Academic Pharmacy
The News Magazine of the American Association of Colleges of Pharmacy
For the Record
A comprehensive oral history initiative highlighting the careers of pharmacist leaders in the U.S. Public Health Service underscores their valuable contributions to the profession. 14
Also in this issue: Meet the Newest NAM Pharmacy Fellow 10 Timely Takeaways from Boston 24
The News Magazine of the American Association of Colleges of Pharmacy
Academic Pharmacy NOW
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Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.
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Editorial Advisor
Managing Editor Jane E. Rooney
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Freelance Writer Joseph Cantlupe
Freelance Writer Athena Ponushis
Freelance Writer
Emily Jacobs
Maureen Thielemans
Tricia Gordon
Lynette R. Bradley-Baker
campus connection
Facilitating an Inclusive Mindset
A student-led diversity event at the University of Wisconsin-Madison School of Pharmacy focused on the need for compassionate, equitable patient care.
community impact
On a Mission
As the 2024 NAM Pharmacy Fellow, Dr. Jennifer Bacci relishes the opportunity to tout the benefits that community pharmacies offer.
For the Record
A comprehensive oral history initiative highlighting the careers of pharmacist leaders in the U.S. Public Health Service underscores their valuable contributions to the profession.
Forward Thinking
A productive Annual Meeting in Boston featured a wide range of programming, including discussions about climate change and readying the clinical research workforce.
Dear Colleagues:
It’s hard to believe we’re nearing the end of another year but as 2024 draws to a close, we have the opportunity to pause and reflect on the challenges we’ve faced and the triumphs we’ve celebrated. This past year was filled with high-impact member programming, including Institutes, the Interim and Annual Meeting, a robust webinar portfolio, the launch of AACP Learn (our new AACP learning management system) and much more. AACP members and staff have been working hard to transform pharmacy education and practice through research, teaching and service, and this year’s final issue of Academic Pharmacy Now highlights more of this amazing work.
In the feature story, For the Record, key stakeholders led a major undertaking to bring greater attention to the vital work of Public Health Service pharmacists. Spearheaded by retired Chief Pharmacist Officers Dr. Richard Bertin and Dr. Richard Church, as well as the legendary pharmacy leader, Bill Zellmer, this comprehensive oral history initiative features interviews with past CPOs recalling the various public health challenges they faced.
Another AACP member contributing in important ways is Dr. Jennifer Bacci, the 2024 National Academy of Medicine Pharmacy Fellow. In our profile piece On a Mission, you can learn more about her passion for community pharmacies and what she hopes to achieve during the two-year fellowship. Her dedication to growing patient care in communities shines through; she will be a true asset to the National Academies and our profession.
We also look back at some of the outstanding programming featured during Pharmacy Education 2024 in Boston. Two particularly timely sessions addressed topics that must be front of mind as pharmacy moves forward: climate change and drug development. The speakers at the climate change session made persuasive arguments about why we need to train students to consider environmental impacts and why the topic should be part of the pharmacy school curriculum. In a session focused on preparing the clinical research and drug development workforce, speakers made the case for updating standards to better prepare pharmacists to generate drug discovery knowledge--work that is underway at AACP.
I’m hopeful that 2025 will bring AACP and the profession even more opportunities to make a difference in patient care. Best wishes for the December holidays and a fantastic New Year.
Sincerely,
Lee Vermeulen, B.S.Pharm., M.S., FCCP, FFIP CEO and Publisher
Facilitating an Inclusive Mindset
A
student-led diversity event at the University of WisconsinMadison School of Pharmacy focused on the need for compassionate, equitable patient care.
By Emily Jacobs
Many different factors can influence a person’s health outcomes. Some are obvious, such as diet and genetics, while others are less apparent, such as housing status and language barriers. Healthcare providers, including pharmacists, can help improve patient outcomes with a better understanding of those unique, underlying influences on healthcare.
This was the central idea behind the DiveRxsity Dialogues event, created and organized by students at the University of Wisconsin–Madison School of Pharmacy. With funding through a grant from Phi Lambda Sigma (PLS), this event brought together students, faculty and staff to discuss topics involving health disparities and inclusive care. Dr. Sally Arif, professor of pharmacy practice at Midwestern University, delivered the keynote address for DiveRxsity Dialogues, speaking on the value of inclusion in pharmacy and navigating concerns such as implicit bias. Other topics covered during the event included housing instability, gender-affirming care and how racism impacts healthcare.
Greater Awareness
Many student pharmacists will go on to serve diverse patient populations with needs that go far beyond receiving medication. When pharmacists understand different influences on patients’ lives and health outcomes, it can help build trust between patients and providers and lead to
greater medication adherence. By bringing attention to this in pharmacy school, pharmacists will be better prepared to serve their unique patient populations in their new careers.
“Pharmacists really need to be attuned to the varied experiences of their patients’ lives, and that allows for these more equitable outcomes for our patients, those that might have different experiences that might not be so straightforward,” said Lisa Imhoff, associate dean for Diversity, Equity and Inclusion at UW-Madison’s School of Pharmacy. The School of Pharmacy’s strategic plan emphasizes preparing students to serve marginalized and vulnerable populations. This led faculty members to include more concepts and patient case scenarios focused on diversity in the curriculum. For example, a “Professional Development and Engagement” course touches on discrimination and other inclusivity issues through professional insights.
However, students wanted to take the subject of inclusion and diversity further, seeking more opportunities for small groups to discuss these issues in greater detail. Thus, DiveRxsity Dialogues was conceived and launched entirely by UW-Madison student pharmacists. PLS student leaders Mara Gosch and Amy Bowles partnered with two other student organizations: Promoting Recognition of Identity, Dignity and Equality (PRIDE) in Healthcare and the Student National Pharmaceutical Association (SNPhA). This level of collabora-
tion and the effort to include other student organizations demonstrated that the student organizers took the issue seriously, noted Imhoff.
“As an international student, I’ve observed that discrimination still exists among students, and unfortunately, it’s a widespread issue,” said third-year Pharm.D. student Yoonsoo Kim, SNPhA co-president and one of the event organizers. “Inspired by healthcare professionals who respect and listen to all patients, we felt it was crucial to address one of our topics, ‘Structural Racism in Healthcare,’ to encourage students’ better attitudes and behaviors.”
Student organizers and faculty are working to make DiveRxsity Dialogues an annual event, allowing each student to share ideas and learn from diverse healthcare providers. “As university students pursuing pharmacy degrees, our primary focus naturally revolves around understanding various medications and their applications,” Kim said. “However, the role of pharmacists extends far beyond dispensing prescriptions, and they are integral members of healthcare
teams responsible for providing patient consultation and care. Therefore, understanding diverse patient backgrounds becomes paramount for the future.”
Imhoff is working with student organizers and other faculty to consider how to sustain the DiveRxsity Dialogues event over time. Part of the plan, she noted, is for the School of Pharmacy to offer an inclusive healthcare track, in which the different student organizations that participate in DiveRxsity Dialogues will hold individual events during a semester. Students who attend these events and complete relevant assignments could get credit toward that inclusive healthcare track.
“I think our students are hungry for more because they are seeing that there’s this need,” Imhoff said. “So the fact that they stepped up to fill the need, I was very impressed and excited that we have this next generation that I think is going to make a significant impact on the field of pharmacy.” P Emily Jacobs is a freelance writer based in Toledo, Ohio.
Third-year Pharm.D. student Yoonsoo Kim was one of the student pharmacists who conceived and launched the event.
Photo credit: Todd Brown, University of Wisconsin-Madison
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On a Mission
As the 2024 NAM Pharmacy Fellow, Dr. Jennifer Bacci relishes the opportunity to tout the benefits that community pharmacies offer.
By Joseph A. Cantlupe
There are not many aspects of pharmacy in healthcare that Dr. Jennifer Bacci, endowed associate professor in innovative pharmacy practice at the University of Washington School of Pharmacy, has not studied, written about or lectured on, a testament to her varied interests as an academic. After working in community pharmacy, Bacci said she turned to academia with the “goal of working across partners to accelerate community pharmacy transformation.” She has examined everything from closing gaps in care, targeting medication adherence, ensuring vaccinations, evaluating opioid use, and treating diabetes and epilepsy. “All of that is with the focus on being responsive to the needs of community pharmacy practice and patients. I always have been driven by what I’m hearing from those frontline practitioners about the things that are impacting their day-to-day practice and keeping them from being able to provide the care to patients that they want to provide.”
That community pharmacy perspective deeply touches her teaching, and that thrust is expected to be a strong part of her work after being named one of seven outstanding health professionals for the class of 2024 National Academy of Medicine (NAM) Fellowship. The fellows are chosen based on their professional qualifications, reputations and accomplishments, as well as the relevance of their current field expertise to NAM’s work.
Bacci is thrilled by the recognition and the prospect of working with NAM. “I think it takes a little while to sink in—it’s a great honor. There are many incredible professionals in pharmacy who are deserving of this.” She decided to apply for the fellowship “because it is merging what is happening in community pharmacy and my own professional growth. I’ve been really focused on how we grow patient care and community pharmacies. This fellowship is that opportunity to really focus on the policy piece for me but also to raise awareness within health policy circles about community pharmacy and what’s happening.”
Bacci and the other scholars will continue their primary academic or research posts while engaging with the National Academies health and science policy work over a two-year period. They will also work with an expert study committee or roundtable related to their professional interests, including contributing to reports or other products. A flexible research grant will be awarded to every fellow.
Opening Doors
“We always talk about the community pharmacies as the front door to the profession,” Bacci said. “There’s a wide spectrum of what it means to be a community pharmacy; not every community pharmacy looks the same. There’s a lot more that we can do [at a community pharmacy] than say, ‘here are your medications, I’ll see you next month.’”
Patients go in and out of pharmacies without appointments, asking pharmacists about medications and illnesses. Surely, pharmacies are intimately involved with the public, but they face myriad issues around staffing, medication shortages and safety concerns. They are also the focus of much debate regarding pharmacist payments, which have been stagnant or decreasing. In addition, workplace conditions and stress are taking a toll on efforts to recruit new hires, according to academic studies. Those issues are impacting the ability to train and retain pharmacy employees.
But the demand for pharmacies continues to rise, leading to new opportunities, particularly for recent graduates. Through it all, “community pharmacy is at a very important point in terms of what the future looks like,” Bacci emphasized. “I’m really focused on how we grow patient care in communities, how policy frames what we can do in the community and raising awareness within health policy circles about community pharmacy. We’re not trying to replace physicians, but we have different and complementary skills so when we work together with physicians and other healthcare professionals, that’s when we can provide the best care possible. Our unique knowledge and skills are important to
“Our
unique knowledge
and skills are important to patients, and we need to preserve existing pathways and generate new ones to have pharmacists on the team as an expert in medications.”
—Dr.
Jennifer
Bacci
patients, and we need to preserve existing pathways and generate new ones to have pharmacists on the team as an expert in medications.”
She pointed out that the issue is not just that community pharmacies are closing but that we are seeing consolidation across healthcare. “The community pharmacy is the last remaining healthcare facility in many rural and even urban centers,” she pointed out. Of course, the issues go beyond patient care, particularly related to pay. “Payment drives so much—we can’t have payment without changing how we practice but we can’t change how we practice without payment, so they really go hand in hand.”
As a fellow, Bacci will dedicate about 10 to 20 percent of her time to work related to the fellowship. “The National Academy of Medicine is a group of incredible scholars who come together to make recommendations and consensus statements that are important for policymakers and other governing bodies. It’s exciting to see the process of how we synthesize evidence and make impactful recommendations,” Bacci said. “There’s not a checklist of things that I need to accomplish, but the main goal is to embed into one or two projects that the National Academies are working on and grow my skillset in health policy and networking.”
A Champion for Community-Based Care
Bacci attended the University of Pittsburgh School of Pharmacy and completed her Pharm.D. in 2011, followed by a PGY community-based pharmacy residency with the University of Pittsburgh and Rite Aid. After working full time in community practice, she returned to Pitt Pharmacy to complete a Postgraduate Fellowship in Community Pharmacy Research and obtain her MPH.
“I think what started my trajectory toward becoming a pharmacist was being diagnosed with asthma really young. I grew up in a time where there were significant advancements in the treatments for asthma, so I saw how it impacted my own life,” she noted. “So, when it was time to pick a career, I was
really interested in healthcare, and becoming a pharmacist seemed to make a lot of sense.”
As a faculty member at the University of Washington School of Pharmacy for the past nine years, she has focused her research on evaluating innovative patient care models in community pharmacy practices, including childhood and adult vaccinations, point of care testing, chronic disease management, pharmacist prescribing, medical billing, monitoring drug interactions and medication adherence. Bacci has cultivated partnerships with community pharmacy leaders in Washington State and collaborates on various practice models to address needs and challenges faced by practitioners and patients to amplify the positive impact of communitybased pharmacy teams.
Bacci teaches first-year student pharmacists, including a course series called Foundations of Being a Pharmacist. In addition, she covers patient care process, introductory therapeutic materials and professional identity and leadership. She attempts to help students understand the intricacies and mindset of the profession. Bacci calls it the “intentional work of understanding as an individual how your personal identity now merges with this new professional identity as you become a pharmacist and find joy and align your value and strengths in your work.” In advancing pharmacy education, she reminds students to be aware of the population they will be serving and helps them feel confident about the path they have chosen.
“How we engage patients is one of the most important things we do to make sure people use medications effectively,” Bacci said. “I know that there are a lot of emerging roles that we would like to see pharmacists pursue, so we have to think about how to make sure we’re preparing our graduates for that. Pharmacy practice looks different in every state, and we want to make sure that every graduate is prepared for the highest level of practice.” P
Joseph A. Cantlupe is a freelance writer based in Washington, D.C.
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For the Record
A comprehensive oral history initiative highlighting the careers of pharmacist leaders in the U.S. Public Health Service underscores their valuable contributions to the profession.
By Jane E. Rooney
Their mission: to protect, promote, and advance the health and safety of the nation. They are the commissioned officers of the United States Public Health Service, serving in agencies across the government and representing 11 professional categories—including pharmacists. The Chief Pharmacist Officer (CPO) provides leadership and coordination to pharmacists serving as PHS officers and facilitates professional and community relationships. These pharmacists serve a crucial role in the public health sphere, but they often fly under the radar due to a lack of awareness about their involvement with the Public Health Service.
community impact
In recent years, conversations among several current and retired PHS pharmacy leaders revealed a desire to spotlight those who had served as CPO to bring greater attention to the vital work of Public Health Service pharmacists. These leaders also regretted missing the opportunity to preserve the recollections of former CPOs who had passed away. In response, Dr. Richard Bertin and Dr. Richard Church, both retired CPOs with the PHS, committed to finding a way to conduct oral history interviews with past CPOs. They reached out to William A. Zellmer, president of Pharmacy Foresight Consulting and a pharmacist who served in the PHS and who has experience conducting oral history interviews with pharmacy leaders. The result is an oral history project featuring extensive interviews with eight individuals who each served a four-year term as CPO between 1987 and 2022. Transcripts of the interviews are accessible through the American Institute of the History of Pharmacy’s website (https://aihp.org/collections/u-s-public-health-service-commissioned-corps-oral-history-project).
The interviews reveal that each individual faced different public health challenges during his or her term and brought unique perspectives to the job. Zellmer noted that these oral histories provide a comprehensive record of individuals’ contributions to the field and take a deep dive into all aspects of their careers. In a conversation with Academic Pharmacy Now, Bertin, Church and Zellmer discussed the project’s evolution and how the transcripts can be used by pharmacy educators to shed light on pharmacy history, leadership development and the possible career avenues in the PHS that future practitioners can explore.
What did you learn about the individuals who served as Chief Pharmacist Officer?
Did you see any common threads as you conducted these interviews?
Church: There were some commonalities and there were some dramatic differences. Our backgrounds were quite different but our training is similar—we have common professional roots in pharmacy. Our focus in these interviews is on the mission of the PHS and the various ways people served in different agencies. There was a willingness on everyone’s part to serve where needed. As time goes on there have been a variety of public health issues we’ve faced, and each was willing to address those as needed. There’s a lot of learning and sharing through our careers. In the later stages of our careers when there was a need to assume other leadership positions, every person was ready to do so. But no two CPO terms were the same.
Bertin: Many of us were in different programs of the PHS and had unique missions and responsibilities. We all had a ‘real job’ as well as serving as CPO, so those responsibilities gave us unique settings in which to develop our careers and figure out how we were going to contribute in the future. When a person looks at these oral histories, they see the wide variety of careers that were represented.
“You can find many examples in these interviews of pharmacists with various leadership qualities who built on their pharmacy education to meet major leadership challenges in pharmacy practice and public health.”
—William Zellmer
Zellmer: There’s a great deal of interest in pharmacy education in helping student pharmacists understand the broad array of career opportunities in our profession. There are many wonderful opportunities in the PHS commissioned corps, as these interviews document. There’s also a lot of interest in the academic community in developing leadership skills in student pharmacists. You can find many examples in these interviews of pharmacists with various leadership qualities who built on their pharmacy education to meet major leadership challenges in pharmacy practice and public health.
In what ways do you see this project being useful to pharmacy educators, and how might it be used in a classroom setting?
Church: We have colleagues who have spent portions of their careers in the PHS prior to taking on some form of academic or leadership experience later on. They have additional stories to share of their experiences and how the PHS helped in their careers as they now mentor students. The combination of stories from each of the past CPOs illustrated examples of the challenges that we’ve taken on over time and how they are related to pharmacy practice and the issues of the day.
Zellmer: This series of interviews can be valuable in helping pharmacy students understand important
chapters in the profession’s history. For example, pharmacy used to be primarily a male profession, which sometimes made things difficult for women in the field. In the interview with former CPO Pamela Schweitzer, she talked candidly about the barriers she faced in advancing her career. For student pharmacists today who are thinking about non-traditional careers, working for the Food and Drug Administration might come to mind. If you look at Dick Bertin’s interview transcript, you’ll find that he spoke about the leadership role he had at the FDA—a great example for someone who is considering a career in a government agency. Another example: In Dick Church’s interview, he spoke about patient-counseling innovations in the 1960s by pharmacists in the Indian Health Service (IHS) and how that influenced the profession as a whole. During his career, Dick brought to the attention of the broader pharmacy community that the IHS had pioneered patient-counseling teaching techniques; those methods were then applied in helping the profession prepare for an expanded role in this area.
More About the Mission
Interested in a more detailed look at the Public Health Service Commissioned Corps? The PBS documentary “Invisible Corps” ( https://www.pbs.org/video/invisible-corps-5czrsw/ ), which aired in May 2023, covers the history of the PHS and explores how public health has evolved. The program features two CPOs who were interviewed as part of the oral history project.
“A significant number of pharmacists started in the PHS. They got some good early practice experience and went on for more post-graduate education and many ended up as faculty members or deans. Those individuals are valuable as sources of information to students.”
—Dr. Richard Bertin
Do you think there is enough awareness about the PHS as a possible career path? How could it be better publicized?
Bertin: I think there’s never enough information out there for students about the PHS. We’re always interested in having excellent students, excellent pharmacists consider joining the PHS to deliver direct care in the IHS or the Bureau of Prisons or in a more administrative capacity (with agencies such as the FDA, CDC or NIH). We are always looking for ways to get that information out there. Officers used to be assigned to visit one of the pharmacy schools and talk to the dean or make some presentations to classes, but as far as we’re concerned there can always be more information. That’s one reason we are happy to call attention to it as a great career option through this article.
Church: I agree, there can never be enough information available. I’ve spent a great deal of time over my career visiting schools and organizations and the story was always new to the students since they turn over with each graduating class. There are still many people actively visiting schools but there are more schools today and there’s always a need for more personal contact. Whenever a PHS pharmacist comes from one of several agencies, they bring unique career experiences that always lead to great discussions. There are so many unique stories. They are able to share behind-
the-scenes experiences…for instance, with COVID and some of the work with vaccines or efforts leading to a role for pharmacists prescribing follow-up medications. Another example is in the area of achieving reimbursement for professional services where PHS pharmacists have played key roles. Other PHS pharmacists have had significant involvement in international activities like dealing with Ebola in Africa. There are many stories to be shared through these oral histories.
Zellmer: In thinking about this article, I was reminded about how I first learned about the PHS as a student—it was through the written word. In a reference book— Remington’s—that all pharmacy students used, there was a section dealing with careers, which included an article about the PHS. That stimulated me to apply, and I was accepted. There is great power in the written word.
Bertin: A significant number of pharmacists started in the PHS. They got some good early practice experience and went on for more post-graduate education and many ended up as faculty members or deans. Those individuals are valuable as sources of information to students. I didn’t really know much about the PHS until I was doing graduate work and learned about it from an advisor who served in the PHS in Alaska. He’s the guy who recruited me.
“They are able to share behind-the-scenes experiences… for instance, with COVID and some of the work with vaccines or efforts leading to a role for pharmacists prescribing follow-up medications. Another example is in the area of achieving reimbursement for professional services where PHS pharmacists have played key roles. Other PHS pharmacists have had significant involvement in international activities like dealing with Ebola in Africa.”
—Dr. Richard Church
How can pharmacy educators use the insights shared in these interviews to better prepare future pharmacists for practice?
Church: There are many pharmacists across the country in academic institutions who have spent some time in the PHS. They can leverage their own experience through these oral histories to share what pharmacists are capable of doing. Their challenge is to prepare graduates with a broad range of skills and experiences while in training so they are ready to tackle new challenges. Through this series of oral histories there are examples of how this group started with a substantially similar underlying core of pharmacy training, then added their own specialized skills along with a strong focus on the mission of healthcare delivery and service to make noteworthy contributions. The resources and tools available in pharmacy education today are so much more sophisticated than when we were in our training. Pharmacy educators are challenged to inspire student pharmacists to apply their own personal sense of mission in the direction of service to others.
When I was being interviewed, I tried hard to recall what was going on within our profession and the world at the time and to capture what I was thinking at the time. Each person we talked to had experiences they recalled that made them realize the significance of certain events to pharmacy practice. Perhaps our stories can serve as examples of how our careers started from similar training but took us in some remarkably different directions.
Bertin: Everyone who participated agreed that although these interviews were a lot of work—we had to dig deep in our memories—at the end we all really appreciated the opportunity to go through this process and research and relive many of the very important aspects of our personal and professional lives. It was a valuable experience.
Zellmer: Pharmacy history is severely undervalued today in pharmacy education and by most pharmacists. This collection of interviews can provide great lessons in how the PHS helped advance pharmacy practice. By pointing people to these interview transcriptions, we can help elevate appreciation for pharmacy history and stimulate discussions about how to draw lessons from that history that can be applied to contemporary challenges and opportunities. P
Jane E. Rooney is managing editor of Academic Pharmacy Now.
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Forward Thinking
A productive Annual Meeting in Boston featured a wide range of programming, including discussions about
climate
change and readying the clinical research workforce.
By Athena Ponushis
Pharmacy Education 2024, AACP’s Annual Meeting held in Boston this year, gave faculty, staff, administrators and practitioners a chance to take note of where they are, where they are going, and consider what principles from their past might help them achieve future aspirations. The programming aimed to educate and inspire attendees. This spotlight summarizes two sessions that addressed particularly timely topics: climate change and drug development. Speakers shared examples from their own institutions and underscored the urgency of devoting attention to these topics that will affect how pharmacists practice and offer patient care. Read on for the main takeaways from these session speakers.
Climate Crusaders
It is widely accepted that climate change poses a threat to public health. Recently the pharmacy community has started to examine its role in addressing the problem. A 2019 study looking at the global carbon footprint of pharmacy found greenhouse gas emissions from the pharmaceutical industry were 55 percent higher than that of the automotive industry in 2015. A study by the Healthcare Plastics Recycling Council in 2020 found healthcare facilities in the United States accumulate approximately 14,000 tons of waste daily, with roughly 20 percent of that being plastic. And another study found that Americans filled 5.8 billion prescriptions in 2018, introducing active pharmaceutical ingredients into the environment.
Pharmacists are well positioned to influence what medications go into patients’ bodies, but the time has come for sustainability and environmental consideration to be just as much of an educational and professional practice requirement. The role that student pharmacists will play in addressing the climate crisis is twofold: Pharmacists must be prepared to treat the public health impacts of climate change, but also, to consider and curb the way pharmacy
contributes to global warming. In education and practice, pharmacy needs to go green.
Dr. Katherine Gruenberg, associate professor of clinical pharmacy at the University of California San Francisco School of Pharmacy, sees the absence of climate content in the required curriculum as a risk to the profession. “If we are not addressing this, we are going to be behind,” she said. “Over half of medical schools are already addressing this. Students are asking for it, it’s in the lay media all the time. Nursing is advocating for it, as well. If we are the only profession that decides this isn’t important, we are going to be at a complete loss when it comes to being at the forefront of helping make decisions to address this issue.”
At the Annual Meeting, Gruenberg and Dr. Hayley Blackburn, associate professor of pharmacy practice at the University of Montana Skaggs School of Pharmacy, aimed to elevate the conversation through their session, “Time for Change: A Discussion on Climate Change Education in Pharmacy Curricula.” They shared their experiences to build momentum and compel more schools to train pharmacists to combat the climate crisis.
At the UCSF School of Pharmacy, faculty have woven climate content throughout their required curriculum. While learning about respiratory diseases in their first year, students find out how climate impacts air quality and how that may intensify respiratory conditions. They also learn how medications can inflame the issue further—for instance, how certain inhalers emit greenhouse gases when used. “Students see the two-way street: how climate impacts health, but also how the medications we choose (in this case, inhalers) can exacerbate the problem,” Gruenberg said.
Through interactive classroom discussions, students talk about what factors they may consider or what questions
they might ask patients to recommend more environmentally friendly prescriptions. Instructors hope to train students to think about environmental impacts as much as they would price or patient preference when suggesting a medication. “Our goal is that this train of thought would be included in the decision-making process,” Gruenberg said.
In their second year, UCSF pharmacy students explore how climate impacts mental health. They read scoping reviews, participate in facilitatorguided discussions and work through two patient vignettes, one global and one local case, to apply the knowledge they gained through the literature. They examine policies and alternate ways they could support patients, moving from knowledge to solution-based applications. To those who point to curricular overload or are skeptical about how relevant climate change is to the profession, Blackburn pointed out, “This is not as heavy of a lift as it may seem. We do not need to develop an entirely separate climate module or treat this as an additional, stand-alone topic in the curriculum. I would say that’s a disservice to these topics because then it’s perceived as separate from our day-to-day roles in pharmacy practice. It should be regularly integrated into our discussions of patient care and management of medications.”
At the UM Skaggs School of Pharmacy, Blackburn started to incorporate climate content into the curriculum by broadening a fourth-year elective on global health to include planetary health, where students work with a clinic in Indonesia to address health outcomes in the community. She realized that she needed to work backward, inter-
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“Patients want to know how a drug is going to work when they are on six other medications and only the pharmacist, the medication specialist on the team, is going to be able to explain how these other medications may affect their potential outcomes. Pharmacists are the sole clinicians who are trained to do that.”
—Dr. Jonathan Watanabe
twining climate content across the curriculum, so students would understand environmental determinants of health to prepare them for this global partnership.
In the fall of their third year, students attend lectures on climate and public health. They work on projects surrounding climate resilience. Students are given scenarios specific to the Missoula community, where the greatest climate challenges are extreme heat and wildfire smoke. “I give them a scenario where their group needs to come up with a way pharmacists could address this as a public health issue,” Blackburn said. “It’s a sneaky way to get students more engaged and do a really deep dive into the topic, and then have those students educate their classmates more about the issue in a local context.”
In the spring, students look at the environmental impacts of healthcare as an ethical and environmental justice issue in Blackburn’s pharmacy ethics course. “We talk about things like healthcare’s carbon footprint and pharmaceutical pollution in India as a byproduct of generic manufacturing and regulatory policies in our global supply chain, then talk about climate change as a health equity issue,” she said.
Blackburn also precepts a population health elective rotation, where her work with the local health department and a climate change nonprofit—aimed at getting pharmacists more involved in community climate resilience efforts—gives students an opportunity to do research and community outreach. “It’s so easy to give them a ton of information about the climate crisis and really leave them in a negative place. It feels so important to give them some optimism and avenues for action once you give them that information,” she noted. “So, I’ve put a lot of my energy into developing different pathways for them to get involved.”
When presented with climate lessons, students are engaged. “The reason we were able to incorporate this in our required curricula was largely due to students voicing concern about this topic and wanting to incorporate it,” said Gruenberg. Student groups on campus also try to tackle
climate issues through community engagement. “When we look at the current generation of young people, we see that personal values and working to make a difference in the world are some of their most important factors in choosing a career, and climate is forefront in their minds,” Blackburn added. Integrating the subject gives schools an opportunity to present pharmacists as agents of change, attracting motivated young people who may not have previously seen the connections between pharmacy and the environment. Pharmacy must embrace this as an opportunity and a priority.
Getting Comfortable in Clinical Roles
The current landscape of pharmacy school programs for soon-to-be drug development researchers includes a vast array of offerings. There’s no requirement for the curriculum to be standardized, and according to Dr. Jonathan Watanabe, professor of clinical pharmacy and associate dean, University of California Irvine School of Pharmacy & Pharmaceutical Sciences, that’s not necessarily a bad thing. Diversity leads to drug discovery paradigms. However, he does support an emerging push for training to be more consistent. “There’s this notion that we probably need to be more systematic and more intentional about the training and instruction we deliver for the clinical research workforce, because so many more pharmacists are being pulled in that direction,” Watanabe said.
Pharmacists fresh out of pharmacy school are going straight into clinical research. Some pharmacies have become clinical trial sites. As pharmacists become more clinically focused, pharmacy schools need to make sure they are more comfortable—with clinical research, with ensuring inclusive patient populations and with being on
“We do not need to develop an entirely separate climate module or treat this as an additional, stand-alone topic in the curriculum. I would say that’s a disservice to these topics because then it’s perceived as separate from our day-to-day roles in pharmacy practice. It should be regularly integrated into our discussions of patient care and management of medications.”
—Dr. Hayley Blackburn
a research team. That was one key message he emphasized in the panel presentation, “Preparing the Clinical Research and Drug Development Workforce,” moderated by Dr. Dorothy Farrell, senior director of science policy at AACP, and featuring panelists Dr. James Polli from the University of Maryland and AACP’s Miranda Steinkopf.
Watanabe has a vision that when investigators have certain clinical questions such as inquiries over medication-related outcomes, the first place they will look will be pharmacy research. Pharmacists will take the lead in generating such scholarly content and other health professionals will rely on pharmacists’ expertise. “That’s how I see it…researchers saying to themselves, ‘I’m going to turn to the pharmacy literature on this patient outcome,’ or asking, ‘Who is the clinical pharmacist who’s going to be involved in this project?’ That is really what I would like to see develop,” he said.
Watanabe believes there is a yearning for pharmacy schools to deliver more original research, to generate the drug discovery knowledge that others are seeking. “Patients want to know how a drug is going to work when they are on six other medications and only the pharmacist, the medication specialist on the team, is going to be able to explain how these other medications may affect their potential outcomes,” he pointed out. “Pharmacists are the sole clinicians who are trained to do that.”
The changes he would like to see are already underway. AACP is making efforts to better standardize, measure and forecast the clinical research workforce, to better prepare pharmacists to fulfill the roles that await them. Watanabe does not see updating standards as a loss to innovative programming, but as a map, guiding schools to deliver more translational science to improve precision health and precision medicine. This will help develop programs that will allow pharmacists to harness this information to improve patient care.
As the scope of practice expands, pharmacists must be more comfortable being involved in clinical research, understanding how to interpret the
research and whether a study was well designed. It’s also key to ensure inclusive representation of the patient populations they treat. “Minorities, people with varied gender identities need to be recognized. We also have 11,400 older adults who turn 65 every day, so we have a rapidly aging population, oftentimes on multiple medications, who are not included in studies,” he said.
Clinical researchers must study the actual patients for whom medications are intended to understand how well the medications work. “Sadly, the studies we are using are not often reflective of the populations that are impacted by those decisions,” Watanabe noted. “That’s just not good science. So, how do we make our research better? How do we make it a more inclusive study sample? We make it a more inclusive workforce. If I make a workforce that looks more like the patients that I want to be included, that is what I would achieve. And it just happens that it’s better from an equitable standpoint and from a social justice standpoint.”
Selection of the research site also proves to be a crucial part of reaching populations that need representation. Researchers must remember the adage, “meet people where they are.” Underrepresented and excluded populations are not at academic centers, they are at pharmacies. Pharmacists and clinical researchers working at community health centers are the health professionals they trust. Pharmacists have an obligation to elevate care, and more than ever, they are able to do so by elevating research. P
July 20–23
Athena Ponushis is a freelance writer based in Ft. Lauderdale, Florida.
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