Examining pharmacy workforce issues in the United States and the United kingdom

The objective of this item it to examine available data and actions surrounding current pharmacy workforce issues in the United States and United Kingdom.  Published pharmacy workforce data from the United States and United Kingdom were gathered from various sources, including PUBMED, Internet search engines, and pharmacy organization websites. Data was collated from additional sources including scientific literature, internal documents, news releases, and policy positions.  The number of colleges and schools of pharmacy has expanded by approximately 50% in both the United States and United Kingdom over the previous decade. In the United States, continued demand for the pharmacy workforce has been forecasted, but this need is based on outdated supply figures and assumptions for economic recovery. In the United Kingdom, workforce modeling has predicted a significant future oversupply of pharmacists, and action within the profession has attempted to address the situation through educational planning and regulation.  Workforce planning is an essential task for sustaining a healthy profession. Recent workforce planning mechanisms in the United Kingdom may provide guidance for renewed efforts within the profession in the United States

Changes to inhaled corticosteroid dose when initiating combination inhaler therapy in long-acting β agonist-naive patients with asthma : a retrospective database analysis

Retrospective prescribing data were obtained from 46 general practice surgeries in NHS Scotland. Patients with asthma who were naïve to previous long-acting β agonist therapy and initiated combination inhaler therapy in 2008–2009 were classified according to the inhaled corticosteroid (ICS) dose in their combination inhaler compared with the highest dose of ICS they received before initiation. Among the 685 patients (541 (79.0%) who had been prescribed an ICS previously), those originally on low-, medium- or high-dose ICS were changed to high-dose combination therapy in 122/250 (48.8%), 94/151 (62.3%) or 85/113 (75.2%) cases in each ICS dose category, respectively. These results suggest that evaluation of appropriate high-dose ICS prescribing in general practice is needed

Public Health in Pharmacy Practice: A Casebook 2nd Edition

This casebook, now in its second edition, is a collaboration of over 90 individuals with expertise and training in public health pharmacy. A total of 54 chapters are presented, covering a broad array of topics relevant to pharmacy applications of public health. These topics include, but are not limited to, cross-cultural care, health literacy and disparities, infectious disease, health promotion and disease prevention, medication safety, structural racism, advocacy/policy analysis, chronic disease, women’s health, rural health, travel medicine and more. The book is designed to allow educators/students to choose chapters of interest as they feel suited, as each chapter is independent from the others. Each chapter contains learning objectives and an introduction to the topic, followed by a case and questions. The chapter closes with commentary from the authors and patient-oriented considerations for the topic at hand.https://knightscholar.geneseo.edu/oer-ost/1026/thumbnail.jp

Quetiapine and olanzapine misuse prevalence in a US general population sample

Introduction: Second-generation antipsychotics (SGA) are associated with misuse potential; however, there are limited data describing the prevalence and characteristics of this misuse. This study was conducted to identify and describe quetiapine and olanzapine misuse among US adults. Methods: This cross-sectional survey questionnaire was conducted online using Qualtrics research panel aggregator service to identify a quota-based sample of respondents constructed to mimic the general US population aged 18 to 59 years, with regards to gender, geographic region, ethnicity, income, and education level. Misuse was defined as using quetiapine or olanzapine for treatment outside of medical recommendations, for reasons other than a diagnosed medical condition, or obtaining without a prescription. A logistic regression was used to identify factors associated with SGA misuse, incorporating relevant covariates. Results: Among 1843 total respondents, 229 had a history of quetiapine or olanzapine use. Misuse prevalence was estimated to be 6.3% (95% CI: 5.2, 7.5%). Although most respondents (?70%) using quetiapine or olanzapine reported doing so to treat a diagnosed medical condition, those misusing them most commonly did so because prescribed medications failed to relieve their symptoms. Misuse was commonly reported (?50%) concomitantly with opioids, benzodiazepines, or alcohol. Factors significantly associated with quetiapine or olanzapine misuse included employment (OR = 4.64), previous substance use disorder treatment (OR = 2.48), and having riskier attitudes toward medication misuse (OR = 1.23). Discussion: Misuse of quetiapine and olanzapine, while fairly limited in prevalence, appears to be primarily associated with under-treatment of existing medical conditions

Analysis of treatment of respiratory disease in the United Kingdom and United States

INTRODUCTION: Asthma and chronic obstructive pulmonary disease (COPD) affect 8% and 5% of the population, respectively, in the United Kingdom (UK) and the United States (USA). A variety of medicines are available but how they are utilised in real practice is not fully understood. The aim of this work was to describe and compare the treatment of asthma and COPD in the UK and USA. METHODS: Three retrospective databases (two administrative and one electronic health record datasets) were formed from sources in National Health Service (NHS) Scotland, NHS Forth Valley, Scotland, and Kentucky, USA. Several analyses were conducted, including mapping and evaluation of national medicine utilisation, evaluation of adherence/persistence with chronic therapy, classification of therapy against guideline recommendations, and appraisal of inhaled corticosteroid (ICS) prescribing. RESULTS: National medicine utilisation figures indicated an increasing preference over time for combination therapy with ICS and long-acting beta agonist (LABA) inhalers. Therapy for asthma demonstrated some unanticipated trends, with widespread use of high-dose combination therapy in up to one-third of patients and a lack of standardised therapy approach by clinicians at step 2/3. For COPD, spirometry data was unable to verify diagnosis in up to a quarter of patients, and approximately one-third of patients received unlicensed doses of combination therapy. Adherence and persistence with chronic medicine in both databases was better amongst women, with advancing age and with oral therapy. Direct comparisons between the UK and USA were difficult due to the different healthcare structures and methods for data collection, but doses of ICS in children appeared more aggressive in the USA. CONCLUSION: The treatment of respiratory disease can be optimised in several clinical areas, most notably with ICS prescribing. Further research and quality improvement measures are needed to improve the care of respiratory disease.INTRODUCTION: Asthma and chronic obstructive pulmonary disease (COPD) affect 8% and 5% of the population, respectively, in the United Kingdom (UK) and the United States (USA). A variety of medicines are available but how they are utilised in real practice is not fully understood. The aim of this work was to describe and compare the treatment of asthma and COPD in the UK and USA. METHODS: Three retrospective databases (two administrative and one electronic health record datasets) were formed from sources in National Health Service (NHS) Scotland, NHS Forth Valley, Scotland, and Kentucky, USA. Several analyses were conducted, including mapping and evaluation of national medicine utilisation, evaluation of adherence/persistence with chronic therapy, classification of therapy against guideline recommendations, and appraisal of inhaled corticosteroid (ICS) prescribing. RESULTS: National medicine utilisation figures indicated an increasing preference over time for combination therapy with ICS and long-acting beta agonist (LABA) inhalers. Therapy for asthma demonstrated some unanticipated trends, with widespread use of high-dose combination therapy in up to one-third of patients and a lack of standardised therapy approach by clinicians at step 2/3. For COPD, spirometry data was unable to verify diagnosis in up to a quarter of patients, and approximately one-third of patients received unlicensed doses of combination therapy. Adherence and persistence with chronic medicine in both databases was better amongst women, with advancing age and with oral therapy. Direct comparisons between the UK and USA were difficult due to the different healthcare structures and methods for data collection, but doses of ICS in children appeared more aggressive in the USA. CONCLUSION: The treatment of respiratory disease can be optimised in several clinical areas, most notably with ICS prescribing. Further research and quality improvement measures are needed to improve the care of respiratory disease

U.S. Pharmacist Opinions Regarding the Rescheduling of Hydrocodone Combination Products: A Pilot Study

In October 2014, the Drug Enforcement Administration in the U.S. reclassified hydrocodone combination products (HCPs) from Schedule III to Schedule II, initiating one of the most significant and controversial regulatory changes for opioids in recent national history. The aim of the present study was to determine community pharmacist opinions on the effect of the rescheduling of HCPs on their personal practice. A web-based pilot survey was emailed to a convenience sample through online newsletters of professional pharmacy organizations in Pennsylvania, Kentucky and West Virginia in April/May 2015. A total of 62 surveys were initiated, yielding 56 complete responses. More than 75% of respondents noted increases in their workload as a result of the rescheduling of HCPs. Opinions regarding the intended outcomes of rescheduling were only weakly positive, with only 37.5% of respondents believing it has increased safety and 44.6% of respondents believing it has lessened abuse/diversion. For overall attitudes regarding the rescheduling, respondents were split between positive (26.8%), neutral (26.8%) and negative (46.4%). These initial data suggest that pharmacists have encountered barriers in practice resulting from the rescheduling. Further expanded work is necessary to verify these results from the small sample, and to assess the intended effects of the rescheduling upon the safe and effective use of hydrocodone