Pharmacist Segments Identified from 2009, 2014, and 2019 National Pharmacist Workforce Surveys: Implications for Pharmacy Organizations and Personnel

The role of clinical pharmacist in the management of resistant hypertension

BACKGROUND

Hypertension is a major contributor to global cardiovascular morbidity and mortality. Treatment-resistant hypertension (TRH) presents a significant management challenge, requiring a pharmacist-physician collaborative model to achieve sustained blood pressure (BP) control.

AIM

This study aims to evaluate the impact of a clinical pharmacy interventions on BP control, medication adherence, and patient outcomes in patients with TRH in a primary care setting.

METHODS

A randomized controlled trial was conducted involving 142 patients with TRH at two primary care clinics. Participants were randomly assigned to either the intervention group, receiving clinical pharmacy services including medication reviews and personalized counseling, or the control group, receiving standard care. Medication adherence was assessed using the Medication Adherence Rating Scale, and patient outcomes, including BP control and quality of life (QoL), were measured over a 6-month period.

RESULTS

The intervention group demonstrated a significant improvement in medication adherence compared to the control group (p < 0.001), with an effect size of - 1.75. Clinical parameters, such as BP (mean reduction in BP: 27.9/13.4 mmHg), showed more favorable outcomes in the intervention group (p = 0.003). Furthermore, patients receiving clinical pharmacy services reported higher QoL scores (p < 0.001) and expressed higher satisfaction with medication management.

CONCLUSION

Clinical pharmacy interventions significantly enhance medication adherence and improve patient achievement of target BP goals in TRH patients. Incorporating clinical pharmacy services into routine care can lead to better health management and increased patient QoL. Further research is needed to explore long-term benefits and cost-effectiveness.

Assessing the Alignment Between Pharmacists' Reported Tasks and Employer-Advertised Skills

OBJECTIVE

This study examined the alignment between and changes within the tasks performed by pharmacists and skills sought by pharmacist employers from 2012 to 2022.

METHODS

The United States Department of Labor's Occupational Information Network (O*NET) surveys a random sample of employees in targeted occupations every 5 years and provides a publicly available database allowing exploration of the frequency with which essential tasks are performed and perceived relevance and importance. Lightcast (formerly Burning Glass) provides labor market analytics of job advertisements; cross-sectional and longitudinal data can be filtered according to occupation, industry, location, and area of specialty. A crosswalk was developed between the top 20 most frequently performed pharmacist tasks (O*NET) and the most frequently-advertised skills by employers for pharmacist positions (Lightcast).

RESULTS

The 5 most frequently performed pharmacist tasks changed minimally over the period, including prescription review and drug information and advice. There was a consistent upward trend in the frequency of interprofessional collaborations and informatics and a downward trend in compounding. Advertised skills fluctuated over the period, with business and management skills most desired. There was a decline in sought-after experience in specific health care settings and some fundamental clinical skills. Emerging skills pertained to patient care, such as vaccination, allergies, diabetes, and wellness.

CONCLUSION

The fact that prescription review remains the top task from O*NET over the past 10 years and the top advertised skill in Lightcast is patient care underscores the contemporary misalignment and highlights a potential discrepancy in the emphasis of pharmacy education.

Analysis of Laboratory Skills Curricula Surrounding Professional Identity Formation in Doctor of Pharmacy Students

OBJECTIVE

The purpose of this study was to describe how laboratory curricula in 6 pharmacy programs provides student pharmacist experiences to develop professional identity formation and explore personal identities.

METHODS

Learning objectives for courses with laboratory components were independently reviewed and then reconciled to identify the associated historical professional identities, professional domains, and associated with personal identity from 6 pharmacy programs. Counts and frequencies for historical professional identities, domains, and personal identity associations were obtained by program and overall.

RESULTS

Thirty-eight (2.0%) unique objectives were associated with personal identity. The most identified historical professional identity was healthcare provider (42.9%), followed by dispenser (21.7%). The highest professional domain identified was prepare/dispense/provide medications (28.8%) followed by communicate/counsel/educate (17.5%).

CONCLUSION

Discordance between the historical identities and professional domains covered in the laboratory curricula was identified in this analysis. The prevalence of the "health care provider" professional identity in the laboratory curricula likely mimics what is currently seen in practice, but most lab activities fell under the domain of preparing and dispensing medication which may not be considered a component of healthcare provider professional identity. Going forward, educators must be intentional in the experiences we provide to students to help foster their professional and personal identity. Future research is needed to identify if this discordance is present in other classes along with research to identify intentional activities that can be incorporated to foster professional identity formation.

Pharmacist gender and physician acceptance of antibiotic stewardship recommendations: An analysis of the reducing overuse of antibiotics at discharge home intervention

OBJECTIVE

To assess association of pharmacist gender with acceptance of antibiotic stewardship recommendations.

DESIGN

A retrospective evaluation of the Reducing Overuse of Antibiotics at Discharge (ROAD) Home intervention.

SETTING

The study was conducted from May to October 2019 in a single academic medical center.

PARTICIPANTS

The study included patients receiving antibiotics on a hospitalist service who were nearing discharge.

METHODS

During the intervention, clinical pharmacists (none who had specialist postgraduate infectious disease residency training) reviewed patients on antibiotics and led an antibiotic timeout (ie, structured conversation) prior to discharge to improve discharge antibiotic prescribing. We assessed the association of pharmacist gender with acceptance of timeout recommendations by hospitalists using logistic regression controlling for patient characteristics.

RESULTS

Over 6 months, pharmacists conducted 295 timeouts: 158 timeouts (53.6%) were conducted by 12 women, 137 (46.4%) were conducted by 8 men. Pharmacists recommended an antibiotic change in 82 timeouts (27.8%), of which 51 (62.2%) were accepted. Compared to male pharmacists, female pharmacists were less likely to recommend a discharge antibiotic change: 30 (19.0%) of 158 versus 52 (38.0%) of 137 (P < .001). Female pharmacists were also less likely to have a recommendation accepted: 10 (33.3%) of 30 versus 41 (8.8%) of 52 (P < .001). Thus, timeouts conducted by female versus male pharmacists were less likely to result in an antibiotic change: 10 (6.3%) of 158 versus 41 (29.9%) of 137 (P < .001). After adjustments, pharmacist gender remained significantly associated with whether recommended changes were accepted (adjusted odds ratio [aOR], 0.10; 95%confidence interval [CI], 0.03-0.36 for female versus male pharmacists).

CONCLUSIONS

Antibiotic stewardship recommendations made by female clinical pharmacists were less likely to be accepted by hospitalists. Gender bias may play a role in the acceptance of clinical pharmacist recommendations, which could affect patient care and outcomes.

A 15-Year Ecological Comparison for the Hiring Dynamics of Minnesota Pharmacies between 2006 and 2020

Labor market forces in pharmacy are affected by frictional unemployment (job turnover), structural employment forces that require new skill sets for employees, and hiring practices that integrate technology or less costly labor such as pharmacy technicians. The objectives of this study were to describe hiring trends for both the pharmacist and technician workforces in licensed pharmacies on a biennial basis from 2006 through 2020 using data collected in Minnesota. Ecological comparisons were made between the survey years using descriptive statistics. For open-ended questions added to the 2020 survey, content analysis was applied. Demand for technicians increased which might be due to the expansion of their roles into activities that had been reserved for the pharmacist. Pharmacies reportedly would like to hire pharmacists to meet the demand for new services that pharmacists can provide. However, respondents articulated that this is not feasible under current economic pressures. This represents a lost opportunity for transformation in pharmacy that would establish pharmacists’ roles in the rapidly transforming health care value chain. We conclude that hiring dynamics in pharmacies are being driven more by economic and organizational shifts than meeting the demand for services that pharmacists can provide.