Culture response programs are an important antimicrobial stewardship strategy in the emergency department. Pharmacists often have a key role in culture response but are most often dependent on other providers to optimize a patient's antimicrobial therapy. This study assessed the impact of advanced practice pharmacists, with independent prescribing authority, on an emergency department culture response program. This was a quasi-experimental preimplementation vs postimplementation evaluation performed at an academic medical center, with a 91-bed adult and pediatric emergency department, during the transition from a nurse-driven to an advanced practice pharmacist-driven program. The primary endpoint was time elapsed between initial culture review and intervention. Data on 200 interventions were collected from both the pre- and postimplementation phases. Median time from culture review to intervention was 5.27 hours (interquartile range [IQR], 2.8-24.2 hours) before implementation, compared to 2.95 hours (IQR, 1.4-6.1) after implementation (P < 0.001). The nurse-driven program intervened on 27% of positive cultures, while pharmacists intervened on 42% of positive cultures. The types of interventions performed and antibiotic prescribing patterns differed between the 2 study phases, but all choices were deemed appropriate by the criteria set for the purposes of this study. The roles of advanced practice pharmacists allowed for the establishment of a streamlined culture response workflow. Culture responses occurred at a faster rate than with the previous nurse-driven program while maintaining high-quality clinical decision-making.

To describe the presence, type, and management of drug-drug interactions (DDIs) at prescription cannabidiol (CBD) therapy initiation. We conducted a single-center, retrospective study of patients prescribed CBD from a medical center's neurology clinic for seizure management from January 2019 through April 2020. Patients were excluded if they were enrolled in a CBD clinical trial or the insurance approval or medication fulfillment process was not completed by the center's specialty pharmacy. The primary outcomes were the numbers, types, and management of DDIs identified at the time of CBD prescribing. Of the 136 patients included, 109 (80%) had a DDI identified at baseline. Of the 260 DDIs, 71% (n = 184) were pharmacodynamic and 29% (n = 76) were pharmacokinetic in nature. Management of the 260 DDIs detected included counseling only (89% [n = 232 interactions]), discontinuation of the interacting agent [9% (n = 22 interactions]), and dosage change for the interacting agent [2% (n = 6 interactions]). Clobazam was the most commonly identified interacting medication (n = 63, 24%), while valproic acid accounted for 10% (n = 26) of the DDIs. The population was predominantly white (n = 115, 85%), 18 years of age or younger (n = 92, 68%), and had an indication for prescription CBD treatment of Lennox-Gastaut syndrome (n = 117, 86%). This study provides new information on the role that integrated specialty pharmacists can play in identifying and managing initial DDIs in patients starting prescription CBD.

DisclaimerIn an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

The purpose of this study was to quantify the growth and trends in postgraduate year 2 (PGY2) pharmacy residencies. Summaries of the American Society of Health-System Pharmacists (ASHP) Resident Matching Program from 2008 to 2021 were obtained. Only standalone PGY2 residencies were included in the analysis. Descriptive analyses were completed for data related to the programs and positions. From 2008 to 2021, the total number of ASHP-accredited PGY2 programs increased from 282 to 1,131 (301%) and the overall number of unfilled positions decreased from 22% (77 of 351) to 2% (34 of 1,492). The percentage of positions filled early increased from 23% (81 of 351) to 40% (594 of 1,492) during this time. In 2021, programs with a clinical focus accounted for 91.6% of total positions. The Ambulatory Care category accounted for the largest percentage of all PGY2 residency positions, at 19.2% (287 of 1,492) in 2021 compared to 12.8% (45 of 351) in 2008. The total share of PGY2 residency positions in the Critical Care category decreased from 22.8% (80 of 351) in 2008 to 13.7% (205 of 1,492) in 2021; however, the share of PGY2 residency positions in the Emergency Medicine category increased from 1.4% (5 of 351) to 5.9% (88 of 1,492). From 2008 to 2021 the total number of PGY2 residencies increased; however, this growth was uneven, as the share of positions within individual residency categories changed. It is important for pharmacy stakeholders to review the current state of postgraduate training and ensure it reflects the goals for future practice.

Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

The impact of goal setting in pharmacy preceptor development was evaluated using the Habits of Preceptors Rubric (HOP-R), a criterion-referenced assessment developed to assess, quantify, and demonstrate growth across 11 preceptor habits. This study retrospectively evaluated initial and follow-up survey responses from the 2019-2020 Clinician Educators Program cohort at Midwestern University College of Pharmacy, Glendale Campus. Enrollees in this teaching and learning curriculum (TLC) were invited to assess their precepting habits using the HOP-R after attending the first seminar and again toward the end of the longitudinal program. Using online surveys, participants rated their precepting capabilities as developing, proficient, accomplished, or master level for each habit. In the initial survey, each participant selected a habit of focus for deliberate development and established an individualized goal using the specific, measurable, achievable, relevant, and time-bound (SMART) framework. In the follow-up survey, participants indicated their satisfaction with and progress toward accomplishing their precepting goal. Initial survey results from 55 study participants identified developing as the most frequently self-reported habit level (53%; n = 605 ratings), while master was the least frequently reported (1%). In the follow-up assessment, accomplished (45%) was the most frequently self-reported habit level, while master (5%) remained the least reported. The cohort reported a median progress in SMART goal accomplishment of 69% (range, 12% to 100%; n = 54). Preceptor and resident pharmacists reported perceived advancement in precepting capabilities within the conceptual framework of the HOP-R encompassing both their self-selected habit of focus and adjacent habits while enrolled in a TLC. SMART goals facilitated qualitative and quantitative assessment of development.

To describe the creation of a statewide leadership training program for practicing pharmacists and pharmacy technicians. The 2 overarching goals were to (1) enable learners to develop foundational leadership skills that could be used at their place of work or would enable them to take on a new or advanced role and (2) help foster sustainability within our state pharmacy society through incorporation of the learners on committees and projects, bringing awareness to board member roles and functions. Overall, the program's mission was to empower practicing pharmacists and pharmacy technicians to take on leadership roles within their organization and the state pharmacy society. Leadership training for pharmacists and pharmacy technicians can be variable, elusive, and costly. We provide our experiences in establishing a 1-year leadership certificate program affiliated with the state pharmacy society. In the first 4 years, a total of 15 program fellows have graduated, with 8 more set to finish in September 2022. Since completion of the program, a majority of the graduates have taken on new leadership positions (65% have accepted new leadership positions and 35% have been elected to state pharmacy society board positions). Implementation of a statewide pharmacy leadership program provided a low-cost, high-value option to develop local leaders, in affiliation with a state pharmacy society.

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

James Charles McAllister III, educator, past president of ASHP, and lifelong voice for advancing the practice of pharmacy, died December 20, 2021. He was 73 years old. McAllister was ASHP president in 1990–1991. He was active in the organization for more than 30 years, including service on councils and the Board of Directors. He was named a Fellow of ASHP in 1993 and was the 2003 recipient of the ASHP Harvey A.K. Whitney Lecture Award. “We were deeply saddened to learn of Jim’s passing,” said ASHP Chief Executive Officer Paul W. Abramowitz. “In his 2003 Harvey A.K. Whitney lecture, Jim asked ‘What will be your legacy?’ During his long career in health-system pharmacy, Jim established his own legacy as a visionary leader who advanced pharmacy practice, including intravenous admixture services, home health care, pharmacy informatics, and professional education and residency training. His service to ASHP, including as president, contributed to advances in the profession that continue to this day. I was fortunate to have served on the ASHP Board of Directors when Jim was president and have valued his friendship ever since. Patient care, the profession, and ASHP members were his highest priorities as he led the organization. I send my deepest condolences to his wife Anita Groves McAllister and entire family at this very sad time.”

Veterans prescribed oral antineoplastic therapies (OATs) by community providers outside the Veterans Health Administration (VA) may lack access to comprehensive medication management. To address this, our multidisciplinary team developed and implemented a pharmacist-led telehealth medication management program for veterans prescribed OATs by community providers. The program exclusively uses telehealth to connect veterans with a dedicated board-certified clinical oncology pharmacist who provides comprehensive medication management. The program is based on established pharmacy models found in the research literature. We developed a standard operating procedure, communication templates, patient education materials, and a suite of health information technology tools to help streamline pharmacy processes. The Consolidated Framework for Implementation Research was used to design implementation strategies to promote the adoption of the program. In the first year, 64 veterans from 3 VA medical centers were enrolled in the program. The oncology clinical pharmacist performed 342 encounters and 101 interventions. The program saved an estimated $200,724 in medication-related costs. The veterans we surveyed reported high levels of satisfaction with the pharmacy services provided by the program. The delivery of comprehensive medication management through telehealth is feasible from a healthcare system perspective and beneficial for patients. The board-certified oncology clinical pharmacist provided remote pharmacy services to Veterans across three sites in a large and rural service area for the VA. The program realized several benefits, including positive clinical outcomes, high levels of patient satisfaction, and cost savings on medication-related costs.