International Clinical Pharmacist - ACCP

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1 ACCP International Clinical Pharmacist ACCP Winter 20112012 International Clinical Pharmacist Editor: Wafa Y. Dahdal, Pharm.D., BCPS (AQ Cardiology) Volume 1; Issue 4 U.S. Surgeon General Supports Recognition of Pharmacists as Health Care Providers In December 2011, the Office of the Chief Pharmacist of the to clinical pharmacy services.2-4 The report maintains that U.S. Public Health Service released a report to the U.S. Sur- compensation mechanisms are needed to sustain such ser- geon General on Improving Patient and Health System Out- vices that will be in alignment with health care reform and comes through Advanced Pharmacy Practice. The report is future primary care workforce demands and that pharmacists .. constructed around four focal points1: should be recognized as health care providers, as defined in the Social Security Act and other health legislation and policy. Pharmacists Integrated as Health Care Providers: Defini- In a public letter in support of the report, Regina Benja- tion of primary care; pharmacist roles; interprofessional .. min, M.D., MBA, U.S. Surgeon General, recognized that the collaboration and support comprehensive patient care services that pharmacists pro- Recognition as Health Care Providers: Advanced phar- .. vide through collaborative practice agreements increase ac- macy practice models; pharmacy education and training cess to care, optimize patient outcomes, and contain health Compensation Mechanisms: Essential for sustainabil- care costs. Moreover, she recommended that health leaders ity; legislation history; medication therapy management .. and policy-makers explore ways to expand such services.5 Dr. (MTM) under Medicare Part D Benjamin noted that recognizing pharmacists as health care Evidence-Based Alignment with Health Reform: Quality providers is appropriate and that compensation models are of care and patient outcomes; disease prevention and needed to sustain these patient-centered pharmacy services. management; cost-effectiveness and cost-containment; primary care workforce; access to care 1.Giberson S, Yoder S, Lee MP. Improving Patient and Health System Outcomes through Advanced Pharmacy Practice. A Report to the U.S. The report summarizes pharmacists contributions to Surgeon General. Office of the Chief Pharmacist. U.S. Public Health patient care in various practice settings either as part of a Service, December 2011. Available at www.usphs.gov/corpslinks/phar- health care team or as an individual provider working in col- macy/comms/pdf/2011AdvancedPharmacyPracticeReporttotheUSSG. pdf. Accessed February 1, 2012. laboration with physicians in a pharmacist-delivered service. 2. Schumock GT, Meek PD, Ploetz PA, Vermeulen LC; and the Publications It highlights the role of the pharmacist in managing diseases Committee of the American College of Clinical Pharmacy. Economic evaluations of clinical pharmacy services19881995. Pharmacotherapy through collaborative practice agreements with physicians in 1996;16:1188208. .. which pharmacists 3. Schumock GB, Butler MG, Meek PD, et al. Evidence of the economic ben- efit of clinical pharmacy services: 19962000. Pharmacotherapy 2003;23: 11332. perform patient assessment (subjective and objective data .. 4. Perez AD, Doloresco F, Hoffman JM, et al. Economic evaluations of clinical including physical assessment); pharmacy services: 20012005. Pharmacotherapy 2009;29:128. 5. 2011 Support Letter from the U.S. Surgeon General. Available at www. have prescriptive authority (initiate, adjust, or discon- usphs.gov/corpslinks/pharmacy/comms/pdf/2011SupportLetterFrom tinue treatment) to manage disease through medication USSG.pdf. Accessed February 1, 2012. use and deliver collaborative drug therapy or medication .... management; order, interpret, and monitor laboratory tests; formulate clinical assessments and develop therapeutic Table of Contents U.S. Surgeon General Supports Recognition of ..plans; provide care coordination and other health services for Pharmacists as Health Care Providers A Survey of Students Perceptions of the 1 ..wellness and prevention of disease; and develop partnerships with patients for ongoing (follow up) care. Pharmacy Profession in Japan Pharmacist Education and Practice in Genomics Call for Papers 2 3 4 Advertise with ACCP International Clinical Pharmacist 4 In addition to reciting the evidence supporting the im- Book Highlights 4 pact of various pharmacist services on improving patient and A Message from the Editor 5 Mark Your Calendar 5 health care outcomes, the report summarizes the economic Preparatory Review Courses for Pharmacotherapy and Ambulatory benefit, explaining that, between 1998 and 2005, the overall Care Pharmacy Specialties to Be Offered This April 5 average benefit gained was $10.07 per $1 of funds allocated Winter 20112012 American College of Clinical Pharmacy

2 ACCP International Clinical Pharmacist Winter 20112012 A Survey of Students Perceptions of the Pharmacy Profession in Japan* Shigeo Yamamura, Ph.D., and Rieko Takehira, MSPharm all students had yet experienced practical training at clinical Faculty of Pharmaceutical Sciences, sites, and sixth-year students were absent. Josai International University Two-thirds of the students did not feel pharmacists had Chiba, Japan high visibility or high professional status in Japanese society (Table). Sixty-five percent of students agreed that pharma- In 2006, the Ministry of Education, Culture, Sports, Science cists had limited fields of practice. The number of students and Technology in Japan started a 6-year education system for with negative perceptions of pharmacists status increased pharmacists. At present, two pharmacy education systems ex- with school year. Of course, this is part of societys superficial istthe 6-year program to educate aspiring pharmacists and understanding of the pharmacy profession. In addition, with the 4-year system to educate pharmaceutical scientists. The advancing school years, students come to learn about the dif- Pharmaceutical Society of Japan then developed a model core ferences between the ideal and real situations of pharmacists. curriculum, adopted by all 6-year programs. Subjects taught Two-thirds of pharmacy students were satisfied with their in the first 3 years of 6-year programs are quite similar to educational program. However, the degree of satisfaction de- those in the 4-year programs. These include basic and phar- creased with school year. Only one-third of students were sat- maceutical sciences such as chemistry, pharmacology, phar- isfied with the relevance of practical training and subjects in maceutics, and pharmacotherapy. In the fourth year, clinically school, suggesting that students in higher grades want to be oriented subjects are increased, and students must pass the trained further on practical and clinical issues. In Japan, phar- Pharmaceutical Common Achievement Test, consisting of macist licenses can be renewed without any continuing edu- Computer-Based Testing and the Objective Structured Clinical cation. About half of the students answered that a mandatory Examination. The fifth-year students gain clinical experience renewal system of pharmacist licensure was necessary, sug- in pharmacies both at hospitals (11 weeks) and in the com- gesting that students are aware that, to possess the advanced munity (11 weeks). Sixth-year students complete a graduation knowledge and skills needed to offer high-quality services to research project, with themes ranging from basic pharmaceu- tical science to clinical practice. After completing the 6-year patients, continuous professional development is required. program, they are eligible to take the National Examination In summary, Japanese pharmacy students are unsatis- for Pharmacists. fied with the status of pharmacists in society. Moreover, they In May 2010, we administered a survey to all first- through desire additional clinical training during the pharmacy educa- fifth-year students enrolled in the 6-year programs of two tion program and mandatory continuing professional devel- pharmacy schoolsJosai International University and Toho opment for licensure renewal. University (which provides only a 6-year program). The survey *Opinions, judgments, and data expressed or implied in this article are those of investigated students perceptions of the status of pharma- the author and do not reflect the policy or position of the American College of cies and pharmacists in Japan and of their ongoing pharmacy Clinical Pharmacy, and the American College of Clinical Pharmacy provides no education. In total, 1551 students enrolled in the survey. Not warranty regarding their accuracy or reliability. Table: Student Responses to Survey Items First Year Second Year Third Year Fourth Year Fifth Year Total (n=310) (n=338) (n=312) (n=282) (n=309) (n=1551) SA/A or SD/D or SA/A or SD/D or SA/A or SD/D or SA/A or SD/D or SA/A or SD/D or SA/A or SD/D or Survey Item VS/S VU/U VS/S VU/U VS/S VU/U VS/S VU/U VS/S VU/U VS/S VU/U Pharmacists have high visibility in 139 165 88 247 83 229 61 221 66 242 437 1104 Japanese society. n (%) (45.7) (54.3) (26.3) (73.7) (26.6) (73.4) (21.6) (78.4) (21.4) (78.6) (28.4) (71.6) Pharmacists have a high professional 176 128 154 181 138 174 68 214 74 234 610 931 status in Japanese society. n (%) (57.9) (42.1) (46.0) (54.0) (44.2) (55.8) (24.1) (75.9) (24.0) (76.0) (39.6) (60.4) Pharmacists have limited fields of 184 120 183 152 210 100 202 79 216 91 995 542 practice. n (%) (60.5) (39.5) (54.6) (45.4) (67.7) (32.3) (71.9) (28.1) (70.4) (29.6) (64.7) (35.3) The scope of the educational 225 83 222 115 220 91 162 120 160 149 989 558 contents in your program. n (%) (73.1) (26.9) (65.9) (34.1) (70.7) (29.3) (59.6) (40.4) (51.8) (48.2) (63.9) (36.1) The relevance of practical training 132 171 128 210 76 235 79 202 106 202 521 1020 and subjects in the school. n (%) (43.6) (56.4) (37.9) (62.1) (24.4) (75.6) (28.1) (71.9) (34.4) (65.6) (33.8) (66.2) Mandatory continuous education for 178 124 143 191 140 170 136 145 170 137 767 767 the renewal of pharmacists licenses (58.9) (41.1) (42.8) (57.2) (45.2) (54.8) (48.4) (51.6) (55.4) (44.6) (50.0) (50.0) is necessary. n (%) SA/A = strong agree and agree; SD/D = strong disagree and disagree; VS/S = very satisfactory and satisfactory; VU/U = very unsatisfactory and unsatisfactory. Because of some missing values, the sum of each school years numbers does not equal the total number of students in each school year. 2 American College of Clinical Pharmacy

3 ACCP International Clinical Pharmacist Winter 20112012 Pharmacist Education and Practice in Genomics Major pharmacy organizations and stakeholders in the genomic ect was being developed in the early 1990s, ACCP recognized education of pharmacists participated in the Pharmacist Educa- pharmacogenomics as a factor that would promote change in tion in the Era of Genomic Medicine Meeting held November pharmacist roles and responsibilities1: 30 to December 1, 2011, and sponsored by the National Hu- man Genome Research Institute (NGHRI), National Institutes of Pharmacogenomicsthe application of principles of Health, and Department of Health and Human Services. pharmacogenetics to the development of optimal regi- In addition to representatives from the American College mens for treatment or prevention of diseasealso may of Clinical Pharmacy (ACCP), representatives were present result in new pharmacist roles. It is likely that knowledge from the Academy of Managed Care Pharmacy, Accreditation of a particular patients genetic profile will be used in the Council for Pharmacy Education, American Association of Col- future to individualize drug selection and dosing, or to leges of Pharmacy, American Association of Pharmaceutical predict adverse effects. Pharmacists may be required to Scientists, American Pharmacists Association, American Soci- assist in the interpretation of diagnostic genetic tests and ety for Clinical Pharmacology & Therapeutics, American So- ciety of Consultant Pharmacists, American Society of Health- to use their knowledge of pharmacokinetics and pharma- System Pharmacists, and National Alliance of State Pharmacy codynamics to optimize drug therapy for a specific pa- Associations. Also in attendance were representatives from tient. The greater degree of complexity associated with medicine, nursing, and physician assistants as well as the Na- this mode of drug selection may further increase phar- tional Coalition for Health Professional Education in Genetics, macists roles on the patient care team. In addition, one National Cancer Institute, Centers for Medicare & Medicaid would expect that the evolution of pharmacogenomics Services, U.S. Food and Drug Administration, and IMS Health. will increase the need for patient and health care pro- In view of the recent advances in genomic discoveries, vider education regarding drug therapy. together with the direct-to-consumer marketing of genetic and pharmacogenomic tests available at local drug stores, In addition, statements on the knowledge and applica- the meeting was convened to define the current landscape of tion of pharmacogenomics in designing patient-specific drug pharmacist education in genomics; identify core educational therapy plans were delineated in the clinical pharmacist needs; and plan next steps to strategically address pharmacy competencies.2 Today, clinical pharmacists assimilate phar- education at various stages of health professional education. macogenomics into daily practice, and several generate new Improved health outcomes from genomic discoveries knowledge paramount to pharmacogenomic research and will only be realized if the health care community is aware of optimal patient outcomes. Further educational efforts will and can translate these findings to clinical practice. In his ad- enhance pharmacists knowledge and the application of ge- dress, Greg Feero, M.D., Ph.D., Special Advisor to the Director, nomic discoveries in various practice settings. NHGRI, stated that because pharmacy services exist across the health care funnel from primary care to specialty care, [p]harmacists are well positioned to ensure maximal societal 1.American College of Clinical Pharmacy. A vision of pharmacys future benefits of genomic discovery. roles, responsibilities, and manpower needs in the United States. Phar- macotherapy 2000;20:9911022. ACCP has long recognized the pharmacists role in pro- 2. American College of Clinical Pharmacy. Clinical pharmacist competencies. viding individualized medicine. As the human genome proj- Pharmacotherapy 2008;28:80615. 3 American College of Clinical Pharmacy

4 ACCP International Clinical Pharmacist Winter 20112012 Call for Papers Advertise with ACCP Individuals are invited to submit articles for publication in future International Clinical Pharmacist .... issues of the newsletter on the following departments: Announcements of quality educational programs, confer- Clinical Pharmacy Practice .... ences, or products and position listings of interest to the Clinical Pharmacist or Clinical Practice Profile international audience may be published in ACCP Interna- Patient Care .... tional Clinical Pharmacist. Research and Practice To obtain more information and submit an advertisement, Pharmacy Education see Advertising Rate Card at www.accp.com/docs/interna Continuing Professional Development tional/RateCard.pdf. For more information and to submit an article, see www. accp.com/docs/international/InformationForAuthors.pdf. Book Highlights Pharmacogenomics: Applications xx Cardiovascular Diseases to Patient Care, Second Edition xx Psychiatry xx Respiratory Diseases ..xx xx Transplantation Ethical, Legal, Social, and Regulatory Issues Written by national experts in phar- Ethical, Legal, and Social Challenges to Applied macogenomics from different prac- tice areas, disciplines, and research Pharmacogenetics environments, the second edition xx Cost-effectiveness, Economic Incentives, and of Pharmacogenomics: Applications Reimbursement Issues to Patient Care combines the basics xx Ethical and Privacy Issues in Pharmacogenomic ..xx of pharmacogenomics with disease-specific applications to Research give practitioners a solid foundation for understanding the Fundamentals of Applied Human Genomics basic science of pharmacogenomics and the skills for integrat- Principles of Genetic Medicine ing pharmacogenomics into daily clinical practice. xx Applied Molecular and Cellular Biology xx Analysis of the Human Genome and Proteome .. Chapters include: Pharmacogenomics Basics xx Applications of Genomics in Human Health and xx Bioinformatics Also available is the Pharmacogenomics: Applications to Pa- Complex Disease tient Care Self-Assessment Tool. This online tool includes more xx The Rich Life of a Poor MetabolizerTribute to Werner Kalow, M.D. than 230 questions designed to assess how well the reader xx Pharmacogenetics: A Historical Perspective has accomplished the learning objectives from each chapter. xx Pharmacogenetics of Oxidative Drug Metabolism and Once tests are submitted, the test taker receives his or her Its Clinical Applications test score as a percentage of correct responses; information xx Phase II Drug-Metabolizing Enzymes on which answers were correct and which incorrect; and the xx Drug Transporter Pharmacogenetics explained answers for that individual test. xx Drug Target Pharmacogenetics Pharmacogenomics: Applications to Patient Care and the xx Pharmacogenomics in Drug Discovery and Drug self-assessment tool are must-have resources for all practi- ..xx Development tioners seeking to optimize individualized drug therapy and Pharmacogenomics Applications in Treating Disease patient outcomes but facing the challenge of learning and Pharmacogenomics of Solid Tumors keeping up with the seemingly limitless amount of pharma- xx Pharmacogenomics of Hematologic Malignancies cogenomics information available. xx Warfarin Pharmacogenetics More information on these resources is available at xx Infectious Diseases www.accp.com/bookstore/th_02pg.aspx. 4 American College of Clinical Pharmacy

5 ACCP International Clinical Pharmacist Winter 20112012 A Message from the Editor Dear Colleagues: This issue of ACCP International Clinical Pharmacist features The article on A Survey of Students Perceptions of the three articles that are very much in sync with the priorities Pharmacy Profession in Japan represents the views of phar- of the American College of Clinical Pharmacy (ACCP)to macy students. Survey findings highlight the significance of promote the professional development of, advocate for, and need for (1) adequate clinical practice opportunities and position clinical pharmacists. during professional education to equip future pharmacists The December 2011 report released by the Office of the for their prospective roles and (2) continuing professional Chief Pharmacist of the U.S. Public Health Service summa- education opportunities for practicing pharmacists to main- rizes clinical and economic evidence in support of the vari- tain lifelong competence. The article also highlights the ous direct patient care services provided by clinical pharma- need to educate the general public on the pharmacy profes- cists. It argues for the recognition of pharmacists as health sion and pharmacists evolving roles. care providers and the exploration of new compensation ACCP International Clinical Pharmacist editorial staff in- models to sustain these patient-centered, quality improve- vite you to use this newsletter as your voice to reflect on ment, cost-effective services. The article on U.S. Surgeon changes occurring in the pharmacy profession worldwide General Supports Recognition of Pharmacists as Health and share with the international pharmacy community key Care Providers summarizes the report and a letter released initiatives and innovative practices taking place at your in- by the U.S. Surgeon General in support of the report. The article Pharmacist Education and Practice in Ge- stitution or in your home country. nomics describes initiatives led by the National Human Ge- nome Research Institute to educate pharmacists practicing Sincerely, in various settings to incorporate genomics into their daily practice. This, again, highlights the value of pharmacists and the services they provide across the health care continuum. Wafa Y. Dahdal, Pharm.D., BCPS (AQ Cardiology) Mark Your Calendar Preparatory Review Courses for Pharmacotherapy and Ambulatory ACCP Updates in Therapeutics 2012 Care Pharmacy Specialties to Be April 27May 1, 2012 Offered This April Reno, Nevada ACCP Updates in Therapeutics 2012 featuring The Phar- macotherapy Preparatory Review and Recertification Course and The Ambulatory Care Pharmacy Preparatory Review and Recertification Course will be held from April 27 to May 1 in Reno, Nevada. Each of these two 5-day preparatory courses offers a comprehensive review of pharmacotherapeutic and practice topics relevant to the 2012 ACCP Annual Meeting Pharmacotherapy and Ambulatory Care Pharmacy special- October 2124, 2012 ties, respectively. These courses are highly recommended Hollywood, Florida for practitioners preparing for board certification as well as for seasoned practitioners seeking the most up-to-date information that is essential for optimal patient care and contemporary pharmacy practice. More information on these courses is available at www.accp.com/meetings/ut12/. American College of Clinical Pharmacy 13000 W. 87th St. Parkway, Suite 100 Lenexa, KS 66215 (913) 492-3311 (913) 492-0088 Fax www.accp.com American College of Clinical Pharmacy

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