Student pharmacists' perceptions of testing and study strategies

Objectives

To solicit student pharmacists'' perceptions of testing, study strategies, and recall ability, and use of retrieval practices in metacognitive learning strategies.

Methods

A 42-item survey instrument was constructed that covered the following areas of interest: perceptions of the purpose of testing, perceptions of study strategies, perceptions of recall ability, use of retrieval practice, and demographic characteristics. The survey instrument was administered to first-, second-, and third-year doctor of pharmacy (PharmD) students (N = 425) at Purdue University.

Results

Students perceived the primary purpose of tests to be to assess the amount of material they had learned. Massed practice was a technique that they frequently used in studying for course examinations. Students did not express confidence in their ability to recall learned information once they became pharmacists. The use of retrieval practice in learning was not used by most student pharmacists, nor did students perceive retrieval practice to increase retention or learning.

Conclusion

Perceptions of testing and the manner in which student pharmacists engage in learning activities may not be optimal for the development of lifelong learners.     

PPIs: community pharmacists' perceptions

In order to measure pharmacists' perceptions about the PPis for estrogen and oral contraceptives, questionnaires were distributed to a random sample of 105 community pharmacists in a large midwestern city. Seventy completed questionnaires were returned, producing a response rate of 67 percent. A slight majority of the responding pharmacists indicated that pharmacists should be responsible for distribution of these PPIs but that physicians should be responsible for determining whether a patient should receive a PPI. The pharmacists indicated that patient information should be verbally communicated and accompanied by a written summary sheet and that patients neither read nor understand these PPIs. Although limited in size and geographic area, this study suggests that retail pharmacists have doubts about the current PPI program mandated by the Food and Drug administration.     

临床药师参与急诊药房审方药师在岗规范化培训工作模式的建立与实践

目的建立由临床药师参与的急诊药房审方药师在岗规范化培训工作模式,以促进审方药师与临床药师共同发展。方法通过临床药师在相关制度及法规、岗位职责和药品调剂SOP流程、常见中毒解救药物了解、处方点评及处方审核技巧、特殊药品用药交待、不同类型患者沟通技巧等6个方面向审方药师开展药学知识专项培训。结果在该规范化培训工作模式下,急诊药房审方药师的药学专业知识水平不断提高,药学服务工作质量不断提升。结论建立由临床药师参与的审方药师在岗规范化培训工作模式可以促进审方药师与临床药师共同发展,实现药学学科的可持续发展。     

Nutritional support: pharmacists' influence on the prescribing process

A commitment was made at a 1,025-bed county teaching facility to increase staff pharmacists' involvement in nutritional support and physician prescribing. The plan was to utilize the Nutritional Support Clinical Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient care for patients receiving parenteral nutrition. The implementation included specialized training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition patients, pharmacists' attendance at nutritional support rounds, documentation of all pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation (DUE) process. The results of the increased influence of pharmacists on the prescribing process included more appropriate parenteral nutrition therapy, earlier transitioning from parenteral to enteral nutrition, recognition of staff pharmacists as resources by the physicians, and increased job satisfaction for pharmacists.     

Exploring pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland

Objectives The introduction of non‐medical prescribing in the UK has provided opportunities and challenges for pharmacists to help ensure prudent use of antimicrobials. The objective of this research was to explore pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland. Methods Pharmacists' perceptions were explored using focus groups in five Scottish regions representing (a) urban and rural areas and (b) district general hospitals and large teaching centres. Senior hospital pharmacists, both prescribers and non‐prescribers, working in specialities where antimicrobials are crucial to patient management, were invited to participate. A topic guide was developed to lead the discussions, which were audio‐recorded and transcribed. The framework approach to data analysis was used. Key findings Six focus groups took place and some emerging themes and issues are presented. Pharmacists believed that the feasibility of antimicrobial prescribing is dependent upon the patient's clinical condition and the area of clinical care. They identified potential roles and opportunities for pharmacist prescribing of antimicrobials. Perceived benefits included giving patients quicker access to medicines, reducing risk of resistance and better application of evidence‐based medicine. Conclusions Pharmacists feel they have a good knowledge base to prescribe and manage antimicrobial treatment, identifying possible opportunities for intervention. Roles within a multidisciplinary antimicrobial team need to be clearly defined.     

‘It's showed me the skills that he has’: pharmacists' and mentors' views on pharmacist supplementary prescribing

Objectives Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary prescribers. Methods The setting was primary and secondary healthcare sectors in Northern Ireland. Pharmacists and mentors who had participated in a pre‐training study were invited to take part. All pharmacists (n= 47) were invited to participate in focus groups, while mentors (n= 35) were asked to participate in face‐to‐face semi‐structured interviews. The research took place between May 2005 and September 2007. All discussions and interviews were audiotaped, transcribed and analysed using constant comparison. Key findings Nine pharmacist focus groups were convened (number per group ranging from three to six; total n= 40) and 31 semi‐structured interviews with mentors were conducted. The six main themes that emerged were optimal practice setting, professional progression for prescribing pharmacists, outcomes for prescribing pharmacists, mentors and patients, relationships, barriers to implementation and the future of pharmacist prescribing. Where practised, pharmacist prescribing had been accepted, worked best for chronic disease management, was perceived to have reduced doctors' workload and improved continuity of care for patients. However, three‐quarters of pharmacists qualified to practise as supplementary prescribers were not actively prescribing, largely due to logistical and organisational barriers rather than inter‐professional tensions. Independent prescribing was seen as contentious by mentors, particularly because of the diagnostic element. Conclusions Supplementary prescribing has been successful where it has been implemented but a number of barriers remain which are preventing the wider acceptance of this practice innovation.     

Pharmacist independent prescribing in secondary care: opportunities and challenges

In recent years a number of countries have extended prescribing rights to pharmacists in a variety of formats. The latter includes independent prescribing, which is a developing area of practice for pharmacists in secondary care. Potential opportunities presented by wide scale implementation of pharmacist prescribing in secondary care include improved prescribing safety, more efficient pharmacist medication reviews, increased scope of practice with greater pharmacist integration into acute patient care pathways and enhanced professional or job satisfaction. However, notable challenges remain and these need to be acknowledged and addressed if a pharmacist prescribing is to develop sufficiently within developing healthcare systems. These barriers can be broadly categorised as lack of support (financial and time resources), medical staff acceptance and the pharmacy profession itself (adoption, implementation strategy, research resources, second pharmacist clinical check). Larger multicentre studies that investigate the contribution of hospital-based pharmacist prescribers to medicines optimisation and patient-related outcomes are still needed. Furthermore, a strategic approach from the pharmacy profession and leadership is required to ensure that pharmacist prescribers are fully integrated into future healthcare service and workforce strategies.     

Pharmacist interventions to improve prescribing of vancomycin and tobramycin

The effect of clinical pharmacist interventions that promoted the use of nafcillin rather than vancomycin and of gentamicin rather than tobramycin, when appropriate, was evaluated. Physician information sheets and criteria describing appropriate use of the target drugs vancomycin and tobramycin were developed by a clinical pharmacist and infectious disease physicians. When drugs were prescribed for indications that did not meet the established criteria, the clinical pharmacist either contacted the prescribing physician or left the sheet in the patient's chart if the physician was not available. The average use of the target drugs and their alternatives was evaluated monthly during two six-month study periods and compared with the average use of these drugs during a three-month period before the target-drug programs were initiated. Throughout the 12-month study, on a per-patient basis, nafcillin use increased 31% while vancomycin use decreased 27% compared with the reference period; gentamicin use increased 21% while tobramycin use decreased 12% during the same period. These changes in use resulted in a net decrease in drug expenditures of $161,396. Approximately 0.5 full-time equivalent was spent on the program, and the return on investment for the service was greater than 10 to 1. Clinical pharmacist interventions through target-drug programs were effective in improving the appropriateness of vancomycin and tobramycin prescribing based on literature-derived criteria. The effects achieved by these interventions may decrease with time, and ongoing drug-use monitoring and physician education are necessary.     

Investigation of community pharmacists' participation in a local medicines management project

□ In practice, some community pharmacists found obstacles to making domiciliary visits □ In this study number and costs of medications were not lowered by pharmacist visits     

Student pharmacists' perceptions of community pharmacy residency programs

ObjectivesTo compare penultimate-year (next-to-last) and final-year student pharmacists' perceptions of the educational value of community pharmacy residency programs (CPRPs) and to compare student pharmacists' perceptions of the educational value of CPRPs and health-system residency programs (HSRPs).MethodsA self-administered online survey was sent to administrators at 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy for ultimate distribution to penultimate- and final-year student pharmacists. The survey included demographic measures and a 20-item residency program “perceived value of skill development” scale developed for this study.Results1,722 completed surveys were received and analyzed. Penultimate-year students attributed greater value to CPRPs more frequently than final-year students. Students more often attributed higher value to CPRPs for skills related to business management, practice management, and medication therapy management, while they attributed higher value to HSRPs for skills related to teaching, research, and clinical knowledge.ConclusionThe results of this study suggest students' perceived value of CPRPs may be related to their year of pharmacy school and the pharmacy practice skill in question.