The Role and Education of the Veterinary Pharmacist
Ceresia, Michelle L., Fasser, Carl E., Rush, John E., Scheife, Richard T., Orcutt, Connie J., Michalski, Donald L., Mazan, Melissa R., Dorsey, Mary T., Bernardi, Stephen P., American Journal of Pharmaceutical Education
The practice of veterinary pharmacy is an emerging field in the United States. Among the first references to the pharmacist's role in veterinary medicine surfacing about 50 years ago were articles addressing the use of antibiotics and veterinary biologicals. (l-3) Traditionally the roles of the veterinarian and pharmacist were mutually supportive. The veterinarian's charge was to diagnose and prescribe therapy, whereas the pharmacist's was to compound and dispense medications for animals. (4) A 1977 interview of veterinarians in southeastern Wyoming found a need for increased pharmaceutical services in agriculture, and proposed that certain veterinary medications should be closely monitored and dispensed as prescriptions. (5) But before undertaking such a role, suggested Kernan, pharmacists should develop an appreciation of veterinary products in general, and then should dispense veterinary medicines with the same diligence and attention to detail accorded to human drugs. (6) However, in recent years, others have recommended that the pharmacist's role in veterinary care could be expanded even further to include clinical services such as pain management and pharmacokinetic consults. (7)
Several publications have highlighted the increasing involvement of pharmacy in animal health care in the United States. Pharmacists caring for animals were initially employed by veterinary schools; the role of these pharmacists entailed medication selection and inventory and formulary control. (8,9) Any additional knowledge and skills were obtained through job experience. (10,11) Contemporary practicing veterinary pharmacists are presumed to be well versed with an in-depth knowledge of pharmaco-kinetics of the various species. (8) Community pharmacists likewise have found themselves providing services to pet owners and filling prescriptions written by veterinarians. While a working knowledge of veterinary therapeutics is essential, Lust found a remarkable lack of confidence in knowledge of veterinary pathophysiology, legal aspects of compounding, and pharmacotherapy among pharmacists. The confidence ratings increased consistently upon completion of a veterinary pharmacy continuing education tutorial. (12)
Efforts to remedy this situation have been slow in coming due in part to the lack of consensus regarding the definition of the veterinary pharmacist. (12) The limited efforts under way in schools of pharmacy are focused on elective course offerings in animal therapeutics, with continuing education courses directed at providing practicing pharmacists with the knowledge and skill base needed for veterinary pharmacy. (12) Attempts to identify the content areas of importance to providing supportive animal care services by the pharmacist have relied largely on opinions, which have stressed the importance of familiarity with legal and regulatory issues, (12,13) compounding practices for veterinary patients, (14-16) antimicrobial agents used in veterinary medicine, (17) the role of the pharmacist in veterinary medicine, (18) veterinary therapeutics, (12) and the pharmacist's involvement in the education of veterinarians. (19)
Professional organizations provide support to community and hospital veterinary pharmacists. (20-23) The Society of Veterinary Hospital Pharmacists focuses its efforts on being a resource for an exchange of ideas in this specialized area of pharmacy. (20) The American College of Veterinary Pharmacy encourages independent pharmacies to expand into the field of veterinary pharmacy. (21) Professional organizations that support the community pharmacist concentrate their efforts on enhancing pharmacists' skills in the preparation of compounded medications for the treatment of animal illnesses, (21,22) providing marketing strategies, (21) and representing pharmacists on legislative issues to protect pharmacists who compound for animals. (23) A recent effort to prepare pharmacists for a role in veterinary medicine is exemplified in the learning experience offered at the University of California-Davis. (24)
Despite these accomplishments, the challenge faced by pharmacy educators is how best to prepare current and future pharmacists to assist veterinarians in effectively providing pharmaceutical services to large, small, aquatic, wild, and exotic animals. The intent of this research was to delineate the role responsibilities and educational needs of the traditional pharmacist who supports the veterinarian and of the pharmacist who practices solely in veterinary pharmacy. The information derived from this effort will provide the foundation for pharmacy educators to design and build competencies and objectives required to ensure mastery of veterinary pharmacy practice.
This Delphi study was approved by the Massachusetts College of Pharmacy and Health Sciences Institutional Review Board. The Delphi technique was utilized be cause it is a consensus-building method uniquely suited for role delineation. It is a systematic approach for the collection and collation of opinions from experts without their need to convene; this eliminates bias based on social interaction among the respondents. The purpose of the Delphi study is to generate crucial information for decision making in a structured and reproducible fashion. (25-28) "The technique uses anonymity, iteration, controlled feedback, statistical group response, and expert input to accomplish this goal." (28)
The process began with the formation of a 7-member advisory group composed of large-, small-, and exotic-animal veterinarians; veterinary hospital, community based, and clinical-setting pharmacists; and a pharmacy educator (Figure 1). The group's initial meeting was devoted to a discussion of the opinions and observations reflected in the literature on the veterinary pharmacist's role and of the members' thoughts about the areas of information to be in the first questionnaire. This discussion resulted in the formation of 10 open-ended questions structured to capture information about the perceived role, training requirements, pharmacy school's role, barriers to practice, related benefits, and practice settings associated with the traditional pharmacist who supports the needs of the veterinarian and with the pharmacist who practices solely in veterinary pharmacy. The description of a traditional pharmacist who supports the needs of the veterinarian (hereafter referred to as the veterinary pharmacist) and a pharmacist who practices solely in veterinary pharmacy (hereafter referred to as the veterinary pharmacy specialist) was not provided on the questionnaire and was left up to interpretation by the expert panelist. The advisory group then identified 20 experts in their respective areas to serve on each of 7 panels, and as a result invited 143 experts to participate as panelists in the study.
[FIGURE 1 OMITTED]
Round 1, Questionnaire 1
Responses to questionnaire 1 …
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Publication information: Article title: The Role and Education of the Veterinary Pharmacist. Contributors: Ceresia, Michelle L. - Author, Fasser, Carl E. - Author, Rush, John E. - Author, Scheife, Richard T. - Author, Orcutt, Connie J. - Author, Michalski, Donald L. - Author, Mazan, Melissa R. - Author, Dorsey, Mary T. - Author, Bernardi, Stephen P. - Author. Journal title: American Journal of Pharmaceutical Education. Volume: 73. Issue: 1 Publication date: February 2009. Page number: Not available. © American Association of Colleges of Pharmacy 2008. COPYRIGHT 2009 Gale Group.
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