Pharmacists' desired and actual times in work activities: evidence of gaps from the 2004 National Pharmacist Workforce Study.

OBJECTIVES: To describe pharmacists' work activities in the United States during 2004 in terms of (1) the desired amount of time they would like to spend in each of four work activities (medication dispensing, consultation, business management, drug use management), (2) the amount of time they actually spend in each activity, and (3) the gaps between desired and actual time reported in each activity. DESIGN: Cross-sectional study. SETTING: Pharmacies (community chain, community independent, hospital, and other) in the United States. PARTICIPANTS: 1,564 actively practicing pharmacists. INTERVENTION: Mailed survey from portions of the 2004 National Pharmacist Workforce Survey. MAIN OUTCOME MEASURES: Differences between desired and actual time spent in work activities in medication dispensing, consultation, business management, and drug use management and the associations between practice setting characteristics and demographic variables were explored using linear and logistic regression analyses. Practice variables included position, years in current position, working part time, work with other pharmacists, work with technicians, proportion of staff who are pharmacists, staff size, dispensing level. Demographic variables included age, gender, race, marital status, and year of licensure with respondents' reported work activity amounts and gaps. Linear regression results were interpreted based on standardized beta coefficients and corresponding P values. Logistic regression results were interpreted based on 95% confidence intervals for odds ratios. RESULTS: The proportion of time pharmacists devoted to medication dispensing, consultation, business management, and drug use management did not change between 2000 and 2004. Practice setting was the most consistently influential variable on pharmacists' work activities when controlling for other variables. Pharmacists in all practice settings would like to spend more time in consultation and drug use management and less time in medication dispensing, but compared with community pharmacists, hospital and other patient care pharmacists were less likely to report a gap between desired and actual time spent in dispensing activities. Age was a significant predictor of gaps between desired and actual time spent in various activities, but only the oldest age groups (ages of 60 or 70 years and older) were significantly different from the reference group of pharmacists aged 23 to 30 years. CONCLUSION: Pharmacists would like to devote more of their time to consultation and drug use management activities in community pharmacy settings but have not yet been afforded a full opportunity to engage in these activities to the extent that they desire.     

Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

OBJECTIVES: To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. DESIGN: Cross-sectional study. SETTING: Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). PARTICIPANTS: Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. MAIN OUTCOME MEASURES: Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). RESULTS: Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. CONCLUSION: Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.     

An intersectional review of discrimination and harassment experiences in pharmacy: Findings from the 2019 National Pharmacist Workforce Survey

BackgroundMost pharmacists in the United States are women, and the profession is becoming more racially diverse. The recent increase in political and social movements in the United States has heightened our awareness of the importance of better understanding the experiences of underrepresented individuals and groups. Little is known about discrimination and harassment in the profession of pharmacy in the United States.ObjectivesThe purpose of this study was to provide evidence that discrimination and harassment exist in the pharmacy profession and explore differences in discrimination and harassment using the intersectionality of race and sex.MethodsThe 2019 National Pharmacist Workforce Survey (NPWS) utilized an electronic survey that was distributed using a 3-contact Dillman approach by email to a randomized sample of 96,110 licensed pharmacists from all 50 U.S. states using the National Association of Boards of Pharmacy Foundation e-profile system. The 2019 NPWS included a new battery of questions to assess the prevalence of discrimination and harassment in pharmacy.ResultsThe most common bases of discrimination experienced were based on age (31.2%), sex (29%), and race or ethnicity (16.6%). The most common type of harassment experienced was “hearing demeaning comments related to race or ethnicity” at 15.6%. The intersectionality analysis revealed different experiences among sex or race combinations. Black and Asian male pharmacists had the highest rate of “hearing demeaning comments about race or ethnicity.” Nonwhite pharmacists were more likely to experience harassment from customers or patients compared with their white colleagues. Black female pharmacists had the highest rate of being “very unsatisfied” with the results of reporting discrimination and harassment to their employer.ConclusionDiscrimination, including harassment and sexual harassment, is illegal, immoral, and unjust. As the profession of pharmacy continues to become more diverse, there must be a conscious, systemic, and sustained effort to create and maintain workplaces that are safe, equitable, and free of discrimination.     

Snapshot of unemployed pharmacists from the 2019 National Pharmacy Workforce Survey

BackgroundPrior national surveys have quantified unemployment in the pharmacy workforce, and recent surveys have occurred in a changing environment, with increased numbers of pharmacists in the labor market.ObjectivesWe sought to investigate the rate of unemployment and situations of unemployed pharmacists.MethodsData from the 2019 National Pharmacist Workforce Survey were analyzed, focusing on an initial question about employment status and follow-up questions for unemployed respondents about whether they were seeking a job, the reason they were unemployed, and how long they had been unemployed.ResultsOverall, 4.4% of the respondents were unemployed, with higher rates occurring for female pharmacists, older pharmacist cohorts, and respondents of color, with the highest rate occurring (9.3%) for Black pharmacists. Most (74.4%) of the unemployed pharmacists were seeking a job in pharmacy, but 16.6% were not seeking any job. Nearly two-thirds of the unemployed pharmacist respondents had left the workforce involuntarily, with men at higher rates than women. The youngest cohort of unemployed pharmacists was the least likely to be forced to leave and more likely to leave for workplace-related or personal reasons. Black pharmacists had the overall highest rate of leaving the workforce involuntarily. On average, the unemployed pharmacists had been out of work nearly 2 years (19.2 months), and the periods out of work ranged widely. Those seeking a job in pharmacy predominantly (75.7%) had been unemployed for 1 year or less. More than half of the pharmacists involuntarily unemployed had been unemployed for 6 months or less.ConclusionAn increased rate of unemployment and a higher proportion of those unemployed seeking work occurred in this most recent national survey of the pharmacist workforce. Differences in the extent of unemployment and whether leaving the workforce was voluntary or involuntary occurred in pharmacists of color and in some age cohorts.     

Pricing and Reimbursement of Pharmaceuticals. A New Culture for the Community Pharmacist.

Pricing and reimbursement of pharmaceuticals are of concern for pharmacists. Different countries have different ways of organising their health care systems. The place for pharmaceuticals within these systems also differ. This article looks into the price and reimbursement systems for medicinal products in Germany, Sweden, the UK and Norway. Various ways of organising the pharmaceutical market emerge. Some existing measures have been in place for a long time while others have been introduced more recently. A common goal for the four countries seems to be the drive to cut costs, and attempts to do this can be directed through various reimbursement systems, by focusing on prices or by influencing the physicians' prescribing behaviour, either through the use of advice or through the use of budgets. It is important for the pharmacists to have indepth knowledge of the price and reimbursement system they have to work within in order to be of full service to their customers.     

Prospective predictors of premature death: evidence from the National Longitudinal Study of Adolescent Health

This study was based on data from the National Longitudinal Study of Adolescent Health (Add Health), which revealed that 96 of its original Wave I respondents died prior to the collection of the Wave III survey. We compared psychosocial and behavioral characteristics reported at Wave I among those who died and those who lived (n = 16,719) using chi-square tests, t-tests, and logistic regression analyses to determine the most important risk factors for premature death among adolescents and young adults. Results suggested that driving while drunk was the most important risk factor for premature death (adjusted odds ratio = 2.48; 95% confidence interval: 1.12-5.50). The prevalence of driving while drunk was 17.7% among decedents compared with 6.4% among the survivors. Decedents were also significantly more likely to report multiple risk behaviors than survivors. As the current study demonstrates the importance of alcohol use as a contributing factor to the three leading causes of youth deaths, renewed efforts are needed to prevent and reduce alcohol consumption and abuse among this vulnerable population.     

Migration and substance use: evidence from the U.S. National Health Interview Survey

Representative data from the U.S. National Health Interview Survey are used to investigate the substance use patterns of immigrants and compare them to those of the native born populations. The information examined is from the 1991 supplementary Drug and Alcohol Use Data File, which examined the self-reported substance use behaviors of approximately 21,000 adults aged 18-44. Findings indicate that immigrants to the U.S. in the late twentieth century are less likely to use alcohol and other drugs than are native born citizens. Additional findings suggest assimilation processes by which exposure to mainstream American society leads to patterns of alcohol and illicit drug use among long term immigrants that approximates that of the native born population. The patterns of substance use observed among immigrants, however, are not consistent with acculturative stress mechanisms. These findings provide an important and representative profile of the substance use patterns of one of the largest international migration streams of the past one hundred years.     

Taking the lead: Community pharmacists' perception of their role potential within the primary care team

BackgroundPatient-focused care provided by an interprofessional team has long been presented as the preferred method of primary care delivery. Community pharmacists should and can provide leadership for many clinical and managerial activities within the primary care team.ObjectiveTo determine the extent to which community pharmacists are prepared to be members of the health care team, and to assess their support for general expansion of clinical responsibilities.MethodsA mail questionnaire (in either English or French) was sent to 1500 community pharmacists between February and April 2004. Respondents were asked to indicate the necessity of pharmacy leadership for a range of clinical and managerial services associated with a primary care team. Respondents were also asked to indicate the extent to which they should be more involved in drug therapy selection and monitoring, as well as assuming greater responsibility for treating both minor and chronic illnesses.ResultsThe response rate was 35.2% (470/1337) with the highest response rate in the Prairie provinces (40.6%) and the lowest in Quebec (24.4%). Most pharmacists in the study did not advocate a strong leadership role for non-discipline-specific clinical and managerial activities. Most of them indicated that community pharmacists should be more involved in selecting (69.9%) and monitoring (81.0%) drug therapy, and be more responsible for treating minor illnesses (72.0%). Support for more responsibility declined to 50% for chronic illnesses.ConclusionsThe findings of the study suggest substantial variability among pharmacists in their perception of the need for pharmacy leadership across 16 clinical and managerial activities.     

A Novel CBT Web Course for the Substance Abuse Workforce: Community Counselors' Perceptions

ABSTRACT

This article describes (a) a Web-based course for substance abuse counselors on cognitive behavioral therapy (CBT), and (b) the evaluation of a prototype module from the Web-based course to determine the feasibility of the e-learning program for a community-based counselor audience. The course is part of a unique study that trains counselor-supervisor teams to increase the transfer of learned skills to the agency. Following curriculum design, the authors sought counselor reactions to the prototype module on strengths/limitations of the design, functionality, and effectiveness. Results showed that counselors learned new information, found this format effective compared to other training, and wanted to complete a full CBT Web course. Counselors' evaluation led to content and technology changes: the authors added and segmented material aimed at the advanced, more theoretically oriented counselor, and housed these topics behind an “advanced concept” graphics button; added seven screens to accommodate text broken into smaller units; and increased the difficulty of the end-of-module quiz.     

Monitoring ecstasy content in France: results from the National Surveillance System 1999-2004

The French National Identification System for Drugs and Other Substances (SINTES) is an original scheme gathering analytical information for synthetic drugs, both through police and customs' seizures in the entire country and collection of samples and questionnaires directly from the users by social field workers. Between July 1999 and June 2004, 9543 samples were included. Tablets (7004) were mainly containing MDMA (82%) and caffeine was the most frequent blended psychoactive substance. Mean MDMA dosage of tablets decreased from 1999 to 2003 and dosage for tablets bearing the same logo appeared to be highly variable. Notwithstanding the difficulties for data collection due to the illicit nature of these drugs, this surveillance and early warning system, which combines the cooperative efforts of law enforcement laboratories and social workers, provided relevant and timely information. It is accurate regarding the follow-up of trends in drugs' composition, and the identification of new or potentially dangerous substances, to the professionals, the public, and the European partners.