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1.  Medication Adherence Challenges among Patients Experiencing Homelessness in a Behavioral Health Clinic 
Research in social & administrative pharmacy : RSAP  2012;S1551-7411(12)00349-X 10.1016/j.sapharm.2012.11.004.
Background
Behavioral health medication nonadherence is associated with poor health outcomes and increased healthcare costs. Little is known about reasons for nonadherence with behavioral health medications among homeless people.
Objectives
To identify reasons for medication nonadherence including the sociodemographic, health-related factors, and behavioral health conditions associated with medication nonadherence among behavioral health patients served by a Health Care for the Homeless center (HCH) in Virginia.
Methods
The study sample was selected from an existing database that included sociodemographic, health-related information, and medication-related problems identified during a pharmacist-provided medication review conducted during October 2008–September 2009. Patients experiencing or at risk of homelessness who were ≥ 18 years old with at least one behavioral health condition who had a medication review were eligible for the study. A qualitative content analysis of the pharmacist documentation describing the patient’s reason(s) for medication nonadherence was conducted. The Behavioral Model for Vulnerable Populations was the theoretical framework. The outcome variable was self-reported medication nonadherence. Descriptive and multivariate (logistic regression) statistics were used.
Results
A total of 426 individuals met study criteria. The mean age was 44.7 ± 10.2 years. Most patients were African-American (60.5%) and female (51.6%). The content analysis identified patient-related factors (74.8%), therapy-related factors (11.8%), and social or economic factors (8.8%) as the most common reasons for patients’ medication nonadherence. Patients with post-traumatic stress disorder (PTSD) (adjusted odds ratio: 0.4; 95% CI: 0.19–0.87) were less likely to have a medication adherence problem identified during the medication review.
Conclusions
The content analysis identified patient-related factors as the most common reason for nonadherence with behavioral health medications. In the quantitative analysis, patients with a PTSD diagnosis were less likely to have nonadherence identified which may be related to their reluctance to self-report nonadherence and their diagnosis, which warrants further study.
doi:10.1016/j.sapharm.2012.11.004
PMCID: PMC3733792  PMID: 23218849
Medication nonadherence; homeless; behavioral health
2.  Integration of collaborative medication therapy management in a safety net patient-centered medical home 
Objective
To describe the integration of collaborative medication therapy management (CMTM) into a safety net patient-centered medical home (PCMH).
Setting
Federally qualified Health Care for the Homeless clinic in Richmond, VA, from October 2008 to June 2010.
Practice description
A CMTM model was developed by pharmacists, physicians, nurse practitioners, and social workers and integrated with a PCMH. CMTM, as delivered, consisted of (1) medication assessment, (2) development of care plan, and (3) follow-up.
Practice innovation
CMTM is integrated with the medical and mental health clinics of PCMH in a safety net setting that serves homeless individuals.
Main outcome measures
Number of patients having a CMTM encounter, number and type of medication-related problems identified for a subset of patients in the mental health and medical clinics, pharmacist recommendations, and acceptance rate of pharmacist recommendations.
Results
Since October 2008, 695 patients have had a CMTM encounter. An analysis of 209 patients in the mental health clinic indicated that 425 medication-related problems were identified (2.0/patient). Pharmacists made 452 recommendations to resolve problems, and 384 (85%) pharmacist recommendations were accepted by providers and/or patients. For 40 patients in the medical clinic, 205 medication-related problems were identified (5.1/patient). Pharmacists made 217 recommendations to resolve the problems, and 194 (89%) recommendations were accepted.
Conclusion
Integrating CMTM with a safety net PCMH was a valuable patient-centered strategy for addressing medication-related problems among homeless individuals. The high acceptance rate of pharmacist recommendations demonstrates the successful integration of pharmacist services.
doi:10.1331/JAPhA.2011.10191
PMCID: PMC3280342  PMID: 21382806
Medication therapy management; patient-centered medical home; collaborative care
3.  Preparation of Faculty Members and Students to Be Citizen Leaders and Pharmacy Advocates 
To identify characteristics and quality indicators of best practices for leadership and advocacy development in pharmacy education, a national task force on leadership development in pharmacy invited colleges and schools to complete a phone survey to characterize the courses, processes, and noteworthy practices for leadership and advocacy development at their institution. The literature was consulted to corroborate survey findings and identify additional best practices. Recommendations were derived from the survey results and literature review, as well as from the experience and expertise of task force members. Fifty-four institutions provided information about lecture-based and experiential curricular and noncurricular components of leadership and advocacy development. Successful programs have a supportive institutional culture, faculty and alumni role models, administrative and/or financial support, and a cocurricular thread of activities. Leadership and advocacy development for student pharmacists is increasingly important. The recommendations and suggestions provided can facilitate leadership and advocacy development at other colleges and schools of pharmacy.
doi:10.5688/ajpe7710220
PMCID: PMC3872939  PMID: 24371344
student leadership; advocacy; faculty member; pharmacy student; citizen leader
4.  Educating Pharmacy Students to Improve Quality (EPIQ) in Colleges and Schools of Pharmacy 
Objective. To assess course instructors’ and students’ perceptions of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) curriculum.
Methods. Seven colleges and schools of pharmacy that were using the EPIQ program in their curricula agreed to participate in the study. Five of the 7 collected student retrospective pre- and post-intervention questionnaires. Changes in students’ perceptions were evaluated to assess their relationships with demographics and course variables. Instructors who implemented the EPIQ program at each of the 7 colleges and schools were also asked to complete a questionnaire.
Results. Scores on all questionnaire items indicated improvement in students’ perceived knowledge of quality improvement. The university the students attended, completion of a class project, and length of coverage of material were significantly related to improvement in the students’ scores. Instructors at all colleges and schools felt the EPIQ curriculum was a strong program that fulfilled the criteria for quality improvement and medication error reduction education.
Conclusion The EPIQ program is a viable, turnkey option for colleges and schools of pharmacy to use in teaching students about quality improvement.
doi:10.5688/ajpe766109
PMCID: PMC3425924  PMID: 22919085
quality improvement; medication error; pharmacy education; pharmacy student; assessment; curriculum
5.  Pharmacoepidemiology Education in US Colleges and Schools of Pharmacy 
Objective
To examine the type and extent of pharmacoepidemiology education offered by US colleges and schools of pharmacy.
Methods
An electronic Web-survey was sent to all 89 US colleges and schools of pharmacy between October 2005 and January 2006 to examine the type and extent of pharmacoepidemiology education offered to professional (PharmD) and graduate (MS/PhD) students.
Results
The response rate was 100%. Of the 89 schools surveyed, 69 (78%) provided pharmacoepidemiology education to their professional students. A mean of 119 (±60) PharmD students per college/school per year received some pharmacoepidemiology education (range 1-60 classroom hours; median 10 hours). Thirty-five schools (39%) provided education to a mean of 6 (±5) graduate students (range 2-135 classroom hours; median 15 hours).
Conclusions
A majority of US colleges and schools of pharmacy offer some pharmacoepidemiology education in their curriculum. However, the topics offered by each school and number of classroom hours varied at both the professional and graduate level.
PMCID: PMC1959224  PMID: 17786268
pharmacoepidemiology; epidemiology; curriculum

Results 1-5 (5)