Addressing disparities in pharmacogenomics through rural and underserved workforce education

Introduction: While pharmacogenomic (PGx) testing is routine in urban healthcare institutions or academic health centers with access to existing expertise, uptake in medically-underserved areas is lagging. The primary objective of this workforce education program is to extend access to didactic, case-based and clinical PGx training for pharmacists serving rural Minnesota and populations experiencing health disparities in Minnesota.Methods: A PGx workforce training program funded through the Minnesota Department of Health was offered through the University of Minnesota College of Pharmacy (COP) to pharmacists working in rural and/or underserved areas in the state of Minnesota. Learning activities included a 16-week, asynchronous PGx didactic course covering PGx topics, a 15-min recorded presentation, an in-person PGx case-based workshop, and a live international PGx Conference hosted by the University of Minnesota COP and attendance at our PGx Extension of Community Health Outcomes (ECHO).Results: Twenty-nine pharmacists applied for the initial year of the program, with 12 (41%) being accepted. Four (33%) practiced in a hospital setting, four (33%) in retail pharmacy, two (17%) in managed care, and two (17%) in other areas. The majority had not implemented a PGx program as part of their practice, although nearly all responded definitely or probably yes when asked if they expected their organization to increase its use of PGx testing services over the next three years. All participants either strongly or somewhat agreed that this program helped them identify how and where to access clinical PGx guidelines and literature and improved their ability to read and interpret PGx test results. Eight participants (67%) strongly or somewhat agreed that they expected to increase the number of PGx consultations in their practice, while ten (83%) strongly or somewhat agreed they would be able to apply what they learned in this program to their practice in the next six months to a year.Discussion: This novel PGx training program focused exclusively on pharmacists in rural and/or underserved areas with a delivery method that could be accomplished conveniently and remotely. Although most participants’ organizations had yet to implement PGx testing routinely, most anticipated this to change in the next few years

Experience and Outcomes of a Pharmaceutical Care Leadership Residency Program

The University of Minnesota College of Pharmacy’s Ambulatory Care Residency Program has graduated 22 residents from its Leadership Emphasis program from 1999 to 2014. The Leadership Emphasis program is unique in its design, providing a set of experiences over two years focused on developing leadership skills in practice development, establishing personal influence, advocacy in the profession, and teaching. The program’s design has focused on bringing value to three distinct audiences: pharmacists enrolled in the program, the local pharmacy practice community, and the College of Pharmacy. This paper explores the program’s contributions in each of these areas. Program graduates from 1999-2009 were interviewed and cited the independent, yet mentored, activities of the program as instrumental to their professional and personal development. The program has provided significant value to the College of Pharmacy, primarily in the form of instructional support, service to faculty practice sites and development of new practice sites for APPEs. Teaching and precepting hours offset the salary of the residents, resulting in financial benefits for the College. In the second year of the program, residents pursue development of new practice sites, 15 of which have been sustained to provide at least a half-time pharmacist position, having a direct impact on pharmacy practice development in the region. The program provides a win-win-win situation for all the stakeholders involved. Schools and colleges of pharmacy are encouraged to consider whether a similar program may assist in achieving its own goals in practitioner development, teaching and learning, and community engagement

INDOLMYCIN BIOSYNTHESIS: STUDIES ON A C-METHYLTRANSFERASE, A TRANSAMINASE, AND ON REGULATORY ASPECTS.

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Interview with Marilyn K. Speedie

Dr. Marilyn K. Speedie was born and raised in Salem, Oregon. She earned her B.S. in pharmacy in 1970 and Ph.D. in medicinal chemistry and pharmacognosy in 1973, both from Purdue University. Before graduating, she became assistant professor of pharmacognosy at Oregon State University. She then moved, in 1975, to the University of Maryland to become assistant professor of pharmacognosy. Dr. Speedie was promoted to associate professor in 1980 and full professor in 1991. While at the University of Maryland, she also served as chairman of the Department of Biomedicinal Chemistry (1989-1993) and as chairman of the Department of Pharmaceutical Sciences (1993-1995). She then became dean and professor at the University of Minnesota College of Pharmacy, positions she held from 1996 to 2017. In addition to her university commitments, Dr. Speedie served for the American Association of Colleges of Pharmacy as president (2006-2007) and on the board of directors (2005-2008). She also served on the board of directors for the National Institute for Pharmaceutical Technology and Education (2007-2017) and two terms on the board of trustees for the United States Pharmacopeia (2010-2020).Dr. Speedie begins part one of her interview by describing her early life and educational background. She reflects on her undergraduate education at Purdue University, discussing her early experiences working in community pharmacies and her exposure to laboratory research. She briefly discusses her time in graduate school and reflects on her return to Oregon following graduation. She discusses her move to Baltimore, as well as her becoming assistant professor and department head at the University of Maryland. Dr. Speedie then reflects on being recruited to the University of Minnesota. She discusses the appeal of an administrative position, as well as her ongoing interest in teaching and research. She reflects on the chaotic state of the University of Minnesota College of Pharmacy upon her arrival, the mentorship she received, and the openness of the pharmacy profession to women. Dr. Speedie then discusses some of the College’s more famous research projects, including investigations into epilepsy, HIV, and opioids. She then details the founding of the Rural Health School and the impetus behind the Duluth expansion. She concludes by comparing revisions made to the College of Pharmacy curriculum in 1995 and 2013 and by reflecting on faculty responses to those changes. Dr. Speedie begins part two of her interview by offering some additional comments about curricular design and the contributions of specific people to that project. She then reflects on changes in pharmacy practice in the mid 2000s, describing the significance of medication therapy management (MTM), collaborative practice, and pharmaceutical care. She then discusses the changing status of the Pharm.D. degree. Dr. Speedie then reflects on the founding and vision behind the Doctor of Pharmacy Program for Practicing Pharmacists (DP4). She then describes the relationship between academic and practicing pharmacists and discusses Dr. Lawrence Weaver’s role in bridging these groups. She discusses the significance of the Center for Leading Health Care Change and the Academic Health Center (AHC). She briefly reflects on the difficulties involved with connecting the College of Pharmacy and Fairview Health Services and with securing physical space for the College. Dr. Speedie concludes by commenting on her position as the first female dean and on the future of pharmacy enrollments