rxpharmacist

Helping to Find Focus and Clarity in a Cloud of Uncertainty

Being a part of RxPharmacist has been rewarding in many ways. Thanks to a colleague and friend, I was introduced to the RxPharmaicst Internship opportunity and applied. Prior to applying, I was really confused about professional plans after graduating from pharmacy school (May 2020). As on the verge of graduating with my pharmacy degree in 2020, I also had no plans for the next phase of my life. I later successfully passed the NAPLEX exam but found myself struggling to pass my state’s MPJE exam. At RxPharmacist, I served as a Data Analytic Informatics Intern, in charge of creating online MPJE content. While doing so, I was also able to study for the MPJE at my own pace and passed!

I have witnessed the profession of Pharmacy play a vital role in alleviating chronic and infectious diseases which stirred my intellectual curiosity. This was further reinforced when I witnessed my father having a diabetic attack, which almost led to a stroke. Barriers such as lack of affordable healthcare and medication non-adherence was the leading cause of his inability to properly manage his condition. This incident left a huge impression on me and re-established my desire to want to help engage underserved populations in better managing their disease condition through my public health expertise, pharmacy, and other clinical initiatives. From my personal experience, I can engage and empathize with healthcare providers, patients, and their families in understanding the outcomes that are important to them and co-creating sustainable solutions.

Over the years of schooling obtaining a Master’s in Public Health: Epidemiology and Biostatistics, and Doctor of Pharmacy degree, I’ve acquired the necessary research, analytical and statistical skills including methods to test hypothesis for association or causality of different risk factors and health outcomes in different populations, as well as build clinical knowledge to effectively promote and deliver optimal healthcare. In addition, I have been able to work within teams to evaluate the clinical effectiveness and value of the Pneumococcal vaccine in pediatrics in the state of Maryland, working with the Maryland Emerging Infections Program and Active Bacterial Core Surveillance team at Johns Hopkins University in collaboration with the Centers for Disease Control and Prevention (CDC). The research was a case-control study that evaluated the effectiveness of the 13-valent Pneumococcal Conjugate Vaccine (PCV13) against invasive Pneumococcal disease (IPD) in children 2-59 months living in Baltimore. Clinical endpoints were not assessed for the new antigens, which led us to conduct a post-licensure matched case-control study to assess vaccine effectiveness.

Joining RxPharmacist gave me better insight on how to constructively figure out my life goals while helping other students succeed to prepare for their NAPLEX, MPJE, and BCPS exams.  The internship later convinced me that the next stage of my learning may lay in the field of public health professionally as a pharmacist. The internship led to an opportunity to continue my development as a Public Health professional, serving as an Epidemiologist. I later plan to combine my public health and pharmacy efforts linking disease prevalence and drug utilization, to enable development of effective health policies, as well as allow disease prevention to be placed within a larger context. At RxPharmacist, I found being in an environment that’s right for me in terms of performing tasks that allow for personal enjoyment and professional growth.

-Catherine W., 2021 RxPharmacist Intern

A new beginning- RxPharmacist Intern Testimonial

Transitioning to a brand new career in pharmacy was daunting for me, especially after graduating pharmacy school. When I found out about RxPharmacist, LLC through my pharmacy school, I knew it was my last chance to take a leap of faith before venturing to a new path of my own. As we are all facing this devastating COVID-19 pandemic, I knew that being open to new opportunities instead of being selective would help me in the long run, and I am glad that RxPharmacist was there when I needed them the most.

In a sense I knew what I wanted in a career, but I felt I didn’t quite have my skills refined just yet. As soon as I found out there was a medical writing position available through RxPharmacist, LLC, I immediately took the position and gave it my best that I had. During this program I had a chance to improve my medical and technical writing skills as well as my time management. I also worked beside amazing people who had my best interests in mind and their mentorship was the best I have experienced as a pharmacist.

My specific project with RxPharmacist, LLC was working on a Board Certified Pharmacist Specialist® guide to help thousands of seasoned pharmacists pass their boards. This project exceedingly expanded my knowledge of pharmacotherapy beyond what my studies encompassed in pharmacy school and that knowledge is transferable in whatever capacity I will end up in. Currently, I am pursuing a PGY-1 residency program and the valuable skills I have taken with me from RxPharmacist, LLC will undoubtedly help me achieve my goal of entering into a program that is the perfect fit for me. I recommend RxPharmacist, LLC to any pharmacy student or graduate who needs to refine any skills needed for success and am grateful that I chose RxPharmacist, LLC to allow me to be a part of their team.

– Joseph S.

University of North Texas Health Science Center at Fort Worth, 2021 PharmD Graduate

2021 Intern Testimonial!

Intern Testimonial

Before my internship with RxPharmacist, I really had no idea what was possible with medical writing in the field of pharmacy. Now I’ve learned that it can really just be whatever you make of it. If you’re interested in a certain aspect of pharmacy, no matter how niche, there’s bound to be others just like you who are willing to read your work on it. I personally am interested in compounding and veterinary pharmacy, and was able to work on RcPharmacist’s first compounding guides!

The biggest thing I appreciated about this internship is how mutually beneficial it is. I got to work on projects that interested me and was given the opportunity to improve my own writing skills. RxPharmacist got to have content by pharmacists, for pharmacists. Everyone in the field of pharmacy benefits from the work put out by RxPharmacist. Like pretty much every new graduate, I had to also study for the NAPLEX and MPJE while working the internship. They understand this and will work with you and your schedule to make sure you feel comfortable and are successful!

Another thing I greatly enjoyed about the internship was the mentorship and networking that happened on the side. My mentor acted as the editor for my guide, and was always supportive and willing to give feedback. They try to match your mentor to your interests, and while my interests were sort of niche, my mentor was still a great source of information and mentorship. One of my mentors knew other pharmacists who were currently working in the fields that I’m interested in, and helped me connect with them to further network. I had some of the nicest mentors a new graduate could ask for.

-Christina I., 2021 RxPharmacist Intern

University of Texas at Austin

Using literature in medicine: An overview on clinical study types

In healthcare, collaboration and the sharing of information is vital to the expansion of knowledge. Different types of studies are conducted to confirm or build upon key concepts, such as the efficacy of a drug, the safety of an intervention, or the superiority of a specific treatment. In this blog, we will briefly review different study types that are used to answer clinical questions in the healthcare setting.

Quantitative studies1

Clinical guidelines are based upon evidence-based medicine (EBM), which is primarily derived from quantitative studies. Quantitative studies can either be descriptive or analytical.

A descriptive study does not try to establish a relationship between variables, and instead, simply describes the data that was found. Descriptive studies include case reports and case series.

An analytical study tests a hypothesis in a group of people to determine if there is a specific cause or relationship between variables. A hypothesis can be tested one of two ways: through the use of an intervention (an experimental study) or by observing the effect without directly applying an intervention (an observational study). Analytical studies include case-control, cohort, or randomized controlled studies, as well as those of a factorial design.

Below the different subtypes of studies are summarized.

Some studies pool together information from a variety of quantitative studies. Meta-analyses focus on pooling data to conduct further statistical analyses with increased power to support conclusions5. Forest plots are a tool typically utilized by meta-analyses. A systematic review focuses on answering a clinical question by summarizing data from other studies, without doing a separate statistical analysis5.

Qualitative studies6

While quantitative research is needed to justify consensus for EBM, qualitative studies are a major component of health care practice, particularly in the fields of academia and community health. If you are part of a non-profit organization looking to apply for grant funding, qualitative data can help to justify the needs of your population of interest.

The methodology of qualitative studies is based upon the information needed.

The _________ qualitative method…asks the question(s)…
Phenomenology  How do people experience a certain event?  
Grounded theoryWhat is the theoretical framework for a particular behavior, thought process, etc.?
EthnographyWhat are the important cultural aspects of a particular community?
HistoricalHow can the past events affect the future for this group?
Narrative inquiryWhat are the unique perspectives or lived experiences of this specific (often marginalized) group of people?
Action researchWhat approach does this specific (often marginalized) group of people propose for addressing groups like themselves? How can we get this group involved in the process?
Case studyWhat is the experience of a particular entity (individual, community, organization, etc.)?

Methods for achieving these types of studies are focus groups, interviews, surveys, and observation.

These study types can help to answer various questions within the healthcare setting. Although each type has the ability to elicit different information and outcomes, they all share in the common goal of expanding knowledge, and ultimately, improving patient care.

-Gabriela O., 2021 RxPharmacist Intern

References:

  1. Ranganathan P, Aggarwal R. Study designs: Part 1 – An overview and classification. Perspect Clin Res. 2018;9(4):184-186. doi:10.4103/picr.PICR_124_18
  2. Ranganathan P, Aggarwal R. Study designs: Part 3 – Analytical observational studies. Perspect Clin Res. 2019;10(2):91-94. doi:10.4103/picr.PICR_35_19
  3. Aggarwal R, Ranganathan P. Study designs: Part 4 – Interventional studies. Perspect Clin Res. 2019;10(3):137-139. doi:10.4103/picr.PICR_91_19
  4. Aggarwal R, Ranganathan P. Study designs: Part 2 – Descriptive studies. Perspect Clin Res. 2019;10(1):34-36. doi:10.4103/picr.PICR_154_18
  5. Haidich AB. Meta-analysis in medical research. Hippokratia. 2010;14(Suppl 1):29-37
  6. Qualitative study design: Qualitative study design. LibGuides. https://deakin.libguides.com/qualitative-study-designs. Accessed August 20, 2021.

2021 Intern Testimonial

Flexibility towards a vision, mission, and goal

My initial plan post-graduation was to find a retail pharmacy position as soon as possible. At the time, I was not working as an intern and was relying heavily on being able to take my board exams early. An opportunity to work at RxPharmacist was presented to me around the same time and I took the chance to develop skills that I otherwise would not be able to gain.

I worked on the first RxPharmacist Retail OTC guide with my preceptor. I was able to gain skills in content creation, medical writing, and professional development. The entire team was very supportive of each other, and communication was excellent.

At first, the project was daunting, given the scope of the guide. In addition, I also was studying for the NAPLEX and MPJE. However, with encouragement and support from the RxPharmacist team, I was able to overcome any obstacles. I am very appreciative of the independence that interns are given as I was able to choose my work schedule and even deadlines. 

Overall, the RxPharmacist Internship has made me more confident in my own abilities. This internship has not only allowed me to improve myself, but also to give back to the profession.

-Edward S., 2021 RxPharmacist Graduate Summer Intern

University of Texas at Austin, Class of 2021

All about writing- RxPharmacist Internship Testimonial

All about writing- RxPharmacist Internship Testimonial

Throughout my experience in the world of health care, I’ve learned that one of the most important skills a clinician can have is writing. I have discovered that the pharmacists and physicians who can expertly navigate a patient case and process large amounts of data are the same ones who have published numerous papers and have excellent writing/technical skills. Throughout pharmacy school, I have sought to fine-tune my writing skills by joining and later becoming Editor-in-Chief of EMSOP Chronicles, a student run newspaper service for the Ernest Mario School of Pharmacy. Additionally, I participated in a rigorous research project to test the effects of sulfur mustard on the corneas where I learned valuable skills in writing a scientific thesis.

After graduating pharmacy school, I sought to refine my writing skills further by taking on new challenges and accepting an intern position with RxPharmacist. My job was to create a study guide and practice questions for the New Jersey Multistate Pharmacy Jurisprudence Examination (MPJE). This opportunity was especially educational as I was able to transition my writing skills from scientific/technical writing to study guides that can be easily read and understood. The amazing and supportive team at RxPharmacist gave me the necessary resources to guide me in creating the best version of my study guide. With their help, I had the opportunity to assist students across New Jersey with not only passing but excelling at their pharmacy licensing exam.

I am very thankful for RxPharmacist for giving me the opportunity to learn, make mistakes, and cultivate my writing skills which ultimately makes me a better clinician. My goal is to progress further and build on my skills by continuing my education at the Robert Wood Johnson Medical School. I believe that by entering medical school, I will find more opportunities to write and gain new perspectives to write about.

-Musab S., 2021 RxPharmacist Graduate Intern

Rutgers University, Ernest Mario School of Pharmacy, Class of 2021

Taking a risk, leading to a phenomenal reward

Taking a risk, leading to a phenomenal reward

The RxPharmacist internship program is an absolute must for anyone that feels even the slightest pull towards pursuing a pharmacy career that is non-traditional. Not only do you get paid to study, you get daily interactions with an army of mentors ready to help you with networking, job hunting, CV writing, and LinkedIn polishing.

The RxPharmacist team hosted many personalized workshops to help the interns transition from student to pharmacist, and more importantly, succeeding in their first job right out of school.

From step one my journey with RxPharmacist has been in my control, I was allowed to make my own project schedule and also make my MPJE guide exactly how I wanted. I was EXTREMELY nervous to sign on, I was concerned it would be too much to do with work, having a family, job hunting, and studying for the NAPLEX and MPJE, but I am so glad I bet on myself and the support RxPharmacist provided to take on this internship program. I have a completely unique addition to my CV, a new mentoring network, and an incalculable boost to my confidence. 

I would highly recommend anyone who is eyeing this internship to apply! It is a highly competitive process, but well worth it.

-Ally B., 2021 RxPharmacist Graduate Intern

University of Minnesota College of Pharmacy, Class of 2021

The Compounding Conundrum of Personalized Medicine

It is no wonder personalized medicine has been taking a rise, after all the one size fits all approach seen in manufactured medicine cannot work for everyone. For patients with unique healthcare needs, compounding can be incredibly useful but the catch is these medications do not actually go through a traditional approval process. Why is that important? It means these medications and products have not been reviewed, studied, and evaluated by a third party regulatory entity such as the Food and Drug Administration (FDA).

Compounding is defined as the process of “combining, mixing, or altering ingredients to create medications tailored to the needs of an individual patient”.1 For example, a patient with allergies to certain ingredients in a medication such as a preservative or dye can receive a modified compounded form instead.1 Another example is a patient who may require an alternate dosage form such as a liquid as opposed to a tablet which is especially prominent in pediatric or geriatric populations.1

Access to compounding services are invaluable for some patients, however, vigilance is critically important in this particular field of practice. In the absence of FDA review and approval, guaranteeing the safety, efficacy and quality of these medications can be tricky… so tricky you might even call it a compounding conundrum. The interactable module below outlines common pharmaceutical ingredients used in compounding.3

In 2012, a Massachusetts pharmacy caused more than 750 infections and more than 60 fatalities across 20 states due to fungal contamination.2 This event would lead to passing of the Drug Quality and Security Act (DQSA) which was officially enacted the following year.2 A prior blog post of ours outlined the need for REMS programs and Why We Can’t Be Hasty When It Comes to Drug Safety, the same is particularly true here as patients can be placed in serious harms way when appropriate measures or precautions are not taken in compounding. The following links below assembled by the United States Pharmacopeial (USP) Convention are highly useful in better understanding appropriate standards for compounding and have been linked below for your convenience: 

The FDA also provides a plethora of compounding guidance and resources found here as it is trying to gain a more involved approach given the recent deaths and news from a lack of quality assurance or sterility in compounded products causing patient harm. For example, there is a federal law that specifies a 5% limit on distribution for out of state drugs compounded by pharmacies and physicians under Section 503A of the FDCA. The FDA plans not to enforce this rule until after states sign and finalize the memorandum of understanding (MOU) as ultimately it is under the state jurisdiction and regulation to oversee compounding pharmacies. 

References

  1. U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers. Accessed May 6, 2021. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers.
  2. U.S. Food and Drug Administration. Compounding Laws and Policies. Accessed May 6, 2021. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers.
  3. Ansel, HC, Loyd VA. Pharmaceutical Dosage Forms And Drug Delivery Systems. 10th ed. Lippincott-Williams & Wilkins; 2014.

Rising Rates of Asthma and the Hygiene Hypothesis

Many years ago, I came across a tale of The Wheezing Wolf and the Three Little Pigs , you could call it a breathless spin on a timeless children’s classic. It is also a tale that manages to very creatively highlight a disease state which affects a large number of children worldwide, specifically asthma. It is estimated more than 22 million people (~6 million children) in the United States have some form of asthma, a chronic but reversible condition which causes inflammation and bronchoconstriction of our airways.1

Although there is no magic bullet or cure for people who suffer from asthma, we do have a large variety of medications that allow for proper management to help prevent long term airway remodeling, permanent lung damage, hospital stays and emergency room visits.1 You might be wondering what causes people to acquire asthma. Data is gathered meticulously to better highlight trends in asthma for this very reason. For example, one trend already identified makes clear that African American and Hispanic children are generally more likely to experience mortality from asthma related causes.1 Below you will find several interactable modules which outline the rise in asthma cases over time and the demographic aggregation of cases across the United States.

One theory which has gained traction over the years to explain rising cases of asthma is called the hygiene hypothesis. This hypothesis suggests our post natal immune response is compromised by an ultra clean environment.3 There is evidence to suggest lower levels of the bacterial protein lipopolysaccharide (LPS) in a person’s home would predispose them to develop conditions like asthma (LPS helps our immune system grow and learn by switching on toll-like receptor 4 (TLR4) on T-cells).3 If you would like to learn more about how this may relate to the COVID-19 pandemic, the following article is a nice read: The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome.

As a whole, asthma attacks can vary in severity and in nature from one person to another. Common triggers include tobacco smoke, dust mites, pollen, air pollution, mold, a man’s best friend, perfumes, harsh cleaners/disinfectants and even acid reflux.2 It is important for patients who suffer from asthma to identify and avoid triggers. For example, encouraging tobacco cessation in households with smokers or using an air cleaner with a HEPA filter for people who may be allergic to their furry friends.2

Lastly, if there is one thing we know from the hygiene hypothesis, it’s that people love to clean their homes. It is especially true now perhaps more than ever before and we may very well see an even steeper rate of asthma cases moving forward, even if just from COVID sequelae alone. Here is a CDC guide for properly cleaning and disinfecting homes that patients (especially those sensitive to harsh detergents or cleaners) may find useful; it’s even COVID approved. 

References

  1. U.S. Food and Drug Administration. Asthma Fact Sheet. Accessed May 2, 2021. Retrieved from https://www.fda.gov/consumers/minority-health-and-health-equity/asthma-fact-sheet.
  2. Centers for Disease Control and Prevention. Common Asthma Triggers. Accessed May 2, 2021. Retrieved from https://www.cdc.gov/asthma/triggers.html.
  3. U.S. Food and Drug Administration. Asthma: The Hygiene Hypothesis. Accessed May 2, 2021. Retrieved from https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/asthma-hygiene-hypothesis.
  4. National Center for Health Statistics, Centers for Disease Control and Prevention. Asthma Data Visualizations. Accessed May 2, 2021. https://www.cdc.gov/asthma/data-visualizations/default.htm.
board, school, dreams

Mentorship and Networking – Beyond a Job!

Before my graduation in 2020, I was uncertain about my career and future with pharmacy being heavily saturated and the COVID-19 pandemic hit creating an ecomonic downturn. I first came across the summer internship at RxPharmacist because I recognized the opportunities that they offered including the flexibility of a remote work role, creating my own study guide, and achieving growth in medical technical writing and growing my professional network. Now as I complete the program, I am glad to share with you this incredible experience at RxPharmacist. 

My first project was to edit the CPJE guide, which aided me passing the exam on my first attempt. Besides providing feedback on my work performance, my inspiring mentor spent time discussing with me about entrepreneurship, marketing, and my career goal. There was a heavy emphasis on strategy to approach achieving my goals of attaining my dream fellowship program. For example, knowing my interest in the pharmaceutical industry, she introduced me to experts in the field and helped me on my CV, letter of intent, and practicing with mock interviews. Thanks to her unwavering support, I got accepted into my top choice fellowship program where I would practice as a clinical development fellow in oncology at Rutgers (2021-2023). Although I was already working as a full-time pharmacist, this remote job was so flexible that it allowed me to work on my own schedule. Needless to say, beyond a job, not only the internship offered a unique opportunity to expand my networks and writing skills, but it also was a good transition for me from a graduate student to a pharmacist. I’m incredibly thankful of being able to get into my top fellowship program with the unwavering support of RxPharmacist and also was able to gain the FDA ORISE fellowship as a backup opportunity should I not be able to get my top choice through their help.

Therefore, I highly recommend this internship to anyone who seeks for professional networks and experience in medical and scientific communications. The preceptors and team are highly supportive. If your willing to work hard, learn new skills, and try something new, this might be a wonderful opportunity for you.

Thi N., 2020-2021 RxPharmacist Graduate Intern

UC San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, Class of 2020

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