Charles R. Phillips

Teaching Cultural Competency Through a Pharmacy Skills and Applications Course Series

Objective. To incorporate cultural competency in a Pharmacy Skills and Application course series and assess the level of cultural competency in students who did and did not complete the courses. Design. The course series focused on cultural competency throughout the PharmD curriculum and included such activities as self-reflection, lecture, diversity service-learning, case studies, and discussion. Assessment. The Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals – Revised (IAPCC-R) was used to measure cultural competence in 2 cohorts: the last class preceding implementation of the new course series and the first class after its implementation. Overall scores between the 2 cohorts were not significantly different; however, 2 subscale scores were significantly higher among students who completed the course series: cultural skills (p = 0.021) and cultural encounters (p = 0.048). Conclusions. The Pharmacy Skills and Application course series appears to improve some aspects of cultural competence in pharmacy students, but may not be sufficient to elicit change in all areas.

Implementation and Evaluation of a Lipid Screening Program in a Large Chain Pharmacy

OBJECTIVE To evaluate the implementation of a lipid testing service across an entire market of a large chain pharmacy. DESIGN Observational study using a validated satisfaction scale. SETTING Nine Osco Drug pharmacies in Des Moines, Iowa. MAIN OUTCOME MEASURES Number of patients choosing to participate in a fee-for-service lipid screening program, type of test chosen, effects of marketing on service volume, and patient satisfaction. RESULTS A total of 159 screenings were performed in the 9 pharmacies. The majority of patients (79.7%) chose the more expensive fasting lipid profile, and service volume seemed to correspond to the number and intensity of marketing efforts. There was a trend toward increased patient satisfaction with the services represented by the Managing Therapy and Friendly Explanation dimensions addressed in the survey. CONCLUSION Patients were willing to pay out-of-pocket for lipid screening. More efforts need to be devoted to marketing this service to create value for the customer and to establish it as a viable component of pharmacy business.

Identification of barriers to medication adherence in a Latino population

BACKGROUND Barriers to medication adherence may present differently in diverse patient populations. Because of changing U.S. demographics, health care providers will be required to identify alternative strategies for managing increasingly diverse patient populations. OBJECTIVES This pilot project identified barriers that may hinder medication adherence in a Latino population. The results of the survey may identify trends in barriers allowing for the development of interventions aimed at improving medication adherence. METHODS The study used a convenience sample of Spanish-labeled prescriptions that had not been picked up from a community pharmacy after a 2-week period to identify study subjects. Patients were contacted by phone and surveyed regarding reasons for not picking up their prescription medication. The 24-item survey instrument consisted of demographic and medication-related questions, reasons for, and associated barriers with failure to pick up medications. RESULTS The most common classes of medications patients failed to pick up were chronic medications. More than 90% of the patients thought that the medication in question was helpful to them, and nearly 80% thought that the medicine was still needed. Patients cited communication issues (ie, content matter, such as when the prescription was ready), logistics, and limited hours of pharmacy operation as the primary barriers in picking up their medications, whereas nearly 40% failed to identify any barriers. Barriers identified by patients that could be improved included confusion regarding when their prescription was ready and limited hours of pharmacy operation. Most of the patients were comfortable using the American health care system. CONCLUSIONS The barriers to medication adherence identified did not appear to be the result of cultural influences. This could be because the community pharmacy had bilingual staff and interpreters available for patient education and prescription processing. Alternative methods are needed to further identify reasons for failure to pick up medications before medication adherence programs can be designed.

Garnering Widespread Involvement in Preparing for Accreditation Under ACPE Standards 2007

On February 17, 2006, the Accreditation Council for Pharmacy Education (ACPE) announced the release of the revised Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree that became effective on July 1, 2007. (1) Although there are numerous differences between Standards 2007 and previous versions, the general core areas remain similar but are condensed into 6 groupings of the Standards and Guidelines: Mission, Planning, and Evaluation; Organization and Administration; Curriculum; Students; Faculty and Staff; and Facilities and Resources. (2) Within these core areas, significant changes have occurred, including the reorganization of standards to include institutional accreditation, student complaint policies, and more specific requirements for areas such as experiential education hours. Review procedures are more defined with an emphasis on the evaluation form/ rubric, use of standardized survey instruments, and broad participation by faculty members and other key groups. (3) Implementation of Standards 2007 presents several unknowns to schools and colleges undergoing accreditation for the first time under the new standards. Ramifications for being partially or non-compliant with the standards include a limited (2-year) time period to become compliant, potential probation, public availability of a college/schools status, and potential adverse accreditation action. (4) Clearly, colleges/schools need to have their stakeholders knowledgeable and involved in the self-study to assure success. The self-study process also changed, including the use of a self-study template supplied by ACPE. The template offers a consistent format to self-study reports, additional direction on sources of information to be used, and specific requirements for each standard and guideline. The template includes sections for both a summary of self-study process and a formal rating of the overall organization and clarity of the self-study process. The latter addition adds further evidence of the need for broad and inclusive participation during the self-study process. Within the Overall Organization and Clarity section of the template, colleges and schools of pharmacy are rated on 6 general areas, 3 of which are linked directly to the involvement of stakeholders in the self-study process and their awareness of the subsequent findings. These 3 areas are: * Participation: the self-study report was written and reviewed with broad-based input from students, faculty members, preceptors, staff members, administrators, and a range of other stakeholders, such as patients, practitioners, and employers. * Completeness and transparency: all narratives and supporting documentation are thorough, clear, and concise. The content appears thoughtful and honest. Interviews match the self-study findings. * Knowledge of the self-study: students, faculty members, preceptors, and staff members are conversant in the major themes of the report and how the program intends to address any deficiencies. Little information has been published on how schools and colleges of pharmacy approach the self-study process or the new Standards 2007. Although one program published their experiences using a project management approach, no other information is available. (5) To our knowledge, no literature focuses on garnering widespread stakeholder involvement in the accreditation process. This paper describes several practices that may aid programs in achieving such involvement in the self-study process. PARTICIPATION IN THE SELF-STUDY PROCESS When possible, colleges and schools of pharmacy should consider attending a program such as the AACP Institute that can help focus and plan the self-study process. The 2007 AACP Institute coincided with the start of our self-study, and included a topic related to accreditation. (6) Programs like this allow the faculty to begin planning and discussing their self-study, including the main ideals to promote throughout the process. …