Impact of COVID-19 pandemic on training of pharmacy residents and fellows: Results from a national survey of postgraduate pharmacy trainees.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has impacted the activities of healthcare workers, including postgraduate pharmacy trainees. Quality training experiences must be maintained to produce competent pharmacy practitioners and maintain program standards. METHODS: A cross-sectional survey of postgraduate pharmacy trainees in the United States was conducted to evaluate training experience changes and assess perceived impacts on residents and fellows following the COVID-19 pandemic's onset. RESULTS: From June 4 through June 22, 2020, 511 pharmacy trainees in 46 states completed the survey. Participants' median age was 26 (interquartile range [IQR], 25-28) years, with included responses from postgraduate year 1 residents (54% of sample), postgraduate year 2 residents (40%), and postgraduate fellows (6%). Compared to experiences prior to the onset of the COVID-19 pandemic, fewer trainees conducted direct patient care (38.5% vs 91.4%, P < 0.001), more worked from home (31.7% vs 1.6%, P < 0.001), and less time was spent with preceptors per day (2 [IQR, 2-6] hours vs 4 [IQR, 1-4] hours, P < 0.001). Sixty-five percent of respondents reported experiencing changes in their training program, 39% reported being asked to work in areas outside of their routine training experience, and 89% stated their training shifted to focus on COVID-19 to some degree. Most respondents perceived either major (9.6%) or minor (52.0%) worsening in quality of experience, with major and minor improvement in quality of experience reported by 5.5% and 8.4% of respondents, respectively. CONCLUSION: Pharmacy resident/fellow experiences were perceived to have been extensively impacted by the COVID-19 pandemic in varying ways. Our findings describe shifts in postgraduate training and may aid in the development of best practices for optimizing trainee experiences in future crises.

Evaluation of pharmacist-led strategy to reduce outpatient fluoroquinolone prescribing from the emergency department.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of a pharmacist-led initiative to reduce outpatient fluoroquinolone prescribing in the emergency department (ED). DESIGN: Eight common indications for fluoroquinolone prescribing were selected for intervention. The intervention consisted of a multimodal prescriber education program providing empirical recommendations for antibacterial agents on the basis of guidelines, the local ED antibiogram, and clinical trials. The electronic medical record was reviewed to identify all prescriptions for moxifloxacin, ciprofloxacin, and levofloxacin oral tablets written at the time of discharge by ED providers. SETTING AND PARTICIPANTS: This study was conducted in a 62-bed emergency department at an academic community medical center with approximately 90,000 ED visits per year. Adult patients who were prescribed an oral fluoroquinolone at discharge from the ED were included. OUTCOME MEASURES: The primary outcome of the study was fluoroquinolone days of therapy (DOT) prescribed per 100 ED visits. RESULTS: In the preintervention group, the primary outcome of fluoroquinolone DOT per 100 ED visits was 18.4, 17.8, 16.5, 19.8, and 16.8 for the months of December 2017 through April 2018, respectively. The fluoroquinolone DOT per 100 ED visits in the postintervention group was 8.7, 7.9, 8.0, 6.3, and 6.0 for the months of December 2018 through April 2019, respectively. The fluoroquinolone DOT per 100 ED visits was found to be significantly shorter in the postintervention group with P = 0.009. CONCLUSION: The results of this study reveal that pharmacist-led interventions, focused on multimodal provider education, were effective at reducing ED discharge prescriptions for fluoroquinolones.