Barriers to person-centered service design in pharmacy practice: examples, lessons, and potential solutions.

Despite increased attention to, and frameworks conceptualizing person-centered care, systematic, organizational, and provider-level barriers continue to discourage the development and delivery of person-centered care (PCC) in pharmacy practice and beyond. This commentary describes existing pharmacy-specific literature related to PCC, barriers to PCC within the context of pharmacy practice, and potential solutions to increase person-centeredness in pharmacy services. Literature to substantiate and describe barriers and potential solutions was identified from 2008 to 2023, a period where the emphasis on PCC in pharmacy practice dramatically increased.

Academic Entitlement Among Pharmacy Students in the Arab World: A Multi-National Exploratory Study.

Objective: The study's aim was to explore academic entitlement among pharmacy students in different pharmacy colleges in the Arab World and assess associated factors.

Methods: This study design was a cross-sectional survey. Data were collected using a self-administered electronic questionnaire posted across pharmacy college networks in 10 Arab countries (Egypt, Iraq, Jordan, Lebanon, Libya, Oman, Palestine, Qatar, Saudi Arabia, and United Arab Emirates).

Development and validation of a performance-based palliative care assessment tool for student pharmacists.

Introduction: Integration of hospice and palliative care principles within pharmacy curricula is essential to fill the need of pharmacist training in this growing specialty. A formalized assessment tool to evaluate skill development does not exist for student pharmacists specific to palliative care. The objective of this study was to develop a valid and reliable, palliative care-focused, performance-based assessment tool for student pharmacists.

Evaluating motor progression of juvenile-onset Huntington's Disease: An Enroll-HD analysis.

Introduction: Juvenile-onset Huntington's disease (JOHD) is characterized by a unique motor phenotype relative to patients with adult-onset Huntington's Disease (AOHD). This study characterized motor progression of JOHD to propose improved outcome measures for this group.

Methods: We used linear mixed effect regression models to compare progression of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score (TMS) and the chorea score between patients with JOHD and AOHD.

Impact of Formulation and Microneedle Length on Transdermal Metronidazole Permeation through Microneedle-Treated Skin.

Objective: This study aimed to determine the impact of formulation (gel vs cream) and microneedle characteristics (length, number) on permeation of metronidazole through excised microneedle-treated skin. The long-term goal is to apply these results towards a pharmacokinetic study in human subjects with diverse skin types, using in vitro flux data to determine dosing conditions and ultimately establish in vitro-in vivo correlations.

Methods: Metronidazole release from 0.

Beyond satisfaction in person-centered pharmacy services.

Patient self-reported satisfaction is commonly used as an assessment of service experience and quality for community pharmacy services. This commentary discusses alternative foundational approaches to evaluating service experience and quality in patient-centered care. It describes historical and recent literature pertaining to the development and use of satisfaction measures for service design and patient experience assessment.

Awareness with paralysis and symptoms of post-traumatic stress disorder among mechanically ventilated emergency department survivors (ED-AWARENESS-2 Trial): study protocol for a pragmatic, multicenter, stepped wedge cluster randomized trial.

Background: Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1-0.

Dementia: Management and Controversies in Management.

Dementia management requires individualized patient encounters that focus on education and realistic expectations. Numerous vitamins and supplements are promoted for memory enhancement, but they lack evidence to support their use. Nonpharmacotherapy should be used through all stages of dementia.

Hypertensive Emergency: Parenteral Antihypertensives and Population Data.

Purpose Of Review: Review parenteral therapeutic choices in treatment of hypertensive crises by mechanism of action and summarize recent literature on the management of hypertensive crises.

Recent Findings: Recent data have documented the safety and efficacy of labetalol and nicardipine in treatment of hypertensive crises as well as characterized the hypertensive emergency population to a much greater extent. Based on recent data, hypertensive emergencies are seen in 0.

Adherence to Annual Lung Cancer Screening in a Centralized Academic Program.

Background: Adherence to lung cancer screening (LCS) protocols is critical for achieving mortality reductions. However, adherence rates, particularly for recommended annual screening among patients with low-risk findings, are often sub-optimal. We evaluated annual LCS adherence for patients with low-risk findings participating in a centralized screening program at a tertiary academic center.

A smoking cessation intervention for rural veterans tailored to individual risk factors: A multicenter randomized clinical trial.

Introduction: Rates of cigarette use remain elevated among those living in rural areas. Depressive symptoms, risky alcohol use, and weight concerns frequently accompany cigarette smoking and may adversely affect quitting. Whether treatment for tobacco use that simultaneously addresses these issues affects cessation outcomes is uncertain.

Examination of the Rate and Extent of Drug Released from Commercial Topical Delivery Systems During Wear: An Example with Lidocaine Topical Systems.

Objective: This study aimed to determine the extent and rate of lidocaine released in vivo from two bioequivalent topical delivery systems (TDS) by using complementary assessments: pharmacokinetic analysis in healthy human volunteers, and residual lidocaine in TDS following 12 h of wear. The goal was to explore a potentially more clinically meaningful strength presentation than percent active pharmaceutical ingredient loaded in topical systems.

Methods: A three-arm, open-label, crossover clinical study was conducted in 23 human subjects, with 5% lidocaine topical systems from two manufacturers, and intravenous lidocaine administration.

Unravelling the role of huntingtin: from neurodevelopment to neurodegeneration.

This scientific commentary refers to ‘Genetic topography and cortical cell loss in Huntington’s disease link development and neurodegeneration’ by Estevez-Fraga (https://doi.org/10.1093/brain/awad275).

Management of Hyperkalemia in Patients with Chronic Kidney Disease Using Renin Angiotensin Aldosterone System Inhibitors.

Purpose Of Review: Use of renin-angiotensin-aldosterone system (RAAS) inhibiting medications is critical in the prevention of cardiovascular disease and kidney function decline in patients with chronic kidney disease (CKD); however, these agents can lead to hyperkalemia, an electrolyte disorder associated with risk of arrythmia, conduction disorders, and increased overall mortality. Discontinuation, or reduction of dose, of RAAS inhibitor therapy in hyperkalemic patients with CKD can lead to loss of kidney and cardiovascular protection afforded by these medications. Given the high prevalence of hyperkalemia among patients with CKD utilizing RAAS inhibitors, clear management principles are critical to minimize risk and maximize benefit when facing this clinical dilemma.

Differential response to neoadjuvant endocrine therapy for Black/African American and White women in NCDB.

Purpose: Compared to White women, there are higher mortality rates in Black/African American (BAA) women with hormone receptor-positive breast cancer (HR + BC) which may be partially due to differences in treatment resistance. We assessed factors associated with response to neoadjuvant endocrine therapy (NET).

Methods: The National Cancer Database (NCDB) was queried for women with clinical stage I-III HR + BC diagnosed 2006-2017 and treated with NET.

Perspectives of Professionalism, Self-Awareness, Leadership, and Innovation and Entrepreneurship From Experiential Education Preceptors.

Objective: The objectives of this study were to (1) quantify the perceived importance of and comfort with the Accreditation Council for Pharmacy Education Standard 4 (ACPE-S4) key elements, (2) describe how preceptors promote and assess key elements, and (3) describe preceptor perceptions of student key element skill demonstration.

Methods: This study used a cross-sectional electronic survey to assess experiential education preceptors' perceptions of ACPE-S4 key elements. The survey consisted of 2 item categories, with 5 and 15 items included to collect information on preceptor demographics and ACPE-S4 key elements, respectively.

Evaluation of a Telehealth-Based Pharmacist Led Chronic Care Management Program.

Clinical pharmacy services improve several patient chronic disease outcomes. This review evaluates a pharmacist-led chronic care management (CCM) program partnered with a health system for patient outcomes and sustainability. A mixed methods evaluation based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was completed.

Offering an Alternative to Persons with Chronic Pain: How Access to Cannabis May Provide an Off-Ramp from Undesired Prescription Opioid Use.

Background: Chronic pain (CP) is experienced by as many as 50 million Americans and can negatively impact physical and mental health. Prescribing opioids is the most common approach to address moderate to severe CP though these potent analgesics are associated with a significant number of side effects. One alternative some Americans are turning to for CP management is cannabis.

Finalizing the Work Related to the Curriculum Outcomes and Example Objectives and Entrustable Professional Activities (COEPA) Document: The Report of the 2022-2023 Academic Affairs Standing Committee.

The 2022-2023 Academic Affairs Committee (AAC) was charged to (1) complete the Center for the Advancement of Pharmacy Education Outcomes and Entrustable Professional Activities (EPAs) revisions (now renamed as COEPA - Curriculum Outcomes and Entrustable Professional Activities) after receiving feedback at the 2022 American Association of Colleges of Pharmacy (AACP) Annual Meeting; (2) offer guidance on how the revised COEPA education outcomes and EPA statements should be used by member institutions, faculty, preceptor, and students; (3) guide input into the ongoing revision of the Accreditation Council for Pharmacy Education (ACPE) standards for the Doctor of Pharmacy program. The published report of the 2021-2022 AAC outlines the work of the Committee through the spring of 2022. This 2022-2023 AAC report focuses on the work related to finalizing the COEPA educational outcomes, EPAs, preamble, and glossary and formally receiving approval from the AACP Board of Directors.

Thermosensitive biomaterial gels with chemical permeation enhancers for enhanced microneedle delivery of naltrexone for managing opioid and alcohol dependency.

Naltrexone (NTX) can be transdermally delivered using microneedles (MN) to treat opioid and alcohol misuse disorders, but delivery is blunted by rapid micropore closure. Poloxamer (P407), a thermosensitive biocompatible hydrogel, sustains NTX delivery through MN-treated skin by generating a drug depot within the micropores. Optimizing P407 formulations could maintain sustained delivery after micropore closure while reducing required patch sizes, which would be more discreet and preferred by most patients.

The AACP Academic Affairs Committee's Final 2022 Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates to Replace 2013 CAPE and 2016 EPAs.

The American Association of Colleges of Pharmacy (AACP) Academic Affairs Committee was charged with revising both the 2013 Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes (EOs) and the 2016 Entrustable Professional Activities (EPAs). The Committee changed the document name from the CAPE outcomes to COEPA, (Curricular Outcomes and Entrustable Professional Activities) since the EOs and EPAs would now be housed together. A draft of the COEPA EOs and EPAs was released at the AACP July 2022 Annual meeting.

Early skills laboratory warnings: Laboratory faculty perspectives on student barriers for progression to experiential education.

Introduction: This study characterized faculty perceptions of student barriers to achieving an Entrustable Professional Activities (EPA) level 2 or higher in the Patient Care Provider domain.

Methods: Pharmacy skills laboratory faculty participated in a nominal group technique (NGT) session. Participants reflected on two questions: "What behaviors would result in a student not achieving a rank of EPA readiness level 2 or higher?" and "What knowledge and skills would result in a student not achieving a rank of EPA readiness level 2 or higher?" Participants developed a ranked list using silent brainstorming, idea generation, clarification, and discussion.

Integration in mixed-methods studies: existing practices, considerations and recommendations for pharmacy research.

Mixed methods research is increasingly used to investigate complex issues in health and healthcare. Purposeful integration of the qualitative and quantitative strands has a significant potential to yield insights that exceed the value of a study's constituent qualitative and quantitative components alone. The philosophical foundations of mixed methods in pragmatism support the importance of integration as a focus of designing and conducting mixed methods research.

Academic Activism: An Avenue to Action.

Until now, the term "advocacy" in pharmacy education and practice has focused on advocating for the advancement of the pharmacy profession or patient advocacy. With the 2022 Curricular Outcomes and Entrustable Professional Activities publication, the focus of advocacy has broadened to include advocacy for other causes that impact the health of patients. This commentary will highlight 3 pharmacy-focused organizations advocating for social issues impacting the health of patients as well as encourage members of the Academy to continue to expand personal social advocacy efforts.