Objectives: 1) To determine 2010 pharmacy-related ambulatory care sensitive condition (ACSC) hospital discharges by Tennessee (TN) county; 2) To explore pharmacy-related ACSC hospital discharges across county characteristics for Tennessee counties, including community pharmacies per county, age, and county rurality; 3) To explore pharmacy-related ACSC hospital discharges across age for northeastern Tennessee counties. Methods: Data were obtained from the TN Department of Health Statistics (hospital discharge data), TN Board of Pharmacy (licensed community pharmacies), the United States (US) Census Bureau (county-level populations), the Office of Rural Health Policy (rural designations), and the US Health Resources and Services Administration (health professional shortage area designations). ACSC discharges were determined using the Agency for Healthcare Research & Quality's (AHRQ's) Prevention Quality Indictors (PQIs) for asthma, bacterial pneumonia, congestive heart failure, chronic obstructive pulmonary disease, hypertension, uncontrolled diabetes, and short-term and long-term diabetes complications. County-level analyses were population adjusted and analyzed across age. Analyses were conducted using SPSS and ArcGIS software. Results: In 2010, 79,683 hospital discharges were noted for pharmacy-related ACSCs, 55% of which were for residents 65 and over. For northeast Tennessee counties, 8,538 were documented accounting for 11% of Tennessee pharmacy-related ACSCs discharges. Bacterial pneumonia, heart failure, and COPD accounted for nearly 65% of discharges in northeastern Tennessee counties. The number of community pharmacies per Tennessee county was statistically significantly negatively correlated with county-level bacterial pneumonia (r=-0.339; p=0.001), CHF (r=-0.215; p=0.036), and COPD (r=-0.403; p<0.001) hospital discharges. Implications/Conclusions: Community pharmacies have the potential to positively impact the health needs of Tennesseans by targeting services (e.g., MTM, immunizations, adherence assistance) based on ambulatory care sensitive conditions. Future research is warranted to quantify current services and determine the capacity to provide such services.

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Objective. To assess junior faculty members’ perceptions regarding the impact of past faculty-mentoring relationships in their career decisions, including the decision to pursue postgraduate training and ultimately an academic career. Methods. A mixed-mode survey instrument was developed and an invitation to participate in the survey was sent to 2,634 pharmacy faculty members designated as assistant professors in the American Association of Colleges of Pharmacy (AACP) directory data. Results. Usable responses were received from 1,059 pharmacy faculty members. Approximately 59% of respondents indicated that they had received encouragement from 1 or more faculty mentors that was very or extremely influential in their decision to pursue postgraduate training. Mentor and mentee pharmacy training characteristics and postgraduate training paths tended to be similar. US pharmacy degree earners rated the likelihood that they would have pursued an academic career without mentor encouragement significantly lower than did their foreign pharmacy and nonpharmacy degree colleagues (p = 0.006, p = 0.021, respectively). Conclusions. For the majority of junior pharmacy faculty members, faculty mentoring received prior to completing their doctor of pharmacy degree or nonpharmacy undergraduate degree influenced their subsequent career decisions.

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET) PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88%) were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%), improved relationships with providers in the community (75.9%), and professional development opportunities (69.0%) were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63%) and workflow disruptions (20%) as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas. Type: Original Research

Objective To describe common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. Setting: Five schools and colleges of pharmacy in the United States. Practice description: Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training. Practice innovation: Community pharmacy fellowships, each structured as 2 years long and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill, and The Ohio State University. Evaluation: Program directors from each of the 5 community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs. Results: Common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n = 4) have been successful in securing pharmacy faculty positions. Conclusion: Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice.

Objectives: To assess and compare interprofessional and interpersonal communication self-efficacy beliefs of medical, nursing and pharmacy students before and after participation in a communication skills course. Method: Using self-efficacy as a theoretical framework, a 37-item survey instrument was developed based on Interprofessional Education Collaborative (IPEC) Core Competencies and course learning objectives. Medical, nursing, and pharmacy students voluntarily completed the survey instrument before and after the required course. Nonparametric tests were employed to examine matched pre- and post-assessments within colleges and to explore differences in self-efficacy beliefs across college. Results: A response rate of 87% (168/193) was achieved. Overall, nursing students entered the course with higher self-efficacy beliefs as compared to medical and pharmacy students. Pharmacy students indicated particularly low self-efficacy beliefs regarding their ability to communicate with other health professionals (p=0.009) and contribute to healthcare teams (p=0.002). Matched pre/post analyses indicated statically significant increases in student self-efficacy beliefs across all colleges. After the course, pharmacy students continued to perceive a relative lack of confidence in their ability to develop positive relationships with other health care providers as compared to medical and nursing students (p=0.02). Implications: Our findings suggest that completion of an interprofessional communications course was associated with a positive effect on self-efficacy beliefs aligned with IPEC competencies across all colleges. Pharmacy students, in particular, noted significant improvements in self-efficacy beliefs across multiple domains. Research is being conducted to examine relationships between validated observational assessments and student self-perceptions.

Objectives: To evaluate the extent to which students’ personal finance perceptions, projected student loan indebtedness, and demographic characteristics predict post-PharmD career intentions. Methods: Students at three pharmacy colleges completed a 31-item survey instrument that assessed personal finance perceptions, self-efficacy beliefs, anticipated student loan debt upon graduation, postgraduate intentions, anticipated practice setting upon graduation, and demographic characteristics. Logistic regression models were used to examine the extent to which personal finance perceptions, student loan indebtedness, and demographic characteristics predicted postgraduate intentions and anticipated practice setting. Results: A total of 763 usable responses were obtained (response rate=90.3%). Students reported an anticipated personal student loan debt mean at graduation of $162,747±87,093 and an estimated 7.4±5.8 years to pay off non-mortgage debt post-graduation. Fifty-three percent of students reported planning to practice in a community pharmacy setting post-graduation, and 54% indicated intentions to enter practice directly. Student loan indebtedness was not a significant predictor of planning to pursue postgraduate training. There was a significant association between debt influence and pressure perceptions and pursuance of postgraduate training (aOR=0.78;p=0.009). The odds of indicating hospital (vs. chain community) pharmacy as the anticipated setting decreased 36% with every 1-point increase in debt influence and pressure perceptions (aOR=0.64;p<0.001 Conclusions: Perceived debt pressure and influence predicted intention to enter practice directly (vs. pursuing postgraduate training) and selection of chain community pharmacy (vs. hospital pharmacy). Student loan indebtedness was not a significant predictor of postgraduate training intentions. Interventions that equip students to manage pressure associated with student loan debt should be explored.

Objectives: To determine if there is a relationship between the number of self-testing attempts and subsequent exam grade in a pharmacy course. Method: A total of 1,342 multiple choice questions were developed for pharmacy students to self-test for a pathophysiology course. Prior to each examination, students were allowed to take online quizzes which were randomly generated and related to the exam content. Quizzes were scored immediately, and students were shown the incorrect questions along with all answer choices. A matrix of intercorrelations and repeated measures ANOVA, with post hoc tests, was generated using PASW Statistics Version 19 (IBM, Armonk, NY) to evaluate all variables. Results: 77 of 79 students (97.5%) participated, resulting in a total of 7,042 attempts. Non-participants were assigned a zero. There were variations in both the average practice attempts (18 – 30) and subsequent exam grade (82 – 90) on the 4 exams. However, a significant correlation (p ≤ 0.05) existed between number of attempts and each exam grade (R = 0.478, 0.426, 0.385, and 0.218). For each exam, students were stratified into the upper and lower 50%, according to the number of self-test attempts. On all four exams the lower 50%, based solely on attempts, scored significantly lower (p ≤ 0.05) on the subsequent exam based on a two group T-test. Implications: Although self-testing strategies increase recall ability, this strategy is uncommon in pharmacy education. These results suggest that the number of self-testing attempts improves subsequent exam grade, regardless of the score for the self tests. Read More: http://www.ajpe.org/doi/full/10.5688/ajpe76599

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