Pharmacy Administration, Policy and Regulation Commons^™

Pharmacy Access Is Out Of Reach For One In Six South Carolinians, Bryan L. Love Pharm.D., Tessa J. Hastings Phd, Abby Davies

CORE Research Briefs

A cross-sectional geospatial analysis mapped active South Carolina community pharmacies and used 2020 Census tract data to estimate the population residing within and beyond five-mile pharmacy service areas. About one in six South Carolinians lives more than five miles from an active community pharmacy, with limited access disproportionately affecting rural communities.

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Charity Pharmacies: An Integrative Overview Of Operations: A Continuing Education Program For Pharmacists, Stella Bertram

Honors Theses

PROGRAM DESCRIPTION

The goal of this activity is to educate pharmacists about Charity Pharmacies by creating an integrative overview of their purpose, laws and regulations, processes and procedures, eligibility, and opportunities for involvement. This course will ensure pharmacists are competent in the operations involved in volunteering or working within a charitable pharmacy.

Additionally, the information provided supports pharmacists in understanding their roles as well as roles of volunteers. They will understand the importance of their role in the community and the depth of their service within Charity Pharmacies.

Assessing Current Telehealth Mobile Applications In The United States: Accessibility, Privacy, And Care Delivery, Rosemary K. Frugé

Honors Theses

Telehealth has improved patient access by reducing barriers to convenient, cost-effective, and quality health care. Telehealth mobile applications allow individuals to remotely access services through smartphone-based platforms. The purpose of this study was to evaluate leading telehealth applications available in the United States, analyzing key factors that influence platform selection, including cost, prescribing and diagnostic capabilities, user feedback, and data privacy practices. Applications were identified through keyword-based searches of major app stores using the term “telehealth,” and each app was systematically evaluated using predefined criteria. Findings highlight variability across platforms in pricing transparency, service offerings, and privacy disclosures, despite generally …

Pharmacovigilance Practices For New Drugs In Thailand: A Situation Analysis In Tertiary And University Hospitals, Nisittra Polkot, Osot Nerapusee, Pantira Parinyarux, Puree Anantachoti

The Thai Journal of Pharmaceutical Sciences

Background: In 2017, Thailand’s Food and Drug Administration introduced a risk-based safety monitoring program (SMP) aimed at strengthening pharmacovigilance (PV) for new drugs, including new chemical entities and biologics. Despite this policy shift, drug safety monitoring continues to rely primarily on spontaneous adverse drug reaction (ADR) reporting. This study aimed to explore the implementation of PV practices for drugs with SMP status in selected tertiary and university hospitals in Thailand.
Materials and Methods: A qualitative study was conducted using in-depth interviews. Pharmacists and physicians involved in drug safety monitoring were invited. Eight hospitals (five university and three tertiary …

Developing Nlp-Based Open-Source Tools To Improve Titratable Infusion Order Interpretation In Ehr Systems, Benjamin Brewer, Jay Dorris

Student Scholar Symposium

This study evaluates the feasibility of using natural language processing (NLP) tools to identify errors in titratable infusion orders for Joint Commission readiness. Titratable infusions are adjusted at the bedside by nurses based on predefined parameters, such as monitoring goals, titration rate, conditions for adjustment, and maximum dose. These parameters are often documented as free text within order sets but can be inadvertently removed during the verification process. Some electronic health records (EHRs) may not prominently display this critical information, leading to potential Joint Commission violations. A synthetic dataset was generated using artificial intelligence to simulate one year’s worth of …

Impact Of An Educational Intervention On Pharmacy Students’ Knowledge, Attitudes, And Confidence Regarding Alcohol And Substance Use Disorders, Lina Itenberg

Student Scholar Symposium

This study examines the impact of an educational intervention on student pharmacists’ knowledge, attitudes, and confidence regarding alcohol and substance use disorders (AUD/SUD) at Lipscomb University College of Pharmacy. Current literature denotes that student pharmacists often feel unprepared to address substance use disorder in practice. This study evaluates whether a targeted educational intervention can enhance student understanding of first-line pharmacological treatments, increase confidence in handling opioid-related emergencies, and improve their ability to educate patients on harm reduction strategies, including naloxone use and opioid overdose risks. Pre- and post-intervention surveys will assess changes in students’ preparedness and identify ongoing concerns about …

Exploring The Prevalence And Determinants Of Self-Medication During Pregnancy Among Women From South Punjab, Pakistan, Madiha Madiha, Sehar Jabbar, Imran Masood

Makara Journal of Health Research

Background: For developing countries with high neonatal and maternal mortality rates, any practice that may threaten the maternal-fetal health must be gauged. This study evaluated the prevalence and contributing factors of self-medication during pregnancy among women opting for antenatal or postnatal care in South Punjab, Pakistan.

Methods: A cross-sectional study design was used. Data was collected from 424 women, selected through multi-stage sampling, who visited health care facilities located in six randomly selected cities of South Punjab. Outcomes reported by descriptive and inferential statistics (p < 0.05). Binary logistic regression analysis was performed to determine the association of self-medication with different factors.

Results: Most of the women were involved in self-medication practice (38.9%) …

Opportunities To Improve Continuity In Medicines Management For Aboriginal And Torres Strait Islander People Accessing Care In South Australian Hospitals: Coverage, Quality, Monitoring And Accountability, Annabelle Cranwell, Cheyne Sullivan, Kezia Daniel, Erik Cornelisse, Brianna Kinnear

Journal of the Australian Indigenous HealthInfoNet

This paper proposes that hospital admissions, which are traditionally considered high risk transitions, can be opportunities to strengthen continuity in medicines management (CMM) for Aboriginal and Torres Strait Islander patients and across the healthcare system. There are four key areas of focus in this paper including CMM coverage, CMM quality, health system monitoring of CMM, and health system accountability for CMM to Aboriginal and Torres Strait Islander people and communities. These areas for improvement are justified by the National Agreement on Closing the Gap (The National Agreement), the Guiding Principles to Achieving continuity in medication management, and Continuity in Medication …

Continuous Glucose Monitoring Versus Self-Monitoring For Patients With Type 1 Diabetes: A Systematic Review And Meta-Analysis, Prayuth Poowaruttanawiwit, Kwanchai Rattanamanee, Nonnachanok Chaiyot, Saranpreeya Srisinroongruang

The Thai Journal of Pharmaceutical Sciences

Background: Patients with type 1 diabetes mellitus (T1DM) require intensive glucose monitoring to achieve optimal glycemic control and prevent complications. While self-monitoring of blood glucose (SMBG) has long been the standard approach, continuous glucose monitoring (CGM) offers real-time data and trend analysis that may enhance clinical decision-making.

Objective: This study aimed to evaluate whether CGM provides superior glycemic outcomes compared with SMBG in individuals with T1DM.

Materials and Methods: A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses guidelines. Four randomized controlled trials involving T1DM patients using either CGM or SMBG were included. …

Patient Information Needs During Ambulatory Medication Changes: A Qualitative Study, Elaine Giletta, Vanessa B. Hurley, Yushi Yang, Jessica L. Schwartz, Rabia Jalalzai, Nicole L. Mollenkopf, Raquel Mayne, Samantha I. Pitts

Journal of Patient-Centered Research and Reviews

Purpose: We performed interviews with patients and caregivers to explore whole-person, whole-regimen information needs at times of routine outpatient medication changes. We categorized information needs in this relatively unstudied context and identified which needs were commonly recognized as insufficiently met.

Methods: We explored the content of the semi-structured interviews, which involved nine patients and two caregivers of pediatric patients, all of whom experienced a recent medication change in the outpatient setting of a large urban academic healthcare system. We used inductive thematic analysis to organize information needs into categories to identify key information gaps.

Results: We identified five categories of …

The Use Of Health And Herbal Products For Covid-19 Self-Prevention And Its Affecting Factors According To Theory Of Planned Behavior, Suppachai Insuk, Supanida Kittirattanasak, Mullika Sirithongkaset, Daranee Chiewchantanakit

The Thai Journal of Pharmaceutical Sciences

Introduction: Despite the World Health Organization’s recent declaration of the end of the COVID-19 pandemic, the lessons learned from the outbreak remain crucial for future public health responses. In Thailand, the pandemic’s impact led individuals to explore self-protection methods, including potentially ineffective health products. This study examined the prevalence of health and herbal products used for COVID-19 self-prevention, to identify the types of these products in use and to identify factors influencing their utilization.

Methods: A cross-sectional study surveyed 400 Thai participants aged 25–60 who had never contracted COVID-19. The study employed convenience sampling and self-administered online questionnaires based on …

5x-Multiplier Vs 3-Tier Model For Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery: Randomized Clinical Trial Protocol, Brittany C. Fields, Timothy E. Newhook, Heather A. Lillemoe, Wei Qiao, Jose A. Karam, Surena F. Matin, Larissa A. Meyer, Ching-Wei D. Tzeng

Advances in Cancer Education and Quality Improvement

Background

Surgeons provide up to 10% of total opioid prescriptions across all specialties, and more than one-third of surgeon-prescribed medications are opioids. Patient-reported opioid consumption and risk of persistent opioid use beyond the postoperative recovery period correlate with the initial opioid quantity prescribed at discharge. Interventions to reduce postoperative opioid prescribing have demonstrated no adverse effects on pain control or increased need for prescription refill; however, in the absence of standardized prescription protocols, opioid prescribing practices vary widely.

Objective

The study objective is to identify the opioid prescribing model that provides the lowest oral morphine equivalents (OME) volume prescribed at …

Over-The-Counter Cold Medication Usage Self-Efficacy Among Undergraduate Students In The United States, Ray Goodwin

Honors Theses

Background

This study looks at the trends in over-the-counter medication usage and self-efficacy among undergraduate college students in the United States. Over-the-counter (OTC) medications serve as the most easily accessible and commonly purchased medications and can be used as a basis to determine this demographic’s attitudes and behaviors towards self-medication. In addition, undergraduates represent a diverse population for analyzing differences among demographic groups.

Methods

A Qualtrics survey was sent out to undergraduates across the US via a panel, and the team received 403 useable responses. As part of a larger study, the survey presented participants with four different scenarios at …

Optimizing Endogenous Glp-1 Holistically: A Nursing Led Approach To Sustainable Weight Loss Without Glp-1 Agonist Use, Taylee A. Carscadden

Nursing | Senior Theses

The increase in off-label Glucagon-like peptide-1 (GLP-1) receptor agonist drugs, such as semaglutide (Ozempic), for weight loss has sparked concern in regards to the not fully understood drug outcomes and safety. GLP-1 agonists were originally developed to manage Type 2 Diabetes Mellitus, but have been widely prescribed for obesity management despite minimal research on prolonged use in non-diabetic patients. This study explores how off-label use of GLP-1 agonist drugs exacerbate various adverse health outcomes, highlighting gastrointestinal complications, and the very possible dependency on drugs for weight management. It will also examine the efficacy of nursing-led education on the implementation of …

Customary Corruption, Ani B. Satz, Liza Vertinsky

Faculty Articles

For over a hundred years, it has been well-accepted among tort scholars that physicians—as one of the legally recognized professions— determine their own customary practices. Within tort law, and medical malpractice more specifically, customary practice establishes whether physicians breach or uphold the required standard of care toward their patients. The results of our hand-coded examination of decided cases and statutes show a more complex picture. While some states have endeavored to shift the standard away from professional custom, it continues to play a critical, and in many cases a determinative, role in establishing physician liability in most states.

Using illustrative …

Understanding The Impact Of Pharmacist Prescriptive Authority On Hiv Pre-Exposure Prophylaxis At The State Level, Cameron G. King

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

HIV transmission, with relative risk reductions of up to 99%. However, real world data have revealed that even with large increases in PrEP use, new HIV diagnoses may only slightly decline. This disparity suggests that access to PrEP may be suboptimal, especially among high-risk subgroups, who are often hard to maintain on the continuum of HIV care. Pharmacists, because of their accessibility, trusted role in their communities, and growing scope of practice, could serve as an intervention point to improve access to PrEP.

A previously validated algorithm using National Drug Codes (NDCs) and the International Classification of Disease, 10^{th …}

The Revised Cdc Chronic Pain Guidelines And Payer Opioid Analgesic Policies In Michigan, Victoria Tutag Lehr, Cynthia L. Arfken

Michigan Journal of Public Health

Abstract

The 2016 publication of A Guideline for Prescribing Opioids for Chronic Pain by the Centers for Disease Control and Prevention motivated commercial and Medicaid payers to restrict their opioid prescribing policies including the imposition of hard limits on opioid daily dosages and duration. One result of these policies was an increase in abrupt opioid discontinuation and rapid tapering events for patients receiving long-term opioid therapy. Responding to this misapplication of the 2016 guideline, the 2022 revised guidelines emphasized individualized opioid therapy and exclusion of certain chronic diseases. However, it is not known if the payers changed their policies to …

Impact Of A Pharmacist-Led Hcv Treatment Program At A Federally Qualified Health Center, Jerika T. Lam, Sharon Xavioer

Pharmacy Faculty Articles and Research

Pharmacists are key players who can help to eliminate the hepatitis C virus (HCV) epidemic in the United States. This pilot retrospective study evaluated the impact of a pharmacist-led HCV treatment program in a federally qualified health center (FQHC) primary care clinic setting. The primary outcome was to assess sustained virologic response (SVR) rates 12 weeks after patients were initiated and completed their oral direct acting antiviral (DAA) treatment regimens. Methods: This pilot retrospective study included historical analyses of patients who received DAA treatment in the pharmacist-led HCV treatment program in a FQHC clinic between 1 January 2019 and 31 …

Pour Une Diffusion Éthique Des Connaissances De La Médecine Traditionnelle: L’Intersection De La Culture Yoruba Et Des Besoins Médicaux, Isabel Sala

CISLA Senior Integrative Projects

No abstract provided.

Opioid Prescription Rates Before And After Alto Program And Various Factors Affecting Emergency Department Opioid Prescription Rates, Neel B. Patel, James F. Baird

Rowan-Virtua Research Day

Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, …

Perceptions Of Metabolic Syndrome Management Utilization In Relation With Patient Characteristics And Health-Related Quality Of Life, Olajide Adekunle

Pharmaceutical Sciences (PhD) Dissertations

Challenges in managing MetS include untreated risk factors and ineffective management, resulting in poor health-related quality of life (HRQoL). A significant factor contributing to these challenges is the underutilization of management services, possibly due to patients' perceptions of disease management resource utilization (PMU). Therefore, understanding patients' PMU is crucial for improving health outcomes. The study investigated PMU, explored PMU predictors, and investigated the impact of PMU and patients’ demographics on HRQoL. Using a cross-sectional design, data on perceptions of healthcare, medication, and pharmacy service utilization, prior experience with pharmacy services, demographics, and HRQoL were collected from adult individuals with obesity …

Pharmacist Interventions Increase Uptake Of Pneumonia Vaccination In At-Risk Populations: A Review., Kaitlyn Hinton

Annual Research Symposium

Pneumonia is a large burden to healthcare costs and a large cause of hospitalization (Hayes, BH. Chest. 2018, 153(2), 427), and bacterial pneumonia can be prevented through vaccination. While pediatric vaccinations are routinely given, an additional dose is required for adults 65+ years of age or otherwise immune compromised, including diabetics. Only 22.2% of Immunocompromised patients and 65% of the elderly population have received the extra dose (Hung, MC. CDC. 2022). With pharmacist interventions, these vaccination rates could increase significantly. The purpose of this study was to conduct a review of the literature to identify interventions that have yielded higher …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Does Federal Preemption Inoculate Us Against The Alarming Prospect Of State Vaccine Bans?, Lars Noah

UF Law Faculty Publications

With growing resistance to vaccinations-premised, for instance, on misplaced fears of side effects or religious objections-it takes little effort to imagine that a state might act to prohibit some or all uses of a particular vaccine licensed by the federal government. Indeed, one year ago, legislators in a couple of states toyed with the idea of banning the primary vaccines against Covid-19, and, twenty years ago, half a dozen states effectively barred certain uses of one flu vaccine formulation. Although federal law should preempt at least some of these types of state restrictions, the Supremacy Clause of the U.S. Constitution …

Recent Trends In Stimulant Prescribing In Kentucky, 2021-2023, Jordan Shannon

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Introduction

Prescription stimulants have a long history of clinical use dating as far back as the 1930s. In the United States stimulant prescribing rates have steadily climbed over the last 3 decades. The primary objective is to describe recent (2021-2023) prescribing trends of stimulant medications in the Commonwealth of Kentucky

Methods

Prescription data collected from Kentucky’s prescription drug monitoring (PDMP) database known as the Kentucky All Schedule Prescription Electronic Reporting System (KASPER). Annual and quarterly trends in stimulant prescribing between 2021-2023 were calculated, examined by age, sex, and geographic location.

Results

Stimulant prescribing increased by ~15% where the majority …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience: Master of Public Health

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …