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I had never taken part in a discussion that started out being for an issue and then halfway through switched to against. But, I learned as I went and it definitely took some getting used to! In terms of formulating statements both for and against, I found myself having to make a strength for one argument or position be offset by another. It’s harder than you’d think!

Usually when formulating an argument in the past, I’ve tried to build statements around a main strength or the thing I find myself agreeing most with. I then look for supporting evidence to help strengthen the argument and throw in some persuasive verbiage for the good of the order. In participating in this discussion, my approach was flipped upside down. I had to find supportive evidence for both sides. But in doing so, I believe I am in a better place to take a stance on the matter than how I’ve approached past arguments and communicating stances. I found myself both getting confused as well as being able to attain as much knowledge on the topic as I possibly could. This is a subject matter that isn’t cut and dry. It demands more than just a 5 minute glance and a quick to judge attitude.

I would recommend this exercise for future years just because if future students come from a similar background, I believe it beneficial to expose them to a type of discussion that they haven’t seen before. Knowing the facts before forming an opinion can help for a strong argument no matter the topic. Whether it be controversial topic like medicinal marijuana or a more relaxed one like the legislation that just passed for the heightened awareness for service dogs, I think legislatures should give this method a try!

Last night I attended the NCPA Advocacy Night at the Ohio Pharmacists Association Headquarters. I had never been to the building before, but I sure did make up for lost time. I took a tour of the pharmacy museum and felt like I took a step back in time. There were drugs on display that I had never heard of as well as ones that I had, but just for their use illegally and recreationally. It was insane to think that some of the drugs that have become so notorious in today’s world were used so readily only decades ago.

The speakers for the evening included Antonio Ciaccia, Megan Marchal and Max Peebles. Through various meetings for different organizations I had heard the two former speak, however I had never heard Mr. Peebles. Antonio brought us up to speed with current legislation that he has been working so hard to lobby for to protect our profession. Megan explained to us what she does both as a specialty pharmacist working at the James as well as her role on the Ohio State Board of Pharmacy. Max informed us of the changes he has seen working at an independent pharmacy over the past thirty years. His opening statement was, “Techs today perform the same duties pharmacists could only perform when I started out in 1983.” That statement alone echoed the importance of lobbyists like Antonio and Board members like Megan. We need to advocate for our profession in order to protect autonomy in the workplace as well as to provide excellent patient care.

The article I chose to discuss can be found in the American Journal of Health-System Pharmacy and is titled Evolution of ambulatory care pharmacy practice in the past 50 years.

The article outlines the progression of the ambulatory care facet of pharmacy and the impact that it has made in patient care along the way. It starts off discussing the addition of oral consultation stating it to be “the genesis of a professional obligation to contribute to the education of patients about their medication.” Interestingly enough, it was less than about 20 years earlier that same service was deemed prohibited to the profession, as only physicians were seen fit to counsel. The Omnibus Budget Reconciliation Act is a perfect example of advocacy for our profession; it mandates the act of pharmacists having to offer patients the opportunity to discuss new prescriptions.

Other examples of advocacy outlined in the article include the Asheville project, the expansion of pharmacists’ scope of practice in administering vaccines and MTM practices. The city of Asheville, NC, was among the first to allow ambulatory care pharmacists to provide patients with diabetes an alternative way to manage their chronic condition and has continued to expand their services in their present-day clinics. The state of Washington was the first to approve the expansion for pharmacists to administer vaccines and in doing so led the way to helping improve public health. The Medicare Modernization Act defined the service of medication therapy management and provided means for its reimbursement.

There is one tiny paragraph among a 4 page spread that pertains to the provider status movement. It defines provider status as “formal recognition of pharmacists as direct care providers in government-funded healthcare programs.” Using the terms “gathering at the grassroots level” in describing its status among three states out west. Up until this point in the article, I thought the information presented to be pertinent and thorough. However, I wish the authors could have expanded more on the on-going efforts in the provider status movement. After reading the paragraph, it seemed as though only the western United States was advancing the profession. It would’ve been to my liking to see something about how I could help get the ball rolling in my state about provider status. As a student pharmacist this issue impacts me directly; I would be remiss if I didn’t take advantage of an opportunity to mold the future of my profession.

I have learned that there are many differences between the United States and Taiwan when it comes to smoking. I learned that Ohio is one of the states in the US with the highest percentage of smokers. I’ve also learned that E-Cigs are just as harmful as regular cigarettes, but have their own set of hazards. In Taiwan, E-Cigs are illegal and they really only have cigarettes and Betel Quid as forms of tobacco. Their government will reimburse pharmacists for their work in counseling patients towards smoking cessation, albeit only about a pack of cigarettes worth (about $2 US). In many ways, it seems Taiwan is being more progressive towards the act of smoking cessation than here in the US. This course has exposed me to solutions to combat one of the deadliest addictions not only Americans, but people from all parts of the world face today. I feel more qualified to counsel patients on different types of smoking cessation aids as well as am better able to empathize with a more diverse patient demographic.

While practicing for my portion of the presentation, I wanted to make it a goal to be able to have the information I was trying to relay be easily understood and clearly audible. I made it a point to slow my words and speak more clearly than I usually do during presentations. I have the tendency to speak fast in front of large group of people out of nervousness, but I wanted to make sure that this presentation was the exception. I was nervous to speak in front of the Taiwanese students, but after seeing their silly dramas, they put me at ease. I loved all of their jokes and props, they really went all out for us! The skills I’ve acquired from this course will help me in my future endeavors as a  pharmacist in presentations and conferences, relating to different cultures as well as learning from other cultures to implement different approaches to the same addiction or disease.

I just completed our first online meeting with students from TMU and CMU. All of the students were so pleasant to talk to and asked us pertinent questions regarding our program. I learned that pharmacy student overseas have many more professors than we do, 38 to be exact! I also learned that their programs place more of an emphasis on Traditional Chinese Medicine/herbals as well as introduces the form of therapy earlier on in their curriculum. The students also seemed surprised that we didn’t spend more time in research courses or in the lab. We explained to them that our professional practice lab consisted more of us learning how to make different forms of pharmaceutical preparations as opposed to researching new forms of therapies. I enjoyed speaking with each and every one of the students from TMU and CMU and am looking forward to doing so again in the near future!

Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319467/

The article titled, “Pharmaceutical care in smoking cessation” tried to “assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking.” It took in place Murcia, Spain over a time span of 4 months and included patients that came to the pharmacy asking for help to quit. Patients enrolled in the smoking cessation program received both psychological and pharmacological treatment; the former being “providing advice to patients to help them get ready to give up smoking, stay motivated, and avoid relapse” and the latter being a form of nicotine replacement therapy. Their major finding included a 10-20% increase in abstinence rates than with other primary care clinics. This study helped advocate for the profession of pharmacy to be implemented in smoking cessation programs. The bottom line is, patients are more likely to quit!

Discussion Questions:

1) Why do you think a pharmacist can have more of an impact on patients when trying to quit smoking as opposed to other health care providers?

2) Do you think the implementation of the dual therapy (using psychological and pharmacological forms of treatment) is good for every patient? As a future pharmacist, how would you determine what therapies to use on your individual patients?

Summaries

1. A cancer research center has created what they believe to be the first app for a smart phone scientifically proven to help smokers quit. It is predicted that “SmartQuit” will be a supplemental therapy to help assist in cessation programs. The idea behind the app was to create an autonomous way for smokers ready to quit to take their health into their own hands.

2. The media plays a huge role in what society perceives to be “in” or “out.” This article compares some of the various techniques used by antismoking campaigns throughout the years to get their messages across to the public. They’ve appealed to the younger generations in wanting to fit in, they’ve appealed to those that feel a responsibility to protect the Earth, and they’ve even appealed to those that smoking adds used to target, just with their own twist.

Discussion Questions

1. How effective do you think using an app like “SmartQuit” would be in helping smokers to quit? Do you think it could take the place of a seeing tobacco treatment specialist?

2. What do you think have been the most effective forms of antismoking campaigns? For example, do you think campaigns that show the effects of long-term use of tobacco overpower ones that impart guilt towards their users?

1) http://mynorthwest.com/11/2509848/Fred-Hutch-going-into-tech-business-with-SmartQuit-smoking-cessation-app

2) https://www.nlm.nih.gov/exhibition/visualculture/nonsmoker.html