Considerations of management and marketing courses within pharmacy curricula in the United States

INTRODUCTION

To assess the extent pharmacy programs are offering courses in management and marketing.

METHODS

We sampled the extent of management and marketing coursework in the doctor of pharmacy (PharmD) curricula in the United States (US) by examining website descriptions of the best pharmacy schools in 2020 (N = 134) as ranked by the US News and World report. Links to curriculum descriptions and catalogs were reviewed for coursework having the words, marketing, management, entrepreneurship, or business plan in the title.

RESULTS

Of the 134 PharmD curricula reviewed, 36 (27%) had no required or elective management courses, and 101 (75%) had no required or elective marketing courses in their curriculum. Most schools did offer a core (n = 89) or elective (n = 9) management course. However, of those, about half (n = 46) provided only a single management course over the entire curriculum. Only 33 (25%) schools offered a marketing course, of which most (n = 27) were elective.

CONCLUSIONS

Many pharmacy schools in the US are not providing pharmacy graduates with the business management and marketing education required for the role of a pharmacist. Pharmacy education should consider curriculum changes that equip pharmacy students with sufficient business knowledge and skills to be innovative and entrepreneurial in all practice settings.

A literature review of pharmacist’s impact on lifestyle modifications among obese, hypertensive patients

Objectives

Previous trials have confirmed a positive relationship between obesity and hypertension. The purpose of this article is to identify the impact of pharmacists in lifestyle adherence among obese, hypertensive patients.

Methods

A literature search was performed at an academic institution using secondary databases, PubMed/MEDLINE and EBSCOhost. Reviews, observational and experimental reports published in English between 2010 and 2020 were included. Terms searched were pharmacy, pharmacist, lifestyle modifications, adherence, compliance, hypertension, obesity, consultation, intervention. Effect on lifestyle modifications consisted of change in blood pressure values, weight, body mass index, diet/sodium intake and/or exercise.

Key findings

Six hundred seventy-five articles were reviewed with 10 meeting inclusion criteria. The role of a pharmacist has a positive impact on compliance in lifestyle adherence with obese, hypertensive patients. Additionally, age, gender marital status, education, monthly income, knowledge level and beliefs of hypertension and co-morbidities all can affect adherence to lifestyle modifications.

Conclusions

The pharmacist has a vital role in the management of hypertension and obesity through frequent interactions with patients to increase adherence to lifestyle modifications.

Destigmatizing public health concerns and supply of COVID-19 vaccines

The end of the global pandemic caused by COVID-19 and a future without masks and restrictions are promising with the discovery of a vaccine. Still, there is much worry about the vaccine itself. Fears about what is inside the vaccine, how quickly it was created and plans for distribution are major concerns. This article aims to address these concerns to relieve vaccine hesitancy. Methods for distribution within the United States as well as different strategies to ensure proper and equitable allocation of COVID-19 vaccine worldwide is also described.

"Daltexpharma": A Case Addressing Potential Pharmaceutical Cargo Theft

This paper is provided as an innovative resource for those in the academic and training arenas to use as a case example in discussing the problem of pharmaceutical cargo theft. The case delves into the worldwide, on-going dilemma of pharmaceutical trucking cargo theft losses and the effects of such theft. For those unfamiliar with the case method of instruction, the paper’s ending may be rather unsettling. But that is where the student’s learning and faculty instruction process come together. Typically, students (whether in teams or individually) will fully develop their responses based on the queries provided at the end. Faculty may then proceed in any number of ways to elicit the students’ insights in a classroom setting.

For decades the pharmaceutical industry has been plagued with a plethora of criminal acts that impact the daily processes and procedures of operations. Pharmaceutical warehouse and trucking thefts have not only aided in the currently debilitating state of the opioid crisis in the United States, but these thefts also aid the black market in the illegal sale of diverted prescription drugs. Due to the lack of security measures, vulnerability of the truck drivers, their rigs, and the value of the cargo being transported, pharmaceutical theft is a lucrative opportunity for organized crime. The case presented here describes the issues within the pharmaceutical industry as companies must deal with “last mile” cargo thefts. Daltexpharma represents a synthesized, hypothetical example of a pharmaceutical firm that must develop policies to deal with such potential thefts in its supply chain. Although a fictitious company, the case realistically details the important factors to consider in establishing strong security practices that may be necessary for a pharmaceutical company operating in today’s environment. In order to protect the integrity and security of the authors’ case notes, particularly for use in an academic setting, the Journal’s editor will maintain control of them. They may be obtained by faculty upon presenting their request to the Editor.

Patient Assistance Programs and Technology in Medication Adherence

Background:

Patient assistance programs, including medication management and counseling, have the potential to improve care in chronic disease states with complex therapies. Incorporating technology as a tool to foster adherence is becoming more commonplace in practice.

Objectives:

The purpose of this report is to identify barriers of medication adherence and review the impact of patient assistance programs and technology on medication adherence.

Methods:

A literature search was conducted in secondary databases, PubMed/MEDLINE and EBSCOhost of peer-reviewed systematic reviews, experimental, quasi-experimental, and observational reports published in English within the last fifteen years. Terms searched included patient assistance program, pharmacist role, technology, adherence or compliance, income and health.

Results:

Ten studies met our prespecified criteria. Male sex, several self-reported chronic diseases, negative expectancy of treatment, engagement in polypharmacy, financial hardships and lower education level correlated with lower medication adherence. Patient care assistance programs and utilization of technology (e.g., use of a mobile application) improved medication adherence.

Conclusions:

Patient assistance programs and technological tools, such as mobile applications,are necessary resources in improvingmedication adherence.

Trends of cancer-associated venous thromboembolism (VTE) in the United States (2005-2014)

INTRODUCTION

Cancer patients are prone to higher risk of venous thromboembolism (VTE) compared to the general population. However, the estimated incidence of cancer-associated VTE varied among the studies. The primary objective of this study was to determine the national annual incidence and examine the trend of cancer-associated VTE in the US over the years from 2005 to 2014.

METHODS

A retrospective population based study was conducted using data from the Medical Expenditure Panel Survey. The study included all noninstitutionalized US adults aged ≥18 years who had a final person-weight > 0 to be representative of the national population. Simple linear regression (SLR) and Mann-Kendall (MK) tests were used to examine the trend of cancer-associated VTE over the years.

RESULTS

On average, there were 15,570,000 adult persons living with a cancer condition every year. Female represented 53.8% of the study population, and the mean of age was 63.5 years. The overall annual incidence of cancer-associated VTE varied between 1.80 and 0.72% over the years, with an overall average of 1.18%. The study found a non-significant downward trend in the incidence of cancer-associated VTE over the years. Patients who had cancer-associated VTE were significantly older than patients without VTE (mean 68.64 vs. 62.68 years, p < .0001).

CONCLUSION

The study found cancer patients continued to have the risk of VTE over the years. The non-significant downward trend in cancer-associated VTE suggests that health care practitioners are heading in the right direction, but enhanced preventative care is needed to avoid further incidents of cancer-associated VTE.

A retrospective cohort study of the prevalence of anxiety and agitation in schizophrenic smokers and the unmet needs of smoking cessation programs

Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a "self-medication" strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.

Patient Counseling Guidelines for the Use of Cannabis for the Treatment of Chemotherapy-Induced Nausea/Vomiting and Chronic Pain

The use of cannabis medications has grown in recent years for the symptomatic relief of chemotherapy-induced nausea/vomiting (CINV) and chronic pain (cancer-related and non-cancer-related). As states legalize the use of cannabis, it is important for pharmacists and other health care professionals to be aware of how to counsel patients receiving prescriptions for cannabis medications. The aim of this study was to develop patient counseling guidelines for the use of cannabis products in treatment of CINV and chronic pain. A literature search was performed using Medline/PubMed resources and Google Scholar between July 2015 and August 2018 using broad search terms, e.g., cannabinoids adverse effects, cannabis, natural cannabinoids, and tetrahydrocannabinol. Using the American Society of Health-System Pharmacists patient counseling guidelines and medical information on cannabis medications gathered from drug databases, a comprehensive counseling guideline was developed. Medical evidence of the use of natural cannabis medications that are smoked or orally ingested have not been studied as extensively as oral therapeutic agents currently available. Cannabis medications have become more prevalent by approval of legislators in several states. Hence, pharmacists and health care professionals should counsel patients effectively on its use. This guideline needs to be tested to assess its utility in patients.

Cultural Sensitivity and Global Pharmacy Engagement in the United States

Objective. To provide a resource for schools and colleges of pharmacy in different regions of the world that are considering sending their students and faculty members to the United States for training. Methods. A literature review (2000-2018) was conducted that involved database and Internet searches using specific keywords and terms. Information was also solicited from authors in different regions of the United States who have hosted international students and faculty members. Recommendations for pharmacists and other health care practitioners on culturally sensitive engagement were formulated. Results. Global engagement between schools and colleges of pharmacy from different regions of the world and the United States is increasing. In addition to various cultural aspects, general information about the US health care system, pharmacy education programs, and pharmacy practice were found to be available to individuals who are charged with organizing and facilitating these exchanges. Common stereotypes and misconceptions about the United States were also identified. Conclusion. For international learners to have an enriching and fruitful engagement while in the United States, an understanding of American culture in general as well as the unique cultural aspects of different regions of the country as provided in this paper is critical.

Cultural Sensitivity and Global Pharmacy Engagement in Asia: India, Indonesia, Malaysia, Philippines, and Vietnam

Schools and colleges of pharmacy in the United States increasingly interact with those in Asian countries for various purposes such as education and research. For both those visiting and those hosting, it is important to understand and respect the culture of the other's country to enrich these interactions. This paper, the second of two manuscripts on Asian countries, focuses on India, Indonesia, Malaysia, Philippines, and Vietnam. For each country, the following information is provided: general introduction, health care system, pharmacy practice, and pharmacy education, stereotypes and misconceptions, recommendations for US-based health care professionals, faculty members, and students who visit these Asian countries, and recommendations for them to host visitors from these Asian countries. The aim of this paper is to assist US health care professionals, faculty members, and students in initiating and promoting a culturally sensitive engagement.

Cultural Sensitivity and Global Pharmacy Engagement in the Arab World

Objective. To create a resource on cultural sensitivity for schools and colleges of pharmacy that are currently engaged or considering future outreach opportunities in the Arab world. Methods. A literature review (2000-2018) of databases and Internet searches with specific keywords and terms were conducted. Authors who had experience in travelling to and hosting students and professionals from the Arab world and authors with local work experience in the Arab world were solicited. Results. General information about the Arab world, including unique aspects of individual countries, is presented. Stereotypes and misconceptions regarding the region and the people are discussed. Specific information about the government and infrastructure of each country, including their health care system is provided, with emphasis given to pharmacy education and practice in the region. In addition, recommendations for culturally sensitive engagement for pharmacy and other health care practitioners are discussed. Finally, recommendations for culturally sensitive engagement when hosting students and/or faculty members from the Arab world are also addressed. Conclusion. Global engagement between schools and colleges of pharmacy in the United States and those in the Arab world is increasing. For an enriching and fruitful engagement, sensitivity toward the cultural and clinical needs of the people, and in particular, the professionals of that region is critical.

A comparative study of the depth, breadth, and perception of pharmacogenomics instruction in a subgroup of US pharmacy curricula

INTRODUCTION

This study was designed to assess the depth, breadth, and perception of pharmacogenomics education in pharmacy curricula in the United States (US).

METHODS

A modified, online questionnaire from previous studies was sent to all accredited US schools and colleges of pharmacy. The survey covered three distinct areas related to the schools' educational environments, the depth and the extent of pharmacogenomics core competencies and topics taught, and the institutions' perceptions of the importance of pharmacogenomics in the curriculum and future plans for expanded pharmacogenomics education. Multiple approaches were used to increase the response rate, and results were analyzed using descriptive statistics.

RESULTS

Of the 133 eligible programs, 32 participated in the survey. Six invalid surveys were excluded from our study, resulting in a 19.6% response rate. Results revealed that all responding schools included pharmacogenomics in the curriculum. Interestingly, 76.9% of the respondents believed pharmacists do not have the appropriate knowledge of pharmacogenomics. However, only 30.7% indicated that their programs planned to expand pharmacogenomics in their curriculum.

CONCLUSIONS

The responding schools all included some pharmacogenomics in their curriculum. However, the depth and the extent of pharmacogenomics topics covered varied. Respondents perceived that pharmacists today do not possess the appropriate level of pharmacogenomics knowledge. Despite this, there is limited emphasis on expanding pharmacogenomics instruction in the responding schools' curriculums.

Banning Tobacco Sales at the Retail Pharmacy: Natural Evolution of Drug Store As Responsible Health Provider Or Effective Marketing Strategy?

CVS Health has taken a strategic marketing move by banning tobacco sales. They risk losing customers who buy medications and cigarettes at their drugstores. They estimate they will lose 2 billion dollars by banning cigarette sales. CVS Health believes they will benefit from being regarded as health care partner by insurers and banning cigarette sales is an important step in being recognized as such. The Affordable Care Act expanded access to pharmacy-based medical clinics, increased affordability of medications, and expanded the clinical role of pharmacists. CVS Health is positioning itself to take advantage of these changes.

Self-reported influence of television-based direct-to-consumer advertising on patient seasonal allergy and asthma medication use: An internet survey

BACKGROUND

Direct-to-consumer advertising (DDTCA) of medications, a marketing tool used by the pharmaceutical industry to increase patient awareness of products, affects both consumer behavior and, ultimately, physician prescribing practices. Billions of dollars are budgeted each year for DTCA, and its influence is far-reaching. However, little information is available about patient-initiated physician interactions in which television-bbased DTCA has played a role in consumer behavior.

OBJECTIVE

The objective of this study was to explore the influence of television-based DTCA on treatment changes in patient-initiated medication use.

METHODS

A 68-item survey instrument consisting of dichotomous, multiple-choice, and open-ended questions was constructed and sent to a convenience sample of US residents during 3 consecutive months ending in February 2005. The survey, which was accessed through an Internet link provided in the e-mail, was designed to capture data about patient perceptions and behaviors regarding television-based DTCA of prescription medications used for seasonal allergy and asthma as well as demographic information. Inferential and descriptive analyses were performed. Key tests included Crosstabs analysis and normal approximation to the binomial test with the z score.

RESULTS

Surveys were sent to 2500 individuals. A total of 427 valid surveys were returned for a 17.1% response rate. Of the 402 respondents (94.1%) who stated that they had seen DTCA for seasonal allergy medication, 50 (12.4%) said they had discussed the advertised medication with their physician and 22 of those discussions (44.0%) resulted in a change in treatment. Three hundred forty-two respondents (80.1%) stated that they had viewed DTCA for prescription asthma medications, and 23 of those respondents (6.7%) said that they had discussed the brand of asthma medication viewed on television with their physician. Those discussions resulted in a change in treatment for 9 respondents (39.1%).

CONCLUSION

Within th his limited, self-reported, survey sample, patient-initiated discussions with physicians regarding television-based DTCA of allergy and asthma medications resulted in a change of treatment in 44.0% and 39.1% of respondents, respectively.

Patient Attitudes Toward Community Pharmacist Attire

The white coat has symbolized professionalism, while representing provider–patient fiduciary relationship. Although well described in the literature for physicians, few studies examine the impact of pharmacist attire on patients’ opinions regarding professionalism and trust. Therefore, understanding patient perceptions regarding pharmacist’s attire and its influence on comfort, confidence, trust, and professionalism may provide guidance on ways to enhance the quality of the provider–patient relationship. A 43-item Likert-type questionnaire was administered to 347 adults in a community pharmacy setting to determine preferences about the pharmacist’s attire, accessories, and body art incorporating 8 photographs depicting a male pharmacist in various degrees of dress formality (ie, casual to professional). Descriptive and inferential statistics were used to summarize and analyze the data. Survey respondents reported it was desirable/strongly desirable that pharmacists be dressed in a shirt and tie, dress shoes, white coat, and name tag (mean 4.21-4.72), whereas they should not be dressed in jeans, casual shoes, or have visible body art (mean 2.17-2.78). Over 86% of the respondents felt that a pharmacist with a white coat instilled feelings of comfort, confidence, trust, and professionalism. In a community pharmacy setting, a pharmacist wearing a white coat appears to be the mainstay in displaying professionalism and inspiring trust in adult patients.

Marketing retail health clinics: challenges and controversies arising from a health care innovation

Since their founding in 2000, retail-based health care clinics, also called convenient care clinics, have flourished but continue to generate controversy. This article examines the literature with respect to the industry's background, establishment of industry standards, types of services offered, marketing of retail health clinics, industry growth with new target markets, and patient demographics. It also examines the growing relationship with insurers and third-party payers, quality-of-care concerns by medical associations, and legal regulations and their potential impact on industry growth nationwide.

The Lasting Effects Of Social Media Trends On Advertising

<p style="text-align: justify; margin: 0in 0.5in 0pt; mso-pagination: none;"><em style="mso-bidi-font-style: normal;"><span style="font-size: 10pt;"><span style="font-family: Times New Roman;">Americans are exposed to an astounding number of advertising messages every day.<span style="mso-spacerun: yes;">&nbsp; </span>The result of this bombardment of advertising on society is that consumers have become increasingly resistant to traditional forms of advertising.<span style="mso-spacerun: yes;">&nbsp; </span>After spending millions of dollars on mass advertising that consumers tend to block out and ignore, marketers have re-evaluated their advertising methods and are following holistic marketing concepts that focus on customer relationship marketing and more creative, understated ads instead of in-your-face billboards and loud television segments.<span style="mso-spacerun: yes;">&nbsp; </span>This paper explores social media trends, including social media opportunities and mobile marketing, and the potentially lasting effects that these trends have on advertising<strong style="mso-bidi-font-weight: normal;">.</strong></span></span></em></p>

Influence on consumer behavior: the impact of direct-to-consumer advertising on medication requests for gastroesophageal reflux disease and social anxiety disorder

A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD). Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that they subsequently initiated a conversation with their physician. Nearly half of respondents, 47.4% for GERD and 40% for SAD, reported that a change in therapy occurred as a direct result of these discussions. Televised DTCA for these two drug classes can have a significant impact on patient-initiated prescription requests.

Impact of direct-to-consumer advertising (DTCA) on patient health-related behaviors and issues

The pharmaceutical industry spends billions of dollars annually on direct-to-consumer advertising (DTCA). Patient perspectives on the impact of televised DTCA on health-related behaviors and issues were assessed by means of a 68-question survey. 58.6% of respondents believed that DTCA allowed consumers to have a more active role in managing their health. However, 27.6% felt DTCA caused confusion, and an alarming 17.8% of respondents stopped taking their medication because of concerns about serious side effects mentioned in DTCA. Overall, participants believed DTCA plays a useful role in health self-management; however, a considerable percentage thought that the cost outweighs the benefits.

Characteristics of physicians targeted by the pharmaceutical industry to participate in e-detailing

Electronic detailing (e-detailing) has been introduced in the last few years by the pharmaceutical industry as a new communication channel through which to promote pharmaceutical products to physicians. E-detailing involves using digital technology, such as Internet, video conferencing, and interactive voice response, by which drug companies target their marketing efforts toward specific physicians with pinpoint accuracy. A mail survey of 671 Iowa physicians was used to gather information about the physician characteristics and practice setting characteristics of those who are usually targeted by pharmaceutical companies to participate in e-detailing. A model is developed and tested to explain firms' targeting strategy for targeting physicians for e-detailing.

Characteristics of physicians who frequently see pharmaceutical sales representatives

Pharmaceutical sales representatives (PSRs) can impact physician prescribing. The objective of this study was to test a model of physician and practice setting characteristics as influences on decisions by physicians to see PSRs. A survey was sent to a random sample of 2000 physicians. Multiple linear regression analyses were used to test models for predicting influences on decisions to see PSRs frequently, defined as at least monthly. Independent variables included: presence of restrictive policy for pharmaceutical detailing, volume of prescriptions, gender, age, type of specialty, academic affiliation, practice setting size, and urban versus rural. The dependent variable was frequency of PSRs visits to physicians. Six hundred seventy-one responses were received yielding a response rate of 34.7%. Four hundred thirty-two physicians (79.5%) reported seeing PSRs at least monthly. The decision influence model was found to be significant. Primary care physicians and high-volume prescribers showed increased likelihood to see PSRs. Physicians practicing in settings that were small, urban, without restrictive policies for pharmaceutical detailing, and not academically affiliated were more likely to see PSRs frequently. This model of physician and practice characteristics is useful in explaining the variations in physicians' characteristics who see PSRs frequently. These characteristics could be used to guide the development of future academic or counter-detailing initiatives to improve evidence-based prescribing.

D-Optimal Mixture Design: Optimization of Ternary Matrix Blends for Controlled Zero-Order Drug Release From Oral Dosage Forms

The objective of the present study was to develop a tablet formulation with a zero-order drug release profile based on a balanced blend of three matrix ingredients. To accomplish this goal, a 17-run, three-factor, two-level D-Optimal mixture design was employed to evaluate the effect of Polyox (X1), Carbopol (X2), and lactose (X3) concentrations on the release rate of theophylline from the matrices. Tablets were prepared by direct compression and were subjected to an in vitro dissolution study in phosphate buffer at pH 7.2. Polynomial models were generated for the responses Y4 (percent released in 8 h) and Y6 (similarity factor or f2). Fitted models were used to predict the composition of a formulation that would have a similar dissolution profile to an ideal zero-order release at a rate of 8.33% per hour. When tested, dissolution profile of the optimized formulation was comparable to the reference profile (f2 was 74.2, and n [release exponent] was 0.9). This study demonstrated that a balanced blend of matrix ingredients could be used to attain a zero-order release profile. Optimization was feasible by the application of response surface methodology, which proved efficient in designing controlled-release dosage forms.

Squamous cell carcinoma in the ovary of a 14-year-old girl

Squamous cell carcinoma (SCC), whether primary or metastatic, rarely involves the ovary. All previously reported cases have been in adults. Herein we describe a 14-year-old girl who underwent extensive neurologic and musculoskeletal assessment because of symptoms of generalized muscle weakness and pain. She was found to have SCC that involved the ovary, with widespread metastases. This case illustrates the importance of eliciting a thorough history and evaluating the patient's symptoms. A review of the differential diagnosis of ovarian SCC is included. To our knowledge, our patient is the youngest to be described in the literature with SCC in the ovary.