Barriers to and factors influencing the pursuit of pharmacy student research.

INTRODUCTION: The objective of this study was to identify perceived barriers and factors influencing student pursuit of research during pharmacy school. METHODS: A voluntary, paper-based or electronic questionnaire was administered to all pharmacy students at a private college of pharmacy in mandatory courses during the 2016-2017 academic year. Survey questions collected information pertaining to demographics, factors influencing student pursuit of research, and barriers to pursuit of research. Participation was incentivized with gift cards. RESULTS: A total of 623 students completed the survey (79% response rate). The average respondent was female (69.1%), 25-years old (IQR 23-26 years), employed (69.9%), and had a prior degree (66.6%). During pharmacy school, 27.3% of respondents pursued a research project. Of students not pursuing a research project during pharmacy school, the amount of interest to complete a project differed significantly between professional years (P < .01) with the second-year class having the highest interest. Lack of time (91.3%), unfamiliarity with the research process (81.8%), and too much coursework (80.5%) were cited as the top three perceived barriers that prevented students from pursuing research. A mandatory research class (87.6%), presentations describing faculty research interests (83.4%), and ability to work with a friend (83.9%) would most strongly influence students to complete research. CONCLUSIONS: Students report additional information regarding research opportunities would positively influence their decision to pursue research while in pharmacy school. Future studies should evaluate strategies to familiarize students with the research process.

Focus group describing simulation-based learning for cardiovascular topics in US colleges and schools of pharmacy.

INTRODUCTION: This qualitative focus group study sought to describe how colleges of pharmacy use simulation-based learning (SBL) to teach cardiovascular topics and to identify challenges and benefits. MATERIAL AND METHODS: Participants were recruited from a screening survey disseminated via e-mail to select American College of Clinical Pharmacy Practice and Research networks. Subjects were selected based on diversity in institution and simulation types. Two 1-hour focus group sessions were conducted by the primary investigator following a script designed by the research team. Each recorded session was independently reviewed by all investigators and coded into final themes. Results are reported in a qualitative fashion. RESULTS: Five individuals provided consent and participated. Themes identified include topics, formats, interprofessional education, challenges, strategies for success, and benefits. Frequent topics included advanced cardiac life support, heart failure, hypertension, and transitions of care. Multiple formats were used including standardized patients or providers, task trainers, and high-fidelity mannequins. Multiple institutions reported simulating interprofessional teams by involving students from other health professions. Scheduling, pharmacy program size, faculty availability, and logistics around planning and/or conducting an event were identified challenges. Institutions reported success when clear expectations were provided to students and skill development progressed from low-stakes to high-stakes events. Benefits reported included real world applicability with participants noting that students do not realize the importance of SBL until they have reached rotations. CONCLUSIONS: Various topics and simulation methods were employed to teach cardiovascular topics. While challenges exist, institutions have identified strategies for success and report students recognized the benefits to their learning.

Impact of the FDA Warning for Azithromycin and Risk for QT Prolongation on Utilization at an Academic Medical Center.

A US Food and Drug Administration (FDA) drug safety communication was released in March 2013, warning prescribers of the risk of QT prolongation associated with azithromycin. Overall azithromycin utilization and adherence to an inpatient QTc monitoring guideline during 8-month time periods before and after the warning were assessed to evaluate the impact of this warning on inpatient azithromycin utilization and QTc monitoring. Fifty-five patients were included in the prewarning time period and 50 were included in the postwarning period. A significant reduction in utilization in days of therapy per 1,000 patient days was observed (31.2 prewarning vs 17.5 postwarning, p < .001) in these groups. No changes in QTc monitoring among patients receiving azithromycin were identified. FDA warnings of severe, life-threatening toxicities can have a profound impact on utilization and prescribing of medications, however they may not necessarily change monitoring practices.

Challenges With Insulin in the Inpatient Setting.

IN BRIEF This article reviews potential challenges to and necessary considerations for ensuring the safe and effective use of insulin in the hospital setting. It offers practical suggestions for managing insulin-related issues regarding medication reconciliation, general inpatient management, and the use of concentrated insulin products.

Canagliflozin, a new sodium-glucose cotransporter 2 inhibitor, in the treatment of diabetes.

PURPOSE: The published evidence on the pharmacology, pharmacodynamics, pharmacokinetics, safety, and efficacy of a promising investigational agent for managing type 2 diabetes is evaluated. SUMMARY: Canagliflozin belongs to a class of agents-the sodium-glucose co-transporter 2 (SGLT2) inhibitors-whose novel mechanism of action offers potential advantages over other antihyperglycemic agents, including a relatively low hypoglycemia risk and weight loss-promoting effects. Canagliflozin has dose-dependent pharmacokinetics, and research in laboratory animals demonstrated high oral bioavailability (85%) and rapid effects in lowering glycosylated hemoglobin (HbA(1c)) values. In four early-stage clinical trials involving a total of over 500 patients, the use of canagliflozin for varying periods was associated with significant mean reductions in HbA(1c) (absolute reductions of 0.45-0.92%) and fasting plasma glucose (decreases ranged from 16.2% to 42.4%) and weight loss ranging from 0.7 to 3.5 kg. More than a dozen Phase II or III clinical trials of canagliflozin in adults are ongoing or were recently completed, but the final results of most of those studies have not been published. Adverse effects reported in clinical trials of canagliflozin include urinary tract and genital infections, occurring in about 10% of patients. Additional and larger Phase III clinical trials to delineate the potential role of canagliflozin and other SGLT2 inhibitors in the management of diabetes (including studies involving the elderly, children, and patients with renal or hepatic dysfunction) are planned or currently underway. CONCLUSION: Canagliflozin and other investigational SGLT2 inhibitors have a novel mechanism of action that may offer a future alternative treatment pathway for managing type 2 diabetes.