Miami Dade College Pharmaceutical Care Reflection Paper Reflect on the content assigned using the below questions as a guide, at a minimum:
What made you most curious about this week’s content?
What was different that you thought?
What has been the significance of the “Ninth-Floor Project”?
Research and describe the history of either drug information provision or unit-dose dispensing.
What do you think about the content of the two posted articles? Are the concepts presented still relevant today?
How important do think pharmacists obtaining “Provider Status” is?
What can we do today, similar to the “Ninth-Floor Project”, to move the practice of pharmacy forward more rapidly?
The essay needs to be from 2-3 pages long and sources need to be cited. Please note this is a reflection paper rather than a research paper. For the most part this essay needs to be reflective on the material assigned. Thank you! Content assigned:
PART 1 1850 to 1990 ( Drug information, clinical pharmacy, pharmaceutical care)֎ Evolution of Pharmacy Practice – from Compounder to Pharmaceutical Care Power Point ( see attachment) AP – pages 1-10; 11-15Can be found at the following URL: https://books.google.com/books?id=gwooeCp0eEQC&printsec=frontcover&dq=9780931292392&hl=en&newbks=1&newbks_redir=0&sa=X&ved=2ahUKEwiVxpnNk4jmAhUxw1kKHc7KBuIQ6AEwAHoECAAQAg#v=onepage&q=9780931292392&f=false (Links to an external site.)KU – pages 317-322 ( see attachment) 1950–1965: Setting the Stage – History of the Department of Clinical Pharmacy (UCSF)Can be found at the following URL: https://pharm.ucsf.edu/history-cp/1950-1965 (Links to an external site.)
1965-1972: The Ninth Floor Pharmacy Project ( UCSF)
Can be found at the following URL: https://pharm.ucsf.edu/history-cp/1965-1972
PART 2: 1990 to present ( Disease State Management, MTM, and Provider Status
Dr. Charles Hepler and Dr. Linda Strand Article֎ Opportunities and Responsibilities in Pharmaceutical Care available at the following URL: https://www.researchgate.net/publication/20838625_Opportunities_and_Responsibilities_in_Pharmaceutical_Care (Links to an external site.)Dr. Richard Penna Article֎ Pharmaceutical Care: Pharmacy’s Mission for the 1990s posted ( See attachment) Also review the following websites:
https://pharmacistsprovidecare.com/ (Links to an external site.)
https://www.cdc.gov/dhdsp/pubs/guides/best-practices/pharmacist-mtm.htm Rennebohm Hall n University of Wisconsin-Madison School of Pharmacy
777 Highland Avenue n Madison, WI 53705-2222 n 608.262.5378 n aihp@aihp.org
This slide presentation was compiled and produced by Robert
McCarthy, Ph.D., Professor and Dean Emeritus at the University of
Connecticut School of Pharmacy for his class “The History of
American Pharmacy.” Prof. McCarthy created this version of the
slide talk for his class in the Spring of 2016.
This slide presentation was downloaded from the Teaching the
History of Pharmacy section of the website of the American Institute
of the History of Pharmacy (https://aihp.org/historicalresources/teaching-the-history-of-pharmacy/) where a copy of the
syllabus (.pdf) for Prof. McCarthy’s class is also available.
This .pdf copy of the slide presentation was shared with the permission
of Prof. Robert McCarthy for the personal and educational use of
interested readers.
PHRX 4001W-002
The History of American Pharmacy
Spring 2016
Virtually
every aspect of American
pharmacy practice has changed over the
last 200 years
Nature of the practice site
Education and scope of practice of pharmacists
Role of the pharmacist in the health care team
Financing issues
• Role of the government
• Patient expectations
•
•
•
•
Independent
pharmacies dominated
Part of Americana
Era of the “soda fountain” pharmacy
Local pharmacist known as “doc”
The
soda fountain transformed the
apothecary shop into a drug store.
1888: Pharmacist Jacob Baur established the
Liquid Carbonic Company after having
perfected carbon dioxide tanks; by1900, he
produced and sold soda fountains with an
instruction and recipe manual.
Mass-produced syrups included Coca-Cola,
Ward’s Orange Crush, Cherry Smash,
Orange Julep, Hires’ Root Beer, and Dr.
Pepper, which became favorites in
American drugstores.
American
pharmacy practice from its
earliest days gained its stature through the
manufacturing and compounding of drugs.
By the mid-19th century, there was a battle
within the profession between those who
believed the essence of pharmacy practice
lay in the preparation of medicines and an
increasing number of apothecaries who
were purchasing prepared medicines from
manufacturers.
As
more and more drug products became
commercially available, the role of the
community pharmacist began to shift toward
being a dispenser of manufactured drug
products.
Products could be manufactured less
expensively and more reliably by the
pharmaceutical industry.
The pharmaceutical industry became the
source of new, synthetic drugs such as
aspirin.
From
the Civil War to WWII, the average
community pharmacy filled 6-12
prescriptions per day, relying on the front
store to remain profitable; prescription
areas were moved to the back of stores,
often into an elevated, screened-off area.
After WWII, the prescription business
became more profitable with the
introduction of new drugs, especially
antibiotics.
From
1930 to 1950, the number of
compounded drugs dropped dramatically.
The advent of new manufactured drugs
shifted the major source of revenue from the
front store to the back store (prescriptions).
In the 1950s and 1960s, with the growth of
prescribing, community pharmacies shifted
away from the “soda fountain” era; yet
despite an education that prepared them for
much more, pharmacists of this era
practiced “count, lick, stick and pour.”
There
has always been an inherent
conflict in community pharmacy between
the pharmacist the health care
professional and the pharmacist the
business owner.
This conflict has been mitigated with the
rise of chain pharmacies and the
conversion of most community
pharmacists from owner to employee.
The
most dramatic shift that has occurred in
American community pharmacy has been
the advent of chain pharmacies and the
demise (to a large extent) of independent
pharmacies.
In its heyday, prior to the last quarter of the
20th century, community pharmacy owners
exerted tremendous control over the
profession from state and national pharmacy
organizations to state boards of pharmacy.
The concept of chain pharmacy began in Great
Britain with companies such as Boots, LTD.
After the Civil War, early chain pharmacies
included Cora Dow of Cincinnati, Hall and Lyon
in Providence, Hegeman and Company in New
York, and Charles B. Jayne in Boston; they were
followed by Economical-Cunningham
Drugstores, Read Drug and Chemical Company
(now Rite Aid), Hook Drug, Peoples Drug, and
Thrifty.
Key American pioneers in chain pharmacy:
Charles Walgreen and Louis K. Liggett (Rexall
brand).
For
example, independent pharmacy
owners played an integral role in
enacting legislation in many states
requiring community pharmacies to be
owned by a pharmacist.
In many states, the state boards of
pharmacy prevented chain health &
beauty stores (e.g., CVS) from obtaining
a license to operate a pharmacy.
Gradually, these restrictions were lifted and by the later part
of the 20th century, the number of independent community
pharmacies significantly decreased and the United States
fully entered an era in which chain pharmacies, both
regional and national, dominated community practice.
Although founded in 1933, it was not until the last few
decades of the 20th century that the National Association of
Chain Drug Stores (NACDS) became a powerful force in the
profession and politically.
For many years, NACDS and the National Community
Pharmacists Association (NCPA), which together
represented community pharmacy, were at odds; in recent
years, they have come together in support of common goals
such as freedom-of-choice and pharmacist provider status.
The
first supermarket pharmacies
appeared in the 1960s, while the first “Big
Box” retail pharmacies were opened in
the 1970s.
“Big Box” Retail Pharmacies: e.g.,
Walmart, Costco, Target (CVS)
Supermarket Pharmacies: e.g. Stop &
Shop, Hannaford
Preferred
by third party payers due to
potential for cost savings versus “brick &
mortar” pharmacies
Concerns about “rogue” pharmacies
• NABP: VIPPS (Verified Internet Pharmacy Practice
Sites)
Hospital
pharmacy practice, which
continued to grow in the 20th century,
followed much of the same pattern as
community pharmacists of the era:
dispensers of medications.
Oral medications were generally sent to
patient floors in bulk supply with nurses
using these supplies to meet the medication
needs of several patients.
Parenteral medications were prepared by
nursing staff, without the use of laminar flow
hoods or clean rooms in patient care areas.
1960s: John Webb, pharmacist-in-chief
at the
Massachusetts General Hospital, introduced
the concept of MOSAICS (Medication Order
Supply And Individual Charge System), the
first attempt in the United States to provide a
patient –specific supply of medication and
bring pharmacists to the patient-care area
for the first time.
1970s: Unit-Dose is developed and becomes
widely used, allowing a day’s supply (or
part of a day) for a specific patient to be
sent to the patient care floor.
He grew up in Portland graduating from Deering High School. He started studies at Mass
College of Pharmacy, but his education was put on hold when he was drafted by the Army in
his sophomore year. While waiting to go overseas he was selected to attend a pharmacy
technician program at Fort Sam Houston. After being discharged from the service he
returned to Mass. College of Pharmacy where he received his B.S. and M.S. degrees. In
Portland he worked at H.H. Hayes Store on Congress Street and at Bachelder’s Drug Store in
the Rosemont section. In 1951 he became Chief Pharmacist at Hartford Hospital, Hartford,
CT. He was also on the faculty at University of Conn. College of Pharmacy. From 1959 until
his retirement in 1984 he served as Director of Pharmacy at the Mass. General Hospital and
Mass. Eye and Ear as well as having administrative responsibility for pharmacy service to
the Shriner’s Burn Institute in Boston. He served on the faculty of both the Mass. College of
Pharmacy and Northeastern University College of Pharmacy. He was director of the
graduate program in hospital pharmacy at Northeastern for 20 years. In 1985, Northeastern
established the John W. Webb Visiting Professorship in his name. A longtime member of the
American Society of Hospital Pharmacists, he served as Vice President of the Society and as
a member of the Board of Directors for several years. He also served as Vice President and
President of the Mass. Society of Hospital Pharmacists
John introduced the use of infusion pumps to administer IV solutions, a system which is now
common practice in hospitals throughout the world. This process, for the first time, saved
lives of premature babies with severe infections, reduced the incidence of blindness and
strokes and saved millions of dollars in health care costs. It also allowed the infusion use of
IV solutions to astronauts in outer space where there is no gravity. He also developed
MOSAICS, a distribution system which brought the pharmacist to patient care units, working
alongside nurses. The system reduced hospital costs and medication errors.
The
1960s and 1970s saw the emergence of
clinical pharmacy practice, beginning in
hospitals, that began to take greater
advantage of a pharmacist’s education and
skills; in hospitals, for many years, there was
a differentiation between “dispensing”
pharmacists and clinical pharmacists.
As greater number of medications became
available, physicians began to rely to an
increasingly greater degree on pharmacists
as medication experts.
Since
the clinical pharmacy movement
first occurred in hospitals, pharmacy
hospital practice became the site of
choice for many pharmacists (and gained
greater prestige) in the 1970s and 1980s.
The 1960s and 1970s saw the emergence
of the first residencies (practice-based)
and later fellowships (research-based).
The
number of women in the profession
went through dramatic changes
beginning in the 1970s, going from less
than 4% in 1950 to about 40% by 2000.
While Asian Americans are now largely
not underrepresented in pharmacy,
African Americans (despite the existence
of pharmacy schools at HBCUs) continue
to be, as do Hispanic Americans.
The
late 20th century saw a rapid increase in
the use of technology by pharmacists in
both community & hospital settings.
Computerization and the use of other
advanced technologies became an integral
component of every aspect of practice.
E-prescribing, electronic health records
(EHR), and on-line adjudication of
prescription claims have become
commonplace.
With
the advent of pharmaceutical care,
pharmacists have become true
medication therapy managers; MTM has
found its way into federal and state
legislation.
Contemporary pharmacists now play key
roles as members of Institutional Review
Boards (IRBs), Pharmacy & Therapeutics
Committees, and as consultants to
healthcare facilities.
Managed Care and PBMs
Direct-to-Consumer Advertising
Internet Pharmacies
Traditional Chain Pharmacies, Mass
Merchant Pharmacies, Supermarket
Pharmacies
Provider Status for Pharmacists
Specialty Certification
Chain Pharmacies Big Three: CVS,
Walgreens, Rite Aid (soon to be the Big Two
with Walgreens acquisition of Rite Aid)
• Horizontal & Vertical Integration
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