Karen Whalen - Academia.edu (original) (raw)

Papers by Karen Whalen

The American Journal of Pharmaceutical Education, Dec 1, 2013

To identify characteristics and quality indicators of best practices for leadership and advocacy ... more 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.

American Family Physician, Jun 15, 2010

Saxagliptin lowers A1C levels to a lesser extent and is much more expensive than first-line thera... more Saxagliptin lowers A1C levels to a lesser extent and is much more expensive than first-line therapy with metformin. Its ability to decrease diabetes-related complications, including mortality, is not known. It is a DPP-4 inhibitor that has a more significant drug interaction profile than sitagliptin and offers little cost advantage.

The American Journal of Pharmaceutical Education, Nov 1, 2022

Journal of Interprofessional Education and Practice, Sep 1, 2018

Background: Interprofessional team care is a model that demonstrates positive effects on the trip... more Background: Interprofessional team care is a model that demonstrates positive effects on the triple aim of improving quality of care, improving health and reducing costs. Nurse-led practices are well suited for these models. Archer Family Health Care (AFHC) is a nurse-led practice that utilizes interprofessional team care. Purpose: To describe interprofessional team training at AFHC and evaluate effects of training on perceived team functioning. Methods: The AFHC team participated in TeamSTEPPS ® guided trainings throughout the three year grant period. All staff and providers were included in the team trainings. Training consisted of participation in team retreats, training modules and focus group discussions on team functionality, goal setting and workflow analysis and revision. Standardized assessment of the team competencies was completed five times over three years using the TeamSTEPPS ® Team Perceptions Questionnaire (T-TPQ), the Collaborative Practice Assessment Tool (CPAT), and the Team Competencies (TC) questionnaire. Results identified perceived strengths and weaknesses of interprofessional team and served to guide team training activities. Discussion: Improvements occurred over time for several measures, including teamwork, team performance, communication, and decision-making. Conclusion: Standardized evaluation of team competencies is a useful tool to enhance perceived functioning of a nurse-led interprofessional team. Results support the need for ongoing interprofessional team evaluation and training.

The American Journal of Pharmaceutical Education, Jul 1, 2020

Objective. The purpose of this study was to develop, pilot, and validate a situational judgement ... more Objective. The purpose of this study was to develop, pilot, and validate a situational judgement test (SJT) to assess professionalism in Doctor of Pharmacy (PharmD) students. Methods. Test specifications were developed and faculty members were educated on best practices in item writing for SJTs. The faculty members then developed 75 pilot scenarios. From those, two versions of the SJT, each containing 25 scenarios, were created. The pilot population for the SJT was student pharmacists in their third professional year, just prior to starting their advanced pharmacy practice experiences. The students completed the two versions of the test on different days, approximately 48 hours apart, with 50 minutes allowed to complete each. Subsequently, students completed a questionnaire regarding the SJT at the conclusion of the second test. Results. Version 1 of the SJT was completed by 228 students, and version 2 was completed by 225 students. Mean scores were 390 (SD520, range 318-429) and 342 (SD521, range 263-387) on test versions 1 and 2, respectively. The reliability of the tests was appropriate (test version 1, a50.77; test version 2, a50.79). Students felt that the content of the tests was realistic with respect to pharmacy practice (90.1%), and that the tests gave them an opportunity to reflect on how to approach challenging situations (82.6%). Conclusion. We developed a reliable SJT to assess professionalism in PharmD students. Future research should focus on creating a personalized learning plan for students who do not meet minimum performance standards on this SJT.

The American Journal of Pharmaceutical Education, Nov 25, 2016

Background and Charges According to the Bylaws of the American Association of Colleges of Pharmac... more Background and Charges According to the Bylaws of the American Association of Colleges of Pharmacy (AACP), the Professional Affairs Committee is to study issues associated with the professional practice as they relate to pharmaceutical education, and to establish and improve working relationships with all other organizations in the field of health affairs. The Committee is also encouraged to address related agenda items relevant to its Bylaws charge and to identify issues for consideration by subsequent committees, task forces, commissions, or other groups. President Cynthia Boyle established the theme of "Capitalizing on Foundations of Citizenship" for the 2015-2016 standing committees. 1 According to President Boyle, as the academy prepares our nation's future pharmacists and scholars, the academy is leveraging all of the stakeholders who invest in academic pharmacy. 1 A key group of stakeholders in our academy are pharmacy preceptors. Our preceptors are one group of citizens that bears responsibility for a significant portion of the preparation of practice-ready graduates. Estimated to be approximately 30,000 pharmacists strong, most accept responsibility for precepting Advanced Pharmacy Practice Experiences (APPE) [and often Introductory Pharmacy

PubMed, Dec 1, 2008

Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pre... more Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of angiotensin-converting enzyme inhibitors may slow progression to kidney failure and cardiovascular mortality; these agents are the preferred therapy for managing coexisting diabetes and hypertension. Angiotensin receptor blockers can prevent progression of diabetic kidney disease and are a first-line alternative for patients intolerant of angiotensin-converting enzyme inhibitors. Thiazide diuretics provide additional antihypertensive effects when combined with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. With lower doses of these drugs, the risk of clinically significant metabolic alterations is minimal. Beta blockers and calcium channel blockers also have beneficial effects in managing hypertension in patients with diabetes. Beta blockers reduce cardiovascular events and are useful in a multidrug regimen. Dihydropyridine calcium channel blockers should be reserved for patients intolerant of preferred agents or those who need additional therapy to achieve target blood pressure. Many patients with diabetes require combination therapy with multiple antihypertensive agents.

Annals of Pharmacotherapy, Sep 13, 2011

Objective: To review the pharmacology, pharmacokinetics, efficacy, and safety of the new oral con... more Objective: To review the pharmacology, pharmacokinetics, efficacy, and safety of the new oral contraceptive estradiol valerate/dienogest. Data Sources: Searches of PubMed (1966-July 2011) and International Pharmaceutical s (1970-July 2011) were conducted using the key words estradiol valerate, dienogest, Natazia, and Olaira. Bibliographies of retrieved articles were reviewed to identify additional références. Study Selection and Data Extraction: All identified studies published in English and involving efficacy and safety of estradiol valerate/dienogest as an oral contraceptive were reviewed. Data Synthesis: Estradiol valerate/dienogest is a 4-phasic oral contraceptive approved for the prevention of pregnancy. The 4-phasic design allows for acceptable cycle control with this hormonal combination. In efficacy trials of estradiol valerate/dienogest in women aged 18–35 years, the Pearl Index ranged from 0.40 to 1.64, a range comparable to that of other combination oral contraceptives. The safety profile was also similar to that of other oral contraceptives, with headache, metrorrhagia, breast tenderness, nausea or vomiting, acne, and weight gain reported as the most common adverse effects. Menstrual bleeding patterns and cycle control with estradiol valerate/dienogest were comparable to those of a monophasic oral contraceptive containing ethinyl estradiol/levonorgestrel. Estradiol valerate/dienogest differs from other oral contraceptives in that il necessitates more stringent dosing guidelines for maximum contraceptive efficacy. New starts should be on the first day of menses only, and a back-up method of contraception is required for the first 9 days, as compared to 7 days with other oral contraceptives. Back-up contraception is usually required for any pill taken more than 12 hours later than scheduled. Conclusions: Estradiol valerate/dienogest is an effective oral contraceptive. Because it has more stringent start times and requires a longer duration of back-up contraception and stricter adherence, estradiol valerate/dienogest should be reserved for patients who are intolerant of other combination oral contraceptives.

Clinical Therapeutics, Jun 1, 2015

Sodium-glucose cotransporter 2 (SGTL2) inhibitors are a novel class of antihyperglycemic agents t... more Sodium-glucose cotransporter 2 (SGTL2) inhibitors are a novel class of antihyperglycemic agents that work in an insulin-independent manner by promoting urinary glucose excretion. In addition to efficacious glucose lowering, they exert beneficial effects on blood pressure and weight while avoiding hypoglycemia unless combined with insulin or insulin secretagogues. This review explores the mechanism of action of SGLT2 inhibitors, their effects on glycated hemoglobin, weight, blood pressure and hypoglycemia, potential adverse effects, renal considerations and cardiovascular outcomes.

American Family Physician, Dec 15, 2012

Linagliptin (Tradjenta) is a dipeptidyl-peptidase-4 (DPP-4) inhibitor labeled for the treatment o... more Linagliptin (Tradjenta) is a dipeptidyl-peptidase-4 (DPP-4) inhibitor labeled for the treatment of type 2 diabetes mellitus. Similar to sitagliptin (Januvia) and saxagliptin (Onglyza), linagliptin delays the breakdown of endogenous incretin hormones such as glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide. These hormones, when secreted in response to food intake, stimulate postmeal insulin secretion, inhibit glucagon release, improve satiety, and slow gastric emptying. 1,2 Linagliptin can be used alone or in combination with metformin (Glucophage), sulfonylureas, pioglitazone (Actos), or insulin.

Annals of Pharmacotherapy, May 11, 2010

To review the pharmacology, pharmacokinetics, efficacy, and safety of saxagliptin, a new dipeptid... more To review the pharmacology, pharmacokinetics, efficacy, and safety of saxagliptin, a new dipeptidyl peptidase-4 (DPP-4) inhibitor for the treatment of type 2 diabetes. Searches of PubMed (1966-March 2010) and International Pharmacy Abstracts (1970-March 2010) were conducted using the key words saxagliptin, Onglyza, and BMS-477118. A review of bibliographies of retrieved articles was also performed to identify additional references. All identified studies published in English and involving efficacy and safety of saxagliptin in the treatment of type 2 diabetes were reviewed. Saxagliptin is a competitive inhibitor of DPP-4 that slows the degradation of incretin hormones, thereby stimulating insulin secretion, reducing postprandial glucagon, and decreasing glucose levels. Saxagliptin is well absorbed after oral administration and demonstrates a pharmacokinetic profile that is compatible with once-daily dosing. Clinical trials with saxagliptin monotherapy for the treatment of type 2 diabetes showed a reduction in hemoglobin A(1c) (A1C) of 0.43-0.9%. Saxagliptin has demonstrated similar reductions in A1C when used as add-on therapy with metformin, sulfonylureas, and thiazolidinediones. The combination of saxagliptin and metformin for initial therapy in treatment-naïve patients was associated with greater improvements in A1C than either agent alone. In general, saxagliptin therapy is well tolerated. The most common adverse effects occurring in clinical trials were headache, nasopharyngitis, upper respiratory tract infections, and urinary tract infections. Saxagliptin is effective as monotherapy or add-on therapy for the management of type 2 diabetes. Because saxagliptin has a higher cost and reduces A1C and other surrogate markers of glucose control to a lesser extent than other well-validated therapies, such as metformin, saxagliptin should be reserved for patients who fail or are intolerant of conventional treatments for type 2 diabetes.

Currents in Pharmacy Teaching and Learning, 2023

Background and purposeDuring the early months of the COVID-19 pandemic, experiential education be... more Background and purposeDuring the early months of the COVID-19 pandemic, experiential education became challenging as sites began to cancel scheduled rotations, and the University of Florida College of Pharmacy had to cancel the first advanced pharmacy practice experience (APPE) block. This was allowable given the excess number of experiential hours built into the curriculum.Educational activity and settingTo meet total program credit hour requirements, a six-credit virtual course was created to mimic an experiential rotation. This course was designed to bridge didactic learning with experiential learning. The course included presentation of patient cases, topic discussions, pharmaceutical calculations, self-care cases, disease state management cases, and career development.FindingsStudents provided feedback via a survey containing 23 Likert type questions and four open-ended questions. Most students agreed or strongly agreed that participation in self-care scenarios, small group discussions (calculations and topic discussion), and disease state management cases (preceptor dialogue and verbal defense activities) were valuable learning experiences. The verbal defense portion of the disease management case and the self-care scenarios were the most highly rated learning activities. Peer review activities in the career development assignments were seen as the least beneficial component of the course.SummaryThis course allowed students an opportunity to further prepare for APPEs in a unique learning environment. The college was able to identify students requiring additional support during APPEs and provide earlier intervention. Additionally, data supported exploring incorporation of new learning activities into the current curriculum.

The Journal of pharmacy technology, Mar 1, 2010

Background: Hyperkalemia is one of the most common drug-related electrolyte abnormalities resulti... more Background: Hyperkalemia is one of the most common drug-related electrolyte abnormalities resulting in adverse drug events (ADEs) at our institution. Objective: To determine the effect of a computerized pharmacy alert on the number of adverse events related to hyperkalemia in a hospital setting and to study the impact of guidelines and education on pharmacist response to high potassium levels. Methods: An alert was built into the pharmacy computer system, which warned pharmacists about a potassium level greater than 5.1 mEq/L when processing an order that could increase potassium. The alert was linked to a trigger medication list. After the alert was implemented, the number of ADEs due to hyperkalemia was compared for the 3 months pre- and postalert. Due to a lack of consistency in pharmacist interventions after implementation of the alert, hyperkalemia management guidelines were developed by the pharmacy department. The staff pharmacists received training on how to address hyperkalemia when processing prescriptions. After the education component was completed, the types of pharmacist interventions made pre- and posttraining were also compared. Results: Building an automated pop-up alert resulted in a decreased number of ADEs related to hyperkalemia (p &lt; 0.001) and reduced the utilization of medications needed to treat hyperkalemia (p = 0.019). Conclusions: Implementation of a computerized pharmacy alert resulted in a statistically significant decrease in adverse drug events related to hyperkalemia in our institution. Educating pharmacists about hyperkalemia and developing guidelines for its management provided consistency among responses to the high potassium computerized alert. Further studies are needed to evaluate the impact of guideline development and pharmacist education on the trend of drug-induced hyperkalemia in an inpatient pharmacy setting.

The American Journal of Pharmaceutical Education, Mar 1, 2023

The Journal for Nurse Practitioners, May 1, 2019

Interprofessional teams positively affect the quadruple aim of improving patient experience, impr... more Interprofessional teams positively affect the quadruple aim of improving patient experience, improving the health of populations, enhancing provider satisfaction, and reducing cost. This report details a nurse-led care model developed for a complex patient population in Archer, Florida. The practice, Archer Family Health Care, is a Rural Health Clinic providing integrated primary care and mental health services. The team model included nursing, medicine, and pharmacy professionals and expanded care for case management and mental health. Evaluation included team functionality and clinical outcome data for selected populations. This report describes lessons learned during the implementation process and provides recommendations for the future.

The American Journal of Pharmaceutical Education, Dec 1, 2011

American Journal of Pharmaceutical Education