The sustainability of improvements from continuing professional development in pharmacy practice and learning behaviors.

OBJECTIVE: To assess the long-term sustainability of continuing professional development (CPD) training in pharmacy practice and learning behaviors. METHODS: This was a 3-year posttrial survey of pharmacists who had participated in an unblinded randomized controlled trial of CPD. The online survey assessed participants' perceptions of pharmacy practice, learning behaviors, and sustainability of CPD. Differences between groups on the posttrial survey responses and changes from the trial's follow-up survey to the posttrial survey responses within the intervention group were compared. RESULTS: Of the 91 pharmacists who completed the original trial, 72 (79%) participated in the sustainability survey. Compared to control participants, a higher percentage of intervention participants reported in the sustainability survey that they had utilized the CPD concept (45.7% vs 8.1%) and identified personal learning objectives (68.6% vs 43.2%) during the previous year. Compared to their follow-up survey responses, lower percentages of intervention participants reported identifying personal learning objectives (94.3% vs 68.6%), documenting their learning plan (82.9% vs 22.9%) and participating in learning by doing (42.9% vs 14.3%) in the sustainability survey. In the intervention group, many of the improvements to pharmacy practice items were sustained over the 3-year period but were not significantly different from the control group. CONCLUSION: Sustainability of a CPD intervention over a 3-year varied. While CPD-trained pharmacists reported utilizing CPD concepts at a higher rate than control pharmacists, their CPD learning behaviors diminished over time.

Outcomes of a pharmacist-managed medication refill program.

OBJECTIVE: To compare the completeness of medication and blood pressure monitoring among patients requesting medication refills through the pharmacist-managed medication refill and laboratory monitoring program (MRLMP) versus usual care. DESIGN: Quasiexperimental study. SETTING: Kaiser Permanente Colorado between November 2011 and June 2012. PATIENTS: Patients requesting chronic medication prescription refills. INTERVENTION: Community pharmacists managed the refill authorization request (RAR) process at the intervention site. For each RAR, the pharmacist reviewed patient medication monitoring needs and ordered laboratory test(s) or a clinic visit, as needed, before approval. MAIN OUTCOME MEASURES: For medications due for laboratory or blood pressure monitoring at the time of the RAR, the 1-month rate of attaining complete monitoring was compared between groups. Pharmacist, primary care physician (PCP), and patient satisfaction and PCP time saved also were compared. RESULTS: 3,797 RARs for MRLMP-eligible medications were approved in the month following MRLMP implementation in the intervention and control clinics. The intervention and control groups converted 49% and 29% of medications due for laboratory monitoring ( P < 0.001) and 56% and 33% of those due for blood pressure monitoring, respectively ( P = 0.020). The intervention group PCPs were more likely than control group PCPs to report being "very satisfied" with the RAR process (80% vs. 27%, P = 0.015) and spent fewer minutes per day on refill requests (mean 17 vs. 23, P = 0.049). The intervention group pharmacists reported higher job satisfaction (mean index score 22 vs. 18, P = 0.024), and intervention group patients reported higher satisfaction with the "readiness" of their prescription when they came to pick it up (91% vs. 80%, P = 0.004). CONCLUSION: A pharmacist-managed MRLMP resulted in improved process-related outcomes. Future studies should assess clinical outcomes.

Impact of continuing professional development versus traditional continuing pharmacy education on learning behaviors.

OBJECTIVE: To assess the effect of continuing professional development (CPD) on perceptions of learning behaviors compared with traditional continuing pharmacy education (CPE). DESIGN: Randomized controlled trial. SETTING: Kaiser Permanente Colorado (KPCO) from August 2008 to June 2009. PARTICIPANTS: Licensed pharmacists employed at KPCO. INTERVENTION: After completing a basic CPD course, participants were randomized into a control group that continued with traditional CPE or an intervention group that completed three CPD workshops and used the CPD approach for their professional learning needs. At baseline and follow-up, all participants completed a study questionnaire on perceptions of their learning behaviors. MAIN OUTCOME MEASURE: Comparison of responses to questionnaire items at follow-up. RESULTS: 100 pharmacists were enrolled. The intervention (n = 44; 7 lost to follow-up) and control (n = 47; 2 lost to follow-up) groups were similar at baseline. At follow-up, a higher percentage of intervention than control participants reported changing their learning behaviors/activities sometimes (41% vs. 0%, P < 0.01) or frequently/always (18% vs. 4%, P < 0.05). More intervention than control participants responded that they frequently/always participated in learning by doing (61% vs. 36%, P < 0.05), identified specific learning objectives (93% vs. 30%, P < 0.01), and documented their learning plan (82% vs. 13%, P < 0.01). A higher percentage of intervention than control participants responded that they adhered to their learning plan partially/to a large extent (80% vs. 15%, P < 0.01) and more than three-quarters of the intervention participants responded that they partially/to a large extent achieved their learning objectives ( P < 0.01). CONCLUSION: Pharmacists who adopted a CPD approach were more likely to report that various aspects of their learning behaviors improved as a result of education activities compared with pharmacists who participated in traditional CPE.

The impact of continuing professional development versus traditional continuing pharmacy education on pharmacy practice.

BACKGROUND: The Institute of Medicine states that the new vision for continuing education (CE) for health-care professionals will be based on continuing professional development (CPD); however, information on the utility of CPD is lacking. OBJECTIVE: To assess the effect of CPD, compared with that of traditional continuing pharmacy education (CPE), on perceptions of factors related to pharmacy practice. METHODS: This 10-month, nonblinded, randomized controlled study recruited licensed pharmacists employed at a health maintenance organization (HMO). After completing a basic CPD course, participants were randomized to the intervention or control group. The control group was instructed to continue with traditional CPE. The intervention group participants completed 3 CPD workshops and were instructed to utilize the CPD approach for their learning needs. At baseline and follow-up, all participants completed a study questionnaire on perceptions of their pharmacy practices. The outcome measures were comparisons on follow-up and changes from baseline to follow-up in responses to the study questionnaire. RESULTS: One hundred pharmacists were enrolled. The intervention (n = 44, 7 lost to follow-up) and control (n = 47, 2 lost to follow-up) groups were similar at baseline. At follow-up, a higher percentage of intervention participants reported that they had better interactions with other health-care providers (always/frequently 32% vs 6%, respectively) and initiated practice/work changes (always/frequently 21% vs 0%, respectively) (both p < 0.01) as a result of their education activities. Compared with control participants at follow-up, intervention participants reported that their education activities improved patient care changes (46% vs 23%), professional knowledge (34% vs 6%), skills (48% vs 17%), and attitudes/values (43% to 11%) (all p < 0.05). However, intervention participants reported more often that time was a barrier to completing education activities (75% vs 32%, p < 0.001). CONCLUSIONS: Pharmacists who participated in CPD reported more often that their perceptions of various aspects of their pharmacy practice improved as a result of their education activities compared with pharmacists who participated in traditional CPE.

A model for continuing pharmacy education.

OBJECTIVE: To develop and implement a continuing pharmacy education (CPE) program at Kaiser Permanente Colorado (KPCO) DESIGN: To address the continuing education needs of its diverse pharmacy staff, an internal continuing pharmacy education (CPE) program was developed. The pharmacy department became an accredited provider by the Accreditation Council for Pharmacy Education (ACPE). Live, interactive, and evidence-based CPE programs, presented by highly qualified internal staff members, utilized videoconferencing and a Web-based learning management system. Cross-accreditation of medical and pharmacy educational programs was offered to KPCO staff members. ASSESSMENT: Annual needs assessments were conducted to ensure the provision of relevant educational topics and to assess learning needs. To demonstrate outcomes of the CPE programs, 2 methods were utilized: objective effectiveness assessment and knowledge acquisition assessment. This program met the objectives for CPE activities a large majority of the time (usually over 90%), demonstrated statistically significant (p < 0.05) improvement in knowledge from before to after the CPE activity in 11 of 13 questions asked, and minimized the cost to acquire CPE credit for both the pharmacy department and its staff members. CONCLUSION: The KPCO continuing pharmacy education program has developed a high quality and cost-favorable system that has resulted in significant improvements in attendee knowledge.