Chapter Twenty-One
Drug Information Education and Training
Learning Objectives
After completing this chapter, the reader will be able to
• Determine fundamental drug information skills for all pharmacy students.
• Identify settings in which student drug information skills can be developed and refined.
• Define the recommended training path for drug information specialists.
• Describe job responsibilities of contemporary drug information specialists.
• Formulate a strategy by which interested candidates can learn about available drug information residencies and fellowships.
Key Concepts
Information retrieval, evaluation, and application skills represent a significant component of the core skill set each pharmacist must possess.
Drug information skills are core concepts that must be incorporated in pharmacy curricula.
The majority of foundational skill development should occur prior to student participation in advanced pharmacy practice experiences (APPEs).
Drug information rotations may also occur in nontraditional settings (e.g., pharmaceutical industry, managed care, group purchasing organization), a reflection of the expanding role of drug information in contemporary pharmacy practice.
Activities identified by the Accreditation Council for Pharmaceutical Education (ACPE) in which students should engage to foster their skill development range from responding to drug information requests to preparing materials for consideration by a pharmacy and therapeutics committee.
Pharmacy residency training standards include core drug information retrieval and evaluation skills for both postgraduate year one (PGY1) and postgraduate year two (PGY2) programs.
Consistent with the profession-wide model for specialist training, the preferred training model for a drug information specialist is a PGY1 residency program, followed by completion of a PGY2 residency in drug information.
The American Society of Health-System Pharmacists (ASHP), the organization charged with accrediting pharmacy residency programs, has developed outcomes, goals, and objectives that must be incorporated into ASHP-accredited PGY2 residency programs.
PGY2 programs in drug information are not limited to health systems, as programs exist in academic, pharmaceutical industry, and managed care settings.
Fellowship programs build research skills beyond those provided during residency training programs.
Introduction
Information retrieval, evaluation, and application skills represent a significant component of the core skill set each pharmacist must possess. Combined with other practice responsibilities that have traditionally been linked to the practice of drug information (e.g., medication use policy), developing and maintaining practitioners with expertise in such activities is critically important. This chapter will focus on key models of education and training for all pharmacists, as well as those specializing in drug information practice.
Foundation Skill Development
Building basic drug information skills, a signature feature of early doctor of pharmacy degree programs, remains an essential component of contemporary entry-level doctor of pharmacy education.1–3 Skills are developed by both didactic and experiential methods. Didactic drug information education is provided through stand-alone courses as well as being integrated within other courses or throughout the professional curriculum.
Drug information skills are core concepts that must be incorporated in pharmacy curricula. Pharmacy curricula must be designed to prepare program graduates with entry-level professional competencies to ensure optimal medication therapy outcomes and patient safety in any pharmacy practice setting and incorporate core drug information skills. To meet the profession’s broader needs, the scope of drug information practice has evolved beyond a focus on literature retrieval, evaluation, and application to specific organizational needs and patient care situations such as therapeutic policy management, oversight of safe medication practices including information systems, and promotion of health and wellness.4 The accreditation standards for professional degree programs include the broad set of related concepts that must be taught and evaluated (e.g., professional communication, practice management, biostatistics).2 Those that are readily identifiable as connected to drug information are broadly categorized as drug information, literature and research design evaluation (see Chapters 4 and 5), biostatistics (see Chapter 8), economics/pharmacoeconomics (see Chapter 6), pharmacoepidemiology, pharmacogenomics, and medication safety (see Chapter 16). However, a number of foundational elements relevant to drug information practice are integrated into other categories of the Accreditation Council for Pharmacy Education (ACPE) accreditation standards.2 Those elements include:
• Interpretation of drug screens (e.g., urine toxicology)
• Pharmacist’s role in poison control centers
• Dietary Health Supplement and Education Act and impact on regulation of dietary supplements and herbal products
• Drug-herbal interaction
• Indigent care programs
• Incidence of and problems associated with drug overuse, underuse, and misuse in the health care system
• Tools, including informatics, needed to assess and address change, increase competitiveness, improve quality, and optimize patient services
• Managing and improving the medication use process
• Ethical issues related to the development, promotion, sales, prescription, and use of drugs
• Conflict of interest
• Effective verbal and written interpersonal communication
• Health literacy
• Use of data in continuous quality improvement initiatives
• Systematic processing of data, information, and knowledge in health care
• Identifying pharmacotherapeutic knowledge gaps in the professional literature
• Evidence-based practice and decisions
• Assurance of safety in the medication use process
• Medication error identification and prevention programs
• Identification and prevention of drug toxicity
• Role of automation and technology in workload efficiency and patient safety
• Continuous quality improvement programs
• Evaluation of clinical trials that validate treatment usefulness
The American College of Clinical Pharmacy (ACCP) Drug Information Practice and Research Network (PRN) published an opinion paper to ensure that drug information education and practice is designed to meet the needs of the changing health care environment. This paper recommended core specific drug information concepts that should be formally taught and evaluated in all colleges of pharmacy (see Table 21–1).4 Other topic areas closely aligned with drug information practice include alternative medicine, adverse drug event (medication misadventure) surveillance, drug shortage management and mitigation, safety monitoring during clinical trials, risk evaluation mitigation strategies (REMS), and managing investigational drug services.
TABLE 21–1. ESSENTIAL DRUG INFORMATION CONCEPTS FOR PROFESSIONAL DEGREE CURRICULA3
A number of pedagogical approaches may be used to build drug information associated skills in the didactic setting. A 2012 survey conducted by the ACCP Drug Information PRN summarized the methods by which colleges of pharmacy include drug information, literature evaluation, and biostatics content into the curricula. Survey responses represented 50% of the pharmacy schools listed in the American Association of Colleges of Pharmacy (AACP) online directory. Instructional methodology used included didactic lectures, small group learning, Internet-based learning, and other formats. Survey respondents indicated using online course management programs, audience response systems, YouTube, online blogs, tweets, and wikis to teach drug information, literature evaluation, and biostatistics content.5 The availability of instructional technologies and focus on active learning components in the professional program provide many opportunities for instructors to engage learners through incorporation of practical, practice-oriented scenarios.
The majority of foundational skill development should occur prior to student participation in advanced pharmacy practice experiences (APPEs). Integration of practice-related activities in the introductory pharmacy practice experiences (IPPEs) are also important activities supported by the ACPE.2 Once a student reaches the final year in the professional curriculum, he or she can benefit greatly from a practice experience devoted to drug information practice. Having the opportunity to provide responses to drug information requests following completion of didactic coursework and complete other drug-information-related projects (e.g., medication use evaluation, formulary class review or monograph, evaluation of adverse drug events) provides students even greater opportunities to apply pharmacotherapeutic, pharmacokinetic, legal, and ethical principles to their approach to providing drug information. Drug information historically was a required learning experience for each doctor of the pharmacy student. The growth in the number of colleges of pharmacy and pharmacy student population and reductions in the number of formal drug information centers has resulted in an inadequate number of teaching sites to support a required drug information APPE for every student.6 While some colleges have developed their own formalized centers, others provide only elective drug information advanced practice experiences.1,6 
Drug information rotations may also occur in nontraditional settings (e.g., pharmaceutical industry, managed care, group purchasing organization), a reflection of the expanding role of drug information in contemporary pharmacy practice.
Activities identified by ACPE in which students should engage to foster their skill development range from responding to drug information requests to preparing materials for consideration by a pharmacy and therapeutics committee. Table 21–2 provides a comprehensive list of suggested drug information skill building activities to incorporate into APPEs.2
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