Terry L. Schwinghammer

Board of regents commentary qualifications of pharmacists who provide direct patient care: Perspectives on the need for residency training and board certification

In 2006, the American College of Clinical Pharmacy (ACCP) released a position statement and a white paper to provide the Colleges viewpoints on the importance of postgraduate pharmacy residency training as a prerequisite for direct patient care practice and the vision that future clinical pharmacists engaged in direct patient care would be certified by the Board of Pharmacy Specialties (BPS). Since the release of these papers, some members of the pharmacy profession have interpreted ACCPs position as maintaining that all pharmacists—regardless of the focus of their professional practice activities—should complete formal postgraduate residency training and be board‐certified specialists. That interpretation is not accurate. In this commentary, ACCP further defines “direct patient care” and states that it believes that clinical pharmacists engaged in direct patient care should be board certified (i.e., and residency‐trained or otherwise board eligible) and have established a valid collaborative drug therapy management (CDTM) agreement or have been formally granted clinical privileges. The rationale for this viewpoint is presented in detail. The pharmacy profession has appropriately invested substantial resources to ensure the quality of its accredited residency training programs and board certification processes. ACCP believes that these training and certification programs are essential steps in preparing clinical pharmacists to provide direct patient care.

Desired professional development pathways for clinical pharmacists.

The 2012 American College of Clinical Pharmacy (ACCP) Certification Affairs Committee was charged with developing guidelines for the desired professional development pathways for clinical pharmacists. This document summarizes recommendations for postgraduate education and training for graduates of U.S. schools and colleges of pharmacy and describes the preferred pathways for achieving, demonstrating, and maintaining competence as clinical pharmacists. After initial licensure within the state or jurisdiction in which the pharmacist intends to practice, completion of an accredited PGY1 pharmacy residency is recommended to further develop the knowledge and skills needed to optimize medication therapy outcomes. An accredited PGY2 pharmacy residency should be completed if a pharmacist wishes to seek employment in a specific therapeutic area or practice setting, if such a residency exists. Clinical pharmacists intending to conduct advanced research that is competitive for federal funding are encouraged to complete a fellowship or graduate education. Initial certification by the Board of Pharmacy Specialties (BPS) or other appropriate sponsoring organizations should be completed in the desired primary therapeutic area or practice setting within 2 years after accepting a position within the desired specific therapeutic area or practice setting. Clinical pharmacists subsequently will need to meet the requirements to maintain pharmacist licensure and board certification. Traineeships, practice‐based activities, and certificate programs can be used to obtain additional knowledge and skills that support professional growth. Pharmacists are strongly encouraged to adopt a lifelong, systematic process for professional development and work with ACCP and other professional organizations to facilitate the development and implementation of innovative strategies to assess core practice competencies.

Report of the 2010-2011 Professional Affairs Committee: Effective partnerships to implement pharmacists' services in team-based, patient-centered healthcare.

According to the Bylaws of the AACP, the Professional Affairs Committee is to study: issues associated with the professional practice as they relate to pharmaceutical education, and to establish and improve working relationships with all other organizations in the field of health affairs. The Committee is also encouraged to address related agenda items relevant to its Bylaws charge and to identify issues for consideration by subsequent committees, task forces, commission, or other groups. COMMITTEE CHARGE President Rodney A. Carter charged the 2010-2011 American Association of Colleges of Pharmacy (AACP) Professional Affairs Committee with: Examining how AACP and its members can most effectively partner with a variety of key stakeholders to accelerate the implementation of pharmacist services (e.g., MTM, primary care) as the standard for team-based, patient-centered care. Members of the 2010-2011 Professional Affairs Committee include faculty from various colleges and schools of pharmacy as well as pharmacy practice association representatives from the American Pharmacists Association (APhA), the American Society of Health-System Pharmacists (ASHP), the National Association of Chain Drug Stores (NACDS), and the National Community Pharmacists Association (NCPA). In order to fulfill the Committee charge, the Committee members met for a day and a half in Arlington, Virginia in October 2010 to discuss the committee charge and develop a plan of action to address the charge. Following this meeting, the Committee communicated via a series of conference calls as well as personal exchanges via telephone and email. The result is the following report which is positioned to discuss various models of care, challenges and opportunities pertaining to the charge, successful practices of AACP members and multiple pharmacy practice organizations, and recommendations to AACP in response to the Committee charge. BACKGROUND The pharmacy profession has been intransition from a product-based to a patient-centered care model since the introduction of the pharmaceutical care philosophy in the 1990s. (1) This transition has been accomplished to varying degrees in different pharmacy practice settings and has been influenced by a variety of factors including the transition to the clinically-focused Doctor of Pharmacy (Pharm.D.) degree as the entry level degree and the increasing recognition that medication-related problems pose a significant threat to public health. (2) The Centers for Medicare and Medicaid Services (CMS) recognized the importance of medication therapy management (MTM) services by requiring all Medicare Part D plans to provide MTM as part of their programs. Recent healthcare reform (HCR) legislation includes provisions for MTM and pharmacist-provided services as part of integrated team-based care models designed to improve the quality of healthcare delivered in the United States. (4) Pharmacists are well-positioned to serve as the medication therapy expert on the healthcare team. (5) Currently, MTM services are not offered to all patients in all settings. This creates a situation of inequality and fragmentation of pharmacy services. It is imperative that the profession and the Academy accelerate the implementation of patient-centered, team-based care as the standard of pharmacy practice with the availability of MTM services to all patients. This vision has been clearly articulated in the Joint Commission of Pharmacy Practitioners (JCPP) vision for pharmacy practice. (6) Identification of the factors that are impeding the realization of this vision and the development of strategies to accelerate its adoption as the standard of pharmacy practice in 2015 are the focus of this report. With the current HCR legislation, increasing the momentum for implementation of medication management services and chronic disease management services provided by pharmacists is a critical issue for pharmacy practice and education. …

The 2016 ACCP Pharmacotherapy Didactic Curriculum Toolkit.

The 2016 American College of Clinical Pharmacy (ACCP) Educational Affairs Committee was charged with updating and contemporizing ACCPs 2009 Pharmacotherapy Didactic Curriculum Toolkit. The toolkit has been designed to guide schools and colleges of pharmacy in developing, maintaining, and modifying their curricula. The 2016 committee reviewed the recent medical literature and other documents to identify disease states that are responsive to drug therapy. Diseases and content topics were organized by organ system, when feasible, and grouped into tiers as defined by practice competency. Tier 1 topics should be taught in a manner that prepares all students to provide collaborative, patient‐centered care upon graduation and licensure. Tier 2 topics are generally taught in the professional curriculum, but students may require additional knowledge or skills after graduation (e.g., residency training) to achieve competency in providing direct patient care. Tier 3 topics may not be taught in the professional curriculum; thus, graduates will be required to obtain the necessary knowledge and skills on their own to provide direct patient care, if required in their practice. The 2016 toolkit contains 276 diseases and content topics, of which 87 (32%) are categorized as tier 1, 133 (48%) as tier 2, and 56 (20%) as tier 3. The large number of tier 1 topics will require schools and colleges to use creative pedagogical strategies to achieve the necessary practice competencies. Almost half of the topics (48%) are tier 2, highlighting the importance of postgraduate residency training or equivalent practice experience to competently care for patients with these disorders. The Pharmacotherapy Didactic Curriculum Toolkit will continue to be updated to provide guidance to faculty at schools and colleges of pharmacy as these academic pharmacy institutions regularly evaluate and modify their curricula to keep abreast of scientific advances and associated practice changes. Access the current Pharmacotherapy Didactic Curriculum Toolkit at http://www.accp.com/docs/positions/misc/Toolkit_final.pdf

Pharmaceutical Care Education in Kuwait: Pharmacy Students Perspectives

Background Pharmaceutical care is defined as the responsible provision of medication therapy to achieve definite outcomes that improve patients’ quality of life. Pharmacy education should equip students with the knowledge, skills, and attitudes they need to practise pharmaceutical care competently. Objective To investigate pharmacy students’ attitudes towards pharmaceutical care, perceptions of their preparedness to perform pharmaceutical care competencies, opinions about the importance of the various pharmaceutical care activities, and the barriers to its implementation in Kuwait. Methods A descriptive, cross-sectional survey of pharmacy students (n=126) was conducted at Faculty of Pharmacy, Kuwait University. Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (SD) were calculated and compared using SPSS, version 19. Statistical significance was accepted at a p value of 0.05 or lower. Results The response rate was 99.2%. Pharmacy students expressed overall positive attitudes towards pharmaceutical care. They felt prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Perceived pharmaceutical care competencies grew as students progressed through the curriculum. The students also appreciated the importance of the various pharmaceutical care competencies. They agreed/strongly agreed that the major barriers to the integration of pharmaceutical care into practice were lack of private counseling areas or inappropriate pharmacy layout (95.2%), lack of pharmacist time (83.3%), organizational obstacles (82.6%), and pharmacists’ physical separation from patient care areas (82.6%). Conclusion Pharmacy students’ attitudes and perceived preparedness can serve as needs assessment tools to guide curricular change and improvement. Student pharmacists at Kuwait University understand and advocate implementation of pharmaceutical care while also recognizing the barriers to its widespread adoption. The education and training provided at Kuwait University Faculty of Pharmacy is designed to develop students to be the change agents who can advance pharmacist-provided direct patient care.

AACP Strategy for Addressing the Professional Development Needs of Department Chairs

Objectives. Characterize the skills and abilities required for department chairs, identify development needs, and then create AACP professional development programs for chairs. Methods. A 30-question electronic survey was sent to AACP member department chairs related to aspects of chairing an academic department. Results. The survey identified development needs in the leadership, management, and personal abilities required for effective performance as department chair. The information was used to prioritize topics for subsequent AACP development programs. Subsequent programs conducted at AACP Interim and Annual Meetings were well attended and generally received favorable reviews from participants. A list of development resources was placed on the AACP website. Conclusions. This ongoing initiative is part of an AACP strategy to identify and address the professional development needs of department chairs. Survey results may also inform faculty members and other academic leaders about the roles and responsibilities of department chairs.

Competency-Based Pharmacy Education: An Educational Paradigm for the Pharmacy Profession to Meet Society's Healthcare Needs

Abstract There is growing interest in competency-based education (CBE) in health professions education, including pharmacy. This paradigm focuses on developing in graduates the clinical competencies that best meet the needs of their constituents. The developed countries have been pioneers in adopting competency-based pharmacy education (CBPE). Several pharmacy competency frameworks have been developed in these countries to support construction of CBE curricula, accreditation criteria of pharmacy programs, and professional pharmacy registration/licensure. The adoption of CBE can assist developing countries in tailoring pharmacy education to meet societal needs. The transformation of traditional pharmacy education into CBPE offers several advantages but is also associated with substantial implementation challenges. Proper design and implementation of the curriculum, efficient use of resources, and wise investment in faculty development are important means of meeting these challenges.

Reply to the Hematology/Oncology Pharmacy Association Alternative Viewpoint on the 2016 ACCP Pharmacotherapy Didactic Curriculum Toolkit

On behalf of the 2016 ACCP Educational Affairs Committee, we appreciate the thoughtful Alternative Viewpoint of the Hematology/Oncology Pharmacy Association (HOPA) Task Force1 to the 2016 ACCP Pharmacotherapy Didactic Curriculum Toolkit. The Toolkit2 and its accompanying Commentary3 are published online with the expectation that there will be periodic updates. ACCP plans to review the Toolkit every two to three years and will empanel a Task Force in fall 2017 to conduct the next review, anticipating an update in 2018. This article is protected by copyright. All rights reserved.

Comment on “Educating Our Students About Pharmaceutical Care for Those Living With Cancer”

To the Editor. We read with great interest the recent Viewpoint entitled “Educating Our Students About Pharmaceutical Care for Those Living With Cancer.”1 In the commentary, Anderson and colleagues highlight the importance of properly preparing student pharmacists for involvement in the long-term care of cancer patients. In the United States, 1 in 3 women and 1 in 2 men will develop cancer in their lifetime.2 In 2008, there were an estimated 13 million newly diagnosed cases of cancer worldwide.3 We agree that pharmacists play a vital and rapidly increasing role in the management of patients with malignancy. Although oncology practice in pharmacy has traditionally been the realm of specialists, the increasing ability to manage many cancers as chronic diseases (often by using oral oncolytic agents and concomitant supportive care therapies) has moved anticancer treatment into mainstream pharmacy practice. Given these advances, it is no longer sufficient to leave oncology pharmacy practice to the specialists; pharmacists in all practice settings must be adequately prepared to care for cancer patients across the care continuum from initial diagnosis to end-of-life care.