Using MyDispense to simulate validation of controlled substance prescriptions in a pharmacy law course

BACKGROUND AND PURPOSE

MyDispense is an innovative, web-based program which simulates a community pharmacy. Use of this software may assist students' comprehension of validating controlled substance prescriptions by determining if prescriptions contain errors or omissions.

EDUCATIONAL ACTIVITY AND SETTING

Fourteen MyDispense practice exercises were created and implemented into a required second-year pharmacy law course. Completion of the MyDispense exercises and performance on the pharmacy law midterm exam were recorded. A questionnaire was administered to students to receive feedback on the exercises.

FINDINGS

There were complete data on all 94 student pharmacists enrolled in the didactic course. Thirty-five students (37%) completed all MyDispense exercises, 15 students (16%) completed some of the exercises, and 44 (47%) did not complete any of the exercises. Linear regression results indicate that students who completed more MyDispense exercises were significantly more likely to score higher on the midterm than those who completed fewer exercises (β = 0.28, p = 0.02). Students reported moderate to high exercise value and a willingness to use the software in preparation for future pharmacy law examinations.

SUMMARY

MyDispense provided a platform for students to apply controlled substance laws to the prescription validation process in the community pharmacy setting. Completion of practice exercises in MyDispense was shown to positively impact student performance on a pharmacy law midterm. Students valued the innovative simulation tool and were willing to access the tool again to prepare for future examinations.

The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice

Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

ASSESSMENT OF PRACTICE AT RETAIL PHARMACIES IN PAKISTAN: EXTENT OF COMPLIANCE WITH THE PREVAILING DRUG LAW OF PAKISTAN

The main objective of this study was to assess the practice at retail pharmacies in Pakistan and to compare the same in rural and urban areas. The maintenance of pharmacy and drug inspectors' visit was also assessed. This cross sectional study was conducted in Abbottabad, Pakistan during October-November, 2012. A sample of 215 drug sellers or drug stores was selected by employing convenient sampling method. With a response rate of 91.6%, 197 drug sellers participated in this study. All the drug sellers were male. Overall, 35% (n = 197) of the drug sellers did not have any professional qualification. A majority of the drug sellers were involved in various malpractices like selling of medicines without prescription (80.7%), prescribing practice (60.9%), prescription intervention (62.4%) and selling of controlled substances (66%) without a license for selling it. These malpractices were significantly higher in rural area than that in urban area.

Cooperation in pharmacy education in Canada and the United States

Although the education of student pharmacists and the practice of pharmacy in Canada have many similarities with that in the United States, there also are differences. The planning of curricula in pharmacy education is of particular importance to the advancement of pharmacy in Canada because of significant changes in the scope of practice in several provinces, and in how community pharmacy is reimbursed for the services it can, or should, provide. Greater dialog between Canadian and American pharmacists has the potential not only to impact practice on both sides of the border but also to improve collaborations among Canadian and American pharmacy educators. This article provides background information and some suggestions on how to build partnerships in pharmacy education between Canada and the United States. Consortia-like arrangements have some particular promise, as does engaging border-states and provinces in regional meetings and other activities. By working together, Canadian and US pharmacy educators have the opportunity to implement the best of what each has to offer and to devise new and better ways to educate future and existing pharmacists.

FDA critical path initiatives: opportunities for generic drug development

FDA's critical path initiative documents have focused on the challenges involved in the development of new drugs. Some of the focus areas identified apply equally to the production of generic drugs. However, there are scientific challenges unique to the development of generic drugs as well. In May 2007, FDA released a document "Critical Path Opportunities for Generic Drugs" that identified some of the specific challenges in the development of generic drugs. The key steps in generic product development are usually characterization of the reference product, design of a pharmaceutically equivalent and bioequivalent product, design of a consistent manufacturing process and conduct of the pivotal bioequivalence study. There are several areas of opportunity where scientific progress could accelerate the development and approval of generic products and expand the range of products for which generic versions are available, while maintaining high standards for quality, safety, and efficacy. These areas include the use of quality by design to develop bioequivalent products, more efficient bioequivalence methods for systemically acting drugs (expansion of BCS waivers, highly variable drugs), and development of new bioequivalence methods for locally acting drugs.

Progress of pharmacist collaborative practice: status of state laws and regulations and perceived impact of collaborative practice

OBJECTIVES

To determine the current status and features of states' laws on pharmacist collaborative practice, barriers and facilitators to the passage of such laws, pharmacists' satisfaction with present regulations, and pharmacy leaders' perceptions regarding the impact of collaborative practice on pharmacist-physician relationships and on patients' perceptions of pharmacists.

DESIGN

Cross-sectional survey.

SETTING

United States.

PARTICIPANTS

Executives of state pharmacy organizations and officers of state pharmacy boards.

MAIN OUTCOME MEASURES

Presence and features of collaborative practice law, perceptions regarding effects of collaborative practice on pharmacist-physician relationships, and patients' perceptions of pharmacists.

RESULTS

Of 48 states responding to the survey, 32 (66%) had existing pharmacist collaborative practice laws; 23 states (48%) allowed pharmacists to initiate and modify therapy, whereas 9 (19%) allowed only modification of therapy. Dependent collaborative practice was permitted in 31 states (65%). Most state laws applied to hospital, long-term care, and community settings. Five of the 32 states with pharmacist collaborative practice laws had made changes to broaden the provisions since the original laws were enacted. Nine states out of 16 that did not have collaborative practice laws indicated plans to pursue passage of such laws. Overall, collaborative practice was viewed as having a positive effect on pharmacist-physician relationships and a slightly positive effect on patients' perceptions of pharmacists. Respondents believed that pharmacists currently involved in collaborative practice were mostly satisfied with present laws, although some respondents mentioned the need for further revisions to the laws.

CONCLUSION

Significant progress has been made in passing and implementing laws on pharmacist collaborative practice. As positive experience is gained, good opportunities exist to broaden current laws and increase pharmacists' involvement in collaborative practice.

The outlook for pharmacist initiation and modification of drug therapy

Changing state laws to permit an expanded scope of practice for pharmacists is a key step in positioning pharmacists to provide pharmaceutical care. Sixteen states currently allow pharmacists to initiate and/or modify drug therapy; legislation is proposed in 15 other states. Twenty-eight of the 44 states that completed the survey allow pharmacists neither dependent nor independent authority to prescribe. Physician opposition was often cited as a barrier to passage of legislation. The Indian Health Service and the Department of Veterans Affairs extend pharmacists independent prescribing authority.

[Effects of the process of pharmaceutical deregulation on physicians]

By the term deregulation economists indicate the modulation of regulatory intervention resulting in a decrease of the limitation and restriction imposed on manufacturing and marketing activities. The process applies even to the pharmaceutical area and is enhanced by the increasing subjectivity of the consumers and the irreversible involvement of the medical profession with public expenditure. Health demand is no longer totally and exclusively fulfilled by physician's intervention and prescribing. Therefore, the resulting demedicalization and the use of means other than medications, such as surgical and medical aids, nutritional, dietetic and sanitary products and the so called medicated cosmetics, impose modifications of the preexisting regulation and organization. Generics will follow the assignment of a medicinal product to one class of medicaments rather than to another, thus allowing the adoption of substituting programs. Both national and European legislations follow this trend to attain economical advantages through pharmaceutical deregulation. The medical profession is changed by this process in a way which is much more significant than any other event.

Affiliated state chapter experience with a professional lobbyist for pharmacy legislative activities

The experiences of the New Jersey Society of Hospital Pharmacists (NJSHP) with a professional lobbyist are described. NJSHP hired a part-time lobbyist in 1985 for direct lobbying services, legislative monitoring, and public relations duties. Accomplishments of the lobbyist include reappointment of a hospital pharmacist to the state board of pharmacy, formation of a political action committee, development of a specific political action plan, and creation of position statements. Future goals include sponsoring legislative breakfasts featuring key state legislators and establishing an official state Hospital Pharmacists Day. The experiences of NJSHP with a professional lobbyist have been positive.

Prescribing authority for pharmacists as viewed by organized pharmacy, organized medicine, and the pharmaceutical industry

This study identifies attitudes of organized pharmacy, organized medicine, and the pharmaceutical industry about prescribing authority for pharmacists. A questionnaire designed to assess the impact of a legislative bill permitting a pharmacist in an organized health care setting to initiate or modify drug therapy was mailed to state pharmacy associations, state hospital pharmacy associations, state pharmacy boards, state medical associations, Pharmaceutical Manufacturers Association (PMA)-member manufacturers, and non-PMA-member generic manufacturers. Responses from 194 of the 307 invited organizations were used. The six organization types viewed the impact of the legislative bill differently (p less than 0.05). Hospital pharmacy associations and boards of pharmacy, to a lesser extent, supported the legislative bill; non-PMA-member generic manufacturers and state pharmacy associations were relatively neutral. The medical associations and the PMA-member companies opposed the passage of the bill. Furthermore, medical associations believed that the bill would not be passed in the majority of states in the next five years.