Social Media in Pharmacy: Heeding its call, leveraging its power

This article looks into the use of social media as a major information outlet to consumers. The power of social media is that it reaches millions of people, and companies can choose who to reach out to specifically by sponsoring the outlet. Although this article cautions the information that is to be posted, pharmaceutical companies should not be hindered to inform people on vital health tips. Such tips are important because it allows pharmacists to put all of the information that they learned throughout school into the palms of the consumers who utilizing their products. As long as the consumer has a grasp on the information of the medications they are taking, a stronger bond can be made between pharmacist and consumer through social media outlets.

The article gives points for being concise and effective in language, knowing what audience you want to target, and getting immediate attention of social media goers.

Not only can social media connect pharmacists to patients, but to other healthcare professionals as well. I think it is important to understand and utilize social media now that it has grown so much. Reaching consumers on a personal level is something that should be taken full advantage of, but with caution. I can even say that while scrolling through Instagram at night I’ve seen multiple sponsored posts by UPMC. These posts have quick health tips, encourage screenings and vaccinations, and many more. As a professional it is important to realize that we must be cautious about what we post, but it is also important to be aware of utilizing social media outlets.

Link to Article

O’Hara B, Fox B, Donahue B. Social media in pharmacy: heeding its call, leveraging its power. JAPhA. 2015;53(6):561-68.

 

Pharmaceutical Policy Reform – Balancing Affordability with Incentives for Innovation

As student pharmacists, we come across adherence as a common drug therapy problem. Many patients are unable to take their medication as directed because of its high cost. Pharmaceutical prices are being debated at the institutional policy level, especially now with another presidential election coming up.

Policy makers are debating what is the best way to lower pharmaceutical drug costs. The current laissez-faire system is not working and drug prices are through the roof because there are no close substitutes. There has been talk of the government provided Medicare Part D plan being able to negotiate drug prices with drug companies to drive down the cost of medications. Considering this is where a huge portion of the drug companies’ market lies, this has potential for success. However, one could argue that putting a price limit would hurt drug companies’ drive for innovation. Lawmakers would actually prefer to stay out of the direct government negotiation about drug prices, and instead are talking about encouraging other forces in the drug market to drive prices down that way.

This is a complicated topic with no one clear answer. In order for companies to be motivated to keep producing high quality, high value products, there must be large compensation. However, if prices are the only mechanism through which research is rewarded, affordability will be compromised. Evidently, there is no single, easy answer to the constantly escalating drug prices in the United States.

 

Read the full article here.

Conti RM. Rosenthal MB. Pharmaceutical Policy Reform – Balancing Affordability with Incentives for Innovation. N Engl J Med. 2016;374:703-6

Pharmacists Home Visits: A 1-Year Experience from a Community Pharmacy

Pharmacists are increasingly becoming more involved as part of a medical team to provide direct care to patients. Most of these patient care services are focused in the clinical setting, however, and there is a greater opportunity for pharmacists in a community setting to make an impact on patient care. An independent community pharmacy in Buffalo, NY conducted a one year study in providing home visits that they felt could truly benefit the patients who utilized this service. They observed the overall costs, limitations, benefits, and drawbacks on pharmacists in the community providing home visits.

Home visits were conducted for a variety of reasons including, but not limited to, medication therapy management, medication reconciliation, adherence monitoring or packaging,  management of medications by providing pillboxes and other organizational tools, medical device or disease state counseling, formulary management, and hospital transition. Patients were selected based on need by pharmacists, physicians, pharmacists, and caregivers. These visits were approximately 2 hours each, and the average age of participants was 70 years old. Nearly 200 home visits were conducted over the course of the year.

The study found that these visits enhanced medication adherence and patient understanding of medications and devices. Patients were satisfied with the service, and the value of community pharmacists taking more clinical roles was observed. However, the service was costly to the pharmacy (~$20,000), and in many busier pharmacies, this type of practice may be too time consuming to be a realistic option.

I found this study to be extremely interesting, because I think more community pharmacies should attempt to meet the needs of patients with innovative services like this. Although the service may be costly, the benefits to the patient could be invaluable. Community pharmacists have a wealth of knowledge that could benefit patients of all demographics, and the move towards providing more clinical services is a step in the right direction. I am interested to see ways in which pharmacy practice will continue to advance and allow more opportunities to provide direct care.

J Am Pharm Assoc. 2016:56:67-72.

http://www.japha.org/article/S1544-3191(15)00003-5/fulltext#sec1

Accelerating Medicines Partnership: Alzheimer’s Disease (AMP-AD) Knowledge Portal Aids Alzheimer’s Drug Discovery through Open Data Sharing

The Accelerating Medicines Partnership (AMP) was developed in 2014 as a way to address 3 main problems in the development and testing of new medications. These 3 problems are that drug development and testing are very expensive, they can take a long time, and they often times fail completely.  AMP was developed by Dr. Francis Collins, Director of the National Institutes of Health (NIH), in conjunction with the heads of many pharmaceutical companies. AMP’s efforts focus on 3 diseases, which are Alzheimer’s disease (AD), Type II Diabetes, and rheumatoid arthritis/lupus erythematosus. This article focuses on the role of AMP in AD and how it could change the development of new drugs for AD through 2 projects, which are the Biomarkers Project and the Target Discovery and Preclinical Validation Project.

Biomarkers Project: The goal of this project is to develop novel imaging techniques and to identify fluid biomarkers in people who are clinically determined to have a greater risk of developing AD later in their life (to make this clear, these people DO NOT have AD already!). People are determined to have a greater risk of developing AD if they have one of the three gene mutations that produces early-onset dominantly inherited AD, because they have two copies of the late-onset genetic risk factor for ApolipoproteinE-ε4 , or because they already have beta-amyloid in their brain that was detected by a PET scan (beta-amyloid is the characteristic “plaque” that builds up in the brains of those with AD). This project aims to develop clinical trials in people with a predisposition to AD so that drugs can be developed to prevent the onset of AD.

Target Discovery and Preclinical Validation Project: The main goal of this project is to discover, select, and characterize novel therapeutic targets for AD. In order to reach this goal, AMP is focusing its research on gaining a better understanding of gene, protein, and metabolic networks in human brains where these novel targets would operate and interact, identifying biologic nodes and networks that are linked to the development or progression of AD, and by evaluating the drugability of the targets in multiple model organisms. This project is using genomic, epigenomic, RNA sequencing, and proteomic data derived from studies of over 2000 postmortem human brains from people who had AD or were cognitively normal.

A critical aspect of AMP is how it utilizes an IRB-approved data sharing platform where data can be stored, accessed, and collaboratively analyzed by all members of the AMP-AD research team. There has not been a new therapy approved by the FDA for the treatment of AD since 2003, so AMP’s hope is that this new and comprehensive research platform will help produce a much needed new drug(s) for the treatment of AD. AMP’s hope is ultimately that their platform will stretch to many AD researches across the globe so that a vast communal effort can be put forth to develop new medicinal therapies for treating AD.

I think this is a great new platform in the fight against Alzheimer’s disease. AD is so common in older adults, and it is pretty astounding to think that there has not been any new drugs approved for the treatment of AD since 2003! We learned in Anatomy and Physiology I that AD is starting to be recognized possibly as “Type 3 Diabetes” because researchers are starting to find that beta-amyloid “plaque” in AD patients’ brains may be caused by insulin issues. I personally think AMP’s platform is an innovative way to approach research on a global scale because it seems like AD is so complicated that it may take a widespread effort among researchers from different parts of the world to truly figure out how to combat the disease through medicinal therapies.

My posed question to colleagues: What do you think are the risks and benefits of having a platform like AMP’s to further research in hopes of developing new drug therapies for specific disease states such as AD?

Hodes, RJ, Buckholtz, N. Accelerating Medicines Partnership: Alzheimer’s Disease (AMP-AD) knowledge portal aids Alzheimer’s drug discovery through open data sharing. Expert Opin Ther Targets. 2016;20:1-4.  

Enhanced Responsibilities for Pharmacy Interns at a Teaching Hospital

An increasing demand has been made on hospital pharmacies with large patient populations and the multiple roles of a pharmacist. To combat this, more responsibility has been placed on pharmacy technicians. In some states, tech-check-tech, or TCT, programs have been implemented. These programs place responsibility on the technicians to check each others work and ensure the correct dosing and filling of medications being distributed. These programs allow pharmacists to do more clinical and collaborative work, all while over-seeing the techs.

Unfortunately Massachusetts does not allow TCT programs. So, instead they have implemented an “intern distribution coordinator” position. This position is currently held by only a couple of qualified interns, all ranging from P1-P3s. The inter distribution coordinator is responsible for usual pharmacist responsibilities, but of course they are always under the direct supervision of a pharmacists. These interns undergo 80 hours of training in medication distribution, workflow of the pharmacy, information systems, communication process, and order entry, to name a few. It is the intern’s responsibility to verify the correct patient name, medical record number, medication, strength, quantity, and expiration date much like a pharmacist would.

The use and opportunity for a pharmacy intern to be given some of the responsibility of a pharmacist is very interesting to me. I think this gives interns a great “leg-up” once they are licensed  because they will already have experience in the verification process. As a pharmacy intern now, I do get experience in the order entry and filling process of a script, as well as some inventory management, but I do not get any experience in the verification process, which as a pharmacist in a retail or hospital setting I will have the responsibility of. I think this is a great idea and allows interns to grow and experience more while they are still in pharmacy school.

Link to Article

Gillis C, Anger K, Cotungo M. Enhanced responsibility for pharmacy interns at a teaching hospital. JAPhA. 2015. 55;198-202.

Pharmacists Help Encourage Short Term Antibiotic Regimines

This study aimed to reduce the duration of antibiotics prescribed to children with uncomplicated skin and skin structure infections. Uncomplicated skin and skin structure infections, or uSSTIs, usually are treated with antibiotic therapy and include simple abscesses, cellulitis, impetiginous lesions, and furuncles. Complicated skin structure and skin structure infections (cSSTIs) affect deeper skin or are considered complicated in an immune-deficient patient. These include major abscesses, infected burns and ulcers, other infected wounds, and diabetic foot infections. The guidelines from Infectious Diseases Society of America for the management of SSTIS suggest a 5 day course of antibiotic treatment for uSSTIs, and can be extended if improvement is not made. The short antibiotic courses can help prevent antibiotic resistant bacteria from forming, lower costs, and reduce adverse effects. This study took place at the Cincinnati Children’s Hospital Medical Center, and aimed to increase short course antibiotic treatment (less than 7 days) in patients who came in with uSSTIs, compared to the previously used long-course therapy which lasts 7 to 14 days. At the beginning of this study 23% of patients with uSSTIs were prescribed short course antibiotic treatment.

To accomplish the study’s goal, they used a few methods. First, they had two 15-minute information sessions with residents and attendants. They also attached information cards about optimal antibiotic regimens for SSTIs to medical personnel’s identification badges. Pharmacists identified the third intervention as part of a multidisciplinary team, who noted that the order set default for uSSTIs was a 14-day course of therapy. The last intervention method was having a team member from the study contacting the physicians attending to SSTI patients and reiterating that short term antibiotic therapies can be used for uSSTIs, and to contact them with any questions. 5 months after the project began, 74% of patients with uSSTIs were discharged with the short term antibiotic therapies, and there was no significant difference in the amount of readmissions or recurrence for those who received the short term antibiotic treatment.

I really thought that this article showed the importance of pharmacists as part of a healthcare team, and how pharmacists can contribute innovative practices to medication changes. While changing the automatic duration of therapy in the prescribing system may seem simple, it can remind and alert the physician about the benefits of short term antibiotics and lead to less human error and increased savings. Also, this was the first time I had heard about short-term antibiotic regimens. While at first it seemed a little strange to me since I’ve been taught a lot about the importance of finishing antibiotic treatments to avoid resistance, it makes sense that shorter term antibiotic regimens would lead to increased patient adherence. Do you think that any of these methods could be implemented into a community pharmacy setting? Could pharmacists have played a more important role in this study, perhaps by educating pharmacists as well so that they can perform interventions when filling out prescriptions?

 

Citation: Schuler CL, Courter JD, Conneely SE, et al. Decreasing Duration of Antibiotic Prescribing for Uncomplicated Skin and Soft Tissue Infections. Pediatrics. doi: 10.1542/peds.2015-1223 (published 18 January 2016).

 

Link: http://pediatrics.aappublications.org/content/early/2016/01/15/peds.2015-1223