Karl Hess

Intravenous Artesunate for the Treatment of Severe Malaria

Objective: To review the pharmacodynamics and pharmacotherapeutic use of intravenous artesunate for the treatment of severe malaria. Data Sources: Literature was retrieved through PubMed (1999–March 2010), MEDLINE (1996–March 2010), and the Centers for Disease Control and Prevention (CDC), using the search terms artemisinin, artesunate, malaria, and severe malaria. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction: All articles in English that were identified from the data sources were reviewed. Focus was placed on postmarketing trials examining the safety and efficacy of artesunate in comparison with other regimens. Data Synthesis: The treatment of severe malaria requires prompt, safe, and effective intravenous antimalarials. Many oral and intravenous agents are available worldwide for the treatment of malaria; however, quinidine has been the only option for parenteral therapy in the US. Furthermore, this products lack of availability as well as its adverse safety profile have created a treatment option gap. Recently, intravenous artesunate was approved by the Food and Drug Administration (FDA) for investigational drug use and distribution by the CDC. Three major studies regarding the use of intravenous artesunate are reviewed, in addition to the World Health Organizations malaria treatment guidelines. While there are no published head-to-head trials of intravenous artesunate versus intravenous quinidine for severe malaria, several international studies comparing intravenous quinine and artesunate concluded that artesunate has the highest treatment success, with lower incidence of adverse events. In addition, other literature is reviewed regarding counterfeit and other issues associated with artesunate. Conclusions: Artesunate, a new antimalarial currently available through the CDC, appears to be highly effective, better tolerated than quinidine, and not hampered by accessibility issues. If it were to be FDA approved and commercially available, it would be the preferred agent for the treatment of severe malaria in the US.

Medication Therapy Management Services Provided by Student Pharmacists

Objectives. To evaluate the impact of student pharmacists delivering medication therapy management (MTM) services during an elective advanced pharmacy practice experience (APPE). Methods. Student pharmacists provided MTM services at community pharmacy APPE sites, documented their recommendations, and then made follow-up telephone calls to patients to determine the impact of the MTM provided. Students were surveyed about the MTM experience. Results. Forty-seven students provided MTM services to 509 patients over 2 years and identified 704 drug-related problems (average of 1.4 problems per patient). About 53% of patients relayed the recommendations to their physician and 205 (75%) physicians accepted the recommendations. Eighty-eight percent of patients reported feeling better about their medications after receiving MTM services. A majority of the students perceived their provision of MTM services as valuable to their patients. Conclusions. Providing MTM services to patients in a pharmacy practice setting allowed student pharmacists to apply skills learned in the doctor of pharmacy (PharmD) curriculum.

A Formal Mentorship Program for Faculty Development

Objective. To describe the development, implementation, and evaluation of a formal mentorship program at a college of pharmacy. Methods. After extensive review of the mentorship literature within the health sciences, a formal mentorship program was developed between 2006 and 2008 to support and facilitate faculty development. The voluntary program was implemented after mentors received training, and mentors and protégés were matched and received an orientation. Evaluation consisted of conducting annual surveys and focus groups with mentors and protégés. Results. Fifty-one mentor-protégé pairs were formed from 2009 to 2012. A large majority of the mentors (82.8%-96.9%) were satisfied with the mentorship program and its procedures. The majority of the protégés (≥70%) were satisfied with the mentorship program, mentor-protégé relationship, and program logistics. Both mentors and protégés reported that the protégés most needed guidance on time management, prioritization, and work-life balance. While there were no significant improvements in the proteges’ number of grant submissions, retention rates, or success in promotion/tenure, the total number of peer-reviewed publications by junior faculty members was significantly higher after program implementation (mean of 7 per year vs 21 per year, p=0.03) in the college’s pharmacy practice and administration department. Conclusions. A formal mentorship program was successful as measured by self-reported assessments of mentors and protégés.

Measuring outcomes of a pharmacist-run travel health clinic located in an independent community pharmacy

OBJECTIVES To describe the acceptance and refusal rates of travel-related vaccine and medication recommendations in a pharmacist-run travel health clinic, to evaluate the change in patient understanding of travel-related issues, to determine patient satisfaction with this clinic, and to determine factors influencing both patient acceptance and satisfaction. SETTING Southern California (Claremont) between July 2007 and October 2008. PRACTICE DESCRIPTION Hendricks Pharmacy is an independently owned community pharmacy that is part of the Good Neighbor Pharmacy Provider Network. The pharmacy offers a range of services including home delivery, compounding, and blood glucose, blood pressure, and cholesterol screenings. PRACTICE INNOVATION Comprehensive pharmacist-run travel health clinic. MAIN OUTCOME MEASURES Patient acceptance and refusal rates of pharmacist-made recommendations, changes in patient understanding of travel-related issues resulting from pharmacist counseling, and patient satisfaction with this travel health clinic. RESULTS In a sample of 283 patients, overall patient acceptance of pharmacist-made recommendations was 84.7%. The primary reason for patient refusal of a recommendation was self-perceived low risk for infection. A subsample of patients (n = 82) completing a patient satisfaction survey found that 96% were satisfied with their overall visit. Patient satisfaction with the clinic and pharmacist services was correlated with overall patient acceptance. CONCLUSIONS The high rate of patient acceptance and satisfaction with this clinic supports adoption of pharmacists as nontraditional providers of travel health services.

Mosquito-borne illnesses in travelers: a review of risk and prevention.

In 2008, residents of the United States made 12 million visits to developing countries in Asia, South America, Central America, Oceania, the Middle East, and Africa. Due to the presence of Anopheles, Aedes, and Culex mosquitoes, travel to these destinations poses a risk for diseases such as malaria, yellow fever, and Japanese encephalitis that cause significant morbidity and mortality. To gain a better understanding of the major emerging and established travel‐related infectious diseases transmitted principally by mosquitoes and the measures for their prevention in U.S. residents who travel to these developing countries, we performed a literature search of the PubMed and MEDLINE databases (January 1950–February 2010). Information from the Centers for Disease Control and Prevention and the World Health Organization and relevant references from the publications identified were also reviewed. Vaccines for the prevention of Japanese encephalitis and yellow fever are commercially available to U.S. travelers and should be administered when indicated. However, the prevention of malaria, dengue fever, chikungunya, and West Nile virus relies on personal insect protection measures and chemoprophylaxis for malaria. As the rate of international travel continues to rise, individuals traveling overseas should be made aware of the risk of various infectious diseases and the importance of prevention. Physicians, pharmacists, nurses, and other practitioners can play a vital role in disease education and prevention, including the administration of vaccines and provision of chemoprophylactic drugs.

Teaching Medication Adherence in US Colleges and Schools of Pharmacy

Objective. To determine and describe the nature and extent of medication adherence education in US colleges and schools of pharmacy. Methods. A mixed-methods research study was conducted that included a national survey of pharmacy faculty members, a national survey of pharmacy students, and phone interviews of 3 faculty members and 6 preceptors. Results. The majority of faculty members and students agreed that background concepts in medication adherence are well covered in pharmacy curricula. Approximately 40% to 65% of the students sampled were not familiar with several adherence interventions. The 6 preceptors who were interviewed felt they were not well-informed on adherence interventions, unclear on what students knew about adherence, and challenged to provide adherence-related activities for students during practice experiences because of practice time constraints. Conclusions. Intermediate and advanced concepts in medication adherence, such as conducting interventions, are not adequately covered in pharmacy curriculums; therefore stakeholders in pharmacy education must develop national standards and tools to ensure consistent and adequate medication adherence education.

The Impact of Student Pharmacists at Health Fair Events

Objectives. To evaluate student pharmacists’ impact on health fair participant knowledge of selected disease states and to evaluate the intent of health fair participants with abnormal screening results to seek follow-up care within 1 month of screening. Methods. Health fair participants were assessed for changes in their knowledge of specific diseases before and after screenings. Participants’ intent to seek health care was assessed through a survey instrument developed using Rosenstock’s Health Belief Model. Results. Increases in participant knowledge of hypertension, diabetes, dyslipidemia, and body mass index were significant, and 78% of participants with abnormal results intended to contact a provider. Conclusions. Student pharmacists’ had a positive impact on health fair participants’ disease knowledge and intent to follow up with a provider.

Impact of a Faculty Orientation and Development Committee

This paper describes the faculty enrichment activities and outcomes of a faculty orientation and development committee at a college of pharmacy. The committee used a continuous quality improvement (CQI) framework that included needs assessment, planning and implementation of programs and workshops, assessment of activities, and evaluation of feedback to improve future programming. Some of the programs established by the committee include a 3-month orientation process for new hires and development workshops on a broad range of topics including scholarship (eg, research methods), teaching (eg, test-item writing), and general development (mentorship). Evidence of the committees success is reflected by high levels of faculty attendance at workshops, positive feedback on workshop evaluations, and overall high levels of satisfaction with activities. The committee has served as a role model for improving faculty orientation and retention.

Report of the 2017-2018 Strategic Engagement Standing Committee

EXECUTIVE SUMMARY Student engagement is key to the success of schools and colleges of pharmacies in meeting their mission and programmatic needs. Student engagement in the pharmacy profession often occurs before acceptance to pharmacy school and is essential during students’ formal period of study both for the student’s professional growth and in meeting the mission of the school. Alumni engagement is vital to a school’s continued success in regard to engaging with current students and support of their alma mater. The committee offers best practice recommendations for engaging students in service, scholarship, education, professional practice and continuing professional development.

Overview of a co-curricular professional development program in a college of pharmacy

The goal of a professional program at a school or college of pharmacy is to produce competent and professional pharmacy practitioners. In 2009, The American College of Clinical Pharmacy published a white paper to assist in the teaching of professionalism in schools/colleges of pharmacy to include traits such as responsibility, commitment to excellence, respect for others, honesty and integrity, and care with compassion. In February 2015, the Accreditation Council for Pharmacy Education released their updated accreditation standards (Standards 2016) which introduced the concept of co-curricular activities (Standard 12.3): experiences that complement, augment, and/or advance what is learned in the formal didactic and experiential curriculum. This article details the Professional Development Curriculum at Western University of Health Sciences (WesternU) College of Pharmacy as a potential educational model that promotes professionalism through mandating co-curricular activities for student pharmacists.