Implementation of an ACPE-Accredited PharmD Curriculum at a Saudi College of Pharmacy.

Objective. To establish an academic curricular collaboration between the newly established college of pharmacy at King Saud Bin Abdulaziz Saudi University for Health Sciences (KSAU-HS) and a US college of pharmacy accredited by the Accreditation Council for Pharmacy Education, and assess measures of success. Methods. Criteria for selecting a college for collaboration were established. A systematic approach was followed in negotiating legal, logistical, and financial issues with the selected collaborating institution. Course materials were transferred and implemented and minimal changes were made to the alignment and sequencing of lectures. The faculty at KSAU-HS developed and implemented research and seminar courses. Pharmacy practice experiences were designed and rubrics were developed. Results. All courses were implemented successfully. The PharmD students scored significantly higher in all academic levels in a benchmarked progress test than did students in other programs. Students' evaluation of 43 first-, second-, and third-year courses in 2017-2018 using a survey that assessed numerous aspects of each course showed significantly higher overall satisfaction than the institutional averages. Also, female students indicated significantly higher satisfaction with the PharmD program than did male students. Conclusion. The transfer and implementation of an accredited PharmD curriculum to the KSAU-HS College of Pharmacy went smoothly and the program was launched on time. Learning and teaching success was facilitated by the KSAU-HS faculty. Program outcomes were verified by students' high scores on a benchmarked examination and by their satisfaction with the courses.

An international capstone experience for pharmacy students.

This report describes the experiences of the University of Tennessee College of Pharmacy over 20 years with an international capstone educational experience for students. Although the university provides reciprocal opportunities to international students, this report focuses on the experiences of the college's pharmacy students who have participated in the program. This capstone course is offered as an elective course in the advanced pharmacy practice experience (APPE) component of the college's experiential program. Goals of the program and a brief description of its organizational structure are provided. Results of a structured student satisfaction survey and a survey covering the most recent 3 years of the program are presented. This program has greatly broadened participants' cultural horizons and expanded their global view and understanding of the contributions of pharmacy to health care.

Accessibility of antiretroviral therapy in Ghana: convenience of access.

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.

Does combining antiretroviral agents in a single dosage form enhance quality of life of HIV/AIDS patients? A cost-utility study.

BACKGROUND: Combining various antiretroviral agents into one single dosage form has been a strategy to reduce pill burden and enhance medication adherence among human immunodeficiency virus /AIDS (HIV/AIDS) patients. OBJECTIVES: This is a cost-utility study from a health care system's perspective comparing coformulated fixed dose (FXD) strategy versus multiple free dose combination (FRC) in antiretroviral therapy. METHOD: The Medical Expenditure Panel Survey (MEPS) was used to identify HIV/AIDS patients with ≥2 active antiretroviral medications. Patients on FXD were matched in 1:1 ratio with the FRC group using propensity scores. All medical costs excluding those paid by patients and families were included. Utility was measured using SF-6D scores from the SF-12 questionnaire. Incremental cost-utility ratios (ICURs) were calculated using the mean annual estimates. A cost-effectiveness acceptability curve was determined using a Monte Carlo probabilistic simulation technique. RESULTS: Nine FXD antiretroviral formulations approved by the U.S. Food and Drug Administration by 2005 was included in this study. One hundred seventy HIV/AIDS patients with ≥2 antiretroviral agents were identified from the MEPS database, of which 53% (n=92) were on FXD formulation. On matching, 70 patients from FXD had a match from the FRC group. No differences in sociodemographic and health status variables were observed between the matched groups. The mean annual cost was $15,766.15 for FXD patients and $11,875.21 for FRC patients. The mean utility gained by using FXD over FRC was 0.085; however, this difference was not statistically significant. The ICUR for the FXD treatment over FRC treatment was $45,540.49/quality-adjusted life years (QALYs). Probabilistic sensitivity analysis showed FXD to dominate FRC (>50% probability of being cost-effective) above the $40,000 threshold. CONCLUSION: Although the cost-effectiveness of a single-pill strategy was within the acceptable willingness-to-pay threshold, the QALY difference were minimal. Further research is recommended to explore the long-term impact of the strategy.

Cost burden of the presenteeism health outcome: diverse workforce of nurses and pharmacists.

OBJECTIVES: To describe presenteeism, its cost burden, and comparative and interactive effects of race/ethnicity in nurses and pharmacists. METHODS: Using 226 self-reports, ordinal logistic regression with marginal/interactive effects modeled 12 presenteeism predictors, contingency tables detected differences/associations, and Human Capital Approach determined cost burden. RESULTS: Presenteeism's prevalence was 52.65% with mean productivity decrement 13.2%. Minorities had lower base presenteeism rates; however, race/ethnicity differences were not significant. Physical symptoms and mental conditions were associated with increased presenteeism likelihood, while decreased likelihood was associated with no medications or lack of resumption of previous medications. Indirect cost burden in 2008 averaged $12,605 per professional for $36 billion nationally. CONCLUSIONS: Prevention of symptoms and conditions impacting cognitions, pain, and perceptions can decrease presenteeism. Minorities' lower rates of presenteeism can be viewed both positively and negatively.

African American patients' attitudes toward proactive health behaviors after exposure to direct-to-consumer advertising.

BACKGROUND: Previous research on direct-to-consumer advertising (DTCA) has not focused exclusively on the African American population. PURPOSES: The purpose of this study was to explore African Americans' attitudes toward proactive health behaviors following exposure to DTCA of atorvastatin calcium (Lipitor, Pfizer Inc). MATERIALS AND METHODS: One-hundred fifty African American patients participated in the study. Participants' functional health literacy and health locus of control were assessed. The participants were asked to view a DTCA of Lipitor, followed by face-to-face interviews. RESULTS: After watching the DTCA of Lipitor, 89.4% of participants agreed that they would talk to their physician about their cholesterol, 88.6% agreed that they would ask their physician to test their cholesterol level, and 47.3% agreed that they would ask their physician to write them a prescription for Lipitor. Those who had a history of high cholesterol were more likely to agree to ask their physician to test their cholesterol levels. Low household income, having public health insurance, and prior experience with taking Lipitor were significant positive predictors of patients agreeing to ask their physician to write a prescription of the advertised drug. CONCLUSIONS: African American patients showed favorable attitudes toward proactive health behaviors after exposure to DTCA of Lipitor.

The economic impact of a college of pharmacy.

OBJECTIVES: To quantify the dollar value of economic returns to a community when a college of pharmacy attains its fourfold mission of research, service, patient care, and education. METHODS: United States Bureau of Economic Analyses (BEA) RIMS II input/output analysis and data from student and faculty surveys were used to quantify the economic impact of the University of Tennessee's College of Pharmacy (UTCOP). RESULTS: The UTCOP's revenue of $22.4 million resulted in an indirect output impact of over $29.2 million, for a total impact of nearly $51.6 million in output (production of goods and services), while supporting 617.4 jobs and total earnings of $18.5 million during the 2004-2005 school year. CONCLUSIONS: Demonstrating the economic value of colleges of pharmacy is critical when seeking support from state legislators, foundations, government agencies, professional associations, and industry. Based on this study, UTCOP was able to report that every dollar the state invests in UTCOP yields an estimated net return on investment of $27.90.

Patterns of reporting health-related quality of life across racial and ethnic groups.

The National Institute of Health and the US FDA have regulations on the inclusion of minorities in research, and guidelines on how to conduct and report subgroup analyses among each racial and ethnic group. Although health-related quality of life (HRQL) has enjoyed increased popularity as an important end point in clinical research, the literature lacks a comprehensive review on whether or not racial and ethnic groups report HRQL differently, particularly among patients with specific disease states. HRQL is different from most other end points in clinical research in that it is reported by patients and thus is affected by patients' racial and ethnic background in a special way. This paper summarizes the existing literature on patterns of reporting HRQL across racial and ethnic groups. It begins with a summary of general HRQL patterns and subsequently covers HRQL related to renal disease, breast cancer and prostate cancer. This paper is not intended to be exhaustive, but to inform researchers of good practice in clinical research utilizing HRQL as study end points.

A comprehensive approach to faculty development.

The purpose of this report was to describe the development, implementation, and outcomes from 3 complementary programs to facilitate the development of faculty members. The Faculty Development Committee (FDC) at the University of Tennessee developed 3 new complementary programs: the Individual Faculty Development Program to encourage faculty members to assess and identify their own specific developmental needs; the Seed Research Grant Program to fund scholarly activities by faculty; and the Technology Support Program to foster financial support of technology upgrades crucial for meeting the research, education, and service needs of faculty members. Eighteen faculty members participated in the Individual Faculty Development Program during the first 2 academic years and all provided positive feedback about their experiences. The Seed Research Grant Program funded 6 projects during its inaugural year. Limited outcome data from these 2 programs are extremely favorable relative to grant submissions and publications, and enhanced educational offerings and evaluations. The Technology Support Fund was initiated in the 2005-2006 academic year. The 3 faculty development programs initiated are offered as examples whereby faculty members are given a high degree of self-determination relative to identifying programs that will effectively contribute to their growth as academicians. Other colleges of pharmacy are encouraged to consider similar initiatives to foster individual faculty development at this critical period of growth within academic pharmacy.

Status of PharmD/PhD programs in colleges of pharmacy: the University of Tennessee dual PharmD/PhD program.

OBJECTIVES: To describe the University of Tennessee PharmD/PhD program and assess the prevalence and characteristics of PharmD/PhD programs in the United States. METHODS: Survey instruments were mailed in May 2004 to UT dual-degree program participants and deans of US colleges and schools of pharmacy. RESULTS: University of Tennessee PharmD/PhD students completed more than 30 hours of graduate credit before obtaining their PharmD and 72.2% agreed or strongly agreed that the program met their professional goals. More than 40% of US pharmacy colleges and schools have or plan to have PharmD/PhD programs. A wide variation exists in the level of integration, PhD concentrations offered, entrance requirements, and student benefits. Most schools with PharmD/PhD programs had few students enrolled in the program, but attrition rates were low (<20%) for 69% of the schools. CONCLUSIONS: Dual-degree programs attract and retain pharmacy students in research programs and 47.6% of graduates entered academia and industry.