As the role of the pharmacist in health care continues to evolve and expand, pharmacy careers are adapting to meet modern needs and challenges. Some pharmacists may choose to make a stronger impact outside the walls of community or health system pharmacies. Others may choose to work more closely with patients as part of an interprofessional health care team. Student pharmacists also have many opportunities to serve their patients beyond the more traditional pharmacy roles.

® offers a variety of articles and viewpoints to help students and pharmacists discover which pharmacy specialties they are interested in and navigate the changing workplace.

For students pursuing pharmacy degrees, read advice about Match Day on page 22, tips for securing a residency on page 14, and a recommendation for pursuing a career in senior care on page 6. Kira Voyer, PharmD candidate, makes a case for pharmacy advocacy on page 20. She explains why it’s important for students to become more involved with pharmacy legislation at all levels of government to help enact changes that benefit patients.

For readers who are building their careers, as well as those established in pharmacy, this issue offers 7 ways to elevate your occupation using self-awareness to your drive your trajectory, plus tips for those working in pharmacy management.

An article by Donna Kosteva, RPh, MEd, raises the challenge of “professional ghosting.” She discusses why ghosting might be affecting your job, how the professionals who disappear from the workplace are perceived by their colleagues, and how those affected by the practice can better manage it. Find that piece on page 8.

Finally, as noted on page 16, pharmacists remain some of the most trusted professionals. As the profession continues to move forward and evolve, it is important that pharmacists keep adapting their roles and building careers that reflect our modern lifestyles and the needs of patients to better serve our communities.

Articles

As the role of the pharmacist in health care continues to evolve and expand, pharmacy careers are adapting to meet modern needs and challenges.

Evolving Career Paths Offer Variety to Pharmacists

As 2019 comes to a close and we head into 2020, the anticancer treatment landscape continues to expand, as does the role of pharmacists in the patient care continuum. In light of this ongoing evolution in cancer care, we launched this journal, Directions in Oncology Pharmacy

, with a goal to provide insight and education on areas such as new treatment regimens, optimal patient support, and adverse effect (AEs) management. For a complement to our popular Directions in Oncology Pharmacy

 fall meeting series presented by Pharmacy Times Continuing Education

, see page 17 for an extensive recap of the recently completed fall meeting sessions to catch up on some of the developments you may have missed. Our outstanding continuing education meetings included insight into immune checkpoint inhibitors and oral and infusion therapies for patients with solid tumors and hematologic malignancies.

Also in this issue, on page 43, Libin Philip, PharmD, provides an extensive overview of effective support techniques for patients experiencing AEs associated with targeted cancer therapies. As Philip notes, communicating and addressing effective strategies to mitigate AEs can improve clinical outcomes as well as the quality of life for patients on these therapies.

In addition to these articles, for those who were unable to attend any of the Directions in Oncology Pharmacy meetings, you can participate in live webinars on January 6 (

pharmacytimes.org/live/advancements-in-the-treatment-of-hepatocellular-carcinoma

pharmacytimes.org/live/evolving-pharmacotherapy-options-in-melanoma

). I urge you to take advantage of these free, continuing education—accredited activities to stay ahead in the evolving cancer care landscape.

As we enter 2020, make sure you stay on top of the latest developments in oncology pharmacy in this journal and on our revamped daily news website at PharmacyTimes.com. Follow us online and through our e-newsletters (sign up at pharmacytimes.org/signup) to assure you are providing the highest-quality patient care in the year ahead. 

"As 2019 comes to a close and we head into 2020, the anticancer treatment landscape continues to expand, as does the role of pharmacists in the patient care continuum."

From the Chairman

The holidays are upon us, and that means many people will fly to meet family and friends in the days and weeks ahead to celebrate the season, as well as travel to some popular vacation destinations for some well-deserved rest and relaxation.

Airlines for America (A4A), the industry trade organization for many US airlines, noted that a record 31.6 million passengers will likely travel aboard US carriers worldwide during the 12-day Thanksgiving travel period, which they defined this year as Friday, November 22, through Tuesday, December 3, 2019, about a 3.7% increase over last year.

According to A4A, compared with the 2018 Thanksgiving travel period, US airlines operated 859 more flights per day, adding 108,000 daily seats to their schedules, to accommodate an additional 93,000 travelers.

As opportunities for travel both global and domestic grow, those in the health care industry must remain aware of any problems that our increasingly transient population could face, particularly threats of an infectious nature.

, Stoney et al reported on an analysis of 1222 travelers from abroad to the United States, noting that “nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall” and were comparable to what has been reported among travelers to low- and middle-income countries.

These illnesses were followed by other issues, like skin and soft tissue infections (29 diagnoses), arthropod bites and stings (173 diagnoses), and Lyme disease (42 diagnoses).

 Remember these statistics as you counsel patients, as they are a good reminder that infectious threats don’t respect borders.

, you will find counseling tips on a number of infectious disease issues that your patients may encounter during this very busy travel season, and you can also visit the CDC’s website for more important counseling pearls. As CDC officials note on the website, health care providers, including pharmacists, are in a great position to counsel patients before they head out for their holiday travels.

On their “Holiday Travel Tips” webpage, CDC officials advise that health care providers discuss with patients potential health concerns at destinations (including counseling about any unique vaccines and medicines they may need when visiting a certain area), instruct patients to pack a travel health kit (with items like OTC medications, sunscreen, first aid supplies, and, when appropriate, insect repellent), gather safety information, and, last but not least, counsel patients to expect the unexpected, including checking that medical insurance covers expenses abroad.

Counseling patients on these few items can help ensure they enjoy the weeks ahead. Happy holidays to one and all.

Airlines for America projects record 31.6 Million passengers over Thanksgiving travel period [news release]. Airlines for American website.

https://www.airlines.org/news/airlines-for-america-projects-record-31-6-million-passengers-over-thanksgiving-travel-period/

 Published Nov. 19, 2019.  Accessed Dec. 3, 2019

Centers for Disease Control and Prevention. Holiday travel tips. 

https://wwwnc.cdc.gov/travel/page/traveling-holidays

Stoney RJ, Esposito DH, Kozarsky P, et al. Infectious diseases acquired by international travelers visiting the USA. 

`Tis the Season for Holiday Travel

Suicide rates in the United States increased in nearly every state between 1999 and 2016. More than half of the states had a more than 30% rise in suicides during that period.

In 2016, nearly 45,000 lives were lost to suicide.

The role of pharmacists is evolving and expanding to include a variety of patient care services that increasingly include suicide prevention.

A program at Washington State University (WSU) College of Pharmacy and Pharmaceutical Sciences trains student pharmacists to recognize patients in need of suicide intervention.

In a session at the 2019 American Association of Colleges of Pharmacies (AACP) Annual Meeting in Chicago, Illinois, Christina Buchman, PharmD, BCACP, and Megan Willson, PharmD, BCPS, both with WSU’s College of Pharmacy and Pharmaceutical Sciences, discussed the impact of suicide on student pharmacists and the need for suicide awareness training. They noted that mental illness and suicide are nondiscriminatory and affect all individuals, including student pharmacists.

Suicide is the second-leading cause of death in individuals aged 15 to 34 years, and it claims the life of 1 person every 12 minutes, according to the presenters.

In 2016, Washington became the first state to require pharmacists to complete suicide awareness and prevention training to address this public health issue.

The WSU program, taught in the first semester of the pharmacy curriculum, assesses students’ knowledge at the beginning of the course and near the end to evaluate progress. In between, students see videos demonstrating signs that a person needs help and how best to approach the situation.

In classrooms, live interactions and role-playing exercises reinforce the material.

Students also practice saying the word suicide, Willson said.

WSU counseling staff members are on hand and ready to walk students to a health care facility, as needed, she added.

A pharmacist asking a patient if they are considering suicide should remove dangers and take the next steps, regardless.

September marked Suicide Awareness Month. The WSU program is a good example of how pharmacists can have an impact by just starting the conversation. Suicide awareness and prevention could become second nature to students, who can provide this life-saving service throughout their careers.

Suicide rates in the United States increased in nearly every state between 1999 and 2016. More than half of the states had a more than 30% rise in suicides during that period. In 2016, nearly 45,000 lives were lost to suicide.

Pharmacist Training in Suicide Awareness Can Save Lives

Recent reports of tourists falling ill and 10 American tourists dying in the Dominican Republic in the past year have led health investigators there to look into the causes.

Several media outlets have interviewed many of those who became sick, and the reports from these individuals have yielded a number of potential leads, ranging from reports of becoming sick after drinking at hotel bars to chemical smells in hotel rooms. Meanwhile, these reports have led many tourists to wonder whether they should cancel upcoming travel plans to the country and Dominican representatives, in turn, to hold press conferences seeking to “assure travelers the deaths are isolated events.”

Although the investigation continues, a common thread among many of those who have visited the Dominican Republic and become sick is reports of gastrointestinal (GI) disturbances, such as cramping and diarrhea. Pharmacists can, and should, play an important role in counseling patients before they travel anywhere about what to do in the event of a GI illness while vacationing.

In one of the articles in this issue, Jennifer Gershman, PharmD, CPh, advises pharmacists about norovirus, an illness that has often been associated with cruise ship travel. In her Patient Focus article, she notes that though medications are not recommended for this viral illness, “pharmacists should advise patients infected with norovirus to drink plenty of fluids to prevent dehydration. Sports drinks and other beverages without alcohol or caffeine can help with mild dehydration. Recommend oral rehydration fluids, such as Pedialyte, to replace important electrolytes lost from diarrhea and vomiting. Severe dehydration may require hospitalization with intravenous fluids.”

Gershman also touches on some commonsense advice to share with patients to avoid a number of GI illnesses that are commonly seen, especially during the summer months.

“One important tip is washing hands carefully with soap and water for at least 20 seconds, especially after changing diapers or using the bathroom and before eating or preparing food,” she writes. “If soap and water are not available, individuals should use an alcohol-based hand sanitizer that contains at least 60% alcohol.

 Instruct individuals to carefully rinse fruits and vegetables and thoroughly cook shellfish before eating.”

These tips are as important to share with “staycationers” as they are with those traveling domestically and abroad.

Pharmacists should also discuss other preventive tactics with those who are traveling this summer, including counseling about travel vaccinations. Note the importance of using sun protection for those customers enjoying the outdoors and stress using insect repellents to keep campers happy.

Dispensing advice to patients before they head out for some fun in the sun this summer will no doubt lead to better vacations. Give it a try; they will thank you.

Flores R, Andone D. A 10th American has died while vacationing in the Dominican Republic. 

cnn.com/2019/06/23/world/tenth-american-death-dominican-republic/index.html. 

November 27, 2016. pharmacytimes .com/contributor/jennifer-gershman-pharmd-cph/2016/11/5-facts-about-norovirus. Accessed May 7, 2019.

CDC. Norovirus. cdc.gov/norovirus/index.html. Updated April 5, 2019. Accessed May 6, 2019.

Pharmacists can, and should, play an important role in counseling patients before they travel anywhere about what to do in the event of a GI illness while vacationing.

Pharmacists Should Counsel Patients Before They Travel

Husbands, children, friends, work. Ask the women who are members of the Pharmacist Mom group on Facebook, and the chances are pretty good that you will hear those things noted as some of the top priorities in their, and a lot of women’s, lives. What often suffers because of these competing priorities, unfortunately, is their own health.

Although some 83% of women report having a primary care physician, many report not getting regular checkups. These statistics paint a bleak picture, but there is a lot that pharmacists can do to make an impact on their health, particularly as it relates to one of the top killers of women: cardiovascular disease (CVD). Results from a study presented just last month at Heart Failure 2019, a scientific congress of the European Society of Cardiology, demonstrated that patients who visited the pharmacist once a week adhered better to their medications.

The study investigators noted that the proportion of study patients, 38% of whom were women, who were adherent to their drug regimens increased from 44% to 86% in the pharmacy group and from 42% to 68% in the usual care group. Patients in the pharmacy group were 3 times more likely to become adherent compared with the usual care group.

Although it is unlikely that patients will be visiting pharmacists on a weekly basis, it has been demonstrated time and again that pharmacists can play an integral role in boosting drug adherence rates and in improving the health of their patients overall.

As one of our regular authors, Jennifer Gershman, PharmD, points out in the “Patient Focus” column this month, “Pharmacists can provide important education to patients in community and hospital practice settings. Educating other health care professionals and patients about heart attack symptoms unique to women will help raise awareness throughout the community.”

In her article Gershman offers some pearls for advising female patients about the risks of CVD that are unique to women, including “early menopause, eclampsia, gestational diabetes, and preeclampsia,” among others. She also offers some advice for the pharmacy community about becoming advocates for patients to become enrolled in more clinical trials around CVD and women specifically.

In addition to this article, there is a range of subjects on women’s health in this issue of Pharmacy Times®, including postpartum depression, women’s supplements, dyspareunia, and bacterial vaginosis.

Schulz M. Pharmacy-based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM-CHF randomized controlled trial [published online May 25, 2019]. 

CEO

Articles