Lauren Jonkman - Academia.edu (original) (raw)

Papers by Lauren Jonkman

Drugs & Therapy Perspectives, Apr 25, 2019

Background Warfarin, an anticoagulant with a low therapeutic index, requires frequent internation... more Background Warfarin, an anticoagulant with a low therapeutic index, requires frequent international normalized ratio (INR) monitoring to ensure efficacy and safety. Little is known about anticoagulation management in Namibia. Objective The purpose of this study was to investigate the level of anticoagulation control among outpatients requiring maintenance warfarin therapy. Setting Clinical records of patients attending the warfarin anticoagulation clinic at Windhoek Central Hospital (Windhoek, Namibia) during a 1-year period were reviewed. Methods Of the 294 outpatients who visited the warfarin anticoagulation monitoring clinic in 2017, 215 patients were included in the data analysis. The following information was available and used for data analysis: age and sex of the patient, indication for warfarin use, number of visits, warfarin dose and INR values. The individual's time in therapeutic range (iTTR) was the primary outcome, which was calculated both using the Rosendaal method and as the percentage of the reported INR values in the therapeutic range. Results The patients' mean iTTR was 29.4%, well below the 65% target, when estimated by the Rosendaal method and 25.2% when calculated as the percentage of INR values within the therapeutic range. Only 22 of the 215 patients (10%) had an iTTR ≥ 65%. Conclusions Anticoagulation control at this outpatient clinic was low relative to the target iTTR of 65%. Consequently, patients were at risk for further embolic events or bleeding events based on the high numbers of sub-and supratherapeutic INRs during the time period studied.

The American Journal of Pharmaceutical Education, Nov 1, 2019

Objective. To explore student pharmacists' perspectives on the value of pharmacy-related servicel... more Objective. To explore student pharmacists' perspectives on the value of pharmacy-related servicelearning experiences focused on caring for underserved populations. Methods. Student pharmacists were required to complete a three-hour volunteer experience at a free clinic in western Pennsylvania. Reflective essays from all second-and third-year student pharmacists who participated in the required service-learning experience were deidentified. Essays were thematically analyzed to formulate a list of codes that represent dominant conceptual categories. Two independent coders read and coded all essays submitted from September 2015 to May 2017 using qualitative data analysis. Codes were evaluated for intercoder variability and discrepancies were mediated through discussion. Results. Four hundred twenty-two students submitted reflective essays: 222 essays were submitted by second-year students and 200 by third-year students. The prevailing themes reflected the professional obligation students felt to provide care to the underserved, empathy for underserved patients, perspectives on equitable health resource distribution, the value of service-learning experiences, growth in interprofessional awareness, and self-reported empowerment from the experience. Themes were consistent in the reflective essays of both second-year and third-year students. Third-year students' essays reflected a greater sense of self-assurance and confidence in their role at the free clinics. Students made connections between their didactic learning and experiential education. Conclusion. Student pharmacists valued their experiences working in underserved settings. Free clinics provide opportunities for student pharmacists to develop hands-on training as well as gain a broader perspective on underserved populations, health resource distribution, and the role of pharmacists.

Research in Social & Administrative Pharmacy, Nov 1, 2020

Background: Diabetes is a growing concern in low-and middle-income countries. Medical missions pl... more Background: Diabetes is a growing concern in low-and middle-income countries. Medical missions play a role in increasing access to care and medicines, but often ignore non-communicable disease prevention and advanced management. Increased knowledge of local community needs and resources can lead to the development and implementation of pharmacist-supported interventions to improve diabetes management in rural areas. Objectives: The purpose of this study was to 1) understand the availability of monitoring for diabetes locally; and 2) describe knowledge and health beliefs regarding diabetes management for those with diabetes, and prevention among those at high risk of developing diabetes. Methods: This qualitative evaluation used semi-structured interviews with key informants in a community in rural Honduras. Participants included those with diabetes, those at-risk for developing diabetes, and community leaders. Data was analyzed using thematic content analysis through an iterative process of coding and theme development. Results: A total of 35 interviews were conducted with five resulting themes: 1) participants identified multiple barriers to diabetes management including access to monitoring, access to certain medications, and access to advanced levels of care; 2) participants acknowledge the relationship between lifestyle choices and diabetes control, but struggled with adherence to a healthy lifestyle; 3) participants identify that they have limited knowledge of diabetes pathophysiology, diabetes management, and strategies to prevent diabetes; 4) participants felt that opportunities existed within the community to support diabetes education and prevention, and 5) providers should integrate culture, societal norms, and religion in diabetes management. Conclusion: This research identifies challenges and resulting opportunities for managing diabetes in rural Honduras. Health care providers including pharmacy personnel should consider strategies to engage communities around self-care and diabetes education. Further, strategies are needed to enhance access to resources and essential medicines for diabetes management. These themes can guide clinicians in supporting communities to enhance diabetes care.

Research in Social & Administrative Pharmacy, Nov 1, 2020

INTRODUCTION The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it... more INTRODUCTION The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it, the need for pharmacists to empower patients. This research aims to 1) identify patient-reported barriers and facilitators to managing chronic NCDs for Namibians, and 2) characterize common patient-reported medication and health-related needs of Namibians with chronic NCDs. METHODS This qualitative study used semi-structured interviews to elicit participant perspectives regarding NCDs. The study used the conceptual frameworks of the Health Belief Model, the Theory of Planned Behavior, and the Explanatory Models of Illness to identify and understand key factors necessary to develop relevant patient-centered interventions. Participants were recruited from pharmacies throughout Namibia. Data were analyzed using thematic analysis from the transcribed interviews. RESULTS A total of 23 interviews were conducted, with 20 being included in the final analysis. Themes identified included: 1) participants were motivated to seek care when they were symptomatic; 2) participants felt motivated to care for their condition to improve their own lives and their families for their family's sake; 3) participants integrated information from a variety of sources into their disease knowledge; 4) participants describe wanting to be more engaged in managing their health and wanting support to help manage their condition; 5) participants describe awareness of lifestyle changes necessary to improve health, but face many barriers to achieving them. CONCLUSION This study identified key factors that are essential for pharmacists and other health care professionals to be aware of in order to support patients who are diagnosed with an NCD. Health care providers should consider strategies to engage patients to harness their motivations, enhance health education, and create systems to reduce barriers to addressing lifestyle.

The American Pharmacists Association eBooks, Jan 11, 2021

The American Journal of Pharmaceutical Education, Oct 1, 2022

The purpose of this study was to evaluate the impact of an interprofessional medical service trip... more The purpose of this study was to evaluate the impact of an interprofessional medical service trip to rural Honduras on attitudes toward interprofessional learning. Methods. In this mixed methods research, 19 participating students and residents from medicine and pharmacy completed the Readiness for Interprofessional Learning Scale (RIPLS) before and after the service trip in fall 2017 and spring 2018. Individual semi-structured interviews were conducted with participants following each trip to better understand which aspects of the experience shaped their interprofessional learning. Results. There was a statistically significant improvement for the Teamwork & Collaboration subscale and the Negative Professional Identity subscale of the RIPLS following the service trip. Several themes emerged from interviews, including (1) Face-to-face interaction promotes collaboration; (2) Limited resources encourage team-based problem-solving; (3) Time together outside of work strengthens interprofessional connections; (4) Participating in another profession's patient care activities fosters appreciation of individual roles; (5) Interprofessional care takes time; and (6) Participants felt a greater desire to pursue interprofessional practice in the future. Conclusion. Interprofessional learning during a medical service trip improved participants' attitudes toward collaboration. This study highlights which aspects of this experience contributed most to interprofessional learning, and our results may guide future efforts to design effective interprofessional education experiences.

Pharmacy Education, Feb 15, 2016

Pharmacy students and residents who become involved in research in low and middle-income countrie... more Pharmacy students and residents who become involved in research in low and middle-income countries should be aware of potential challenges that may occur when working in these settings. This article aims to describe logistical and ethical issues associated with conducting research in low and middle-income countries (LMIC) and provides recommendations for individuals who are planning to develop and implement a research project in a LMIC. Recommended planning should involve engagement of local stakeholders where the project will take place, researching and contacting an ethical review board prior to submission, and maintaining flexibility when considering issues that occur on the ground. Anecdotal information is provided to enlighten researchers about potential issues they may encounter. Using the suggested tips as a guide will help to ensure that a successful research project and positive learning experience occur.

Pharmacy, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

JACCP: journal of the American College of Clinical Pharmacy, Jun 28, 2022

IntroductionPeople of South Asian descent carry a high burden of cardiovascular disease (CVD) and... more IntroductionPeople of South Asian descent carry a high burden of cardiovascular disease (CVD) and type 2 diabetes mellitus (DM2) both globally and in the United States. Although retrospective cohort studies indicate decreased medication adherence among South Asian immigrants, data exploring contributing factors are limited.ObjectivesTo explore how cultural perspectives of South Asian immigrants in the U.S. impact adherence to medications for DM2 and CVD.MethodsThis qualitative research study recruited South Asian immigrants in the U.S. with CVD and/or DM2. Semi‐structured interviews were conducted utilizing the conceptual frameworks of the Patient Explanatory Model and HOPE questions. A modified version of the Voils DOSE‐Nonadherence measure was administered to all participants. Interviews were transcribed, coded, and analyzed through an iterative process to develop overarching themes.ResultsTwelve individuals participated: half were female, with an average age of 63 (range 49‐75), and the majority emigrated from Pakistan. The average extent of nonadherence score on the modified version of the Voils DOSE‐Nonadherence measure was 1.36 (range 1‐2.33). Five overarching themes were identified: (1) Numerical results motivated health change; (2) Open communication improved medication adherence; (3) Self‐management and autonomy valued; (4) Religious/spiritual beliefs may strengthen medication adherence; and (5) Complementary and alternative medicines (CAM) augment Western medicines.ConclusionProviders may engage in various culturally‐based strategies to optimize medication adherence in South Asian immigrants. Resources should be allocated toward facilitating disease state education, encouraging self‐monitoring, and providing training for providers on CAM. Providers should engage the patient‐family dyad and cultivate collaborative relationships with patients. Providers should be aware that patients desire autonomy in making health care decisions, and those with higher health literacy and health care providers in their social network may be more likely to self‐titrate medications.

International Journal of Pharmacy Practice, Apr 11, 2011

Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing c... more Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing country can often be challenging due to limited financial and human resources. Organizations face frequent drug shortages, excesses of unnecessary medications and potentially inappropriate international donations. To promote adherence to international recommendations and enable targeted requests for international drug donations, this paper describes a process using a public-health approach to create a site-specific pharmacy formulary in a resource-poor setting using the World Health Organization's (WHO) Model List of Essential Medicines ('Model List'). Methods The study site was a Malawian-run non-profit private clinic serving over 3000 people annually. The organization focuses on providing community support for orphans from the HIV/AIDS crisis in sub-Saharan Africa. While using the Model List as a backbone, we incorporated the clinic's drug inventory, patient needs, clinician prescribing patterns, and the country's national drug list into the final formulary. After analyzing site-specific factors, we determined which WHO Model List therapeutic classes were necessary for the clinic to address in the final formulary. Key findings Of the drug products currently available in the inventory, 65.6% were expired, 29.8% of which were international donations. After removing expired medications from the inventory, seven Model List priority categories remained unaddressed by the clinic's initial inventory. Based on the results of a structured needs assessment, 54 products were selected for the final simplified formulary. Conclusions Conscious selection of pharmaceuticals, resulting in a systematic formulary for drug distribution management, is critical so that a clinic can focus on procuring and prescribing the most needed medications. This selection process using the WHO Model List and a public-health approach to drug management could serve as a private clinic model for pharmaceutical optimization and targeted international drug donations in sub-Saharan Africa and other resource limited settings. Addressing deficient drug supplies in Malawi Julie C. Lauffenburger et al. Addressing deficient drug supplies in Malawi Julie C. Lauffenburger et al.

Currents in Pharmacy Teaching and Learning

Pharmacy

Recommendations for global pharmacy collaborations are predominately derived from US institutions... more Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other’s programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.

Medication management is a complex and expensive multistage process that covers the prescribing a... more Medication management is a complex and expensive multistage process that covers the prescribing and ordering, order communication, dispensing, administering, and monitoring and use of prescription medications. While challenges in medication management are ubiquitous across all settings, they can be particularly exacerbated in a free clinic that serves a medically vulnerable population. These patients suffer from financial constraints, poor health literacy, multiple chronic conditions, and medication non-adherence. Clinical pharmacists play an integral role in the provision of healthcare services to these patients and could benefit from the use of medication management information technology (MMIT) to provide efficiencies in the tracking, provision, and use of medications. While MMITs exist, they are not designed to support the unique needs of pharmacists in these settings

Pharmacy

The COVID-19 pandemic led to significant disruption in students’ lives through lockdowns, restric... more The COVID-19 pandemic led to significant disruption in students’ lives through lockdowns, restricted movement, remote instruction, and mixed information. Therefore, this study aimed to capture the knowledge, attitudes, and practices of student pharmacists during 2020–2021. A 43-item COVID-19 Knowledge, Attitudes, and Practices (COVKAP) survey previously developed was administered at four schools of pharmacy across the U.S. during Fall 2020 and Spring 2021. A total of 418 responses were analyzed from graduating classes of 2021–2024. There were no significant differences in correct COVID-19 knowledge responses across the four graduating years. Respondents’ attitudes around COVID-19 were homogenous with the exception for their belief in their preparedness to administer COVID-19 vaccines. Respondents reported wearing masks daily (76.8%), infrequently visiting restaurants (82.1%), practicing social distancing daily (45.7%), and referring to medical journals for information (72%). In conc...

Complete list of user stories grouped into themes and sorted by user group as used for RxMAGIC im... more Complete list of user stories grouped into themes and sorted by user group as used for RxMAGIC implementation. The 45 user stories are organized into feature-based themes. Following each theme is the number of user stories that comprise it in parenthesis. Each story should be interpreted from the perspective of the identified user group. (PDF 118 kb)

Annals of Global Health, 2014

7 out of the 9 (78%) adults and all children interviewed were supportive of the idea of HPS. 8 ou... more 7 out of the 9 (78%) adults and all children interviewed were supportive of the idea of HPS. 8 out of the 9 adults (89%) are ready to participate in HPS. The most recurrent themes are nutrition, hygiene, mental health, and family relationships. Summary/Conclusion: This is the first study that assessed needs for HPS in underserved rural China. Rural students exhibited more health risk behaviors compared to urban students. Adults and children welcomed the idea of HPS. HPS can be piloted in underserved areas of rural China and, if shown to be effective, can help improve children's health in similar areas worldwide.

American journal of pharmaceutical education, Jan 25, 2016

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provi... more International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, con...

International Journal of Pharmacy Practice, 2011

Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing c... more Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing country can often be challenging due to limited financial and human resources. Organizations face frequent drug shortages, excesses of unnecessary medications and potentially inappropriate international donations. To promote adherence to international recommendations and enable targeted requests for international drug donations, this paper describes a process using a public-health approach to create a site-specific pharmacy formulary in a resource-poor setting using the World Health Organization's (WHO) Model List of Essential Medicines (‘Model List’). Methods The study site was a Malawian-run non-profit private clinic serving over 3000 people annually. The organization focuses on providing community support for orphans from the HIV/AIDS crisis in sub-Saharan Africa. While using the Model List as a backbone, we incorporated the clinic's drug inventory, patient needs, clinician pre...

Drugs & Therapy Perspectives, Apr 25, 2019

Background Warfarin, an anticoagulant with a low therapeutic index, requires frequent internation... more Background Warfarin, an anticoagulant with a low therapeutic index, requires frequent international normalized ratio (INR) monitoring to ensure efficacy and safety. Little is known about anticoagulation management in Namibia. Objective The purpose of this study was to investigate the level of anticoagulation control among outpatients requiring maintenance warfarin therapy. Setting Clinical records of patients attending the warfarin anticoagulation clinic at Windhoek Central Hospital (Windhoek, Namibia) during a 1-year period were reviewed. Methods Of the 294 outpatients who visited the warfarin anticoagulation monitoring clinic in 2017, 215 patients were included in the data analysis. The following information was available and used for data analysis: age and sex of the patient, indication for warfarin use, number of visits, warfarin dose and INR values. The individual's time in therapeutic range (iTTR) was the primary outcome, which was calculated both using the Rosendaal method and as the percentage of the reported INR values in the therapeutic range. Results The patients' mean iTTR was 29.4%, well below the 65% target, when estimated by the Rosendaal method and 25.2% when calculated as the percentage of INR values within the therapeutic range. Only 22 of the 215 patients (10%) had an iTTR ≥ 65%. Conclusions Anticoagulation control at this outpatient clinic was low relative to the target iTTR of 65%. Consequently, patients were at risk for further embolic events or bleeding events based on the high numbers of sub-and supratherapeutic INRs during the time period studied.

The American Journal of Pharmaceutical Education, Nov 1, 2019

Objective. To explore student pharmacists' perspectives on the value of pharmacy-related servicel... more Objective. To explore student pharmacists' perspectives on the value of pharmacy-related servicelearning experiences focused on caring for underserved populations. Methods. Student pharmacists were required to complete a three-hour volunteer experience at a free clinic in western Pennsylvania. Reflective essays from all second-and third-year student pharmacists who participated in the required service-learning experience were deidentified. Essays were thematically analyzed to formulate a list of codes that represent dominant conceptual categories. Two independent coders read and coded all essays submitted from September 2015 to May 2017 using qualitative data analysis. Codes were evaluated for intercoder variability and discrepancies were mediated through discussion. Results. Four hundred twenty-two students submitted reflective essays: 222 essays were submitted by second-year students and 200 by third-year students. The prevailing themes reflected the professional obligation students felt to provide care to the underserved, empathy for underserved patients, perspectives on equitable health resource distribution, the value of service-learning experiences, growth in interprofessional awareness, and self-reported empowerment from the experience. Themes were consistent in the reflective essays of both second-year and third-year students. Third-year students' essays reflected a greater sense of self-assurance and confidence in their role at the free clinics. Students made connections between their didactic learning and experiential education. Conclusion. Student pharmacists valued their experiences working in underserved settings. Free clinics provide opportunities for student pharmacists to develop hands-on training as well as gain a broader perspective on underserved populations, health resource distribution, and the role of pharmacists.

Research in Social & Administrative Pharmacy, Nov 1, 2020

Background: Diabetes is a growing concern in low-and middle-income countries. Medical missions pl... more Background: Diabetes is a growing concern in low-and middle-income countries. Medical missions play a role in increasing access to care and medicines, but often ignore non-communicable disease prevention and advanced management. Increased knowledge of local community needs and resources can lead to the development and implementation of pharmacist-supported interventions to improve diabetes management in rural areas. Objectives: The purpose of this study was to 1) understand the availability of monitoring for diabetes locally; and 2) describe knowledge and health beliefs regarding diabetes management for those with diabetes, and prevention among those at high risk of developing diabetes. Methods: This qualitative evaluation used semi-structured interviews with key informants in a community in rural Honduras. Participants included those with diabetes, those at-risk for developing diabetes, and community leaders. Data was analyzed using thematic content analysis through an iterative process of coding and theme development. Results: A total of 35 interviews were conducted with five resulting themes: 1) participants identified multiple barriers to diabetes management including access to monitoring, access to certain medications, and access to advanced levels of care; 2) participants acknowledge the relationship between lifestyle choices and diabetes control, but struggled with adherence to a healthy lifestyle; 3) participants identify that they have limited knowledge of diabetes pathophysiology, diabetes management, and strategies to prevent diabetes; 4) participants felt that opportunities existed within the community to support diabetes education and prevention, and 5) providers should integrate culture, societal norms, and religion in diabetes management. Conclusion: This research identifies challenges and resulting opportunities for managing diabetes in rural Honduras. Health care providers including pharmacy personnel should consider strategies to engage communities around self-care and diabetes education. Further, strategies are needed to enhance access to resources and essential medicines for diabetes management. These themes can guide clinicians in supporting communities to enhance diabetes care.

Research in Social & Administrative Pharmacy, Nov 1, 2020

INTRODUCTION The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it... more INTRODUCTION The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it, the need for pharmacists to empower patients. This research aims to 1) identify patient-reported barriers and facilitators to managing chronic NCDs for Namibians, and 2) characterize common patient-reported medication and health-related needs of Namibians with chronic NCDs. METHODS This qualitative study used semi-structured interviews to elicit participant perspectives regarding NCDs. The study used the conceptual frameworks of the Health Belief Model, the Theory of Planned Behavior, and the Explanatory Models of Illness to identify and understand key factors necessary to develop relevant patient-centered interventions. Participants were recruited from pharmacies throughout Namibia. Data were analyzed using thematic analysis from the transcribed interviews. RESULTS A total of 23 interviews were conducted, with 20 being included in the final analysis. Themes identified included: 1) participants were motivated to seek care when they were symptomatic; 2) participants felt motivated to care for their condition to improve their own lives and their families for their family's sake; 3) participants integrated information from a variety of sources into their disease knowledge; 4) participants describe wanting to be more engaged in managing their health and wanting support to help manage their condition; 5) participants describe awareness of lifestyle changes necessary to improve health, but face many barriers to achieving them. CONCLUSION This study identified key factors that are essential for pharmacists and other health care professionals to be aware of in order to support patients who are diagnosed with an NCD. Health care providers should consider strategies to engage patients to harness their motivations, enhance health education, and create systems to reduce barriers to addressing lifestyle.

The American Pharmacists Association eBooks, Jan 11, 2021

The American Journal of Pharmaceutical Education, Oct 1, 2022

The purpose of this study was to evaluate the impact of an interprofessional medical service trip... more The purpose of this study was to evaluate the impact of an interprofessional medical service trip to rural Honduras on attitudes toward interprofessional learning. Methods. In this mixed methods research, 19 participating students and residents from medicine and pharmacy completed the Readiness for Interprofessional Learning Scale (RIPLS) before and after the service trip in fall 2017 and spring 2018. Individual semi-structured interviews were conducted with participants following each trip to better understand which aspects of the experience shaped their interprofessional learning. Results. There was a statistically significant improvement for the Teamwork & Collaboration subscale and the Negative Professional Identity subscale of the RIPLS following the service trip. Several themes emerged from interviews, including (1) Face-to-face interaction promotes collaboration; (2) Limited resources encourage team-based problem-solving; (3) Time together outside of work strengthens interprofessional connections; (4) Participating in another profession's patient care activities fosters appreciation of individual roles; (5) Interprofessional care takes time; and (6) Participants felt a greater desire to pursue interprofessional practice in the future. Conclusion. Interprofessional learning during a medical service trip improved participants' attitudes toward collaboration. This study highlights which aspects of this experience contributed most to interprofessional learning, and our results may guide future efforts to design effective interprofessional education experiences.

Pharmacy Education, Feb 15, 2016

Pharmacy students and residents who become involved in research in low and middle-income countrie... more Pharmacy students and residents who become involved in research in low and middle-income countries should be aware of potential challenges that may occur when working in these settings. This article aims to describe logistical and ethical issues associated with conducting research in low and middle-income countries (LMIC) and provides recommendations for individuals who are planning to develop and implement a research project in a LMIC. Recommended planning should involve engagement of local stakeholders where the project will take place, researching and contacting an ethical review board prior to submission, and maintaining flexibility when considering issues that occur on the ground. Anecdotal information is provided to enlighten researchers about potential issues they may encounter. Using the suggested tips as a guide will help to ensure that a successful research project and positive learning experience occur.

Pharmacy, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

JACCP: journal of the American College of Clinical Pharmacy, Jun 28, 2022

IntroductionPeople of South Asian descent carry a high burden of cardiovascular disease (CVD) and... more IntroductionPeople of South Asian descent carry a high burden of cardiovascular disease (CVD) and type 2 diabetes mellitus (DM2) both globally and in the United States. Although retrospective cohort studies indicate decreased medication adherence among South Asian immigrants, data exploring contributing factors are limited.ObjectivesTo explore how cultural perspectives of South Asian immigrants in the U.S. impact adherence to medications for DM2 and CVD.MethodsThis qualitative research study recruited South Asian immigrants in the U.S. with CVD and/or DM2. Semi‐structured interviews were conducted utilizing the conceptual frameworks of the Patient Explanatory Model and HOPE questions. A modified version of the Voils DOSE‐Nonadherence measure was administered to all participants. Interviews were transcribed, coded, and analyzed through an iterative process to develop overarching themes.ResultsTwelve individuals participated: half were female, with an average age of 63 (range 49‐75), and the majority emigrated from Pakistan. The average extent of nonadherence score on the modified version of the Voils DOSE‐Nonadherence measure was 1.36 (range 1‐2.33). Five overarching themes were identified: (1) Numerical results motivated health change; (2) Open communication improved medication adherence; (3) Self‐management and autonomy valued; (4) Religious/spiritual beliefs may strengthen medication adherence; and (5) Complementary and alternative medicines (CAM) augment Western medicines.ConclusionProviders may engage in various culturally‐based strategies to optimize medication adherence in South Asian immigrants. Resources should be allocated toward facilitating disease state education, encouraging self‐monitoring, and providing training for providers on CAM. Providers should engage the patient‐family dyad and cultivate collaborative relationships with patients. Providers should be aware that patients desire autonomy in making health care decisions, and those with higher health literacy and health care providers in their social network may be more likely to self‐titrate medications.

International Journal of Pharmacy Practice, Apr 11, 2011

Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing c... more Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing country can often be challenging due to limited financial and human resources. Organizations face frequent drug shortages, excesses of unnecessary medications and potentially inappropriate international donations. To promote adherence to international recommendations and enable targeted requests for international drug donations, this paper describes a process using a public-health approach to create a site-specific pharmacy formulary in a resource-poor setting using the World Health Organization's (WHO) Model List of Essential Medicines ('Model List'). Methods The study site was a Malawian-run non-profit private clinic serving over 3000 people annually. The organization focuses on providing community support for orphans from the HIV/AIDS crisis in sub-Saharan Africa. While using the Model List as a backbone, we incorporated the clinic's drug inventory, patient needs, clinician prescribing patterns, and the country's national drug list into the final formulary. After analyzing site-specific factors, we determined which WHO Model List therapeutic classes were necessary for the clinic to address in the final formulary. Key findings Of the drug products currently available in the inventory, 65.6% were expired, 29.8% of which were international donations. After removing expired medications from the inventory, seven Model List priority categories remained unaddressed by the clinic's initial inventory. Based on the results of a structured needs assessment, 54 products were selected for the final simplified formulary. Conclusions Conscious selection of pharmaceuticals, resulting in a systematic formulary for drug distribution management, is critical so that a clinic can focus on procuring and prescribing the most needed medications. This selection process using the WHO Model List and a public-health approach to drug management could serve as a private clinic model for pharmaceutical optimization and targeted international drug donations in sub-Saharan Africa and other resource limited settings. Addressing deficient drug supplies in Malawi Julie C. Lauffenburger et al. Addressing deficient drug supplies in Malawi Julie C. Lauffenburger et al.

Currents in Pharmacy Teaching and Learning

Pharmacy

Recommendations for global pharmacy collaborations are predominately derived from US institutions... more Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other’s programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.

Medication management is a complex and expensive multistage process that covers the prescribing a... more Medication management is a complex and expensive multistage process that covers the prescribing and ordering, order communication, dispensing, administering, and monitoring and use of prescription medications. While challenges in medication management are ubiquitous across all settings, they can be particularly exacerbated in a free clinic that serves a medically vulnerable population. These patients suffer from financial constraints, poor health literacy, multiple chronic conditions, and medication non-adherence. Clinical pharmacists play an integral role in the provision of healthcare services to these patients and could benefit from the use of medication management information technology (MMIT) to provide efficiencies in the tracking, provision, and use of medications. While MMITs exist, they are not designed to support the unique needs of pharmacists in these settings

Pharmacy

The COVID-19 pandemic led to significant disruption in students’ lives through lockdowns, restric... more The COVID-19 pandemic led to significant disruption in students’ lives through lockdowns, restricted movement, remote instruction, and mixed information. Therefore, this study aimed to capture the knowledge, attitudes, and practices of student pharmacists during 2020–2021. A 43-item COVID-19 Knowledge, Attitudes, and Practices (COVKAP) survey previously developed was administered at four schools of pharmacy across the U.S. during Fall 2020 and Spring 2021. A total of 418 responses were analyzed from graduating classes of 2021–2024. There were no significant differences in correct COVID-19 knowledge responses across the four graduating years. Respondents’ attitudes around COVID-19 were homogenous with the exception for their belief in their preparedness to administer COVID-19 vaccines. Respondents reported wearing masks daily (76.8%), infrequently visiting restaurants (82.1%), practicing social distancing daily (45.7%), and referring to medical journals for information (72%). In conc...

Complete list of user stories grouped into themes and sorted by user group as used for RxMAGIC im... more Complete list of user stories grouped into themes and sorted by user group as used for RxMAGIC implementation. The 45 user stories are organized into feature-based themes. Following each theme is the number of user stories that comprise it in parenthesis. Each story should be interpreted from the perspective of the identified user group. (PDF 118 kb)

Annals of Global Health, 2014

7 out of the 9 (78%) adults and all children interviewed were supportive of the idea of HPS. 8 ou... more 7 out of the 9 (78%) adults and all children interviewed were supportive of the idea of HPS. 8 out of the 9 adults (89%) are ready to participate in HPS. The most recurrent themes are nutrition, hygiene, mental health, and family relationships. Summary/Conclusion: This is the first study that assessed needs for HPS in underserved rural China. Rural students exhibited more health risk behaviors compared to urban students. Adults and children welcomed the idea of HPS. HPS can be piloted in underserved areas of rural China and, if shown to be effective, can help improve children's health in similar areas worldwide.

American journal of pharmaceutical education, Jan 25, 2016

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provi... more International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, con...

International Journal of Pharmacy Practice, 2011

Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing c... more Objectives Maintaining a well-stocked dispensary at a private non-profit clinic in a developing country can often be challenging due to limited financial and human resources. Organizations face frequent drug shortages, excesses of unnecessary medications and potentially inappropriate international donations. To promote adherence to international recommendations and enable targeted requests for international drug donations, this paper describes a process using a public-health approach to create a site-specific pharmacy formulary in a resource-poor setting using the World Health Organization's (WHO) Model List of Essential Medicines (‘Model List’). Methods The study site was a Malawian-run non-profit private clinic serving over 3000 people annually. The organization focuses on providing community support for orphans from the HIV/AIDS crisis in sub-Saharan Africa. While using the Model List as a backbone, we incorporated the clinic's drug inventory, patient needs, clinician pre...