INNOVATIONS in pharmacy Inspiring Inquiry and Improvement in Pharmacy Practice, Education, and Policy. A quarterly publication featuring case studies, clinical experiences, commentaries, idea papers, original research, review articles, and student projects that focus on leading edge, novel ideas for improving, modernizing, and advancing pharmacy practice, education, and policy. INNOVATIONS in pharmacy. en-US <p>Copyright of content published in <em>INNOVATIONS in pharmacy</em>&nbsp;belongs to the author(s).</p> (Jon Schommer, Ph.D.) (Emma Molls) Thu, 08 Sep 2022 13:55:50 -0500 OJS 60 Consumer Perceptions of a Shingles Infograph Intervention and Vaccination Plans in Community Pharmacy Settings <p><strong>Background: </strong>Cost and lack of knowledge are key barriers to improving shingles vaccination rates in community pharmacies. A health literacy (HL) tailored infograph intervention addressing these barriers can enhance consumer interest in shingles vaccinations. </p> <p><strong>Objectives: </strong>The objectives were to: 1) design a health literacy tailored shingles infograph addressing cost and knowledge about vaccination barriers, 2) determine consumer perceptions of infograph usefulness, and 3) determine factors associated with shingles vaccination plans.</p> <p><strong>Methods: </strong>An infograph addressing the study objectives, and a 22-item self-administered questionnaire assessing shingles vaccine awareness, HL, infograph usefulness, and vaccination plans were designed. The infograph was pilot tested with pharmacists and two community-based focus groups. Inclusion criteria consisted of age-eligible consumers at one chain and three independent community pharmacies. Consenting participants first reviewed the infograph and then completed the survey. Descriptive statistics and multivariable logistic regression analyses were performed. </p> <p><strong>Results: </strong>Of the 422 eligible consumers approached, 112 participated in the study, with 55.4% from the chain pharmacies. Participants were female (56%), white (94%), between 50-70 years old (77%), had adequate HL (96%) and aware of the shingles vaccine (87%). While only 8% of the respondents considered vaccinating on the survey date, 46% considered it in the future, and 29% planned to in the next six months. The infograph was useful (90%) in recognizing vaccination need, was readable (95.5%), and understandable (96%). Consumers who found the infograph useful were significantly more likely to have vaccination plans (OR= 4.06, CI: 1.37 – 11.9, p=0.016). </p> <p><strong>Conclusion: </strong>A shingles vaccine infograph focused on key barriers to vaccination was well-received and useful in promoting consumers’ vaccination plans. </p> Radhika Devraj, Miranda Wilhelm, Maithili Deshpande Copyright (c) 2022 Radhika Devraj, Miranda Wilhelm, Maithili Deshpande Thu, 08 Sep 2022 00:00:00 -0500 Hyponatremic Cognitive Dysfunction Resulting from Drug-Drug-Gene Interaction between Sertraline and Cannabidiol in an Intermediate CYP2C19 Metabolizer Patient <p><strong>Background: </strong>Pharmacogenomics (PGx) can provide more precision in determining causation of adverse drug reactions (ADRs) from drug-drug-gene interaction clinical application.</p> <p><strong>Case Summary: </strong>Patient was an intermediate CYP2C19 metabolizer on stable therapy taking a low but therapeutic dose of sertraline for depression and anxiety over a period of 20 years. The patient then became hyponatremic and cognitively impaired after addition of cannabidiol (CBD) to this sertraline regimen. The proposed mechanism was drug-drug-gene interaction of CBD further inhibiting the CYP2C19 metabolism of sertraline and increasing drug exposure to produce moderate to severe hyponatremia and subsequent cognitive dysfunction.</p> <p><strong>Practice Implications: </strong>Pharmacogenomics (PGx) testing may assist in etiology of patient symptoms from adverse drug reactions (ADRs) or drug-drug interactions by combining these with detection and application of drug-gene interactions. This case shows inhibition of CYP2C19 by CBD to further increase sertraline exposure, producing hyponatremia and subsequent cognitive dysfunction through CYP2C19 phenoconversion by CBD.</p> Jade Nanan, Sheena Crosby, Michael J. Schuh Copyright (c) 2022 Jade Nanan, Sheena Crosby, Michael J. Schuh Fri, 23 Sep 2022 00:00:00 -0500 Comparison of the Seasonal Influenza Vaccination amidst the 2020 COVID-19 Pandemic within Six Regional Community Pharmacies of a Large Pharmacy Chain <p><strong>Background</strong>: The CDC has issued interim guidance on administering influenza vaccines amidst the COVID-19 pandemic including providing specific appointment times. A large chain pharmacy has adopted this guidance and is encouraging patients to make appointments rather than a walk-in visit for the influenza vaccination to help avoid large crowds.</p> <p><strong>Objective(s)</strong>: This study aims to determine the impact of the COVID-19 pandemic on influenza vaccination rates (2019 versus 2020 season) and patient appointments versus walk-in visits. The second goal of this study is to evaluate patient satisfaction with the influenza vaccination process.</p> <p><strong>Methods</strong>: Influenza vaccine data was collected from the chain pharmacy online database from the first week in September to the last week in December during 2019 to 2020 and from 2020 to 2021. The second part of this study included a voluntary survey to be completed by the patient regarding satisfaction and thoughts about the 2020-2021 influenza vaccination process.</p> <p><strong>Results</strong>: The six stores identified showed an overall 7.6% increase in influenza vaccination rates from the 2019-2020 season to the 2020-2021 season (p-value= 0.73). There were a total of 15 survey respondents amongst the stores of which 100% of the patients were at least slightly comfortable with the vaccination process and very satisfied overall.</p> <p><strong>Conclusion</strong>: The six pharmacy locations within a large chain revealed that COVID-19 had a positive impact on influenza vaccination rates. Although these results were not statistically significant, this study sets the framework for future vaccination studies.</p> Haley Pressley, Erica Shelton, Krista Capehart, Betsy Elswick, Gretchen Garofoli Copyright (c) 2022 Haley Pressley, Erica Shelton, Krista Capehart, Betsy Elswick, Gretchen Garofoli Mon, 26 Sep 2022 00:00:00 -0500 Roles of Community Pharmacists in Cancer Management <p>Community pharmacists are among the most easily accessible healthcare practitioners and are usually the first point of contact with the public or community. This is often due to their accessibility, credibility, and widespread within the public sector making them essential members of the healthcare team with significant contributions to the delivery of public health care. Community pharmacists, in addition to their known educational and awareness-raising roles, may play an essential role in risk assessment and screening of patients, detection of symptoms of probable malignancy, and cancer treatments. The pharmacy profession has been evolving from dispensing roles into more patient-oriented outcomes and pharmacists are now participating in more clinical interventions. This places community pharmacists in the best position to provide the necessary knowledge and healthcare to benefit populations at risk of cancer. Active involvement of community pharmacists in the care and management of cancer will significantly contribute to screening and risk assessment, early detection, treatment and eradication of breast, cervical, lung, ovarian and other forms of cancer. As a result, the community pharmacy setting must the developed to maximize its full potential in cancer care.</p> Oluwaseyi Muyiwa Egbewande, Muhsinah Adesewa Abdulwasiu, Rashidat Onyinoyi Yusuf, Aishat Bisoye Durojaye, Zainab Ikeoluwa Ashimiyu-Abdusalam Copyright (c) 2022 Oluwaseyi Muyiwa Egbewande, Muhsinah Adesewa Abdulwasiu, Rashidat Onyinoyi Yusuf, Aishat Bisoye Durojaye, Zainab Ikeoluwa Ashimiyu-Abdusalam Fri, 30 Sep 2022 00:00:00 -0500 Exploring the Impact of Reflecting upon Pharmacy Experts’ Written Career Guidance on Student Professional Identity Formation <p><strong>Study Objective: </strong>To explore the impact of reading and critically reflecting upon professional development guidance provided by pharmacy experts upon student professional identity formation (PIF).</p> <p><strong>Methods</strong>: Fifteen second professional year student pharmacists completed an elective course assignment to read 20 published personal letters from Letters to a Young Pharmacist, in which pharmacy experts offer career and life guidance to novice or student pharmacists. From those, each student selected four letters and for each composed a 500 to 600-word critical reflection describing the impact of the letter, yielding 60 reflections for thematic analysis. Each author individually analyzed and coded de-identified reflections for up to 3 types of impact. Data were then grouped for similarity and collapsed into themes; overarching evidence of transformative thinking and “eye-opening” were also coded. </p> <p><strong>Results:</strong> Of 60 reflections, 160 types of impact were identified, and were grouped into five themes. Most often, students described an impact from Personal Growth (41.3%), followed by Professional Growth (16.9%), Forging Relationships (16.2%), Making an Impact (15%) and Morality (10.6%). “Eye-opening” and “transformative thinking” was evidenced in 21 of 60 (35%) and 53 of 60 (88.3%) reflections, respectively. </p> <p><strong>Conclusions</strong>: Student pharmacists experienced growth in PIF by reflecting upon published excerpts from pharmacy experts, as demonstrated by coding for impact and transformative thinking. This novel method of students’ critically reflecting upon expert’s readings, followed by instructor feedback to reinforce the learning, offers a streamlined and easily implemented modality to enable students PIF development during their didactic curriculum. </p> Laurie L. Briceland, Tatiana Martinez Copyright (c) 2022 Laurie L. Briceland, Tatiana Martinez Mon, 26 Sep 2022 00:00:00 -0500 Does Team Based Learning (TBL) in the Pharmacy Classroom Foster Leadership Skills in the Workplace? <p><strong>Objective</strong>: A well-functioning healthcare team is important to optimizing the health outcomes of patients. As such, the use of Team Based Learning (TBL) in the education of health professionals has emerged as one of the more common active learning strategies. In various anecdotes with preceptors, it had been observed that student pharmacists educated in a TBL classroom exhibited increased skills in the affective domain. This qualitative pilot study begins to examine affective domain skills that are important to pharmacy practice and which of those skills may be developed uniquely through TBL.</p> <p><strong>Methods</strong>: Random samples of preceptors and students (first through fourth-year cohorts), were engaged using a predesigned interview protocol to guide the discussion. Ad hoc questions resulting from the interview were also captured. A grounded theory approach was utilized to develop an a priori theme codebook that was utilized to analyze the interviews with preceptors and focus groups with students.</p> <p><strong>Results</strong>: Nine preceptors were interviewed, and 23 student pharmacists participated in focus groups. Preceptors identified 1) communication, 2) emotional intelligence, 3) education, 4) time management, and 5) advocacy as the top themes important to being a leader. While students identified 1) communicate with or listen to others, 2) accountability/responsibility, 3) patience, 4) self-reflection / feedback as skills developed by TBL. Participants indicated that they believed that TBL was a contributor to the development of affective domain skills among student pharmacists.</p> <p><strong>Conclusion</strong>: Among preceptors and student pharmacists, this initial study found both alignment and divergence with identified skills in the affective domain related to the development of leadership skills. Additional research is needed to further explore and develop an instrument to measure the role of TBL in affective skill development, in the context of being a leader in the pharmacy profession.</p> Robert C. Haight, Marta J. Brooks Copyright (c) 2022 Robert C. Haight, Marta J. Brooks Mon, 26 Sep 2022 00:00:00 -0500