Pharmacy Times

Addressing the Pharmacist Shortage

Author: Marsha A. McFalls-Stringert, RPh, PharmD; Thomas J. Mattei, PharmD; and R. Pete Vanderveen, PhD

The Pharmacy Manpower Project has concluded that the supply of pharmacists will not meet the need by the year 2020. An estimated 417,000 pharmacists will be required to fill a variety of positions, whereas only 260,000 will be supplied by our nation's pharmacy schools.1

In an effort to be part of the solution to the problem, Duquesne University, Mylan School of Pharmacy, in Pittsburgh, Pa, has developed a Pharmacist Refresher Program. This program was designed for pharmacists who have been raising children; working in administration, sales, or academia; or simply not practicing. Many such pharmacists may want to reenter pharmacy practice but may be intimidated because of all the changes that have taken place over the years. Other pharmacists have said that they have a need for such a program to give them the information, education, and confidence to practice again.

The goal of the program is to reinforce and enhance participants' pharmacy background and to afford them the opportunity to apply it to current pharmacy practice through lectures and workshops. Learning objectives are provided for each topic, along with extensive handouts. Participants also are invited to attend the NAPLEX Review Program that is offered to graduating pharmacy students.

The Pharmacist Refresher Program is a 10-week comprehensive program, with sessions conducted once weekly. It is offered in the evening because some participants are working, although not in the pharmacy field. Others have child care considerations.

Topics include New Drug Updates and Regimens, Review of Advances in Medication Distribution System Technology and Software, OTCs and Self-Care, Herbal and Nutriceutical Products, Clinical Skills, Pharmacy Calculations, and Pharmacokinetics and Biopharmaceutics. Also covered are Third- Party Reimbursement Issues, Employee and Inventory Management, Drug Information Resources, Professional Communications, Pharmacy Law, and Medication Errors.

A comprehensive review of the new drugs and drug classes in the last 15 years is given, with attention also paid to emerging topics and treatments that are on the horizon. Because a vast majority of employers are utilizing automation and technology to improve workflow and decrease medication errors, participants are exposed to state-of-theart equipment and software. Participants get to experience this technology firsthand in the Duquesne University Center for Pharmacy Practice.

Studies have shown that 73% of Americans would rather self-treat than visit a physician.2 Patients may not want to wait in a physician's office; some may not have insurance and may not be able to afford to see a physician. In the year 2000, $21 billion was spent on nonprescription medications and at least $11.3 billion on herbal products.3,4 Therefore, the use of OTC medications, herbal products, and nutriceuticals is covered in the program in depth.

A brief review of pharmacy calculations is presented. Laboratory tests and other monitoring parameters are discussed. A major concern of the participants has been interaction with insurance companies and how to handle the many issues pharmacists face every day with third-party agents. This topic is discussed in great detail.

Although it is known that automation and technology help to decrease medication errors, one of the sessions is devoted to how pharmacists can decrease the chance of these errors occurring in their own practice environment. Current drug information resources are presented, and a demonstration of personal digital assistants lets the participants know what information is available to assist them and how to access such programs.

The final session of the program includes a hands-on workshop allowing participants to work with the most current, state-of-the-art automation and technology. At this stage, they should be able to complete the entire prescription-filling process, from entering information into the computer, to evaluating interactions and alerts, to filling the prescription. The most recent participants reported that this one particular session made them feel that they could enter pharmacy practice again with confidence.

By the end of the program, participants generally have a good idea of what practice setting they want to pursue. The program includes a session on employment opportunities, with local community pharmacy and hospital recruiters featured.

A certificate of completion is awarded to each participant who fulfills the program requirements. Continuing education credit also is awarded for several sessions of the program individually or as a whole.

Suggestions for future offerings in the program have been given. Participants want to focus on new drug categories, such as angiotensin-receptor blockers, rather than on specific disease-state approaches. Disease states have not changed, but treatment options have. More information on herbal products is desired. Common uses, drug interactions with prescription and nonprescription medications, and management of adverse effects are a few other areas that need more emphasis. Participants also have said that providing an experiential site at an operational pharmacy at the end of the program would be an enhancement.

The authors are now developing an on-line Pharmacist Refresher Program. It is expected to be available in the late fall of this year.

Dr. McFalls-Stringert is director of the Center for Pharmacy Practice and an instructor of pharmacy practice at Duquesne University, Mylan School of Pharmacy. Dr. Mattei is division head of clinical, social, and administrative sciences and an associate professor of pharmacy practice. Dr. Vanderveen is dean of the Mylan School of Pharmacy and of the Graduate School of Pharmaceutical Sciences and a professor of pharmacy practice.

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