Denise Ragland

Job and career satisfaction among pharmacy preceptors.

Objectives. To examine the perceived benefit of job and career satisfaction among pharmacist preceptors and to explore other factors that might influence satisfaction. Methods. A cross-sectional self-administered survey instrument was mailed to pharmacists in the South Central region of the United States who had active 2010 licenses to investigate whether being a pharmacist preceptor increases job and career satisfaction. Results. Twenty-three percent of the 363 respondents were active preceptors and 62% of these reported that they had been preceptors at some point in the past. Being an active preceptor was significantly related to increased job satisfaction (p = 0.01) but not to career satisfaction. Having a perceived benefit of continuing education and being professionally challenged at work also were associated with increased job and career satisfaction (p < 0.001). Conclusions. Pharmacist preceptors have higher levels of self-reported job satisfaction.

Academic Help-Seeking Behavior Among Student Pharmacists

Objectives. To identify factors associated with academic help-seeking behavior among student pharmacists at a public university. Methods. Semi-structured focus group interviews were conducted to explore in depth perceptions of facilitators of and barriers to the help-seeking behavior and academic achievement of student pharmacists who had received a D or F grade in any year. A 4-part survey instrument was developed and administered to all student pharmacists and included sections for (1) attitudes and academic help-seeking behavior, (2) health status, (3) demographics, and (4) open comments. A structural equation modeling approach was used to assess relationships among domains of interest. Results. Three student focus groups noted that helpfulness of faculty members and school administrators were 2 prominent facilitators of help-seeking behavior and academic achievement. Diminished quality of life caused by stress and depression was the primary barrier to help-seeking and achievement. Three hundred four (68.6%) student pharmacists completed the survey instrument. Academic help-seeking behavior was influenced mostly by perceived academic competence and perceived faculty helpfulness. In contrast, ambivalence and perception of help-seeking as threatening were 2 factors that were negatively associated with academic help-seeking behavior. Conclusions. Academic help-seeking behavior was positively related to greater perceived academic competence and positive relationships among student pharmacists and faculty members.

Impact of emergency contraception status on unintended pregnancy: observational data from a women´s health practice

Objective: This study aimed to determine if nonprescription emergency contraception (EC) availability impacted self-reported unintended pregnancy rates and to assess women’s knowledge and awareness of EC prior to and after nonprescription availability. Methods: A survey regarding contraception use and knowledge was verbally administered to a cross-sectional, convenience sample of 272 pregnant women receiving prenatal care at a large urban community women’s clinic between August 2003 and October 2008. Statistical analyses determined the differences between two groups (before [BA] and after, [AA] non-prescription EC availability in the U.S. drug market) in terms of self-reported unintended pregnancy rates, knowledge and awareness of EC. Results: The AA group reported higher incidence of unintended pregnancy when compared to the BA group (90.7% vs. 72.7%, P = 0.0172). The majority of both groups reported that they were not using any contraception at the time of conception (BA-84.4%; AA-83.3%). There was no significant difference in the participants’ awareness of EC between the two groups (BA-46.8% vs. AA-43.0%) nor was there a significant difference between the two groups in the self-reported willingness to use EC in the future (BA-53.1% vs. AA-63.4%). However, among participants who were unaware of EC, 61% reported they would consider using it in the future after receiving brief EC counseling from a pharmacist or student pharmacist. Neither age nor pregnancy intention was associated with self-reported EC awareness but there was an association with income (P = 0.0410) and education (P = 0.0021). Conclusion: The change from prescription-only to non-prescription status of EC in the U.S. drug market did not impact the unintended pregnancy rate in this patient population. Lack of knowledge and awareness is still a major barrier to widespread EC use.

Depression and diabetes: Establishing the pharmacist's role in detecting comorbidity in pregnant women

Objectives To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression.OBJECTIVES To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression. SETTING Little Rock, AR, between June and August 2007. PRACTICE DESCRIPTION At a womens health clinic providing obstetrical services to local and statewide patients, the clinical pharmacist functions as a diabetes educator, provides treatment recommendations for the OB/GYN medical residents, and precepts fourth-year student pharmacists. PRACTICE INNOVATION The pharmacist and student pharmacists screened patients with diabetes for depression using the Beck Depression Inventory, 2nd ed. (BDI-II). MAIN OUTCOME MEASURES Patient demographics, including obstetrical history, type of diabetes, depression history, and current treatments. RESULTS 50 patients were screened in this pilot study. Of participants, 42% reported scores that indicated clinical depression. Among patients with clinical depression, only 19% were receiving treatment for depression. Obstetrical history (number of pregnancies) showed a positive correlation with the BDI-II total scores (P = 0.0078). CONCLUSION This population had a high prevalence of depressive symptoms, but very few women were receiving treatment for depression. Depression screenings should be integrated into routine prenatal care, offering adequate treatment when needed. This study implies that pharmacists can assist with screening for depression in diabetes and thus ensure that at-risk patients receive the attention needed to better manage their illnesses.

Obstetrical Opportunities: Will Pharmacy Ever Realize Them?:

Based on a survey of the American College of Clinical Pharmacy Womens Health Practice and Research Network and our own experience, the pharmacy profession has limited involvement in obstetric pharmacotherapy. We believe that such involvement in pregnancies with complicated conditions can result in significant improvement of pregnancy outcomes. Moreover, we believe this involvement would be welcomed by the physicians caring for these patients. This commentary documents current obstetrical pharmacy practices and proposes changes for the profession of pharmacy to consider.

Emergency contraception counseling in a retail pharmacy setting: a pilot study.

Introduction: Nonprescription emergency contraception (EC) is now available for purchase without age restrictions. This is a great opportunity for pharmacists to provide counseling to ensure that customers use EC correctly. Objective: This pilot study explored the impact of student pharmacist counseling on customer knowledge of EC in a retail pharmacy setting and assessed customer satisfaction with the counseling. Methods: Counseling was performed at 2 retail pharmacies during June and July 2012. Participants completed a 12-question pretest that measured baseline knowledge of EC prior to a 5- to 10-minute education session, followed by the same 12-question posttest. A follow-up test was conducted via telephone within 1 to 3 months after the counseling. Results: Eighty-seven women participated with a mean age of 30.2 (standard deviation = 7.2) years. The average posttest score was significantly higher than the pretest score (11.5 ± 1.0 vs 8.5 ± 2.5; P < .001). The mean follow-up score (9.9 ± 1.1) was significantly higher than the pretest score (P = .014), which indicated retained knowledge. Participants reported being highly satisfied with the counseling session and strongly agreed that the counseling would help them use EC correctly. Conclusion: Student pharmacist-provided EC counseling increased participants’ EC knowledge both immediate and long term. This study suggests that EC counseling is feasible and valued by customers.

Special FeatureDepression and diabetes: Establishing the pharmacist's role in detecting comorbidity in pregnant womenDisclosurePrevious presentation

Objectives To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression.OBJECTIVES To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression. SETTING Little Rock, AR, between June and August 2007. PRACTICE DESCRIPTION At a womens health clinic providing obstetrical services to local and statewide patients, the clinical pharmacist functions as a diabetes educator, provides treatment recommendations for the OB/GYN medical residents, and precepts fourth-year student pharmacists. PRACTICE INNOVATION The pharmacist and student pharmacists screened patients with diabetes for depression using the Beck Depression Inventory, 2nd ed. (BDI-II). MAIN OUTCOME MEASURES Patient demographics, including obstetrical history, type of diabetes, depression history, and current treatments. RESULTS 50 patients were screened in this pilot study. Of participants, 42% reported scores that indicated clinical depression. Among patients with clinical depression, only 19% were receiving treatment for depression. Obstetrical history (number of pregnancies) showed a positive correlation with the BDI-II total scores (P = 0.0078). CONCLUSION This population had a high prevalence of depressive symptoms, but very few women were receiving treatment for depression. Depression screenings should be integrated into routine prenatal care, offering adequate treatment when needed. This study implies that pharmacists can assist with screening for depression in diabetes and thus ensure that at-risk patients receive the attention needed to better manage their illnesses.

Family Commitment and Work Characteristics among Pharmacists

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse’s family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants’ mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Factors Associated With Health-Related Quality of Life of Student Pharmacists

Objective. To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university. Methods. A survey instrument was administered to all student pharmacists in a PharmD program at a public university to evaluate differences and factors related to the HRQoL outcomes of first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) student pharmacists in the college. The survey instrument included attitudes and academic-related self-perception, a 12-item short form health survey, and personal information components. Results. There were 304 students (68.6%) who completed the survey instrument. The average health state classification measure and mental health component scale (MCS-12) scores were significantly higher for P4 students when compared with the P1through P3 students. There was no difference observed in the physical component scale (PCS-12) scores among each of the 4 class years. Significant negative impact on HRQoL outcomes was observed in students with higher levels of confusion about how they should study (scale lack of regulation) and concern about not being negatively perceived by others (self-defeating ego orientation), while school satisfaction increased HRQoL outcomes (SF-6D, p<0.001; MCS-12, p=0.013). A greater desire to be judged capable (self-enhancing ego-orientation) and career satisfaction were positively associated with the PCS-12 scores (p<0.05). Conclusion. Factors associated with the HRQoL of student pharmacists were confusion regarding how to study, ego orientation, satisfaction with the chosen college of pharmacy, and career satisfaction. First-year through third-year student pharmacists had lower HRQoL as compared with P4 students and the US general population. Support programs may be helpful for students to maintain or improve their mental and overall health.

Maternal knowledge of pertussis and Tdap vaccine and the use of a vaccine information statement

Objective: This study explored maternal knowledge of pertussis and Tdap vaccine and the use of a Tdap Vaccine Information Statement (VIS) to improve that knowledge. Design: Prospective cohort study. Setting: Two outpatient obstetric clinics at a US academic medical centre. Methods: An electronic survey was administered to pregnant women who received care at the clinics. The survey included a test of knowledge of pertussis and Tdap vaccine, a health literacy instrument and demographic questions. A chart review was conducted to determine Tdap vaccination status. The knowledge test was administered before and immediately after participants read the VIS. Differences between pre- and post-knowledge test scores were determined using the Wilcoxon signed-rank test. The effects of two different versions of the VIS on participants’ knowledge gained and associated factors were examined using a repeated-measures mixed model with random effects. Results: In total, 279 participants were analysed with an average age of 26.4 ± 5.7 years. The average post-test knowledge score was higher than the pre-test score (6.4 vs 4.2, p < .001). Health literacy score (p < .001), White race/ethnicity (p = .007) and higher education level (p < .001) were positively associated with improved knowledge scores. Both VIS versions improved participants’ knowledge scores to a similar degree. However, knowledge scores were not a predictor of Tdap vaccination in our population. Conclusion: A Tdap VIS improved maternal knowledge and is an economical and easily accessible educational tool in clinical practice for promoting Tdap vaccine to pregnant women.