Oral antineoplastics (OAs) have become an emerging and rapidly growing field in cancer treatment. As with any chemotherapeutic agent, clinicians must be aware of potential drug interactions. Drug information databases are a common resource utilized to check for interactions between OAs and patient’s home medications. A major concern with OAs is that they are usually taken at home as well as picked up at a pharmacy by the patient themselves. The objective of this study was to determine the reliability of these databases for identifying potential interactions with OAs in a real-world setting. Hospital records were used to identify patients with common malignancies (leukemia, sarcoma, colon, lung, thyroid, prostate, kidney and liver cancers) treated with OAs from 2013 to 2014. To be included patients must have started an OA during the study period and have adequate records to evaluate OA use as well as home medications. The patient’s regimen is then entered into Drugs.com and Lexicomp™ interaction databases. In addition to documenting the number of interactions flagged by both databases, the severity of the interaction and disagreements between databases were analyzed. A major interaction was defined as either a “D” or “X” by Lexicomp™ and “major” by Drugs.com. As of this preliminary analysis, 407 of 876 subjects have been screened. Of the 407 screened, 9 patients (one patient with 3 different OAs) have been enrolled. Lexicomp™ flagged 34 interactions, of which 10 were major interactions. Drugs.com flagged 34 interactions, of which 6 were major interactions. Between the 2 databases there was only 60% agreement in flagging major interactions. These discrepancies are of concern in that clinicians hope resources they utilize are congruent with one another and allow them to practice in the safest manner in terms to avoid clinically significant drug interactions OA.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.

Faculty of Pharmacy in Hradec Králové, Charles University, Czech republic Department of Social and Clinical Pharmacy Author: Kateřina Chalupová Supervisor: Doc. PhDr. František Dohnal, CSc. THE HISTORY OF PHARMACY IN THE REGION OF VELKÉ MEZŘIČÍ AND IN TŘEBÍČ Thesis target: To capture the dominant features of the historical development of pharmacy in a defined part of the Vysočina Region including the town of Třebíč and the area of the former judicial district of Velké Meziříčí. Methods: The historical development of pharmacies is traced in connection with the historical development of the entire region. It is evaluated and dealt with in connection with main historical milestones in health care. The thesis captures chronological characterization of pharmacies and tries to give a complete overview of the ownership and staff. At the same time, it focuses on collecting of documents in question. Results: The history of the oldest pharmacy in the region of Velké Meziříčí comes back to the 16th century. The pharmacy "U Černého orla" was the only pharmacy in Velké Meziříčí until 1993. There were two pharmacies established during socialist era - first in Křižanov in 1952 and the next year in Měřín. There have been established 5 pharmacies and 1 dispensary in Velké Meziříčí since establishment of the Czech...

Class of 2013 Abstract / Specific Aims: To determine the impact of a capstone course, Pharmacy Practice (PhPr) 811 entitled Advanced Patient Care, on preparing third-year University of Arizona College of Pharmacy (UA COP) Doctor of Pharmacy (Pharm.D.) students for their advanced pharmacy practice experiences and their future responsibilities as members of interprofessional healthcare teams. Methods: This study used pretest-posttest design. A survey was utilized to assess both the student’s self-confidence and knowledge in managing eight, commonly-encountered acute and chronic disease states. The students’ level of self-confidence in clinically managing patients with the specified disease states was measured using 17 questions on a 5-point Likert-type scale, while their knowledge was assessed using eight multiple-choice questions. Main Results: A total of 83 students participated in the study by completing both the pre- and post-course surveys (87.4% response rate). Following completion of the course, mean confidence score increased significantly to 4.01 (±0.80, p<0.001), while mean knowledge score increased slightly to 6.85 (±1.08). Positive change scores were determined for each self-assessed confidence item (0.90 ± 0.90), which indicated a significant increase in students’ overall level of confidence (p <0.001). On the other hand, the change in knowledge resulted in an overall positive change (0.47 ±1.19), which was not statistically significant (p= 0.47). Conclusion: The Advanced Patient Care course, PhPr 811, positively impacted the students’ self-assessed level of confidence. Even though the level of knowledge did not change significantly due to high baseline level, the students’ confidence level for clinical management increased significantly after participating in the capstone course.

Class of 2006 Abstract / Advanced Pharmacy Practice Experiences (APPE) provide students an opportunity to develop and demonstrate skills and competencies desired by future employers. The purpose of this study is to examine the impact of performance during APPE rotations on post-graduation hiring practices within the graduates and preceptors of the University of Arizona College of Pharmacy. Alumni who graduated from The University of Arizona College of Pharmacy between the years of 1991 and 2005 were surveyed to determine the impact preceptors had on their employment opportunities after pharmacy school (153 of 734 responded). APPE preceptors for The University of Arizona College of Pharmacy were also surveyed regarding the effect that APPE rotation performance has on the student’s future employment opportunities (84 of 272 responded). Study results show that of the alumni surveyed, 64% (n=96) answered that they asked a clerkship/rotation preceptor to provide references for a job or residency application. Further results show 60% (n=91) of alumni answered that their clerkship/rotation experience did increase their interest in post graduation employment at that specific site. Preceptor response confirmed that the student’s performance had a dramatic impact on his/her hiring potential. Of the preceptors surveyed, 74% (n=62) intentionally tried to hire students based on their clerkship/rotation performance, while 55% (n=46) avoided hiring students based on their clerkship/rotation performance. There is a noteworthy association between student performance and postgraduate employment opportunities. These results emphasize the importance of student performance during APPE rotations.

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Objective: This article describes the process of determining the need for a pass/fail grading system for APPE rotations and the development and implementation of a pass/fail grading process. Methods: Preceptors, faculty, and students were surveyed prior to the development and implementation of pass/fail grading and a new evaluation tool. Preceptors were surveyed after the new grading scheme had been in place for one year about their perceptions of student performance. Rates of APPE commendations under a pass/fail system and the number of students achieving a 4.0 under a point-based system are reported. Results: Surveys from preceptors indicate that pass/fail grading decreased preceptors concerns about distinguishing between student performances (56.6% had concerns prior to switching versus 30.6% having concerns after switching to pass/fail). Survey results also indicate that pass/fail grading did not affect preceptor's perception of student motivation (61.4% felt concerned under a graded system versus 12.2% were concerned after switching to pass/fail). A pass with honors commendation was given in 17.2% of rotation evaluations, contrasting with 83.1% of students achieving a 4.0 grade in a rotation prior to switching to pass/fail. Conclusions: The transition to a pass/fail grading system for APPE rotations is not associated with reductions in student motivation or performance, and is acceptable to preceptors. The implementation of a pass/fail system is complicated and takes a significant investment of time, but resulted in an APPE evaluation system which preserves student motivation, fosters robust feedback, decreases grade inflation, and allows preceptors to distinguish and reward student performance.

Conclusion: The majority of independent community pharmacists are interested in incorporating personalized medicine services into their practices, but they require further education before this is possible. Future initiatives should focus on the development of comprehensive education programs to further train pharmacists for provision of these services.Objectives: To evaluate the perceptions of independent community pharmacists within a regional independent community pharmacy cooperative on implementing personalized medicine services at their pharmacies and to gauge the pharmacists' self-reported knowledge of pharmacogenomic principles.Design: Descriptive, exploratory, nonexperimental study.Setting: American Pharmacy Services Corporation (APSC), 2011-12.Participants: Pharmacists (n = 101) affiliated with the independent pharmacies of APSC.Intervention: Single-mode surveyMain outcome measures: Independent community pharmacists' interest in implementing personalized medicine services, perceived readiness to provide such services, and perceived barriers to implementation.Results: 101 completed surveys were returned for data analysis. The majority of pharmacists surveyed (75%) expressed interest in offering personalized medicine services. When asked to describe their knowledge of pharmacogenomics and readiness to implement such services, more than 50% said they were not knowledgeable on the subject and would not currently be comfortable making drug therapy recommendations to physicians or confident counseling patients based on results of genetic screenings without further training and education. Respondents identified cost of providing the service, reimbursement issues, current knowledge of pharmacogenomics, and time to devote to the program as the greatest barriers to implementing personalized medicine services.

BACKGROUND AND OBJECTIVES: Interprofessional education (IPE) is recommended by many as a means by which to prepare clinicians for collaborative practice and a mechanism by which to improve the overall quality of health care. The objective of this study was to determine the impact of an interprofessional medicine-pharmacy student home visit experience on students' self-assessments of skills and abilities related to team-based care and identification of medication-related problems METHODS: Third-year medical and fourth-year pharmacy students completed an interprofessional home visit centered on identification of medication-related problems. Students were surveyed before and after the IPE assignment to assess changes in self-assessed skills and abilities. Survey items consisted of Likert-type statements on a 5-point scale (1=strongly disagree, 5=strongly agree) and free-text responses. Students also completed reflection papers regarding their experiences RESULTS: Twenty-two medical and 20 pharmacy students conducted medication-focused interviews of 22 patients at home as interprofessional teams. Medical and pharmacy student self-assessments of skills and abilities related to team-based care and identification of medication-related problems improved after completion of the assignment. Both groups of students perceived an improvement in confidence regarding communication skills, both with patients and with other health professions students. Changes were reported on 12 survey items. Student feedback on the IPE experience was positive CONCLUSIONS: Students' self-perception of skills and abilities related to interprofessional team-based care and identification of medication-related problems are improved after IPE medication-focused home visit assignment. Student feedback supports the value of interprofessional patient care clinical experiences.