Report of the 2023-2024 Strategic Engagement Standing Committee.

The American Association of Colleges of Pharmacy (AACP) has long emphasized the value of strategic engagement, recognizing that it is critical to the success of pharmacy education, contributing to the expansion of pharmacy and public health practice, the fulfillment of institutional missions, and the meeting of programmatic needs. The 2023-2024 Strategic Engagement Committee (SEC or the Committee) was charged with operationalizing Advocacy Champions, creating an Advocacy Resource Guide to support Advocacy Champions in their engagement with diverse public and private stakeholders, offering formal training to Advocacy Champions in the form of a new Connect Community and Webinar Series, and conducting focus groups at the 2024 Annual Meeting to determine strengths of the Advocacy Guide and opportunities to support Advocacy Champions further.

Self-Reported Factors Involved in Attrition and Retention of Pharmacy Faculty.

OBJECTIVE: To evaluate factors associated with pharmacy faculty attrition and retention. METHODS: A cross-sectional survey was developed that consisted of 33 closed- and open-ended items related to reasons or potential reasons for leaving academia, motivating factors for staying in academia, and personal and professional demographic characteristics. The survey was distributed via Qualtrics to all current pharmacy faculty using the American Association of Colleges of Pharmacy email listserv and posted in American Society of Health-System Pharmacists and American Association of Colleges of Pharmacy online communities to recruit participants who were no longer in academia. Descriptive statistics were used to analyze the data using SPSS. RESULTS: A total of 1011 current and 79 former pharmacy faculty completed the survey, with the majority being female, white, full-time, nontenure track, pharmacy practice, and at associate rank. Of the current faculty, 21.5% intend to leave their current position within the next year and 37.4% of respondents think about leaving either daily or weekly. Faculty who are no longer in academia or potentially will leave their position cited an unmanageable workload as the most impactful reason, with other risk factors, including unsupportive/inadequate direct supervisors or senior leadership and inadequate work-life balance, compensation, and resources. The top reasons for staying in academia included having an adequate work-life balance, manageable workload, and meaningful relationships with students. CONCLUSIONS: The Academy and individual institutions must evaluate and address risk factors contributing to faculty attrition. Simultaneously, they should actively encourage conditions such as maintaining a manageable workload and promoting work-life balance to retain faculty members.

Performance of Medication Tasks: Relationship Among Patient-Reported Outcomes, Performance-Based Assessments, and Objective Assessments.

IMPORTANCE: Occupational therapy practitioners use standardized assessments to guide their clinical decision-making, but it is unclear how well performance on standardized assessments translates to performance at home. OBJECTIVE: To understand the concurrent and predictive validity of patient-reported outcomes and performance-based assessments for monitoring performance at home within the context of medication management and adherence. DESIGN: Exploratory study. SETTING: Participants completed standardized assessments in a lab or at home, which were followed by home-based electronic monitoring of medication adherence. PARTICIPANTS: Sixty community-dwelling adults with hypertension or stroke who independently took antihypertensive medications. OUTCOMES AND MEASURES: Participants completed the Hill-Bone Medication Adherence Scale, the Hill-Bone Medication Adherence Reasons Scale, the Performance Assessment of Self-Care Skills Medication Management subtask, and the Executive Function Performance Test-Enhanced Medication Management subtest. Then, they used an electronic pill cap to monitor medication adherence at home for 1 month. RESULTS: Patient-reported outcomes and performance-based assessments in the context of medication management and adherence demonstrated poor concurrent and predictive validity to medication adherence at home. CONCLUSIONS AND RELEVANCE: There is a gap between what people think they will do, what they can do on a standardized assessment, and what they actually do at home. Future research is needed to strengthen concurrent and predictive validity to clinically meaningful outcomes. Plain-Language Summary: Occupational therapy practitioners should use caution when using standardized assessments to try to predict client performance at home. They should also continue to use a battery of assessments, clinical reasoning, and client preferences to guide their decision-making for monitoring performance at home within the context of medication management and adherence.

Patient adherence to patient-reported outcome measure (PROM) completion in clinical care: current understanding and future recommendations.

BACKGROUND: Patient-reported outcome measures (PROMs) are increasingly being used as an assessment and monitoring tool in clinical practice. However, patient adherence to PROMs completions are typically not well documented or explained in published studies and reports. Through a collaboration between the International Society for Quality-of-Life Research (ISOQOL) Patient Engagement and QOL in Clinical Practice Special Interest Groups (SIGs) case studies were collated as a platform to explore how adherence can be evaluated and understood. Case studies were drawn from across a range of clinically and methodologically diverse PROMs activities. RESULTS: The case studies identified that the influences on PROMs adherence vary. Key drivers include PROMs administeration methods within a service and wider system, patient capacity to engage and clinician engagement with PROMs information. It was identified that it is important to  evaluate  PROMs integration and adherence from multiple perspectives. CONCLUSION: PROM completion rates are an important indicator of patient adherence. Future research prioritizing an understanding of PROMs completion rates by patients is needed.

The urgency of restructuring the landscape of behavioral medicine: Commentary from early-career diversity institute scholars.

Structural and systemic barriers entrenched in academia have sustained for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for women and underrepresented racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. Increasing opposition to diversity, equity, and inclusion (DEI) efforts in higher education via legislation, policies, and general anti-DEI sentiment contextualizes the importance of prioritizing DEI. The goal of this commentary is to open discussion among academic institutions regarding changes in DEI culture that will facilitate the growth of diverse early-career faculty (ECF). We use an adapted framework which incorporates DEI into a faculty competency model to (i) guide our discussion of the rationale for restructuring academic systems to promote DEI and (ii) recommend strategies for institutional progress for ECF that can translate across academic institutions. Implementing policies and practices that seek to recruit, retain, and support historically underrepresented ECF are needed, and may involve faculty mentorship programs, establishing equitable funding mechanisms, reforming faculty evaluation practices, and examining and correcting inequities in faculty workloads. The onus is on institutions to recognize and replace the exclusionary practices and biases that have existed within their walls, and continuously promote and monitor their DEI efforts and initiatives to ensure their efficacy. Inclusive academic cultures that demonstrate their value of diversity and commitment to equity promotion at all levels of the organization, including among ECF, are necessary for ensuring excellence in scholarship in academia.

Existing structural and systemic barriers in academia have continued for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for underrepresented gender and racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. We outline the need for promoting diversity, equity, and inclusion (DEI) practices in academia, and that it will involve changes to the existing structures within universities. This is especially important as we want our higher education workforce to reflect our increasingly diverse society in its own diversity, but current policies and structures do not promote diversity in our institutions and in our research. Our rationale for restructuring academic systems to promote DEI also stems from a need for behavioral medicine and research more broadly to recognize and challenge the biases and practices that sustain inequity in our research­from the questions we ask, the participants we include (and exclude), and the ways in which the system creates unnecessary barriers for researchers who try to mitigate or address these biases in our work. We recommend implementing strategies for institutional progress that benefit diverse early-career faculty including mentoring programs, developing funding opportunities, changing faculty evaluation practices, and creating equitable workloads.

Career Vitality: Perceptions from Women Faculty in Health Professions.

OBJECTIVE: Career vitality is experienced when personal and professional life commitments align. To examine perceptions of and strategies used by women faculty in health professions to achieve career vitality. METHODS: A 2-round Delphi method was used to identify career vitality descriptors, personal-professional-life equilibrium, and strategies for achieving career vitality among 16 women faculty recruited from the National Academies of Practice. Qualitative analysis identified themes. RESULTS: The consensus-generated descriptors of career vitality were 'growth mindset', 'motivated/passionate', and 'collaborative'. Descriptors of personal-professional-life equilibrium were 'prioritize', 'balance', and 'nimbleness'. Personal resilience was the major strategy to gain equilibrium. Challenging perceptions to overcome included role expectations for women working outside the home, which correlated with a system strategy such as organizational tools. CONCLUSION: Achieving career vitality and personal-professional-life equilibrium is challenging. The strategies generated can be utilized by women faculty to better align work-related demands when challenges are high, and resources are low.

Medicine Use in Chronic Diseases.

Welcome to this Special Issue on "Medicine Use in Chronic Disease" in Pharmacy, an open-access journal focusing on pharmacy education and practice [...].

Pharmacy student perceptions of remote learning and wellness during the pandemic: Lessons learned from a metropolitan commuter city.

INTRODUCTION: The purpose of this study was to assess pharmacy student perceptions of remote learning experiences and personal well-being during the COVID-19 pandemic in a metropolitan commuter city. METHODS: A survey was developed and sent to pharmacy students from the three pharmacy colleges in New York City in January 2021. The survey domains consisted of demographics, personal well-being, classroom experiences, and pandemic and post-pandemic preferred learning modalities and reasons. RESULTS: From a total of 1354 students from professional years one, two, and three across the three colleges, completed responses were received from 268 students (20% response rate). More than half of the respondents (55.6%) reported a negative impact of the pandemic on their well-being. More than half of the respondents (58.6%) reported more time to study. When students were asked their preferred mode of pharmacy education delivery during the pandemic and post-pandemic, a quarter (24.5%) preferred remote learning for all courses during the pandemic, and only a quarter (26.8%) preferred traditional classrooms for all courses post-pandemic. Approximately 60% of the respondents preferred some type of remote learning post-pandemic. CONCLUSIONS: Pharmacy student learning has been and continues to be impacted by the COVID-19 pandemic, especially for pharmacy students in New York City. This study sheds light on the remote learning experiences and preferences of pharmacy students in a commuter city. Future studies could assess pharmacy student learning experiences and preferences after return to campus.

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.

Gender equity perceptions among social and administrative science faculty: A qualitative evaluation.

BACKGROUND: Anecdotal evidence suggests that gender inequity persists in academic pharmacy. To date, there are limited published data about the perception of gender inequity in academic pharmacy. OBJECTIVE: The objective of this project was to determine themes associated with gender inequity perceptions in social and administrative science faculty from 2 national pharmacy organizations. METHODS: A gender equity task force comprising 13 members from Social and Administrative Sciences (SAS) sections of the American Pharmacists Association and the American Association of Colleges of Pharmacy was formed. The task force designed a semistructured interview guide comprising questions about demographics and core areas where inequities likely exist. When the survey invitation was sent to faculty members of the SAS sections via Qualtrics, faculty indicated whether they were willing to be interviewed. Interviews were conducted by 2 members of the task force via video conferencing application. The interviews were transcribed. Topic coding involving general categorization by theme followed by refinement to delineate subcategories was used. Coding was conducted independently by 3 coders followed by consensus when discrepancies were identified. RESULTS: A total of 21 faculty participated in the interviews. Respondents were primarily female (71%), were white (90%), had Doctor of Philosophy as their terminal degree (71%), and were in nontenure track positions (57%). Most respondents (90%) experienced gender inequity. A total of 52% reported experiencing gender inequity at all ranks from graduate student to full professor. Four major themes were identified: microaggression (57%), workload (86%), respect (76%), and opportunities (38%). Workload, respect, and opportunities included multiple subthemes. CONCLUSION: Faculty respondents perceive gender inequities in multiple areas of their work. Greater inequity perceptions were present in areas of workload and respect. The task force offers multiple recommendations to address these inequities.

Reliability and Validity Evidence for an Academic Gender Equity Questionnaire.

Objective. The majority of practicing pharmacists and student pharmacists are women. However, instruments to assess perceptions of gender equity within pharmacy academia are not available. The objective of this research was to describe the psychometric analysis of a questionnaire developed to assess gender equity by a Gender Equity Task Force and to report reliability and validity evidence.Methods. A questionnaire with 21 items addressing the teaching, research, service, advancement, mentoring, recruitment, and gender of college leaders was created. The survey was distributed via email in December 2020 to all social and administrative science section members of two professional associations. Rasch analysis was performed to evaluate the reliability and validity evidence for the questionnaire.Results. After reverse coding, all items met parameters for unidimensionality necessary for Rasch analysis. Once adjacent categories were merged to create a 3-point scale, the scale and items met parameters for appropriate functionality. Items were ordered hierarchically in order of difficulty. The modified instrument and scale can be treated as interval level data for future use.Conclusion. This analysis provides reliability and validity evidence supporting use of the gender equity questionnaire in the social and administrative academic pharmacy population if recommended edits such as the 3-point scale are used. Future research on gender equity can benefit from use of a psychometrically sound questionnaire for data collection.

Viewpoints of Residency Program Directors Regarding Depressive Symptoms in Pharmacy Residents.

Objective: Several publications have highlighted residency-specific factors being associated with depressive symptoms in pharmacy residents, but no studies have investigated the viewpoint of residency program directors (RPDs) regarding this issue. This study's primary objectives were to identify potential contributing factors, determine current resources, and outline possible solutions to decrease depressive symptoms among pharmacy residents from the point of view of RPDs. Methods: RPDs were asked to participate in a 45-60-minute semi-structured interview conducted via phone by the primary investigator, recorded, and transcribed using NVivo. Interviews were manually analyzed by study investigators to identify emerging themes. The investigators discussed findings and discrepancies to agree upon thematic interpretations of the transcripts. Results: Ten interviews were conducted between May 2019 and February 2020. RPD experience ranged from 2-15 years. Pharmacy practice PGY1 programs comprised 60% of interviews, 20% for community practice, and 10% each for managed care and ambulatory care. All RPDs indicated increased workload as a contributing factor to depressive symptoms in residents. The inability to accept and utilize constructive feedback and difficulties transitioning from student to resident were identified as contributing factors by 50% of the RPDs. Nine RPDs reported having employee assistance programs, stating the resource was underutilized, and identified the need for additional education regarding identification and triage, not necessarily management, to help residents. Conclusion: This study highlights consistency among RPDs regarding potential contributors to depressive symptoms in pharmacy residents and emphasizes the need for additional RPD and preceptor training to identify and help residents more effectively with these issues.

Teledentistry Implementation During the COVID-19 Pandemic: Scoping Review.

BACKGROUND: COVID-19 spreads via aerosol droplets. The dental profession is at high risk of contracting the virus since their work includes treatment procedures that produce aerosols. Teledentistry offers an opportunity to mitigate the risk to dental personnel by allowing dentists to provide care without direct patient contact. OBJECTIVE: The purpose of this scoping review was to examine the implementation, challenges, strategies, and innovations related to teledentistry during the COVID-19 pandemic lockdown. METHODS: This scoping review evaluated teledentistry use during the pandemic by searching for articles in PubMed and Google Scholar using the search terms teledentistry, tele-dentistry, covid-19, coronavirus, telehealth, telemedicine, and dentistry. Inclusion criteria consisted of articles published in English from March 1, 2020, to April 1, 2022, that were relevant to dentistry and its specialties, and that included some discussion of teledentistry and COVID-19. Specifically, the review sought to explore teledentistry implementation, challenges, strategies to overcome challenges, and innovative ideas that emerged during the pandemic. It followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). This approach is organized into 5 distinct steps: formulating a defined question, using the question to develop inclusion criteria to identify relevant studies, an approach to appraise the studies, summarizing the evidence using an explicit methodology, and interpreting the findings of the review. RESULTS: A total of 32 articles was included in this scoping review and summarized by article type, methodology and population, and key points about the aims; 9 articles were narrative review articles, 10 were opinion pieces, 4 were descriptive studies, 3 were surveys, 2 were integrative literature reviews, and there was 1 each of the following: observational study, systematic review, case report, and practice brief. Teledentistry was used both synchronously and asynchronously for virtual consultations, often employing commercial applications such as WhatsApp, Skype, and Zoom. Dental professionals most commonly used teledentistry for triage, to reduce in-person visits, and for scheduling and providing consultations remotely. Identified challenges included patient and clinician acceptance of teledentistry, having adequate infrastructure, reimbursement, and security concerns. Strategies to address these concerns included clinician and patient training and utilizing Health Insurance Portability and Accountability Act-compliant applications. Benefits from teledentistry included providing care for patients during the pandemic and extending care to areas lacking access to dental care. CONCLUSIONS: Pandemic lockdowns led to new teledentistry implementations, most commonly for triage but also for follow-up and nonprocedural care. Teledentistry reduced in-person visits and improved access to remote areas. Challenges such as technology infrastructure, provider skill level, billing issues, and privacy concerns remain.

A Theory of Planned Behavior informed factorial survey of New York community pharmacists to determine their intentions to monitor antihypertensive medication adherence among older adults.

BACKGROUND: Older adults with uncontrolled hypertension can benefit from pharmacist-led interventions as they regularly access community pharmacies. However, several barriers to adherence interventions in a community pharmacy setting exist, and few studies have evaluated the feasibility of medication adherence monitoring within the community pharmacy workflow in the United States. OBJECTIVES: To undertake a factorial survey to determine medication adherence monitoring attitudes of pharmacists and the factors that facilitate or impede adherence counseling by pharmacists within a U.S. community pharmacy setting for antihypertensives in older adults. METHODS: The study was a Theory of Planned Behavior informed factorial survey of New York community pharmacists. The survey had (1) a factorial vignette, to determine how pharmacists make real-life decisions in response to complex situations; (2) questionnaires on medication monitoring attitudes, behavioral beliefs, normative beliefs, and perceived behavioral control regarding medication adherence monitoring, and (3) respondent and workplace characteristics. In response to vignettes, the adherence monitoring tasks were (1) examining patients dispensing records to assess adherence, (2) asking patients about their adherence behavior, and (3) exploring patient beliefs about their antihypertensives. RESULTS: From the 350 completed responses, more than the vignette characteristics, it was the pharmacist characteristics that explained the major variance in the 3 medication monitoring tasks. The respondents demonstrated modestly positive attitudes to medication monitoring, were less positive about their external perception of medication monitoring, and reported difficulty to perform the medication monitoring tasks. In factorial vignette analysis, these attitudes and beliefs significantly impacted adherence monitoring tasks as did situational factors such as time pressures, medication beliefs of patients, the relationship developed with patients, and staffing in the pharmacy, and respondent factors such as pharmacy type and location. CONCLUSION: Future community pharmacist-led adherence interventions should be designed to address pharmacist attitudes and beliefs and certain workplace characteristics to enable successful implementation.

Exploring a New Theoretical Model to Explain the Behavior of Medication Adherence.

Medication adherence is essential for optimal therapeutic outcomes. However, non-adherence with long-term therapy is at 50%. Several theoretical models have identified several key factors that could explain medication adherence. Though numerous interventions have been developed based on these theoretical models, the success rates with interventions are not the best. This paper proposes a new Hierarchical Model for Medication Adherence. In this model, we propose medication adherence as a five-tier model with medication adherence as the desirable behavior on the top of the pyramid. From the bottom of the hierarchy upwards, the skills/beliefs/behaviors to be achieved are: health literacy, belief in illness (impacted by perceived susceptibility and severity of illness), belief in medicines (impacted by treatment satisfaction), and self-efficacy (impacted by social support). The model further proposes that each individual will achieve or already have these skills/beliefs/behaviors at various levels. Screening patients for these benchmarks will enable providers to decide where to target interventions.

Feasibility of a Randomized Controlled Mixed Methods Trial to Address Health Literacy, Beliefs, Medication Adherence, and Self-Efficacy (ADHERE) in a Clinical Pharmacist-Led Clinic.

Purpose: To assess the feasibility and acceptability of a health literacy-psychosocial support intervention - ADHERE and explore changes in glycemic values and medication adherence. Patients and Methods: Thirty-one participants with hemoglobin A1c (HbA1c) ≥ 8% were randomly allocated to control (usual care) or intervention groups (receiving usual care plus a 6-session pharmacist-led intervention focusing on the modifiable psychosocial factors that may influence medication adherence). Feasibility metrics evaluated recruitment, retention, and intervention adherence. Questionnaires were administered to collect psychosocial factors and self-reported medication adherence at baseline, the end of the intervention, 3 months, and 6 months post intervention. HbA1c values were extracted from electronic medical records. Repeated measures analysis of variance was used to compare differences in mean outcomes between the control and intervention groups. To assess intervention acceptability, eleven individuals participated in semi-structured interviews about their intervention experiences. Qualitative content analysis was used for analyzing the interviews. Results: Thirty participants completed the study. Overall, the findings support the feasibility of the intervention. There were significant differences in HbA1c values. Participants in the intervention group had lower A1C (8.3 ± 1.4) than in the control group (9.2 ± 1.3) at the time of 6-month follow-up (p = 0.003). In addition, the participants in the intervention group showed improved HbA1c at 6-month follow-up (8.3 ± 1.4), compared to baseline (9.4 ± 1.5, p = 0.011) and after 6-session intervention (8.9 ± 1.6, p = 0.046). However, there were no significant differences in medication adherence between groups over time. Qualitative themes suggest participants liked the intervention and perceived the additional support from the pharmacist as beneficial. Conclusion: A pharmacist-led intervention to provide additional health literacy-psychosocial support may contribute to long-term improvements in HbA1c. Equipping pharmacists with patient-specific diabetes medication adherence information and building in additional follow-up support for patients may improve patient health outcomes.

Trends of self-reported non-adherence among type 2 diabetes medication users in the United States across three years using the self-reported Medication Adherence Reasons Scale.

BACKGROUND & AIMS: To determine the trends of self-reported non-adherence rates among adults taking Type 2 medicines (T2D) medicines between 2017 and 2019 and to identify the patterns for the frequently reported reasons for non-adherence in the United States. METHODS & RESULTS: Data from the National Health and Wellness Survey, a self-administered, internet-based cross-sectional survey of US adults from 2017 to 2019 was used. Non-adherence was measured using the self-reported Medication Adherence Reasons Scale (MAR-Scale). Frequencies were used to identify the reasons for non-adherence for insulin and non-insulin therapies for T2D. Data were obtained from 2983 respondents in 2017, 5416 in 2018, and 5268 in 2019. Based on the MAR-Scale, the self-reported medication non-adherence rate was 25% in 2017, 21% in 2018, and 27% in 2019. The most common reason for non-adherence across all the three years was simple forgetfulness, yet patients reported the lowest mean number of days missing medication for that reason. Though less frequently reported, non-adherence lasted longer when patient did not know how to take their medicines, cost was a reason, or had concerns about the long term effects of the medicines. CONCLUSIONS: With no significant improvement in adherence with T2D medicines over time, regardless of better awareness and extensive diabetes education, focus should be on individualized non-adherence reasons-based interventions.

Telepharmacy during COVID-19: A Scoping Review.

The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy.

Identifying areas of improvement for cultural competence in pharmacy curricula: A multi-school study using the self-assessment of perceived level of cultural competence (SAPLCC) questionnaire.

INTRODUCTION: The implementation of culturally competent healthcare services has been considered a key strategy for the provision of patient-centered care; however, a need remains to address the requirements of teaching cultural competence, including identifying gaps, designing and evaluating curricula, and assessing students' progress toward program objectives. The objective of this study was to explore the applicability of the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire in the identification of improvement areas in cultural competence content in pharmacy curricula. METHODS: This study used previously-collected SAPLCC data from student pharmacists at eight United States pharmacy schools. Total and factor-specific SAPLCC scores were calculated based on the 14 factors published previously and grouped into six domains (knowledge, skills, attitudes, encounters, abilities, and awareness). Differences in overall scores by domain and factors across various student characteristics were examined using analysis of variance. RESULTS: The overall mean total SAPLCC score was classified as moderate. Third-year students had significantly higher SAPLCC mean scores than first-year students, and African American students scored significantly higher than their counterparts. At the factor-level, students scored higher in the Attitudes and Awareness domains and scored lower in the Knowledge, Skills, and Encounters domains. CONCLUSIONS: The application of the SAPLCC in schools participating in this preliminary study allowed for the identification of content areas that may benefit from revision. The SAPLCC may be a useful tool for mapping cultural competence curricular content by each specific domain and identifying areas of potential improvement regarding cultural competence training within pharmacy curricula.

Inclusion of People with Disabilities in Research to Improve Medication Adherence: A Systematic Review.

People with disabilities have high rates of chronic health conditions and often require complex medication regimens to manage their health. Approximately 20-50% of people with disabilities fail to take their medication as prescribed. It is unclear, however, to what extent the literature describes the effectiveness of medication adherence interventions for people with disabilities. In this review, the inclusion and exclusion criteria of the 182 studies included in the Cochrane Review on Interventions for Enhancing Medication Adherence were evaluated for their inclusion of people with disabilities. Of the studies, 1% excluded persons for hearing impairment, 3% for motor impairment, 7% for visual impairment, and 32% for cognitive impairment. Most studies (65%) did not exclude persons based on specific impairment. Medication event monitoring systems were used in 21% of studies, and investigators excluded people unable to use this device in 5% of studies. Caregiver assistance was an exclusion criteria in 4% of studies. Additional barriers like the ability of investigators to exclude persons based on their judgement were found. These barriers exist in addition to the known barriers affecting persons with disabilities, such as accessibility of research facilities and access to transportation. These data suggest that people with disabilities are systemically excluded from the medication adherence intervention literature. Subsequently, it cannot be assumed that current adherence interventions are effective for people with disabilities. More research is needed to understand how to address medication adherence for people with disabilities.