Prescription and Over-the-Counter Medication Record Integration: A Holistic Patient-Centered Approach

Objective: Nonprescription or over-the-counter (OTC) medications play a crucial role in a patient’s ability to make choices to manage his or her own health care. Often these nonprescription choices are unknown to health care practitioners and thus are often not included as part of patients’ health records. The exclusion of these therapies can pose risks to patient safety. There is a significant need to address the capture of OTC medication use in both the physician and pharmacy electronic health records (EHRs) and during the practitionerepatient medication history and reconciliation process. Data sources: On October 26, 2016, the National Association of Chain Drug Stores Foundation hosted a forum for a select group of health care industry professionals to work on a series of recommendations to improve the documentation of OTC medication use by patients. This diverse group of more than a dozen stakeholders included community pharmacy leaders from multiple chain pharmacies, pharmacy system vendors, e-prescribing vendors, health information technology experts, and multiple industry representatives, including individuals from the public sector. This commentary is a summary of the insights and suggestions where the group was in general agreement. Summary: Successful OTC medication EHR integration will require system-level buy-in across multiple layers of the health care industry to improve patient safety. Forum participants suggested incremental steps that could be taken by multiple stakeholders to lay the foundation for integration within an appropriate regulatory structure. Conclusion: Based on the results of the stakeholder forum, an agreement formed around one approach that the group supported as feasible: the creation of a consistent and uniform identification method for OTC medications in cooperation with government regulatory authorities

Implementation of Community Pharmacy Dispensing Software (MyDispense) in an Advanced Pharmacy Practice Course

Objectives: MyDispense is an interactive community pharmacy simulation program designed to build students’ confidence related to community pharmacy practice. MyDispense was implemented in the Advanced Pharmacy Practice course at St. Louis College of Pharmacy during the P3 year as an activity and assessment for competency in the community pharmacy setting. In order to make future curriculum improvements, the objective of this study is to evaluate the usefulness and applicability of the MyDispense program into a required course. Method: The study will consist of an anonymous online survey available to students in the Advanced Pharmacy Practice course for two weeks following completion of the program. The survey is designed to evaluate the usefulness of the MyDispense online pharmacy program implemented during the course of the semester. Results: 98 responses (43% response rate) were collected from students who completed MyDispense as part of the required course. 69% (n=68) of respondents stated MyDispense was straightforward to learn, 75% (n=73) stated MyDispense was more realistic than similar cases on paper, and 78% (n=75) appreciated the opportunity to learn without the consequences of a prescription error. Students felt that MyDispense should be implemented either throughout the curriculum (31%, n=30) or prior to the community IPPE course (23%, n=22). Students’ overall perception of MyDispense was not affected by previous community pharmacy experience (p=0.17). Implications: This study to evaluates the impact of MyDispense with a cohort of P3 students in an Advanced Pharmacy Practice course. This data can be used to help implement MyDispense in other pharmacy school curricula

Student Perception of the Impact of Audience Response Software in a Team-Based Learning Self-Care Course

Objectives: Evidence evaluating audience response systems (ARS) used in team-based learning (TBL) compared to traditional classes is limited. The objectives of this study are to evaluate student perceptions of the technology and compare students’ assessment of technology with their performance. Method: TBL was implemented in the required self-care course (PP2120: Introduction to Pharmaceutical Care: Non-prescription drugs) at St. Louis College of Pharmacy, and an audience response system was implemented in Fall 2015. At the conclusion of the course, a web-based survey was administered to students. Results: Of the 29 students who successfully completed the course, 23 (79%) completed the survey. Student response to the audience response technology was generally favorable. Of the students who responded “somewhat agree” and “strongly agree” to questions related to ARS, 87% were more actively involved in the case, 96% felt the visual responses made understanding easier, and 91% felt the ARS would be useful in other courses in the curriculum. Student performance in the course was analyzed by Pearson correlation and was positively correlated with students who self-reported as technology enthusiasts (0.509, p=0.016) and early adopters of technology (0.601, p=0.004). Implications: This is the first study to measure the impact of ARS with TBL implementation in a self-care course. ARS data can be used to help implement TBL in pharmacy school curricula and further research can be performed to link student adoption of technology to performance in courses that implement ARS

PaCE Yourself: Impact of COVID-19 on Patient-Centered Care Experience

(1) Background: The outbreak of the novel coronavirus, COVID-19, forced colleges of pharmacy to implement new online learning methodologies to ensure that students could complete required courses. This transition was especially acute for laboratory simulation courses that require students to practice professional skills. This study aims to compare student assessment performance within a simulation-based laboratory course for students who completed the module prior to and after the online transition. (2) Methods: This study was a retrospective cohort comparison of student outcome performance with two distinct content delivery methods. Students were organized into two tracks at the beginning of the semester to determine the order of the simulation module. The online learning transition occurred in-between the delivery of the same module, which allowed comparison of online versus in-person content delivery with consistent assessment. Remediation rates on each assessment were compared using chi-squared tests. (3) Results: Student pharmacists across the first and second professional year performed similarly despite in-person or online course formats, with no significant differences in remediation rates. (4) Conclusions: Pharmacy course content, including laboratory-based simulation activity, may produce similar assessment performance when using online content delivery. Further research into hybrid or mixed-delivery models may enhance learning without affecting assessment performance

Chain Community Pharmacists\u27 Willingness, Attitudes, and Barriers in Providing Self-Care Medication and Supplement Recommendations

BACKGROUND: Pharmacists are commonly called on as the first resource for patients when selecting an appropriate self-care medication or supplement. This study examines pharmacists’ over-the-counter (OTC) recommendations in the chain community pharmacy setting in the United States. OBJECTIVES: The objective of the study was to assess chain community pharmacists’ willingness and attitudes to provide self-care recommendations to patients and to identify chain community pharmacists’ barriers to making OTC medication and supplement recommendations. METHODS: An anonymous survey was created to identify pharmacists’ attitudes and their willingness to perform these recommendations. The questionnaire included specific questions to identify barriers that exist to making OTC recommendations. The survey was distributed by fax and email to 527 pharmacists in the Mid-South regional district of a U.S. grocery chain pharmacy. Descriptive statistics were used to identify demographic trends and display results. RESULTS: Pharmacists are overwhelmingly willing to provide OTC recommendations (100%) and see it as an important part of community practice (99%). The greatest barriers were time/prescription volume (94%) and staffing demands (78%). The greatest need for education was in the areas of eye/ear care and vitamins/herbal products. CONCLUSIONS: The results affirmed pharmacists’ willingness and overall positive attitude to providing OTC medication counseling in the community pharmacy setting. The research uniquely identified barriers that pharmacists experience when attempting to make OTC recommendations. This information can be used not only for the implementation of patient care services targeting self-care needs but also in the application of general community pharmacy practice

Analysis of Student Performance Outcomes Using Virtual Dispensing Exercises

The objective of this study was to compare performance outcomes between PY1 and PY2 students on an identical exercise required during their final objective structured clinical exam (OSCE)

Adverse Events and Treatment Discontinuations of Antimuscarinics for the Treatment of Overactive Bladder in Older Adults: A Systematic Review and Meta-Analysis

Introduction Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB. Methods Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic were performed in February 2015. Studies assessing AEs or treatment discontinuations in a population of adults 65 or older were included. The Jadad Criteria and McHarm Tool were used to assess the quality of the trials. Results A total of 16 studies met the inclusion criteria. Eighty AEs and 27 reasons for treatment discontinuation were described in the included studies and further explored. Anticholinergic AEs were more common in antimuscarinics compared to placebo. Incidence of dizziness, dyspepsia, and urinary retention with fesoterodine, headache with darifenacin, and urinary tract infections with solifenacin were significantly higher compared to placebo. Treatment discontinuation due to AEs and dry mouth were higher in the antimuscarinics when compared to placebo in older adults. Conclusions Treatment for overactive bladder using antimuscarinics in adults aged 65 or older resulted in significant increases in risk for several AEs compared to placebo including anticholinergic and non-anticholinergic AEs

Identifying Community Pharmacists' Readiness to Participate in Transitions of Care

Objective: To determine the readiness of community pharmacists to participate in transitions of care and to identify barriers related to participation. Methods: A questionnaire was developed to identify community pharmacists’ willingness, attitudes, and barriers to participating in transitions of care programs. The questionnaire was piloted with community pharmacists prior to implementation. The questionnaire was distributed to a population of chain, supermarket/grocery, and independent community pharmacists (n=200). Descriptive statistics, correlations, and chi square tests were used to analyze demographic trends and final results. Results: Of the 200 questionnaires distributed, 147 pharmacists responded (73.5%). Community pharmacists agreed transitions of care services have the potential to improve patients’ understanding of medications (97.3%), decrease medication-related errors (95.9%), and enhance relationships with patients (96.6%). The largest pharmacist perceived barriers included time (69.7%), communication/lack of patient data (14.6%), and lack of physician acceptance (6.7%). Of the respondents who indicated time as the greatest barrier to participation, 76.9% of pharmacists were still willing to participate in transitions of care given the opportunity. Willingness to participate in transitions of care did not differ by gender (p=0.139), years in practice (p=0.133), or degree of education (p=0.382). Conclusion: Community pharmacists are in a unique position to widely impact patient health outcomes and decrease hospital readmission rates through improved care coordination. This research demonstrates community pharmacists’ readiness and willingness to participate in transitions of care. Awareness of perceived barriers can allow stakeholders to address these areas when designing and implementing transitions of care programs with pharmacists.   Type: Original Researc

Development and Implementation of an Influenza Point-of-Care Testing Service in a Chain Community Pharmacy Setting

Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% of patients testing positive received a prescription as a result. While health insurance cannot be billed for the service due to current pharmacy reimbursement practices, this did not appear to negatively affect patient willingness to participate. As point-of-care testing services become more commonplace in community pharmacy settings, patient awareness will similarly increase and allow for more widespread access to acute outpatient care