, research and scholarship initiatives for faculty members. Activities include educational programs such as an emergency preparedness point-of-dispensing (POD) drill, patient management laboratory simulation, geriatric assessment interdisciplinary team workshop, medical mission as public/global health rotation and service-learning program, rural health fair, and annual university health festival for community outreach. The ESCIPE has also facilitated interprofessional faculty assessment and development, research and scholarship opportunities.

Academic-Community Partnership for Medical Missions: Lessons Learned and Practical Guidance for Global Health Service-Learning Experiences.

To facilitate an academic-community partnership for sustainable medical mis-sions, a 12-step process was created for an interprofessional, global health educational, and service-learning experience for students and faculty in a school of pharmacy and health professions. Lessons learned and practical guidance are provided to implement similar global health opportunities.

Faculty Perceptions, Knowledge, and Attitudes Toward Interprofessional Education and Practice.

As interprofessional education (IPE) is incorporated into health professions programs, it is essential to understand faculty perceptions, knowledge, and attitudes about IPE and interprofessional practice (IPP). A descriptive, cross-sectional design was used. Seventy-one faculty from three campuses of two rural public universities representing seven different programs participated. Despite limited IPE experience, faculty appreciated IPE and IPP. Notably, many felt undervalued by other professions. Participants acknowledged the importance of working with other professions (mean 2.69±0.53), participating on IP teams (2.61±0.52), and integrating IPP in patient care (2.60±0.52). Faculty reported low IPE knowledge (1.74±0.66) and confidence in IPE teaching ability (1.74±0.67). These findings demonstrate a need for faculty development in both IPE and IPP across all health disciplines.

Potential cost savings of medication therapy management in safety-net clinics.

OBJECTIVE: To evaluate potential cost savings based on estimated cost avoidance from medication therapy management (MTM) services delivered in safety-net clinics over 4 years. METHODS: High-risk patients taking multiple medications and with chronic conditions were referred for MTM services in primary care safety-net clinics in Maryland from October 1, 2009, to September 30, 2013. Medication-related problems (MRPs) were identified and pharmacists' costs determined to evaluate the estimated cost savings and return on investment (ROI). A range of potential economic outcomes for each MRP identified was assigned to a cost avoidance for outpatient visit, urgent care visit, emergency department visit, and/or hospitalization. RESULTS: Over 4 years, 246 patients received MTM, nearly 2,100 medications were reviewed, and 814 MRPs were identified. The most common MRPs identified were subtherapeutic doses, nonadherence, and untreated indications, with respective prevalences of 38%, 19%, and 16%. The corresponding costs of medical services were estimated at $115,220-$614,570 for all MRPs identified, yielding a mean of $141.55-$755.00 per identified MRP. Pharmacists' expenses for encounters were calculated at a total expenditure of $57,307.50 for 16,965 minutes. ROI based on the time spent during billable face-to-face encounters ranged from 1:5 to 1:25. CONCLUSION: Pharmacist-provided MTM in safety-net clinics yielded potential economic benefits to the organization. The Primary Care Coalition of Montgomery County plans to expand MTM services to additional clinics to improve patient care and increase cost savings through preventable medical services.

Development and implementation of a navigator-facilitated care coordination algorithm to improve clinical outcomes of underserved Latino patients with uncontrolled diabetes.

Development and implementation of an interprofessional navigator-facilitated care coordination algorithm (NAVCOM) for low-income, uninsured patients with uncontrolled diabetes at a safety-net clinic resulted in improvement of disease control as evidenced by improvement in hemoglobin A1C. This report describes the process and lessons learned from the development and implementation of NAVCOM and patient success stories.

Impact of medication therapy management on underserved, primarily Hispanic patients with diabetes.

BACKGROUND: Diabetes-related complications are more pronounced in Hispanic patients versus patients of other ethnicities. It is documented that medication therapy management (MTM) can improve diabetes outcomes; however, data regarding Hispanic patients are limited. OBJECTIVE: To evaluate the impact of MTM on hemoglobin A1c (A1C), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) in underserved, primarily Hispanic patients who use a safety-net clinic as their medical home. METHODS: A retrospective, observational study of uninsured, primarily Hispanic patients with diabetes who received MTM from October 2009 through March 2011. Patients were stratified into 2 cohorts: A1C less than 9% and A1C greater than or equal to 9%. Patients were also stratified by frequency of MTM visits and insulin use, regardless of A1C. A chart review was conducted to evaluate diabetes-related outcomes pre- and postimplementation of MTM. The primary study outcome was reduction of A1C. Secondary outcomes included reduction of BP and LDL-C and reduction of A1C based on MTM visit frequency or insulin use. RESULTS: Sixty-four patients with at least 1 MTM visit and pre- and postimplementation A1C data were included. In the cohort with A1C greater than or equal to 9%, mean (SD) A1C values decreased from 10.9% (1.4%) to 8.8% (1.5%) versus the cohort with A1C less than 9%, whose A1C changed minimally, from 7.2% (0.9%) to 7.4% (1.4%). Regardless of their A1C, patients who were using insulin at baseline had a change in A1C of -0.8% (1.5%) versus -0.1% (1.6%) in those who were not using insulin at baseline (p = 0.04); patients who participated in multiple MTM visits had a significant reduction in A1C, from 9% to 8.3% (95% CI -1.26 to -0.03; p = 0.02) compared with patients participating in only 1 MTM visit. CONCLUSIONS: Pharmacist-provided MTM can significantly improve diabetes control in uninsured, primarily Hispanic patients with poorly controlled diabetes and in those who are using insulin. Multiple MTM visits also yielded significant A1C reductions.