University Times

Ninety-five percent of Americans live within five miles of a community pharmacy, and all states allow pharmacists to administer flu vaccines and other services, such as screenings, health education and disease management. Yet many people fail to get regular health care.

Pharmacy faculty member Melissa A. Somma McGivney has developed the curriculum for a faculty scholars program sponsored by the National Association of Chain Drug Stores.

“Clearly health care is changing,” says Melissa A. Somma McGivney, associate professor of pharmacy and therapeutics in the School of Pharmacy, noting the increasing role of nonphysicians in health care under the Affordable Health Care Act (or “Obamacare”). “There’s a need for more access points for people to get into the health-care system. Community pharmacies provide good access points.”

Such shifts, coupled with the need to train pharmacy faculty to perform research to evaluate the efficacy of community pharmacy programs, motivated the National Association of Chain Drug Stores (NACDS) to institute a faculty scholars program for junior pharmacy faculty. The strengths of Pitt’s School of Pharmacy prompted the NACDS Foundation to make the University its primary partner, with McGivney developing the curriculum for the program.

“Pittsburgh has a strong reputation for sound, evidence-based research,” notes Alex Adams, the foundation’s vice president for pharmacy programs, and thus was considered the best site to oversee the initial class of scholars.

Pitt’s reputation is based, in part, on the school’s educational series for pharmacy residents that concentrates on best research practices. Since 2009, that series has focused on research in community pharmacy practice settings. The school now partners with Wilkes, Duquesne and Temple universities to provide research support and training for six community pharmacy residents in the state.

The 11 residents who have taken this training thus far have presented posters and had abstracts about their research accepted at national conferences.

“We probably have the finest community practice program in the country,” says School of Pharmacy Dean Patricia Kroboth. The fact that Pitt was chosen for this program, she adds, “says a lot about our school.”

The new scholars program recruits faculty from across the country to take a year-long online course on everything from identifying a research question to partnering with community pharmacies, data collection strategies and how to write a grant. In the end, McGivney says, participants will emerge with enhanced research skills and a completed patient-focused research project in community pharmacy practice, as well as a national network of valuable pharmacy mentors and contacts and a greater ability to pass on their learning to other faculty. Those chosen receive a $2,500 grant toward conducting their research, a stipend to travel to the NACDS Foundation’s annual meeting and frequent conference calls with other scholars to hone their research efforts.

Of the 22 who applied, five scholars were accepted; members of this initial class teach at the University of Missouri-Kansas City, the University of Mississippi, Virginia Commonwealth University, St. Louis College of Pharmacy and the University of Wyoming. Each was selected to apply by his/her school’s dean. They will graduate at the end of July in a ceremony at the American Association of Colleges of Pharmacy meeting. There will be eight scholars in the incoming class.

While emphasizing that the scholars’ research projects are learning experiences, “we’re looking for research that will promise to improve patient care,” the NACDS Foundation’s Adams says of scholars’ research topics. For instance, at least one incoming scholar is focusing on medication adherence, which is a $290 billion annual problem in America, Adams says. Within six months, half of all patients discontinue medications, he says, leading to avoidable disease progression and costs, such as new hospital visits. The pharmacy scholars also are performing transitions of care research, studying how to prevent more patients with chronic conditions from leaving the hospital and returning within 30 days because they didn’t follow up with a physician.

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Ashley Ellis, a clinical assistant professor at the University of Mississippi School of Pharmacy, is a member of the first class of faculty scholars.

There isn’t enough community pharmacy research from which current junior faculty can learn, notes McGivney, although such faculty do work with community pharmacies directly. “We’re helping them to learn to do thorough evaluations of patient care, and of the work being done in their practice,” she says.

This year’s scholars are finishing projects that evaluate pharmacists’ collaboration with physicians (does this make a difference in the patient’s outcome?); patients’ use of an app to manage their cardiovascular health and communicate with the pharmacy, and patients’ thoughts about health and wellness services at their pharmacies, such as osteoporosis, cardiovascular and diabetes screenings.

“This was an opportunity for us to reach beyond the Pittsburgh region and partner with other schools around the country to advance pharmacy research,” McGivney says. Too many people fail to realize that their community pharmacies are more than just places to pick up medications, and that a pharmacist is available for consultation.

“And that’s the shame,” she says. “Behind that counter there is at least one pharmacist who has been highly trained to understand patient care.”

Other pharmacy faculty involved with the program include Randy Smith, Jan Pringle, Kim Coley, Josh Thorpe and Carolyn Thorpe, assisted by Chris Ryan, director of the University’s Institutional Review Board.

Thus far, McGivney says, the program has gone “extremely well.”

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Ashley Ellis, a participant in the first class of scholars, agrees. She is a clinical assistant professor in the Department of Pharmacy Practice at the University of Mississippi School of Pharmacy.

“I thought this would be a good opportunity for me,” Ellis says, “but I got so many more benefits than I thought of at the front end.” Development of research skills “really sets you up for success for a career in academia,” she says. Publishing this research will, ideally, show replicable practices to other pharmacy faculty: “The research that we do really drives practice models. That is really the backbone of why we do research in the first place.”

As a faculty member, she works in a community pharmacy two days a week in Hernando, Miss., performing immunizations, attending health fairs and conducting the pharmacy’s nascent residency program. Until fall 2012, when she entered the faculty scholars program, she also had spent the previous three years working on a research project in the Mississippi Delta, providing medication therapy management for diabetes patients via pharmacies, including lab tests and counseling to recommend dose adjustments and new medications.

For her scholars program research project, she expanded her Delta research by partnering with two nurse practitioners and two physicians, setting up collaborative practice agreements that allowed her to prescribe medications directly, as her state law permits. She had never been the primary investigator on a project before.

“This project gave me a chance to step up and helped me build my confidence and my skills,” she says. “The intention of the project is that I will be able to go out and do this again, and seek funding … I feel very prepared, from what I did in the program.”

She also is pleased that the research project showed much better medical treatment adherence for patients: “The patients were more likely to keep their appointments and get their prescriptions filled in the collaborative group … There was an accountability factor. It really had an impact.”

The scholars program also allowed her to attend the annual NACDS pharmacy and technology conference last August, where she met other conferees, vendors and faculty with whom she could collaborate on research, journal editors and representatives of foundations. “Typically, when you go to a conference you don’t get one-on-one time with that many people,” she says. The weekly webinars and variety of lectures on pertinent subjects, including the basics of statistics, were extremely helpful, she adds. “They gave us feedback all along the way. By the time we were analyzing our data, we had vetted our project to make sure it was well designed. I’m very optimistic that it is going to be published. That is really going to help me in my career development.”

Now Ellis plans to mentor a colleague at Mississippi who is part of the incoming class of the faculty scholars program. “Being selected as part of this is one of the most impactful things that has happened in my career,” she concludes.

According to the NACDS Foundation’s Adams, all five scholars in the first class reported that they benefited from the experience, especially the chance to expand their networks of pharmacy contacts beyond their universities and the chance to partner with health plans and researchers from afar, as well as the weekly conferences discussing their research with fellow scholars and the instructors.

“My hat really goes off to the University of Pittsburgh,” he says. “The research team we’ve been working with, Melissa McGivney, has done a really tremendous job of bringing our vision into reality. This has really solidified Pittsburgh’s reputation as a strong research university.”

—Marty Levine