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PubMed2005

Tobacco education in U.S. schools of pharmacy.

This study is the first to characterize tobacco-related content in pharmacy school curricula in the United States. A national survey mailed to 83 U.S. schools of pharmacy assessed the extent to which tobacco is addressed in required coursework, educational methods of instruction, perceived importance of addressing tobacco in the doctor of pharmacy degree program, perceived adequacy of current levels of tobacco education in curricula, and perceived barriers to enhancing the tobacco-related content. A total of 82 surveys (98.8% response) revealed a median of 170 min of tobacco education throughout the doctor of pharmacy program. The most heavily emphasized topics are aids for cessation, assisting patients with quitting, nicotine pharmacology and principles of addiction, and drug interactions with smoking, yet more than 40% of respondents believed that each of these topics was covered inadequately. Key barriers to enhancing tobacco training are lack of curriculum time and lack of clinical clerkship sites focusing on tobacco interventions. Pharmacy faculty members perceive tobacco cessation training to be important, yet a mismatch exists between the perceived importance and the perceived adequacy of current levels of training in pharmacy school curricula. The results of this study will serve as a baseline measure against which future, parallel assessments will be compared as faculty at schools of pharmacy across the United States work together toward enhancing the tobacco cessation training of student pharmacists.

Curriculum↗
PubMed1996

Academic and training requirements in advertisements for pharmacy management and clinical positions.

The academic and training requirements mentioned in advertisements for various pharmacy management and clinical positions were studied. Position advertisements appearing in five national pharmacy publications between January 1990 and December 1994 were analyzed for requirements or preferences for a particular pharmacy or other degree, postgraduate training (residencies and fellowships), board certification, and experience. The positions were classified as clinical pharmacist, clinical faculty member, pharmacy services manager, clinical manager, or academic manager. A total of 1052 position advertisements were eligible for analysis. Overall, 718 (68%) of the positions either required or preferred postgraduate training; graduates of ASHP-accredited residency programs were sought 10% of the time. Advanced degrees were specified for 934 (89%) of the positions--required for 581 (55%) and preferred for 353 (34%). No degree was specified for 98 (9%) of the positions. Only 20 (2%) of the advertisements indicated that the B.S. degree was a sufficient credential. Board certification was mentioned for 29 (3%) of the positions, although it was never required. Postgraduate pharmacy experience was often acceptable in lieu of advanced degrees and training. Pharmacy management and clinical positions advertised in national pharmacy publications tended to require or prefer residency or fellowship training and advanced degrees.

Advertising↗
PubMed2002

Perceived importance and self-assessment of the skills of Canada's health-system pharmacy managers.

The relationship between the perceived importance of managerial skills and self-assessed proficiency in each skill among health-system pharmacy managers in Canada was examined, and the demographic characteristics associated with pharmacy managers who lack these skills were analyzed. Surveys were mailed to 514 health-system pharmacy managers in Canada in July 2000. The survey listed 61 specific managerial skills, under seven general categories. The respondents were asked to rate the level of importance that each of the skills had in their job and rate their proficiency in each skill. Ratings were based on a five-point Likert scale ranging from very high importance or skill level to very low importance or skill level. The response rate was 52.7%. Of the 61 specific managerial skills considered, the majority of respondents identified "Demonstrating ethical conduct" as both the most important skill and their greatest strength. "Understand the operating principles of managed care" was viewed as the least important skill, while "Participating in the implementation of a marketing program" was respondents' greatest weakness. There were significant differences in the mean self-assessed skill levels of the respondents according to their educational background, size of the institution in which they work, and years of managerial experience. Health-system pharmacy managers with a master of business administration degree had a significantly higher overall mean perceived skill level than managers in all other "Education" categories. Managers with a bachelor of science degree in pharmacy had a significantly lower overall mean perceived skill level than those with a bachelor of science degree in pharmacy plus "other" degrees, while managers employed in institutions of 500 or more inpatient beds had a significantly higher overall self-rated mean skill level than managers employed in institutions of 51-100 inpatient beds. A national survey of health-system pharmacy managers in Canada revealed a pressing need for better training in managerial skills for these pharmacists.

Analysis of Variance↗
PubMed2004

Role of the director of pharmacy: the first six months.

PURPOSE: Interviewing for a director of pharmacy position is discussed, and recommended activities for a pharmacy director's first six months on the job are described. SUMMARY: A prospective pharmacy director should first target the specific positions available that best fit his or her skills. The individual should tour the hospital and the pharmacy for each position of interest. Interviews should include the pharmacy staff, the nursing staff, the direct-report manager, and the medical staff. The hospital's financial condition should be assessed and a postinterview analysis conducted. Once hired, the new director should devote the first three months to an assessment of pharmacy services, staff, and customers; a regulatory and accreditation review; and assessments of organizational leadership, information systems, and clinical services. In addition, key documents, such as hospital policies and procedures, should be reviewed. At the end of the first three months, two documents, a summary of the new director's initial assessments and a chart showing current workflow, should be completed. Tasks for the first six months on the job include devising a work plan to address issues, developing reporting systems and metrics, setting priorities, creating staffing and clinical plans, promoting staff development creating and revising procedures, and evaluating outsourcing needs. The director should take a moment from time to time to celebrate successes with the staff. CONCLUSION: The director of pharmacy has one of the most complex jobs in the hospital. Planning, communicating, networking, writing, listening, leading, and motivating are skills necessary for success.

Humans↗
PubMed2004

Congruence of self-reported medications with pharmacy prescription records in low-income older adults.

PURPOSE: This study examined the congruence of self-reported medications with computerized pharmacy records. DESIGN AND METHODS: Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly persons. The average age of the sample participants was 74.5 years (range = 65-91); 87.8% were females. RESULTS: Congruence between self-report and pharmacy data was generally high. Self-reports omitted drug classes in the pharmacy records less often than the pharmacy records did not include self-reported drug classes. The percentage of individuals with perfect agreement between self-reports and pharmacy records varied from 49% for major drug classes to 81% for specific cardiovascular and central nervous system drugs. Within a drug class, agreement tended to be higher for individuals without a prescription in that class. Poorer health was consistently related to poorer self-report of medications. IMPLICATIONS: Self-reported medications are most likely to be congruent with pharmacy records for drugs prescribed for more serious conditions, for more specific classes of drugs, and for healthier individuals.

Aged↗
PubMed1986

An introductory course to facilitate the implementation of a clinical pharmacy programme in Iraq.

An introductory course in clinical pharmacy is discussed which is designed to implement the basic concepts of clinical pharmacy as well as assist in the stepwise transition from a pharmacy school, with primary emphasis on dispensing, to a more clinically (patient) oriented pharmacy programme. The course is composed of a 2-h didactic session and a 3-h observation session per week for 3 months followed by daily 3-h practical clerkships for 4 months in the following areas: in-patient and out-patient hospital pharmacy, clinical laboratory, internal medicine, paediatrics, surgery, and retail pharmacy. Weekly 2-hour discussion sessions at the college or site of the clerkship are scheduled to review these experiences and introduce additional topics such as patients rights, pharmacist-patient relations, and pharmacy relations with other health professionals. This course promotes the development of a clinically oriented attitude in students and staff members in the college, and decreases the trauma of direct change from a product-oriented to a more patient-oriented curriculum.

Curriculum↗
PubMedDate not supplied

Pharmacy student training in United States hospices.

Hospice is a quickly growing field in health care in the United States. As the pharmacist's role in providing patient care to persons at the end of life increases, considerations should be given for training pharmacy students in this area. The objectives of this study were to examine the frequency of pharmacy student education and training among United States hospice organizations as well as to describe factors of hospice organizations that are associated with pharmacy student training. This is the first study of which we are aware to address the availability of experiential rotations for pharmacy students in hospice programs. A one-page questionnaire was mailed to 3,762 hospice organizations with addresses obtained from the National Hospice and Palliative Care Organization (NHPCO). Following two mailings, eight weeks apart, 907 responses were obtained. Ninety-four (10 percent) hospices trained pharmacy students, 246 (27 percent) trained medical students, 357 (39 percent) trained social work students, and 623 (69 percent) trained nursing students. These results indicate that the experiential training needs of United States pharmacy students are being addressed. However, further study is warranted to describe the various experiences of pharmacy students within the hospice setting.

Curriculum↗
PubMed1984

Establishing a pharmacy clinic in a city-county health department.

During a one-year rotation at an urban-county health department, a pharmacy resident implemented a pharmacy clinic to serve three major purposes: (1) to provide health care to patients with selected chronic illnesses, (2) to expand the revenue base of the health department pharmacy, and (3) to make possible the clinical instruction of Doctor of Pharmacy students and pharmacy residents. The resident's activities in the clinic included conducting interviews, performing physical examinations, initiating and adjusting therapy, and counseling patients. During the first four months of operation, 36 patients were seen in the clinic a total of 98 times. Seven chronic illnesses, along with a number of minor acute disorders, were evaluated and treated by the pharmacist. The pharmacist billed $1740.00 for patient care activities. The success of this initial program indicates that similar pharmacy clinics would be of benefit to other colleges of pharmacy as well as other institutional ambulatory health care providers.

Community Pharmacy Services↗
PubMed1986

Rho Chi lecture. Pharmacy in a smaller world.

Health care is a business. Pharmacy is in the health business. The health care delivery system in the U.S. is rapidly becoming a managed system by corporations. Further, these corporations are moving toward international markets where some already have considerable experience. There are many parts of the world not participating in these developments in health care. Some are just off our shores in the Caribbean Basin. A review of activities occurring in recent years by various groups suggests that more could be done. Two modest approaches are presented. Support of the American Association of Colleges of Pharmacy's "Pharmacy School Twinning Project" through which U.S. pharmacy schools would work with pharmacy schools in Central and South America is recommended. Also, national pharmacy associations jointly with pharmaceutical companies would work together using their expertise in continuing pharmacy education to develop new education models for the needy areas of the world.

Delivery of Health Care↗
PubMed1988

Prescribing authority for pharmacists as viewed by organized pharmacy, organized medicine, and the pharmaceutical industry.

This study identifies attitudes of organized pharmacy, organized medicine, and the pharmaceutical industry about prescribing authority for pharmacists. A questionnaire designed to assess the impact of a legislative bill permitting a pharmacist in an organized health care setting to initiate or modify drug therapy was mailed to state pharmacy associations, state hospital pharmacy associations, state pharmacy boards, state medical associations, Pharmaceutical Manufacturers Association (PMA)-member manufacturers, and non-PMA-member generic manufacturers. Responses from 194 of the 307 invited organizations were used. The six organization types viewed the impact of the legislative bill differently (p less than 0.05). Hospital pharmacy associations and boards of pharmacy, to a lesser extent, supported the legislative bill; non-PMA-member generic manufacturers and state pharmacy associations were relatively neutral. The medical associations and the PMA-member companies opposed the passage of the bill. Furthermore, medical associations believed that the bill would not be passed in the majority of states in the next five years.

Attitude of Health Personnel↗
PubMed1994

Immunization requirements for pharmacy students.

OBJECTIVE: To identify current immunization requirements for pharmacy students throughout the US. DESIGN: Self-administered questionnaire. SETTING: Seventy-five colleges and schools of pharmacy in the US. MAIN OUTCOME MEASURES: Immunization policies, immunologic requirements, timing of vaccination in relation to the beginning of clerkship experience, payment, mechanism to revise policies. DATA ANALYSIS: Descriptive statistics. RESULTS: Overall, 57 programs (81 percent) have an immunization program in place, but 13 programs (19 percent) have no immunization program. More than 50 percent of the colleges or schools reported requiring that pharmacy students have measles, mumps, rubella, tetanus, and purified protein derivative of tuberculin (PPD) vaccinations upon entry of clerkship. Only 25 college or schools of pharmacy (44 percent) required students to have the hepatitis B vaccine and 8 (14 percent) to have a PPD evaluation upon completion of clerkship experience. Responsibility for the immunization program was shared evenly between the clerkship coordinator and the student health clinic. Approximately 65 percent of programs maintain an immunization record on file for each student. Completion of immunizations was required in 36 schools (64 percent) before entering clerkship activities, 15 (26 percent) before entrance to the professional program, and 3 (5 percent) in the first year of the program. Six schools (11 percent) had a program in place for less than one year, 27 (47 percent) between one and five years, and 24 (42 percent) for more than five years. At the majority of schools, students are responsible for the cost of immunization. CONCLUSIONS: Most schools of pharmacy do not adhere to the specific immunization recommendations described by the Centers for Disease Control and Prevention for healthcare workers. Pharmacy schools need to reexamine their immunization policies and update them to reflect the most current standards. We suggest a policy for immunization of pharmacy students.

Clinical Clerkship↗
PubMedDate not supplied

Creating a performance appraisal template for pharmacy technicians using the method of equal-appearing intervals.

OBJECTIVE: To design a highly quantitative template for the evaluation of community pharmacy technicians' job performance that enables managers to provide sufficient feedback and fairly allocate organizational rewards. DESIGN: Two rounds of interviews with two convenience samples of community pharmacists and pharmacy technicians were conducted. The interview in phase 1 was qualitative, and responses were used to design the second interview protocol. During the phase 2 interviews, a new group of respondents ranked technicians' job responsibilities, identified through the initial interviewees' responses, using scales the researchers had designed using an interval-level scaling technique called equal-appearing intervals. SETTING: Chain and independent pharmacies. PARTICIPANTS: Phase 1-20 pharmacists and 20 technicians from chain and independent pharmacies; phase 2-20 pharmacists and 9 technicians from chain and independent pharmacies. MAIN OUTCOME MEASURES: Ratings of the importance of technician practice functions and corresponding responsibilities. RESULTS: Weights were calculated for each practice function. A weighted list of practice functions was developed, and this may serve as a performance evaluation template. Customer service-related activities were judged by pharmacists and technicians alike to be the most important technician functions. CONCLUSION: Many pharmacies either lack formal performance appraisal systems or fail to implement them properly. Technicians may desire more consistent feedback from pharmacists and value information that may lead to organizational rewards. Using a weighted, behaviorally anchored performance appraisal system may help pharmacists and pharmacy managers meet these demands.

Community Pharmacy Services↗
PubMed1984

Educational programs offered by colleges of pharmacy and drug information centers within the United States.

The purpose of this investigation was to determine the scope of drug information educational programs offered by formalized DICs and colleges of pharmacy to pharmacy students. Data were collected from surveys mailed October and December 1982 to 120 institutions known to be active in disseminating drug information as well as the 72 colleges of pharmacy located in the United States and Puerto Rico. A total of 109 questionnaires (91 percent response rate) were returned from the DICs, and 67 questionnaires (93 percent response rate) were returned from colleges of pharmacy. Seventy-four of the DICS and 63 colleges of pharmacy indicated that they provide required and/or elective didactic or experiential drug information training for pharmacy students. These experiences were offered predominantly to fifth year baccalaureate candidates and PharmD candidates. Thirty-two colleges reported that drug information training is a required component of baccalaureate externship-clerkship experiences although most students receive fewer than 40 hours of training. Forty-seven DICs and 20 colleges are affiliated with ASHP approved residency programs. The amount of drug information exposure each resident obtains was highly variable. This survey indicates that many of today's pharmacy students may not be receiving sufficient drug information training to respond to the drug information needs of other health professionals and the lay public.

Drug Information Services↗
PubMed1986

Role of the hospital pharmacy director in experiential education.

Pharmacy departments in community hospitals frequently function as teaching sites for the externship component of the pharmacy curriculum. With the entry-level doctor of pharmacy degree replacing the bachelor of science degree at several colleges of pharmacy, the use of community hospitals as sites for experiential education will undoubtedly increase. This article explores the role of the director of pharmacy in providing an optimal environment for experiential education to take place. The following topics are emphasized: maximizing the usefulness of the hospital pharmacy department as a teaching site; fulfilling the needs and requirements of the college, the hospital pharmacy, and the student; and using educational methods that promote student learning without placing unacceptable demands upon the director's time.

Chicago↗
PubMedDate not supplied

Community pharmacy residency programs, 1997-1998.

OBJECTIVE: To obtain a descriptive "snapshot" of community pharmacy residency programs active in 1997-1998. DESIGN: Survey (telephone interview) of community pharmacy residency program directors. METHODS: An advance letter to residency directors stated the purpose of the study and requested written information on their residency program. Using a scripted questionnaire, telephone interviews were conducted with each residency director. RESULTS: Descriptive statistics were used to portray the data. There were 13 active community pharmacy residency programs with 20 filled residency sites nationwide at the time of the study. Results revealed that 9 (69%) programs were funded by multiple sources, 3 programs were funded solely by the affiliated college, and 1 program was funded solely by the affiliated pharmacy. Of the 10 residency programs that had been in existence for longer than 1 year, 7 (70%) had the same funding source as they did the first year. Respondents provided descriptions of the residency programs, along with insight into the challenges of creating such programs. At the time of publication (November 1999), there were 50 active community residency sites within the 21 active community pharmacy residency programs. Several other programs are planned for implementation in July 2000. CONCLUSION: In general, community pharmacy residency programs continue to grow in number, and funding has been sustained due to the programs' successful outcomes. The results of this study provide a framework for the improvement of existing community pharmacy residency programs and the development of additional ones.

Community Pharmacy Services↗
PubMed2001

Private pharmacy practice and regulation. A randomized trial in Lao P.D.R.

OBJECTIVES: The objective of this study was to assess the effectiveness of government regulation of private pharmacy practice in a low-income country. METHODS: The intervention comprised inspections of the pharmacies, information, and distribution of documents to drug sellers and sanctions. It was implemented at two different intensity levels, active and regular intervention. The methods used to assess the effect of the interventions were interviews with the district drug inspectors, drug sellers and customers, inspection of drug purchases, and indicator surveys of pharmacies. Indicators for pharmacy-specific quality as well as for dispensing quality were developed. RESULTS: The main finding was one of strong overall improvements from initially low levels. The improvements were particularly marked by increases in the availability of essential materials for dispensing by 34% and in order in the pharmacy by 19%. Information given to customers increased from 35% to 51% and the mixing of different drugs in the same package went down from 17% to 9%. The pharmacies in the active intervention districts showed greater improvements for four of the six indicators, although statistically significant compared with the regular intervention districts only for the essential materials indicator. CONCLUSIONS: It was concluded that the regulatory activities have probably been an important factor behind the service quality improvements. It appeared feasible as well as effective to regulate private pharmacy practice in this particular low-income setting.

Developing Countries↗
PubMed1990

Integrated patient-specific model of pharmacy practice.

The deficiencies of traditional models for the provision of clinical pharmacy services are discussed, and a patient-specific model that integrates drug distribution and clinical pharmacy functions is proposed. Traditional models have either designated specific individuals as providers of clinical pharmacy services or have combined distributive and supportive services with clinical services. In both cases, clinical services have been of secondary importance. Such models have resulted in inconsistent clinical services for which the patient is not necessarily the primary focus and have made it difficult for pharmacists to understand their mission. The lack of a well-defined primary clinical role for pharmacists has confused health-care providers and created problems for managers attempting to evaluate pharmacists and justify clinical services. The integrated patient-specific model is based on the ethical imperative that the patient must be central to any health-care endeavor. Under this model, clinical pharmacy services are of central importance and distributive services are integrated as a secondary but still very important aspect of comprehensive institutional pharmacy services. Critical elements of the integrated model include a patient-centered philosophy of practice, a definition of clinical pharmacy work, and a managerial framework. The integrated patient-specific model of pharmacy practice puts pharmacists in a professional relationship with patients and explicitly defines clinical services and priorities.

Institutional Practice↗
PubMed1987

Attitudes and policies about continuing education among Wisconsin hospital pharmacy directors.

Pharmacy directors in Wisconsin hospitals were surveyed to determine their attitudes toward continuing professional education and to assess the status of policies and procedures regarding continuing education (CE) and funding for CE activities. A two-page questionnaire was sent to all pharmacy directors in the state. A total of 151 questionnaires were delivered and 103 (68.2%) usable responses were returned. Written policies and procedures regarding CE were available in 47.6% of pharmacy departments. Most directors (84.5%) had formal mechanisms for documenting staff participation in CE activities but few (19.6%) reported having criteria for determining who would attend CE programs. Only 64% of directors used a formal system of budgeting for CE activities, although 88% provide financial support for CE activities outside the institution. The types of CE activities considered to be most desirable were programs sponsored by pharmacy organizations, programs sponsored by schools of pharmacy, and journal reading. Many directors (72.8%) believed that CE is necessary if pharmacists are to remain competent, but few (5.9%) believed that their budgets were adequate to meet the costs of all CE activities in which their pharmacists might be interested, and few expected their budgets to increase. Based on this survey, Wisconsin pharmacy directors in both small and large hospitals believe that CE is important and that the pharmacy department should support it.

Attitude of Health Personnel↗