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Pharmacy, Volume 5, Issue 1 (March 2017) – 15 articles

Cover Story (view full-size image): Some outcomes around, for example, communication have been extensively theorised; others such as accountability have been relatively neglected in the teaching and learning literature. The question therefore is: if we do not have a clear understanding of the outcome, can we systematically apply good practice principles in course design such that students are able to achieve the outcomes the community and the profession expect? This paper compares and contrasts the literature around competency outcomes regarding students’ communication skills and the development of accountability and proposes a model to guide the selection of teaching and assessment approaches for accountability, based on the students’ sphere of influence. View this paper
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Open AccessBrief Report
Empirical Assessment of the Impact of Low-Cost Generic Programs on Adherence-Based Quality Measures
Pharmacy 2017, 5(1), 15; https://doi.org/10.3390/pharmacy5010015 - 08 Mar 2017
Viewed by 1278
Abstract
In the United States, federally-funded health plans are mandated to measure the quality of care. Adherence-based medication quality metrics depend on completeness of administrative claims data for accurate measurement. Low-cost generic programs (LCGPs) cause medications fills to be missing from claims data as [...] Read more.
In the United States, federally-funded health plans are mandated to measure the quality of care. Adherence-based medication quality metrics depend on completeness of administrative claims data for accurate measurement. Low-cost generic programs (LCGPs) cause medications fills to be missing from claims data as medications are not adjudicated through a patient’s insurance. This study sought to assess the magnitude of the impact of LCGPs on these quality measures. Data from the 2012–2013 Medical Expenditure Panel Survey (MEPS) were used. Medication fills for select medication classes were classified as LCGP fills and individuals were classified as never, sometimes, and always users of LCGPs. Individuals were classified based on insurance type (private, Medicare, Medicaid, dual-eligible). The proportion of days covered (PDC) was calculated for each medication class and the proportion of users with PDC ≥ 0.80 was reported as an observed metric for what would be calculated based on claims data and a true metric which included missing medication fills due to LCGPs. True measures of adherence were higher than the observed measures. The effect’s magnitude was highest for private insurance and for medication classes utilized more often through LCGPs. Thus, medication-based quality measures may be underestimated due to LCGPs. Full article
Open AccessArticle
How Two Small Pharmacy Schools’ Competency Standards Compare with an International Competency Framework and How Well These Schools Prepare Students for International Placements
Pharmacy 2017, 5(1), 14; https://doi.org/10.3390/pharmacy5010014 - 06 Mar 2017
Cited by 2 | Viewed by 1755
Abstract
International standards of pharmacy curricula are necessary to ensure student readiness for international placements. This paper explores whether curricula from two pharmacy programs, in Australia and Canada, are congruent with international standards and if students feel prepared for international placements. Nationally prescribed educational [...] Read more.
International standards of pharmacy curricula are necessary to ensure student readiness for international placements. This paper explores whether curricula from two pharmacy programs, in Australia and Canada, are congruent with international standards and if students feel prepared for international placements. Nationally prescribed educational standards for the two schools were compared to each other and then against the International Pharmaceutical Federation (FIP) Global Competency Framework. Written student reflections complemented this analysis. Mapping results suggested substantial agreement between the FIP framework and Australia and Canada, with two gaps being identified. Moreover, the students felt their programs prepared them for their international placements. Despite differences in countries, pharmacy programs, and health-systems all students acclimatized to their new practice sites. Implications are that if pharmacy programs align well with FIP, pharmacists should be able to integrate and practise in other jurisdictions that also align with the FIP. This has implications for the mobility of pharmacy practitioners to countries not of their origin of training. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
Open AccessReview
Does Competency-Based Education Have a Role in Academic Pharmacy in the United States?
Pharmacy 2017, 5(1), 13; https://doi.org/10.3390/pharmacy5010013 - 27 Feb 2017
Cited by 6 | Viewed by 2384
Abstract
Competency-based Education (CBE) is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US) is under review. [...] Read more.
Competency-based Education (CBE) is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US) is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities) to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities) is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessArticle
CPD Aligned to Competency Standards to Support Quality Practice
Pharmacy 2017, 5(1), 12; https://doi.org/10.3390/pharmacy5010012 - 25 Feb 2017
Cited by 6 | Viewed by 2899
Abstract
As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their [...] Read more.
As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% (n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists’ social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessArticle
Assessment of Knowledge of Diabetes Mellitus in the Urban Areas of Klang District, Malaysia
Pharmacy 2017, 5(1), 11; https://doi.org/10.3390/pharmacy5010011 - 23 Feb 2017
Cited by 4 | Viewed by 2091
Abstract
Diabetes is the most common cause of non-traumatic lower limb amputations and cardiovascular diseases. However, only a negligible percentage of the patients and subjects knew that the feet are affected in diabetes and diabetes affects the heart. Hence, a cross-sectional study was carried [...] Read more.
Diabetes is the most common cause of non-traumatic lower limb amputations and cardiovascular diseases. However, only a negligible percentage of the patients and subjects knew that the feet are affected in diabetes and diabetes affects the heart. Hence, a cross-sectional study was carried out to evaluate the knowledge of diabetes mellitus among the public of different age group, gender, ethnicity, and education level. A sample of 400 participants was randomly selected and data was collected using a structured questionnaire under non-contrived setting. The results showed that there is a statistically significant difference in knowledge on diabetes mellitus among different age groups and different ethnic origin but there is no significant difference in the knowledge among different gender and education level. Out of 400 respondents, 284 respondents (71%) knew that diabetes mellitus is actually a condition characterized by raised blood sugar. Age and education level of respondents were found to be the predominant predictive factors on diabetes knowledge, whereas the gender of respondents did not affect the findings of this study. An improved and well-structured educational programme that tackles the areas of weaknesses should be recommended to increase the level of knowledge on diabetes among Malaysians. Full article
Open AccessArticle
Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management
Pharmacy 2017, 5(1), 9; https://doi.org/10.3390/pharmacy5010009 - 21 Feb 2017
Cited by 2 | Viewed by 2051
Abstract
Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing [...] Read more.
Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs) knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorts achieved similar knowledge scores, less than half (n = 38, 47%) were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32%) were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3). Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as a major by nursing students. Future integration of interprofessional educational (IPE) activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessArticle
A Comparison of Competences for Healthcare Professions in Europe
Pharmacy 2017, 5(1), 8; https://doi.org/10.3390/pharmacy5010008 - 21 Feb 2017
Cited by 3 | Viewed by 1904
Abstract
In Europe and elsewhere, there is increasing interest in competence-based education (CBE) and training for professional practice in healthcare. This review presents competences for pharmacy practice in Europe and compares them with those for medicine and dentistry. Comparisons amongst competence frameworks were made [...] Read more.
In Europe and elsewhere, there is increasing interest in competence-based education (CBE) and training for professional practice in healthcare. This review presents competences for pharmacy practice in Europe and compares them with those for medicine and dentistry. Comparisons amongst competence frameworks were made by matching the European Directive for Professional Qualifications in sectoral professions such as healthcare (EU directive) with the frameworks of competences elaborated by European consortia in pharmacy (PHAR-QA), medicine (MEDINE), and dentistry (ADEE). The results show that the recommendations of the EU directive for all three professions are similar. There is also widespread similarity in the formulation of competences for all healthcare professions. Furthermore, for medicine and pharmacy, the rankings by practitioners of the vast majority of competences are similar. These results lay the foundations for the design of more interdisciplinary educational programs for healthcare professionals, and for the development of team-based care. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessReview
Implementation of Competency-Based Pharmacy Education (CBPE)
Pharmacy 2017, 5(1), 10; https://doi.org/10.3390/pharmacy5010010 - 21 Feb 2017
Cited by 26 | Viewed by 3795
Abstract
Implementation of competency-based pharmacy education (CBPE) is a time-consuming, complicated process, which requires agreement on the tasks of a pharmacist, commitment, institutional stability, and a goal-directed developmental perspective of all stakeholders involved. In this article the main steps in the development of a [...] Read more.
Implementation of competency-based pharmacy education (CBPE) is a time-consuming, complicated process, which requires agreement on the tasks of a pharmacist, commitment, institutional stability, and a goal-directed developmental perspective of all stakeholders involved. In this article the main steps in the development of a fully-developed competency-based pharmacy curriculum (bachelor, master) are described and tips are given for a successful implementation. After the choice for entering into CBPE is made and a competency framework is adopted (step 1), intended learning outcomes are defined (step 2), followed by analyzing the required developmental trajectory (step 3) and the selection of appropriate assessment methods (step 4). Designing the teaching-learning environment involves the selection of learning activities, student experiences, and instructional methods (step 5). Finally, an iterative process of evaluation and adjustment of individual courses, and the curriculum as a whole, is entered (step 6). Successful implementation of CBPE requires a system of effective quality management and continuous professional development as a teacher. In this article suggestions for the organization of CBPE and references to more detailed literature are given, hoping to facilitate the implementation of CBPE. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessArticle
A Curriculum Challenge—The Need for Outcome (Competence) Descriptors
Pharmacy 2017, 5(1), 7; https://doi.org/10.3390/pharmacy5010007 - 17 Feb 2017
Viewed by 1755
Abstract
Some outcomes around, for example, communication have been extensively theorised; others such as accountability have been relatively neglected in the teaching and learning literature. The question therefore is: if we do not have a clear understanding of the outcome, can we systematically apply [...] Read more.
Some outcomes around, for example, communication have been extensively theorised; others such as accountability have been relatively neglected in the teaching and learning literature. The question therefore is: if we do not have a clear understanding of the outcome, can we systematically apply good practice principles in course design such that students are able to achieve the outcomes the community and the profession expect? This paper compares and contrasts the literature around competency outcomes regarding students’ communication skills and the development of accountability and proposes a model to guide the selection of teaching and assessment approaches for accountability, based on the students’ sphere of influence. Full article
(This article belongs to the Special Issue Competence Training for Pharmacy)
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Open AccessArticle
Developing a Model for Pharmaceutical Palliative Care in Rural Areas—Experience from Scotland
Pharmacy 2017, 5(1), 6; https://doi.org/10.3390/pharmacy5010006 - 16 Feb 2017
Cited by 4 | Viewed by 3822
Abstract
Palliative care is increasingly delivered in the community but access to medicines, particularly ‘out of hours’ remains problematic. This paper describes the experience of developing a model to deliver pharmaceutical palliative care in rural Scotland via the MacMillan Rural Palliative Care Pharmacist Practitioner [...] Read more.
Palliative care is increasingly delivered in the community but access to medicines, particularly ‘out of hours’ remains problematic. This paper describes the experience of developing a model to deliver pharmaceutical palliative care in rural Scotland via the MacMillan Rural Palliative Care Pharmacist Practitioner (MRPP) project. The focus of the service was better integration of the MRPP into different care settings and professional teams, and to develop educational resources for the wider MDT including Care Home and Social Care staff on medicine related issues in palliative care. A variety of integration activities are reported in the paper with advice on how to achieve this. Similarly, many resources were developed, including bespoke training on pharmaceutical matters for Care Home staff. The experience allowed for a three step service and sustainability model for community pharmacy palliative care services to be developed. Moving through the steps, the key roles and responsibilities of the MRPP gradually shift towards the local Community Pharmacist(s), with the MRPP starting from a locality-based hands-on role to a wider supportive facilitating role for local champions. It is acknowledged that successful delivery of the model is dependent on alignment of resources, infrastructure and local community support. Full article
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Open AccessArticle
Pharmacy Students’ Attitudes and Perceptions of “Virtual Worlds” as an Instructional Tool for Clinical Pharmacy Teaching
Pharmacy 2017, 5(1), 5; https://doi.org/10.3390/pharmacy5010005 - 05 Feb 2017
Cited by 5 | Viewed by 1888
Abstract
The objectives of this study were to explore pharmacy students’ perceptions and experiences of three-dimensional virtual worlds (3DVWs) as an instructional tool for clinical pharmacy teaching. Semi-structured interviews were carried out with Master of Science in Pharmacy students who had participated in communicative [...] Read more.
The objectives of this study were to explore pharmacy students’ perceptions and experiences of three-dimensional virtual worlds (3DVWs) as an instructional tool for clinical pharmacy teaching. Semi-structured interviews were carried out with Master of Science in Pharmacy students who had participated in communicative exercises in a 3DVW. Interviews were digitally recorded, transcribed and analyzed using thematic analysis. More than half of the students were positive to using 3DVWs for educational purposes and see the advantages of having a setting where communication can be practiced in an authentic but ‘safe’ environment available online. However, many students also reported technical difficulties in using the 3DVW which impacted negatively on the learning experience. Perceived ease of use and usefulness of 3DVWs appears to play an important role for students. The students’ level of engagement relates to not only their computer skills, but also to the value they place on 3DVWs as an instructional tool. Full article
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Open AccessReview
Soothing Properties of Glycerol in Cough Syrups for Acute Cough Due to Common Cold
Pharmacy 2017, 5(1), 4; https://doi.org/10.3390/pharmacy5010004 - 20 Jan 2017
Cited by 8 | Viewed by 4492
Abstract
The treatment and management of acute cough due to common cold costs billions of dollars of healthcare expenditure and there is a growing opinion that a simple linctus containing glycerol with flavourings such as honey and lemon is a safe and effective treatment [...] Read more.
The treatment and management of acute cough due to common cold costs billions of dollars of healthcare expenditure and there is a growing opinion that a simple linctus containing glycerol with flavourings such as honey and lemon is a safe and effective treatment for acute cough in children and adults. Glycerol is a component of most cough syrups, and although it is often thought of only as a solvent or thickening agent in cough syrups, it may be a major component for the efficacy of cough syrups due to its special properties of lubrication, demulcency, sweetness, and acting as a humectant. The major benefit of cough syrups in soothing cough is likely due to the properties of the syrup rather than the active ingredients and this review discusses the special properties of glycerol in relation to the treatment of acute cough. Full article
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Open AccessArticle
From Learning to Decision-Making: A Cross-Sectional Survey of a Clinical Pharmacist-Steered Journal Club
Pharmacy 2017, 5(1), 3; https://doi.org/10.3390/pharmacy5010003 - 12 Jan 2017
Cited by 1 | Viewed by 1981
Abstract
Journal clubs have been traditionally incorporated into academic training programs to enhance competency in the interpretation of literature. We designed a structured journal club (JC) to improve skills in the interpretation of literature; however, we were not aware of how learners (interns, residents, [...] Read more.
Journal clubs have been traditionally incorporated into academic training programs to enhance competency in the interpretation of literature. We designed a structured journal club (JC) to improve skills in the interpretation of literature; however, we were not aware of how learners (interns, residents, clinical pharmacists, etc.) would perceive it. We aimed to assess the perception of learners at different levels of pharmacy training. A cross-sectional design was used. A self-administered online survey was emailed to JC attendees from 2010–2014 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. The survey questions included: introduction sessions, topic selection, JC layout, interaction with the moderator, and decision-making skills by clinical pharmacists. The response rate was 58/89 (65%); 52/54 (96%) respondents believed that JC adds to their knowledge in interpreting literature. Topic selection met the core curriculum requirements for credentials exams for 16/36 (44.4%), while 16/22 (73%) presenters had good to excellent interaction with the moderator. JC facilitated decision-making for 10/12 (83%) of clinical pharmacists. The results suggest that clinical pharmacist-steered JC may serve as an effective tool to empower learners at different levels of pharmacy practice, with evidence-based principles for interpretation of literature and guide informed decision-making. Full article
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Open AccessEditorial
Acknowledgement to Reviewers of Pharmacy in 2016
Pharmacy 2017, 5(1), 2; https://doi.org/10.3390/pharmacy5010002 - 10 Jan 2017
Viewed by 1150
Abstract
The editors of pharmacy would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2016.[...] Full article
Open AccessCase Report
Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review
Pharmacy 2017, 5(1), 1; https://doi.org/10.3390/pharmacy5010001 - 22 Dec 2016
Cited by 2 | Viewed by 1491
Abstract
The purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. [...] Read more.
The purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. A 63-year-old Caucasian female with a previous medical history of HIT thromboprophylaxed with warfarin for a pulmonary embolism presented to an anticoagulation clinic with a subtherapeutic international normalized ratio (INR) after missed warfarin doses. The patient was instructed to increase her warfarin dose and was prescribed fondaparinux daily injections until her INR was in range. The patient tolerated the fondaparinux therapy without thromboembolic, thrombocytopenia or bleeding occurrence. Fondaparinux therapy for HIT is controversial and differs between established guidelines. Currently, there is no studied use of fondaparinux for thromboprophylaxis in warfarin therapy outpatients with a HIT history who need thromboprophylaxis while undergoing therapy for a procedure, or those who have a subtherapeutic INR. Further study of the outpatient use of fondaparinux for this patient subset is needed to explore the potential benefit of an outpatient, less invasive, less expensive and potentially better tolerated option. Full article
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