Bea Riemschneider, Editorial Director

	 Important women’s health issues were front and center at the recent annual meeting of the American College of Obstetricians and Gynecologists (ACOG), which convened in San Francisco, California, May 15-19, 2010. Researchers shared updates on topics that affect the lives of millions of women in the United States every day.

	With the birth control pill celebrating 50 years in May 2010, the health care community is looking back at this much-studied medication, which gave women contraceptive options and also provided a host of benefits, including cancer prevention and relief from menstruation disorders.

	“The pill has revolutionized women’s health care. Obviously, the contraceptive benefits are paramount, but I have become a huge advocate for all the noncontraceptive reproductive health benefits that the pill offers,” said Douglas H. Kirkpatrick, MD, immediate past president of ACOG. “Another advantage is that the pill has enjoyed incredible safety over its 50-year history.”

	Millions of women have used the birth control pill over the decades, and it has remained the leading form of contraception in this country. The birth control pill reduces the risk of endometrial cancer—one of the most common forms of cancer in the United States&mdash;by up to 50%, and that protection may last up to 15 years after discontinuing it, according to ACOG. Women taking the pill also have a reduced risk of pelvic inflammatory disease, acne, benign breast disease, and ectopic pregnancy. It also prevents anemia, heavy uterine bleeding, and endometriosis pain.

	Physicians believe that the birth control pill is here to stay. “In the near future, we’re likely to see variations in pill-taking regimens and different estrogens and progestins, but no radical changes are in sight,” said David A. Grimes, MD, of Family Health International in Durham, North Carolina. Another offspring of the birth control pill are the oral contraceptives for emergency contraception (EC) currently on the market, which pharmacists also see in their practices.

	As the milestone of the birth control pill was celebrated, other important issues on the horizon for women’s health were the focus of papers at the ACOG’s 58th Annual Clinical Meeting. Clinical depression is common among reproductive-age women, and it is the leading cause of disability in women each year. Screening for depression during pregnancy and afterwards is seen as a priority by the college because it represents a serious health issue for the mother, but can also impact an infant’s cognitive, neurologic, and motor skill development, as well as negatively affect older children’s mental health and behavior.

	Gerald F. Joseph, Jr, MD, president of ACOG, introduced postpartum depression as his 2009-2010 presidential initiative. “With over 4 million births in the US every year, we’re talking about a huge number of women with postpartum depression—between 200,000 to more than 1 million each year,” said Dr. Joseph. “And while we don’t have a firm recommendation for universal antepartum and postpartum depression screening, we realize the importance of screening our patients so that we can start gathering the data for future evidence-based guidelines.”

	The Samuel A. Cosgrove Memorial Lecture entitled “Perinatal Depression: Screening, Diagnosis, and Treatment,” presented at ACOG’s meeting by Michael W. O’Hara, PhD, University of Iowa, focused on the tools and procedures that can be used to detect and diagnose perinatal depression. Pharmacists are involved in the medication management of this condition on an ongoing basis; this presentation stressed the importance of diagnosing and initiating treatment. Mary Jo Codey, the wife of the former governor of New Jersey and an advocate for more research for depression in women, spoke on “Recognizing Postpartum Depression—Speak Up When You Are Down” and underscored the pervasive nature of this uniquely female condition.

	New research presented at ACOG’s 58th Annual Clinical Meeting highlighted a wide range of women’s health issues, delivering the latest unpublished research on such topics as experimental drugs, infertility, infectious diseases, gynecologic cancer, menopause, obstetrics procedures, urogynecology, caesarian delivery, and contraception. More than 250 research findings covered key areas for health care providers in women’s health, many of them groundbreaking new areas of study.

	Women with cancer undergoing treatment who choose to become pregnant and seek to preserve their fertility, for example, now have a number of options available to them. A new medical discipline—called “oncofertility”&mdash;is looking at ways the reproductive outlook for women cancer patients can be improved.

	The report by Teresa K. Woodruff, PhD, Northwestern University, outlined how a promising new technique for preserving ovarian tissue has the potential to safeguard the future fertility of younger cancer patients. Nearly 140,000 women younger than age 45 are diagnosed with cancer every year, and chemotherapy affects fertility by attacking follicles in the ovaries. Radiation treatment in the abdomen can also damage follicles, as well as the uterus. The new option involves outpatient surgery with ovarian tissue cryopreservation. Additional research is also underway that is working to perfect the use of preserved ovarian tissue in vitro follicle maturation. “Oncofertility: The Preservation of Fertility Options for Young People with Cancer” explored these new techniques that aim to preserve and extend the fertility of young patients.

	The Edith Louise Potter Memorial Lecture entitled “Gestational Diabetes Mellitus: The Past, The Present, and The Future,” presented by Steven G. Gabbe, MD, chief executive officer, Ohio State University Medical Center, focused on another important health condition by discussing the current and proposed guidelines to detect gestational diabetes in pregnancy. Seven out of every 100 pregnant women develop gestational diabetes. Diabetes—which can develop later in life as well, especially in women who are obese, with a family history, or those who have hypertension&mdash;is a risk factor for coronary heart disease, the single leading cause of death for American women.

	Pharmacists are in a unique position to counsel women patients during pregnancy and at other stages of their lives to help them control key risk factors, including diabetes, high cholesterol, and obesity. They can also suggest OTC products to reduce these risks, along with regular physician visits, prescription medications where indicated, and lifestyle changes that put women patients in the right direction for optimum health.

	For more details and updates on current research in women’s health, visit 

Articles

Women's Health: Current Trends

Tough choices to make, but here are some editorial highlights from 2010 that you will not want to miss as the year winds down! 

We hope you have enjoyed the 12 important theme issues that we have offered to our readers in 2010, providing a broad range of topics for your use in your daily practice. Our goal has been to keep you up to date on the latest products, clinical issues, and significant trends in patient care and in the profession of pharmacy.

This year brought many faces of pharmacy to our pages and Web site as we honored individual pharmacists through the inaugural Next-Generation Pharmacist Awards program. In partnership with Parata Systems, this unique program spotlighted pharmacists across the country who brought their profession to a new level.

It was our great pleasure to meet these pharmacists at the gala awards event in Philadelphia, an evening which we will not forget! The nominations for the 2011 Next-Generation Pharmacist Awards will be open soon, so we invite you to contemplate who you think should be honored next year.

Pharmacists have given us valuable feedback all year long, so in no particular order, here are some of the editorial highlights from 2010:

— We heard this over and over again as many, many, many of you took the CE tests and enjoyed the 

 — The pharmacist’s role is not an easy one, and we recognize the need to help pharmacists take care of themselves as they provide patient care for the public.

Medication Safety: Be Prepared to Respond to an Error 

— All of our medication safety columns were well received, but this one stood out.

 — We know that you need to keep up with the latest over-the-counter products and trends.

Medical Marijuana: Turning Over a New Leaf in Glaucoma Treatment

 — This controversial topic continues to be debated among pharmacists, especially those in states where medical marijuana is dispensed.

, we hope you have enjoyed these practical insights written by practicing pharmacists regarding over-the-counter 

 — As a service to patients and the pharmacists who counsel them, this popular monthly section runs the gamut of health topics that you encounter each and every day.

Overcoming Infertility: Rx Treatment Options Provide Hope

 — A popular article in our Women’s Health issue, this feature provided a clinical overview of the latest treatment options for infertility. It was also the cover topic of our very first Pharmacy Times 

 — You always let us know that you love this 

 — Always educational, entertaining at times, voicing key frustrations—when you share your “peeves” with us you also help your fellow pharmacist. We thank you for participating in our “Pet Peeve Fridays” on the popular 

 Facebook wall, and we look forward to continuing the conversations in 2011!

So, to end 2010, we offer you and your families the very best wishes for a happy, healthy, and successful New Year! It is our pleasure to bring you 

—and we look forward to serving your needs next year.

Can Positive Thinking Yield Rx-Worthy Benefits?

Survey Reveals Top 10 Issues Facing Pharmacists

The Best of 2010 in Pharmacy Times

Nominations for the 2011 Next-Generation Pharmacists Awards will be open soon as we celebrate the winners in 2010.

Celebrating Pharmacists Who Have Made a Difference 

 takes a look back—and forward to 2011&mdash;at the Next-Generation PharmacistTM Awards program. This inaugural program, in partnership with Parata Systems, identified and honored 30 pharmacists across the nation for their contributions to the profession and their innovative leadership. These pharmacists were recognized at an awards dinner on October 25, 2010, in Philadelphia as their stories were told and videos of the category winners were presented during the gala event held in Franklin Hall at The Franklin Institute. (Visit www.nextgener ationpharmacist.org to see the videos for each category.)

Profiles of all the pharmacists honored this year were published in the September and October issues of Pharmacy Times (visit www.PharmacyTimes.com), along with the results of the research survey associated with the Next-Generation PharmacistTM program. The pharmacists’ vision for the future and how they feel about the current state of their profession were among the many topics uncovered in the survey as important trends in pharmacy and opinions were revealed.

 and Parata would like to thank all of those who nominated individual pharmacists for these awards as well as to congratulate the finalists and winners who were part of this special evening and program. The grand winner—the 2010 Next-Generation Pharmacist&mdash;was Mark Aurit, RPh, the owner of Gateway Health Mart Pharmacy in Bismarck, North Dakota, who also was the category winner for Entrepreneur of the Year. His personal style and leadership has made an impact on his community since 1989, as he continues to evolve his business to serve the needs of his patients.

Pharmacists are critical members of the health care team—now even more than ever before&mdash;so it was our great privilege to recognize and honor individual pharmacists who make a difference every single day. We’d like to invite you and your colleagues to nominate pharmacists you admire for the Next-Generation PharmacistTM Awards 2011&mdash;nominations will be open on January 15, 2011, and available online at www.PharmacyTimes.com and www.nextgenerationpharmacist.org.

Bea Riemschneider is Editorial Director of 

Next-Generation Pharmacist Awards

This research project provides insight into the future trends and goals of pharmacists as their role continues to evolve. 

Delving into the thought processes of members of a select profession, especially in the health care arena, is a tough proposition. The values and goals of any one group are not so easily defined. There is historical data, to be sure, as well as a wealth of anecdotal information and observations. But nothing quite takes you to the heart of a matter like a personal one-on-one conversation. Capturing feelings and thoughts “in their own words” and then quantifying them into statistically significant analyses provides valuable insight into a profession—and the vision individuals express about the future.

The goal of the Next-Generation Pharmacist Profile project, conducted this spring through a partnership between 

 and Parata, was to fill a current gap in the industry. The study was fielded to profile the pharmacist in the United States and to better understand the motivations and goals of pharmacists today. Another goal was to gather information about the future visions of the industry as seen through the eyes of those who practice bench pharmacy in the community, chain, and institutional settings. What are the differences, if any, across these sectors of pharmacy practice? What are the career motivations of pharmacists? What is the legacy connection?

Previously, we commented on the scope of the research project, the associated awards program (please see “Announcing the Winners” ) in Part 1 of this research summary (please see “The Next-Generation Pharmacist: What Will the Future Look Like for Pharmacy?” September 2010, 

). In this first year of the program, it has been an exciting time as pharmacists from across the country weighed in with their opinions and stories—painting a picture of the pharmacist that provides a benchmark for future research and touch points that define the profession today.

Equally exciting is the awards program, which honors those pharmacists who bring innovation and creativity to their practices and affect their communities and patients with their commitment. We are proud to present the category winners in this issue.

The judges also selected a top winner— the 2010 Next-Generation Pharmacist of the Year&mdash;who was chosen to represent the profession. A special awards ceremony, to be held in Philadelphia on October 25, 2010, will unveil this pharmacistand a first for 

—as the cover subject of this month. American Pharmacists Month This is an especially appropriate month to celebrate our Next-Generation Pharmacist Award winners, as well as all the finalists and those who were nominated. The American Pharmacists Association (APhA) has encouraged all pharmacists to participate in their “Know Your Medicine, Know Your Pharmacist” campaign, so that the public gains a better understanding of the role pharmacists play and how they impact patient care.

Pharmacists, however, can often be frustrated by the perception of their role by the public, according to the APhA, so it is up to the individual pharmacist to educate customers, one at a time, on a daily basis. Our survey reveals some of these same frustrations, and the one-onone telephone responses offer insights and solutions as well.

Pharmacists, in general, are satisfied with their careers. The key ingredient for making it all work for them revolves around the joy of helping people and “making a difference.” As reported in our previous article, nearly two fifths of those surveyed consider pharmacy to be their “dream profession.” That is encouraging news for the profession, which also has its drawbacks and problems. The Next- Generation Pharmacist survey zeroed in on some of these more negative aspects when the respondents were asked, “What is the biggest disadvantage of your chosen profession?”

The answers revealed that pharmacists, first and foremost, were concerned about their work hours. A total of 25% said that this was the biggest disadvantage of being a pharmacist. Followed closely at 20% was “insurance/administrative burden,” which voiced the concern of many in the profession that too much time is spent on administrative work.

Pharmacists from the institutional and chain pharmacies responded with a total of 5% saying they were “understaffed,” and 4% responded that “standing” was the biggest disadvantage for pharmacists as a profession. Another 4% added “stress” as a major disadvantage, with some responses referring to the large responsibilities of pharmacists in general by saying “stress of having to get it right 100% of the time.”

Pharmacists also revealed that they most enjoyed patient counseling, but they spent most of their time on dispensing or administrative tasks. The pharmacist work day was thoroughly investigated with a question about the typical work day. Asked “Thinking about your typical work day, which of these four tasks do you enjoy the most…or take most of your time?” the results reveal some interesting insights (see Table).

Top on the list of enjoyable tasks is patient counseling (58%) with, the other stated tasks—clinical (19%), dispensing (17%), and administrative tasks (4%)&mdash;following behind as “enjoyable” tasks. Administrative tasks were rated as the least favorite task&mdash;only 4% stated that they enjoyed that task the most&mdash; and were seen as a burden and barrier to patient counseling. This tells us that the pharmacist is most comfortable when counseling patients, but the one task that takes up the bulk of their typical work day does not revolve around what they most enjoy about their careers.

In fact, the biggest time grabber is dispensing (45%) and the second highest time-consuming task is administrative tasks (39%). As far as patient counseling is concerned, the survey respondents reported that only 12% of a typical workday is associated with that task. The desired to work with patients is clear, but the work day only has so much time. When calculating the second most timeconsuming task in a typical day, administrative tasks still take first place at 28%, closely followed by dispensing (26%) and then patient counseling (24%).

The satisfaction level of time spent with patients was also probed with the majority of pharmacists (58%) responding that they were “somewhat” satisfied” when asked, “Overall, how satisfied are you with the amount of time you spend with patients?” Those that expressed complete dissatisfaction were at 9%, with 28% being “very satisfied” with the time they could give patients on a typical work day.

The Next-Generation Pharmacist survey also focused on the technology aspects of pharmacy and what the future may hold. First, the pharmacists were asked how they would rate their own pharmacies as a “technology innovator.” The percentage of pharmacists who rated their businesses as “excellent” in this area was 19% and 22% rated their pharmacies as “fair” or “poor.”

What makes a pharmacy excellent in technology? The answers revolved around the words “new” technology and “being the first” to rollout innovations as the main reasons for rating their pharmacies as having excellent technology in place. Interestingly, pharmacists also perceived this question only in terms of computers and software, and no pharmacist mentioned automation in the one-onone responses.

When asked “What is the most compelling reason to use technology in pharmacy?” a total of 17% of those surveyed responded that technology saved time, while 14% noted improved safety as a reason to use technology in their pharmacy. Institutional pharmacists valued the following compelling reason to use technology—“improved safety”(14%)&mdash; and 8% of the total respondents said that there was more “efficiency” with technology. The reduction of errors (8%) was also cited as another reason for the value of technology as was “improved accuracy” (7%) and “control of information” (6%). A portion (6%) noted that technology was “better for the patient.”

What kinds of technology are currently being used? Those surveyed provided some insights: 31% use electronic prescribing (76% chain pharmacists use electronic prescribing), 15% use semi-automation or counting technology in their pharmacies, 14% use workflow software, 12% use computers, and 4% use bar coding/ scanning.

When asked what type of technology would be the most important for pharmacists in the next 5 years, the answers provided a window on the thinking of the pharmacist who envisions technology as the tool for the future. Cited as most important were electronic prescribing (22%), robotic dispensing (17%), computers or database (6%), semi-automation or counting technology (4%), workflow software (4%), and bar coding (3%).

The Next-Generation Pharmacist research program sought to understand what pharmacists thought were the most important changes in the industry today. When asked, “What is the main difference in the way you practice pharmacy, compared to the previous generation?” the answers were revealing. The role of the pharmacist in patient care stood out—with 22% citing more patient care and clinical involvement as a difference from the past. Chain pharmacists, in particular, cited this as important distinction.

Technology was also a focal issue, with 19% of those surveyed mentioning pharmacy automation, an electronic presence, or technology as a factor. Pharmacists also noted that pharmacy “leads the way” in faster and better technology. Community pharmacists cited computers as a major change from the previous generation, with 6% noting these as more common tools.

In terms of their own practices, the pharmacists were asked what changes they would make in the next 5 years, specifically focusing on what would be the single most important change. The answers contained a mix of technology related responses—with 4% planning on increasing their electronic prescribing or electronic presence and 8% planning on an increased use of pharmacy automation. Patient care was still on the minds of many, with 16% planning on being more involved in patient care.

Some pharmacists planned no changes in their practice (21%) and a fair number (13%) planned to retire in the next 5 years. The retirement of current pharmacists may well be one of the issues that shape the future as more pharmacy graduates come out of school into a tight job market.

In fact, one of the concerns about the next 5 years noted by survey respondents was employment (10%), as well as the impact of the health care plan (17%). Pharmacists in this survey voiced their concerns and hopes, but clearly they were committed to the future of their profession.