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1.  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.
PMCID: PMC3425924  PMID: 22919085
quality improvement; medication error; pharmacy education; pharmacy student; assessment; curriculum
2.  Patient Panel of Underserved Populations and Adoption of Electronic Medical Record Systems by Office-Based Physicians 
Health Services Research  2010;45(4):963-984.
To examine the association between patient panels of underserved populations and adoption of electronic medical records (EMRs) among office-based physicians.
Data Sources
Two thousand three hundred and twenty-six office-based physicians who responded and saw patients in the 2005 and 2006 National Ambulatory Medical Care Surveys.
Study Design
This study used a cross-sectional design. The unit of analysis was the office-based physician. EMR adoption was defined based on functionalities (No EMR, Limited, or Comprehensive). An EMR was considered to have “comprehensive” functionalities if it included computerized orders for prescriptions and tests, test results, and clinical notes by physicians. Patient panels of underserved populations were measured as proportions of racial/ethnic minorities, Medicaid recipients, or self-pay/no charge/charity care patients treated by a physician using the reported sociodemographic characteristics in patient records linked to their treating physicians. Data were analyzed using multivariate regression analyses controlling for other patient-panel characteristics and characteristics of physicians and their practices.
Principal Findings
We found a negative association between the proportion of Hispanics treated by a physician and physician adoption of EMRs with “comprehensive” functionalities after adjusting for other covariates.
Physicians treating high shares of Hispanic patients may have lower access to EMRs with essential functionalities.
PMCID: PMC2910564  PMID: 20403062
Health information technology; underserved populations
3.  Do statins improve outcomes in patients with asthma on inhaled corticosteroid therapy? A retrospective cohort analysis 
BMJ Open  2012;2(3):e001279.
Animal studies and clinical trials have examined the potential benefits of statins in asthma management with contradictory results. The objective of this study was to determine if asthma patients on concurrent statins are less likely to have asthma-related hospitalisations.
A retrospective cohort study using Mississippi Medicaid data for 2002–2004.
Asthma patients ≥18 years were identified using the ICD9 code 493.xx from 1 July 2002 through 31 December 2003. The index date for an exposed subject was any date within the identification period, 180 days prior to which the subject had at least one inhaled corticosteroid prescription and at least an 80% adherence rate to statins. Asthma patients on inhaled corticosteroids, but not on statins, were selected as the unexposed population. The two groups were matched and followed for 1 year beginning the index date.
Main outcomes measures
Patient outcomes in terms of hospitalisations and ER visits were compared using conditional logistic regression.
After matching, there were 479 exposed subjects and 958 corresponding unexposed subjects. The odds of asthma-related hospitalisation and/or emergency room (ER) visits for asthma patients on concurrent statins were almost half the odds for patients not on statins (OR=0.55; 95% CI (0.37 to 0.84); p=0.0059). Similarly, the odds of asthma-related ER visits were significantly lower for patients on statins (OR=0.48; 95% CI (0.28 to 0.82); p=0.0069).
The findings suggest beneficial effects of statins in asthma management. Further prospective investigations are required to provide more conclusive evidence.
Article summary
Article focus
Statins have been shown to have promising therapeutic potential in mediating anti-inflammatory processes in animal model studies as well as clinical trials of rheumatoid arthritis, autoimmune encephalomyelitis, inflammatory colitis and psoriasis.
Along the same line of reasoning, recently there has been some discussion regarding the use of statins in asthma management in addition to inhaled corticosteroid therapy.
The purpose of this study was to investigate the beneficial effects of statins on asthma outcomes using the Mississippi Medicaid claims database.
Key messages
The findings suggest that statins may be beneficial in asthma management.
The study accounts for several additional potential confounders not previously explored in the other observational studies.
Strengths and limitations of this study
The study uses a propensity score-matched cohort study design, which in itself should take into account potential confounding effects.
The study was conducted using Medicaid claims data, and therefore, there is a possibility of misclassification due to coding errors during claims processing.
PMCID: PMC3364455  PMID: 22619271
4.  The Science of Safety Curriculum in US Colleges and Schools of Pharmacy 
Objective. To describe the integration of science of safety (SoS) topics in doctor of pharmacy (PharmD) curricula of US colleges and schools of pharmacy.
Methods. A questionnaire that contained items pertaining to what and how SoS topics are taught in PharmD curricula was e-mailed to representatives at 107 US colleges and schools of pharmacy.
Results. The majority of the colleges and schools responding indicated that they had integrated SoS topics into their curriculum, however, some gaps (eg, teaching students about communicating risk, Food and Drug Administration [FDA] Sentinel Initiative, utilizing patient databases) were identified that need to be addressed.
Conclusions. The FDA and the American Association of Colleges of Pharmacy (AACP) should continue to collaborate to develop resources needed to ensure that topics proposed by the FDA in their SoS framework are taught at all colleges and schools of pharmacy.
PMCID: PMC3175655  PMID: 21969727
medication safety; pharmacy education; curriculum; science of safety
5.  Teaching the Science of Safety in US Colleges and Schools of Pharmacy 
This paper provides baseline information on integrating the science of safety into the professional degree curriculum at colleges and schools of pharmacy. A multi-method examination was conducted that included a literature review, key informant interviews of 30 individuals, and in-depth case studies of 5 colleges and schools of pharmacy. Educators believe that they are devoting adequate time to science of safety topics and doing a good job teaching students to identify, understand, report, manage, and communicate medication risk. Areas perceived to be in need of improvement include educating pharmacy students about the Food and Drug Administration's (FDA's) role in product safety, how to work with the FDA in post-marketing surveillance and other FDA safety initiatives, teaching students methods to improve safety, and educating students to practice in interprofessional teams. The report makes 10 recommendations to help pharmacy school graduates be more effective in protecting patients from preventable drug-related problems.
PMCID: PMC3138345  PMID: 21769153
safety; curriculum; pharmacy education; FDA; quality

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