Shane P. Desselle

Pharmacy faculty workplace issues: Findings from the 2009-2010 COD-COF joint task force on faculty workforce

Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy.

Ask the Pharmacist: An Analysis of Online Drug Information Services

BACKGROUND: The Internet plays a large role in the provision of drug information. Given the growing number of patients seeking consultation on the Internet and the difficulty in regulating online pharmacy providers, an analysis of drug information provided by Internet pharmacies is warranted. OBJECTIVE: To assess the response rates and quality of responses to drug information questions submitted to “ask the pharmacist” services on Internet pharmacy sites and determine whether differences exist between National Association of Boards of Pharmacy—approved and nonapproved sites and among free-standing, chain, and independent pharmacy sites in the quality of information provided. METHODS: A content analysis was conducted on responses to 5 drug information questions electronically mailed to each of 64 Internet pharmacies identified through a meta-engine search. Three judges rated the quality of response components using a scoring system developed by an expert panel, with inter-rater reliabilities subsequently calculated. Both t-test and ANOVA procedures tested for differences in response quality. RESULTS: Responses were received for 51% of all questions submitted to the sites. Few differences in quality were found between approved/unapproved sites and among types of pharmacies. The percentage of correct responses provided for each of 22 response components ranged from 7% to 96%. CONCLUSIONS: While few differences were found among sites based on their approval status or type, low response rates and incomplete counseling information among many of the responses are cause for concern.

Factors influencing migraineur-consulting behavior in a university population.

Objective.—The purpose of this study was to identify factors that contribute to treatment‐seeking behavior in migraineurs in a large employer population. Specifically, the impact of psychographic variables, such as social support, attitudes toward medication, locus of control, and migraine‐associated disability, are considered concomitantly with demographic and disease severity variables.

Content Analysis of FDA Warning Letters to Manufacturers of Pharmaceuticals and Therapeutic Biologicals for Promotional Violations

Manufacturers of pharmaceuticals use advertising and promotion as key marketing activities to foster the success of their products. These activities, however, have to comply with FDA regulations; failure to do so results in FDA enforcement actions such as issuance of warning letters and notices of violation. The purpose of this study is to critically evaluate the content of FDA letters to manufacturers for promotional violations. Two judges formally trained in content analysis procedures critically evaluated the content of publicly available letters from 2000 to 2006. A total of 249 letters described 806 violations from 107 manufacturers. Media most frequently cited in letters were print (n −67), sales aids (n = 42), and television (n = 39). Violations were most frequently related to lack of fair balance (n = 131), misleading claims of efficacy (n = 102), misleading superiority claims (n = 92), and omission of risk information (n = 89). Inter-rater reliabilities between the two judges were exceptional, ranging from 0.89 to 1.00. The marketing of prescription drugs has a significant impact on the medication use process. Managed care policymakers and pharmacists should remain abreast of promotional strategies and claims, particularly those deemed problematic by the FDA, which may spur requests for additional information, prescriptions, or formulary status changes for the drugs promoted.

Identifying Psychological Contract Breaches to Guide Improvements in Faculty Recruitment, Retention, and Development

Objective. To identify pharmacy faculty members’ perceptions of psychological contract breaches that can be used to guide improvements in faculty recruitment, retention, and development. Methods. A list of psychological contract breaches was developed using a Delphi procedure involving a panel of experts assembled through purposive sampling. The Delphi consisted of 4 rounds, the first of which elicited examples of psychological contract breaches in an open-ended format. The ensuing 3 rounds consisting of a survey and anonymous feedback on aggregated group responses. Results. Usable responses were obtained from 11 of 12 faculty members who completed the Delphi procedure. The final list of psychological contract breaches included 27 items, after modifications based on participant feedback in subsequent rounds. Conclusion. The psychological contract breach items generated in this study provide guidance for colleges and schools of pharmacy regarding important aspects of faculty recruitment, retention, and development.

Evaluating the balance of persuasive and informative content within product-specific print direct-to-consumer ads

This study attempts to compare the prevalence of persuasive and informative appeals found in direct-to-consumer (DTC) ads of prescription drugs in consumer magazines. A content analysis of DTC ads in a stratified randomized sample of magazines published from 1995 to 2000 identified the use of 10 types of persuasive appeals and 12 types of informative appeals. The average ad employed the use of 6.24 informative appeals and 3. 13 persuasive appeals. DTC ads in magazines with a predominately male readership were found to contain a greater number of persuasive appeals than ads in other magazines. While the products most frequently advertised were for chronic nonlife-threatening conditions, a panel of pharmacists evaluated the majority of these products as having a high degree of clinical usefulness. Despite significant differences in the prevalence of certain types of appeals among ads for different products, the balance of persuasive and informative appeals did not vary considerably among them. Ads for drugs judged to be more specious in clinical usefulness did not employ the use of additional persuasive appeals and were found to be just as informative as ads for other drugs.

The impact of the internet on community pharmacy practice: a comparison of a Delphi panel's forecast with emerging trends.

Abstract The purpose of this study was to forecast the impact of Internet pharmacy commerce on various stakeholders. A panel of experts assembled from a list of academicians in the social and administrative pharmaceutical sciences participated in a three-iteration Delphi procedure. Feedback from the aggregate responses of the panel was used to construct questionnaires employed in subsequent iterations of the Delphi. The panel converged to form a consensus upon a variety of issues. They forecasted the attainment of a 10-15% share in the market of prescription and over-the-counter pharmaceuticals through on-line purchases, the formation of strategic alliances among stakeholders in the drug distribution process, a shift in marketing strategies by brick-and-mortar stores, an increase in the prevalence of niching among pharmacy service providers and a subsequent growth in the implementation of cognitive services throughout the industry. With few exceptions, the forecast produced by the Delphi panel appears to be coming to fruition.

Treating mentoring programs as a scholarly endeavor.

It has been said that poor mentoring in early adulthood is the equivalent of poor parenting in childhood.1 In 2003, Brown and Hanson opined that formal mentoring appears to be more common in the business world than in the academic world.2 Thankfully, the academic world appears to be catching on to the value of mentorship and formal mentoring programs as it seeks to develop its faculty members as a cadre of knowledge workers seeking the highest levels of self-actualization. A recent report from the American Association of Colleges of Pharmacy Council of Deans/Council of Faculties Task Force on Faculty Workforce identified mentoring as 1 of 4 key elements to elevate the productivity and quality of work life of pharmacy faculty members.3 In fact, the task force viewed mentorship and development as inextricably linked with other organizational outcomes, particularly an academic program’s culture, proffering means in which a program can imbue mentorship as part of the ethos and expectations of junior and senior faculty as well as administrators.

Consumers' Lack of Awareness on Issues Pertaining to Their Prescription Drug Coverage

Abstract Prescription drug coverage is an increasingly important component of any health insurance plan. Previous research has indicated that the optimal use of health insurance by plan members is at least somewhat dependent upon their understanding of its design and inherent cost-containment features. This study employed face-to-face interviews of pharmacy patrons with at least some sort of prescription drug coverage to determine their understanding of any pharmacy plans limitations, the use of formularies, and the concept of generic versus branded drugs, in addition to assessing their sources for obtaining information about their prescription drug plans. Most respondents were able to differentiate between generic and branded drugs, but few of them understood the other cost-containment components of their prescription drug plans. Many subjects relied on their pharmacist, rather than their employer or insurer to provide such information. Despite statistically significant contributions by income level and other demographic and health-related variables, little of the variation in knowledge of these prescription drug issues was explained.

The Intersection of Job Satisfaction and Preceptor Development: Opportunities for Academic Pharmacy Programs

During the past couple of decades have been a host of studies on pharmacist job satisfaction and related quality of work life issues. The interest in this phenomenon is not surprising, given the stake in the profession that these pharmacy researchers have, as many are pharmacists themselves. Moreover, job satisfaction has implications for employee commitment and turnover--factors important in maintaining the labor supply of pharmacists to provide medication therapy management services.1 Another interest in pharmacist job satisfaction might be pharmacy educators’ desire to provide a realistic preview to students of a career that hopefully will one day bring them professional contentment and fulfillment. As such, Payakachat and colleagues address several important issues in their study of satisfaction among pharmacist preceptors in a recent issue of the American Journal of Pharmaceutical Education (http://www.ajpe.org/doi/full/10.5688/ajpe758153).2 The results of satisfaction studies of pharmacists have largely produced a body of equivocal results; that is, there have been considerable inconsistencies in the findings. Payakachat and colleagues allude to this in their discussion of the study results. They point out discrepancies among their findings and the findings of other researchers in regard to the effect of work setting and practitioner demographics.3-6 They also correctly assert that these equivocal results are in part a function of varied sampling strategies and study designs. These seemingly disparate results also may be a function of the instrumentation used to measure satisfaction and even the statistical strategies employed to analyze the data. Some strengths of Payakachat and colleagues’ approach include a validated and reliable measure of job satisfaction and their use of an analysis of covariance model to account for potential confounders such as stress and workload, 2 of many factors that could skew the results. 7 Studies of pharmacist job satisfaction have produced consistent results in some areas. For one, pharmacists have reported higher levels of satisfaction when they have more interaction with patients, are involved in the provision of cognitive services, and have greater opportunity to apply their knowledge and skill sets.8,9 Most pharmacists enjoy a higher quality of work life when they are afforded some autonomy.9,10 Overall, pharmacists are the beneficiaries of relative high levels of work satisfaction with stable careers; however, pharmacists often feel undervalued and complain of poor line management, lack of recognition, and weak levels of support from their employing organization, with the perception that they are viewed merely as cogs in a larger wheel.11,12 The literature is largely in agreement that strong support from supervisors/managers of pharmacists can help ameliorate the deleterious effects of future uncertainty and foster pharmacists’ work satisfaction and organizational commitment.5,10 Additionally, strength of desire to practice pharmacy has been implicated for both improvements in job satisfaction and reductions in pharmacists’ turnover intentions.11 To that end, Gaither called for a deeper understanding of the factors that underlie desire to practice and for inquiries into how pharmacists experience their work environments.13 It is these and other reasons that bring to bear the importance of Payakachat and colleagues’ work.2 Their study is among the first to examine a voluntary role assumed by pharmacists that might contribute to their self-actualization. Teaching and mentoring others can bring greater satisfaction to ones work life, and the opportunity to do so is one of the biggest draws of an academic career.14 For pharmacy programs, eliciting involvement by appointing preceptors might be one tool to encourage enrollment into postgraduate education once these preceptors have had an opportunity to teach students and become more involved with the professional curriculum. And wooing preceptors into postgraduate education might be just as effective a recruitment strategy as trying to attract current students who are straddled with debt, eager to embark on lifes journey, and “burned out from school.” That being said, colleges and schools of pharmacy must do more to engage preceptors and make them feel more a part of the organizations family. Skrabel and colleagues found that nearly all preceptors responding to a survey believed that the quality of students’ experience is improved when a preceptor is able to spend more time with the students; however, a number of preceptors reported that they lack the time to do so.15 Additionally, preceptors tend to overestimate the quality of their performance when self-evaluations are compared to student evaluations.16 Academic programs cannot dictate pharmacists’ workload, nor should they. They can, however, develop more strategic partnerships with pharmacy organizations that seek mutually beneficial gains from engaging preceptors in the academic enterprise. Boyle and colleagues provided innovative suggestions that go even beyond the recommendations of a previous Preceptor Development Task Force.17 These included recognizing preceptors’ excellence, developing preceptors’ educational skills, and facilitating preceptors’ networking opportunities. Boyle and colleagues also touched on the development of strategic alliances with employers, such as creation of medication therapy management certificate programs. It will be critically important that administrators be creative in developing such alliances in ways that involve direct pecuniary benefits (eg, alternative types of faculty appointments, incentivizing preceptor opportunities) and non-pecuniary benefits (eg, joint public relations and media campaigns). Some of these strategies might cost academic institutions some money, but need not require considerable financial investments. The reinforcement and support of employing organizations can be helpful, as academic pharmacy programs attempt to engage preceptors and continuously increase the quality of experiential education, which is now approximately 30% of the professional program. Engagement is key. Academic pharmacy programs must engage professional students, alumni, and other stakeholders. Many are critical of the various systems used to rank academic programs; however, these ranking systems are not unimportant. One concern is the selection of benchmarks used in these ranking systems. Among the more highly criticized indicators in the proportion of alumni giving back to, or remunerating the program; however, careful reflection about how to measure a programs success makes it hard to argue against this criterion. Engaged alumni are those more likely to be satisfied with their academic experience and successful in their careers. Precepting students is an incredibly important role that pharmacists can play, but is only one of the many synergistic endeavors possible between academic pharmacy programs, alumni, and pharmacy provider organizations.