Medicine and Health Sciences Commons^™

Primary Healthcare Policy And Vision For Community Pharmacy And Pharmacists In The United States, Teresa M. Salgado, Meagen M. Rosenthal, Antoinette B. Coe, Tana N. Kaefer, Dave L. Dixon, Karen B. Farris

Faculty and Student Publications

© 2020, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved. The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians …

Memantine: Can It Be Used To Treat Children With Autism Spectrum Disorder?, Austin Brown, Katherine Liu, Pul Lee, Rachel Muhlenkamp, Manoranjan D'Souza

Pharmacy and Wellness Review

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social, behavior and communicative skills. The current therapy for ASD only targets the associated symptoms such as aggression, self-harming acts or temper tantrums but not the core symptoms of social dysfunction. The pathology of ASD is not fully understood. Interestingly, imaging studies in ASD patients have reported abnormal high levels of glutamate in certain brain regions that play an important role in social interaction and communication. Thus, it has been hypothesized that medications attenuating glutamate transmission may be used as treatment for some of the core symptoms of …

Cannabinoids For The Treatment Of Chronic Headaches, Kevin Krivanek, Lucy K. Wagala, Brian Heilbronner, Kimberly Loughlin, David Kinder

Pharmacy and Wellness Review

Species of the Cannabis plant genus were among the earliest medicinal plants cultivated by man, with historical accounts of their medicinal uses dating back before the Common Era. Despite its current legal status, Cannabis has garnered nationwide attention as a therapeutic agent for various disease states, including chronic headaches, due to its medical indications as an antispastic, analgesic, antiemetic, neuroprotective and anti-inflammatory agent. Since headaches have a high prevalence in the American population and greatly impair simple daily aspects of living, chronic headaches have become a particular point of interest in regard to the therapeutic potential of Cannabis. Clinical trials …

Marijuana And Its Cardiovascular Implications, Albert Bui, Daniel Powell, Victoria Cho, Kelsey Lindsley, Lindsey Peters

Pharmacy and Wellness Review

As marijuana becomes legalized for medical use, it is important for prescribers and pharmacists to be knowledgeable about the important aspects of marijuana such as mechanism of action, indications and abuse potential. Although marijuana's medicinal benefits are frequently reported, the risks, namely cardiovascular risks, associated with its utilization are often overlooked. Use of marijuana has been reported to increase the risk of myocardial infarction, tachycardia and hypotension, among others. Health care providers must determine if marijuana's benefits outweigh such risks when marijuana therapy is an option. It is also important for pharmacists to understand how to successfully counsel patients using …

Hormonal Therapy And Preventive Care Of Transgender Patients, Angela Chu, Jana Randolph, Austin Hopkins, Victoria Cho, Sophocles Chrissobolis

Pharmacy and Wellness Review

Transgenderism occurs when an individual's gender identity conflicts with the individual's biological sex. A variety of methods may be used in order to reconcile this disparity in transgender individuals including psychological counseling, cross-sex hormone therapy and sex reassignment surgery. The most important role for pharmacists in the treatment of transgender patients is in dispensing hormonal medications for cross-sex treatment. Hormone therapy may be used to suppress characteristics of the patient's biological sex as well as to induce development of characteristics that correlate with the patient's gender identity. In male-to-female (MtF) transgender patients, the most commonly used medications include agents which …

Pharmacologic And Nonpharmacologic Approaches To Palliative Care In Oncology, Daniel Powell, Sunitha Johns, Samia Alam, Isabel E. Cwikla, Brendan Rasor, David W. Koh

Pharmacy and Wellness Review

In recent decades, few fields have changed as drastically as oncology. A wide variety of approaches must be taken in order to best care for cancer patients. With the globalization of health care and modern society, nontraditional management of cancer symptoms is once again increasing in popularity. The National Comprehensive Cancer Network (NCCN) has also recently updated their palliative care guidelines. These guidelines provide a detailed approach for the care of a wide range of cancer patients but largely focus on traditional pharmacotherapy. An increasing number of studies are being conducted on nonpharmacologic approaches to care for patients with cancer. …

Antibiotic Stewardship And Overcoming Antibiotic Resistance In Upper Respiratory Tract Infections, Katherine Elsass, Austin Hilverding, Steve Blake, Brendan Rasor, Steven N. Leonard

Pharmacy and Wellness Review

Antibiotic resistance has rapidly become one of the most significant challenges facing modern health care. Despite widespread public education efforts by the national government and health organizations worldwide, there remains a significant lack of public understanding of antibiotic resistance, how to prevent it and the implications if the science and health care communities fail to find a solution. The Centers for Disease Control and Prevention (CDC) and the American College of Physicians (ACP) recently published updated guidelines for appropriate antibiotic use in upper respiratory tract infections. These guidelines include several key recommendations for acute bronchitis, pharyngitis and acute rhinosinusitis (including …

A Pharmacist's Role In Educating On The Health Risks Of Smoking During Pregnancy And Helping Patients With Smoking Cessation, Alexandra Herman, Cassandra Hacker, Emily Wells, Brian Heilbronner, Brittany L. Long

Pharmacy and Wellness Review

While many people know smoking causes cancer, heart disease and other major health problems, smoking during pregnancy causes additional fetal health complications including birth defects, premature birth and infant death. Cigarettes contain carbon monoxide and nicotine, both of which can cause a decrease in oxygen delivery to the fetus' developing tissues causing organs like the brain, lungs, kidneys and ears not to develop properly. If children are exposed to these toxins through secondhand smoke after birth, they are more likely to experience severe health problems such as ear infections, cataracts, lung cancer and heart disease. It is also known that …

Legislation Across The Nation And The Impact On Pharmacy Practice, Sabrina Hamman, Hannah Lamb, Jennifer Harklerode, Elizabeth Kramer, Steven Martin

Pharmacy and Wellness Review

Pharmacy legislation is constantly being updated, giving pharmacists a larger role in the health care field. In the past 20 years, pharmacists have seen expansions to legislation involving contraceptive authority, medical marijuana, vaccines and provider status. There is a greater pharmacist impact from legislation passed on the state level in comparison to the national level. As a result, pharmacists have different opportunities to provide new and advanced services to patients based on the state in which they are practicing. Comparing these various laws across the nation allows the profession to determine which sections of the law are problematic and which …

Latest Trends In The Heroin Epidemic And The Responsibility Of The Pharmacist In Controlling Heroin Abuse, Alexandra Herman, Cassandra Hacker, Emily Wells, Sabrina Hamman, Manoranjan D'Souza

Pharmacy and Wellness Review

Over the last few years, there has been an exponential increase in morbidity and mortality associated with heroin abuse. The current rise in heroin abuse and overdose is attributed to widespread use and abuse of prescription opioids, which can produce significant euphoric effects in humans. In fact, reports suggest that heroin abusers initially become addicted to prescription opioids but subsequently switch to heroin because it is cheaper and more easily available than prescription opioids. Over the years, the purity of heroin available for illicit use has been on the decline. Smugglers and heroin vendors have started mixing heroin with other …

Treatment Of Basal Cell Carcinoma With Vismodegib, Sunitha Johns, Katlyn Brown, Emily Loudermilk, Crystal Zheng, Anh Dao Le, Sophocles Chrissobolis

Pharmacy and Wellness Review

The most prevalent nonmelanoma skin cancers are basal cell carcinoma (BCC) and locally advanced basal cell carcinoma (aBCC). Current, effective first-line treatments for BCC aim to remove and destroy cancerous skin cells through excision surgery, Mohs surgery, radiation therapy and cryotherapy, while treatment of aBCC remains limited. An emerging treatment option for aBCC that promotes tumor size reduction is vismodegib, a pharmaceutical product approved in 2012 by the U.S. Food and Drug Administration (FDA). Vismodegib was approved for the treatment of aBCC, metastasized HCC (mBCC) or recurrent BCC after surgery as well as for use in adults who are not …

The Effects Of Long-Term Benzodiazepine Use And Withdrawal In The Elderly, Lydia Suchecki, Hannah Granger, Jamie Kellner, Mary Ellen Hethcox

Pharmacy and Wellness Review

Benzodiazepines remain a commonly prescribed medication in the United States, and the high usage of this drug class is especially a concern in the elderly population for several reasons. First, elderly patients metabolize drugs differently, leading to varying responses. Age-related changes also have a significant impact on the effects of benzodiazepines. Second, elderly patients are more likely to be taking multiple centrally-acting drugs, which can further exacerbate negative effects. In regard to long-term benzodiazepine use, elderly patients experience an increased risk of cognitive impairment, motor vehicle accidents, decline in physical performance, falls and subsequent fractures, and sleep disturbances. Withdrawal is …

Resident Physicians’ Perceptions Of Ambulatory Care Pharmacy, Ashley Meredith, Darin Ramsey, Andrew Schmelz, Rachel Berglund

Scholarship and Professional Work – COPHS

Background: Physicians' acceptance of clinical pharmacy services is dependent on exposure to those services, with use increasing as resident physicians progress through their training. Resident physicians train within environments that have a multidisciplinary teaching and clinical care approach, working closely with other healthcare professionals. Ambulatory care pharmacists are increasingly working with resident physicians in clinic settings as part of the multidisciplinary team, and identification of resident physicians’ perceptions may influence future collaboration.

Objective: The objective of this research is to evaluate the perception of ambulatory care clinical pharmacy services from the perspective of resident physicians.

Methods: A statewide network of …

Co-Located Retail Clinics And Pharmacies: An Opportunity To Provide More Primary Care., Katherine K. Knapp, Keith Yoshizuka, Debra Sasaki-Hill, Rory Caygill-Walsh

Faculty Publications & Research of the TUC College of Pharmacy

This paper proposes that co-located retail clinics (RCs) and community pharmacies can increase opportunities to provide more accessible, affordable, and patient-friendly primary care services in the United States. RCs are small businesses of about 150-250 square feet with a clientele of about 10-30 patients each day and most frequently staffed by nurse practitioners (NPs). Community pharmacies in the U.S. at ~67,000 far outnumber RCs at ~2800, thereby opening substantial opportunity for growth. Community pharmacies and pharmacists have been working to increase on-site clinical services, but progress has been slowed by the relative isolation from other practitioners. An ideal merged facility …

Assessing The Ability Of Student Pharmacists To Facilitate Human Immunodeficiency Virus Point-Of-Care Testing, Anna M. Staudt, Juanita A. Draime, Nicole K. Stute, Meiling G. Norfolk, Zach Jenkins

Pharmacy Practice Faculty Publications

No abstract provided.

Pharmacist Recommendations For Adolescent Smoking Cessation: Results From A Delphi Study, Jessica L. King, Jamie L. Pomeranz, Mary Ellen Young, Julie W. Merten

Julie Merten

While pharmacological and behavioral treatments exist for smoking cessation, there are currently no best practices for helping adolescents quit smoking. This study aimed to reach consensus regarding pharmacist recommendations for adolescent smoking cessation. Using a three-round Delphi technique, pharmacists across the USA with experience working with adolescent substance use provided quantitative and qualitative feedback on recommendations. Forty pharmacists completed Round 1, 37 completed Rounds 2 and 3. In Round 1, 36 (90%) responses included the nicotine patch, gum, or lozenge. Ten recommendations were identified in Round 1: nicotine patch, nicotine gum, nicotine lozenge, bupropion SR, varenicline, quitline, smoking cessation program, …

The Switch From Patented Medicine To The Generic One: An Option Or A Necessity?, Păduraru Dan Nicolae, Ion Daniel, Nica Adriana Elena, Coman Florentina, Coțofană Marius, Badiu Dumitru Cristinel, Grigorean Valentin Titus, Bolocan Alexandra, Andronic Octavian

Journal of Mind and Medical Sciences

This paper assesses the influence of a number of factors taken into account when a brand name drug is replaced by a generic one. It also evaluates responses of health professionals – physicians and pharmacist—and patients regarding the issue of switching. We compared and contrasted their responses in order to identify new points of cooperation for the intended benefit of the patient. Thus, the sample drew from all three groups, consisting of 50 doctors, 50 pharmacists, and 50 patients. We collected information regarding the age, residence, income level, and education level for the patients, and age and experience for the …

Facilitating The Everyday Steward: Impact Of Mandatory Antimicrobial Indication/Duration And A 48 Hour Time Out, Ann L. Wirtz, Alaina N. Burns, Brian R. Lee, Tammy Frank, Laura Fitzmaurice, Richard Ogden, Brian O'Neal, Jennifer Goldman

Posters

Introduction: Required indication, duration, and a 48-hour antimicrobial timeout are an integral part of antimicrobial stewardship standards; however, limited data are available to demonstrate an effect on antimicrobial utilization and antimicrobial stewardship practice. Therefore, we evaluated the impact of mandatory declared indication/duration along with a pharmacy-driven 48-hour timeout on antimicrobial utilization and antimicrobial stewardship interventions.

Methods: We performed a retrospective evaluation of ASP interventions and antimicrobial use following implementation of mandatory antimicrobial indication/duration at the point of computerized physician order entry (CPOE). A pharmacist-driven 48-hour antimicrobial timeout was introduced on the same date. This study was conducted at Children’s Mercy …

Healthcare Provider Perceptions Of The Role Of Interprofessional Care In Access To And Outcomes Of Primary Care In An Underserved Area, Shaowei Wan, Peter G. Teichman, David Latif, Jennifer Boyd, Rahul Gupta

Clinical and Translational Science Institute

To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers’ beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available …

Etsu Didarp Project 1: Health Care Provider Communication And Prescription Drug Abuse And Misuse, Nicholas E. Hagemeier, Fred Tudiver

Nicholas E. Hagemeier

No abstract provided.

Implications Of Student Debt On Financial Wellness: Can Universities Help?, Anne Leighty

Undergraduate Honors Thesis Collection

Introduction. Exploring whether or not students feel prepared financially for graduation is a useful exercise for universities as the results can provide ways to better support their students as they move into life after graduation. Financial wellness plays a role in a person’s overall wellness and happiness. This could be of particular concern for pharmacy students due to increasing cost of education and typically, a minimum of six years of education is required. If universities implemented better ways to educate their students on student loans and financial well-being, new graduates could have decreased financial anxiety, as well as improved overall …

Ethics: A Problem In Pharmacy?, Keith I. Yoshizuka

Faculty Publications & Research of the TUC College of Pharmacy

Ethics, or the lack or attenuation thereof, is an important issue facing practicing pharmacists today. There are both statutory and regulatory provisions to support the requirement of ongoing education and training in ethics. Evidence of formal disciplinary actions by the California State Board of Pharmacy faced requiring pharmacists to take a formal course in ethics as a condition of retention of licensure is sufficient to demonstrate that pharmacists are deviating from the expectations consistent with ethical behavior. Periodic review of the principles of beneficence, non-malfeasance, autonomy, and justice would benefit pharmacists in practice, as evidence infers that a pharmacist’s moral …

Who Enrols And Graduates From Web-Based Pharmacy Education - Experiences From Northern Sweden, Sofia Mattsson, Maria Gustafsson, Sofia Svahn, Helena Norberg, Gisselle Gallego

Medical Papers and Journal Articles

Introduction: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umeå University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden.

Methods: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university's admissions data) and the alumni cohort …

Pharmacist Recommendations For Adolescent Smoking Cessation: Results From A Delphi Study, Jessica L. King, Jamie L. Pomeranz, Mary Ellen Young, Julie W. Merten

Public Health Faculty Research and Scholarship

While pharmacological and behavioral treatments exist for smoking cessation, there are currently no best practices for helping adolescents quit smoking. This study aimed to reach consensus regarding pharmacist recommendations for adolescent smoking cessation. Using a three-round Delphi technique, pharmacists across the USA with experience working with adolescent substance use provided quantitative and qualitative feedback on recommendations. Forty pharmacists completed Round 1, 37 completed Rounds 2 and 3. In Round 1, 36 (90%) responses included the nicotine patch, gum, or lozenge. Ten recommendations were identified in Round 1: nicotine patch, nicotine gum, nicotine lozenge, bupropion SR, varenicline, quitline, smoking cessation program, …

Implementing Pharmacy-Based Travel Health Services: Insight And Guidance From Frontline Practitioners, Tania Gregorian, Albert Bach, Karl M. Hess, Keri Hurley, Edith Mirzaian, Jeff Goad

Jeff Goad

Moseying Along At The Fda, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

Religion, Jacob Grasser, Meiling G. Norfolk, Ashton Prusia

Introduction to Public Health Posters

Pharmacists should be well-trained and sensitive to patient religious concerns and proactive in their research of any drug ingredients that may conflict with a patient's beliefs. Pharmaceutical manufacturing companies should be comprehensive in their product labeling to accommodate religious sensitivities.

Keeping An Eye On The Fda, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

Biosimilar Naming Conventions: Pharmacist Perceptions And Impact On Confidence In Dispensing Biologics, Daniel M. Tomaszewski

Pharmacy Faculty Articles and Research

BACKGROUND: The approval of the first biosimilar in the United States has placed increased pressure on the FDA to provide guidance on the naming convention that will be assigned to current and future biosimilars. The release of the FDA draft guidance on nonproprietary naming of biosimilars in August 2015 established a naming convention for all biologic products, including biosimilars. However, the draft guidance is nonbinding while the FDA continues to receive input from stakeholders, and it does not address the naming convention that will be used for products designated as interchangeable biologics.

OBJECTIVES: To (a) determine pharmacist perceptions …

Assessment Of Texan Pharmacists' Attitudes, Behaviors, And Preferences Related To Continuing Pharmacy Education, Fadi M. Alkhateeb, Omar F. Attarabeen, Alameddine Sarah

Pharmacy Practice & Administration

Background: Whether the available Continuing Education (CE) programs meet pharmacists’ continuously increasing needs and preferences is open to question.

Objectives: to investigate pharmacists’ perceptions and attitudes concerning available CE programs, evaluate the pharmacists’ choices with regard to selecting among different CE programs, and investigate the factors that are associated with preference to utilize online CE programs.

Method: A 17-question survey was developed and mailed to a random sample of 600 Texan pharmacists. In addition to collecting basic demographic information, the survey investigated pharmacists’ choices with regard to delivery and content of CE programs, motivations to participation in CE programs, and …