August 22, 2013

Awards - Stanley Graduate Awards for International Research

Stanley Graduate Awards for International Research





This summer I had the opportunity to be involved in the Stanley International Research Grant Program through which I traveled to The Hague, Netherlands to visit the headquarters of The International Pharmaceutical Federation and The International Pharmaceutical Student's Federation.  As part of my research, I visited a community, Regentesee Pharmacy, and a hospital, MCH Westeinde, pharmacy in The Hague.  While there, I talked to the pharmacists and observed pharmacy operations through which I learned about the pharmacists training, their current role, and was able to identify similarities and differences in pharmacy practice between the United States and the Netherlands. The Netherlands already has technicians verifying each other's work, while in the United States this idea is just starting to take ground.  This allows the pharmacist to devote more of their time to clinical activities and management of the pharmacy.  I also learned that the community pharmacist did not consider addiction to scheduled medications a major problem in the Netherlands though in the United States it is a big challenge.  The pharmacist also spoke of the record keeping they are required to do and the drug information resources they most utilized.  At the hospital pharmacy, I spoke with both the director of pharmacy and the current pharmacy resident and learned about the lengthy training that hospital pharmacists receive to practice in The Netherlands.  While spending time at the FIP headquarters, I interviewed the pharmacists to learn their current role at the organization and their career path leading up to the current role.  This was especially beneficial for me as a student because I was able to learn about the wide variety of work that pharmacists can be involved in.  In addition to the interviews, I wrote a short advertising piece for FIP’s annual 2013 conference.  I also helped Alexandra, the current IPSF chairperson of Media and Public Relations, by compiling World Congress Surveys to help gauge member feedback on various issues, which would hopefully influence the direction of IPSF.  

 

Following my time in The Netherlands, I traveled to London to spend two weeks at the Royal Pharmaceutical Society to continue my research.  During normal office hours at the RPS, I interviewed seven pharmacists with different roles at the organization to complete the main focus of my research. In addition, I assisted the research manager, Rachel Roberts, with analyzing data for the Community Pharmacy Prescription Interventions project.  My primary responsibility was to find discrepancies in the data and work to resolve issues so that the Excel files contained the correct totals before further analysis could be done.  I also did some preliminary analysis consisting of basic statistics and comparing different variables to each other.  I also spent time shadowing the pharmacists at the Heart Hospital, the Royal Free Hospital and the Green Light Community Pharmacist in London to see pharmacy in action.  I found my time at the community pharmacy interesting because I had the opportunity to observe the travel nurse giving immunizations and observe a patient taking part in a methadone program for which he had to drink his medication in front of the pharmacist. I was also told that all contraceptives are free in the United Kingdom and the cost to the patient is 7.85 pounds per item.  I also noticed that the method of dispensing is different in both countries where most medicines already come in 30 blister boxes instead of a stock bottle as it is the case in the United States. The boxes also contain braille on them which I though was a wonderful feature to have for the blind.  Since, it is hard to get a new license to open a pharmacy in the UK and most pharmacies are acquired by buying an existing pharmacy. 


My time abroad has been absolutely wonderful and I look forward to continue helping with the efforts of IPSF by taking on a leadership position in IPSF. Spending time abroad and staying with the IPSF leadership team helped me better understand both the work and rewards of being involved in IPSF at an international level.  The Stanley Grant was a great start and opportunity to begin making international connections since I do wish to be involved internationally in the future.  In addition to helping individual patients, I hope I can work on international health endeavors that improve the health of people around the globe. 

August 19, 2013

Confereces & Meetings - University of Utah School on Alcoholism and Drug Abuse

University of Utah School on Alcoholism and Drug Abuse




Having always lived in Iowa, I never thought I would be travelling to Salt Lake City to attend the internationally recognized School on Alcoholism and Drug Dependencies at the University of Utah. The week has really opened my eyes to the issues of alcoholism and drug abuse in the United States.  Though my time in Salt Lake City was short, it was packed with new and amazing experiences.  I met students from all over the country, developed better relationships with the students from my own school, learned about abuse issues through many amazing speakers, comedians, and meetings, learned about native American culture through traditional dancing, dined at local restaurants, and experienced the Utah Arts Festival.
I would rate the overall quality of my experience at the School as phenomenal.  As I grow older, I find that there are fewer and fewer experiences that change my perceptions of the world around me.  The School drastically altered how I view the issue of drug abuse.  I used to view drug abuse as something to catch through inventory at the pharmacy or searching for the patient in the current Prescription Monitoring Program in Iowa.  I now think about not just fighting drug abuse but rather using it as an opportunity to help and provide resources to patients who may be suffering from it.  My level of empathy for patients has increased drastically since attending the school, though I feel that I am still very limited in the help that I am able to provide for those patients.
The School did a great job of including some humorous sessions during the week to provide some emotional relief to the participants.  The hike and the garden walk were also great options to include some physical activity during the week.  The experience that made the greatest impression on me was the willingness of individuals to share their stories at the group therapy session.  First of all, it always caught my attention when individuals stood up and said their name and identified themselves as an abuser in front of a room full of strangers.  I am not entirely sure why but hearing this self-identification made me a little bit uncomfortable.  This is probably because of how honest they were being with themselves and others and I recognized that it must have taken a lot of courage and determination to reach to that point.  As different individuals worked through their various issues, I could definitely feel a great level of love and empathy in the room.  All the attendees were providing an incredible amount of emotional support.  During one of these meetings a pharmacy student stood up and told everyone that today her mom is sentenced to prison.  It was really powerful to hear her story and experience her strength because I had noticed her positive nature previously during the conference and would never have thought that she was facing these kinds of struggles.  It surprised me to see how many people were personally affected by abuse issues either through their own addiction or through the addiction of their family members. I now recognize that preventing abuse and helping individuals escape the cycle of abuse helps not only the person but all their loved ones around them.  From the single experience of various individuals being open and honest and willing to share their story, I have learned an incredible amount about the impact of drug abuse.
Prior to attending the School, I had always thought that the drug problems in the United States were primarily due to illegal drugs such as cocaine or methamphetamine, and learning from one of the speakers that prescription drug abuse was an even bigger problem was quite shocking.  This has made me realize that as a pharmacy student I need to be more vigilant in observing the red flags of drug abuse.  I have realized the importance of doing inventory on controlled substances to prevent drug abuse, but the hardest aspect of this will be identifying patients who may be abusing while still trying to have empathy for patients who are in actual pain.  Hearing stories of pharmacists who abused drugs and ways that they placed themselves in positions that would be in charge of the controlled medications showed me some of signs I should watch for and demonstrated that everyone is susceptible to this problem no matter how intelligent, educated, or important they are within the company.
Perhaps the most interesting part of the week has been listening to the Alcoholics Anonymous and the Al-anon to actually hear the stories and struggles of abusers and family members. The meetings were very emotional and helped me develop much needed empathy that I needed for patients. The stories of people trying to quit on their own and failing and the support that the group provides over the years is really wonderful.  Some of the seemingly happiest people at the conference had the courage to stand up and tell their stories to a room full of strangers.  The level of trust, honesty, and compassion in the room really touched my heart.  I never realized that not only the patient but also so many people in the patient’s life are affected by their abuse problem.  A single abuse problem can leave a trail of anger, resentment, and broken relationships in the whole family. 
Another major concept that I learned about was recognizing addiction as a disease rather than a choice. Prior to the School, I had never really understood addiction and certainly did not think of it as a disease.  As strange as it sounds, I had always thought that people chose to do drugs repeatedly until eventually they eventually became addicted. The session in which Steve Moore described a cat and it’s craving for milk was really phenomenal in understanding how an addict thinks about his addiction and also described some possible scenarios of how an addict might relapse into addiction by attending milk festivals or going to the grocery store and walking into the milk aisle.
An idea that was briefly mentioned during one of the sessions that stuck with me is that when patients come to the pharmacy, we give them medications to help them, but when an addict comes to the pharmacy, we are supposed to kick them out instead of helping them.  This is something that is inherently wrong with the system when addressing abuse issues and more needs to be done to help the patients rather than sending them away to search for an even worse way to feed their addiction. In conjunction with this idea, it is important to teach patients about proper storage of medications when they are not using the medications to prevent family members, friends, or burglars from stealing the medications.  

Another topic I learned at the School was not about drug abuse but rather about Native American Culture through traditional dancing.  The dance started with flute music and was followed by beating drums with an explanation of the various dances that the dancers were doing.  There were many types of dances which were the men’s traditional, men’s fancy, women’s traditional, women’s fancy, friendship dance, and my favorite the trick dance.  It was very hot that evening and it was impressive that the dancers were wearing the traditional dress and dancing in the heat so that we could learn about some of the unique characteristics of their culture. 
Overall the school informed us about the different aspects of addiction.  We learned about the science behind addiction through the pathophysiology of addiction and introduction to addiction issues session, the group meetings and therapy sessions helped us develop our knowledge of personal stories and develop our empathy, the case study of a recovering pharmacist showed us how even those that are highly educated can be affected by this issue.  The pharmacy section also helped individuals speak about their personal abuse issues and abuse issues of family members to help those who are being personally affected by this issue.
The School included three general session speakers with Chuck Jackson, David Mee Lee, and Jason Hewlett as speakers.  It was also great to see various individuals being recognized for their commitment to this field through the various awards at the general sessions. 
In Chuck Jackson’s session, we began with some physical exercises to help wake everyone up that morning.  He then discussed his town in Oklahoma to allow us to help us understand him better and concluded the presentation with talking about a box that represented abuse issues. The box had always been in the distance but as time progressed more and more people around him were affected by abuse issues and the box had come to the forefront and he recognized that he needed to deal with the box.   
David Mee Lee’s session was more scientific, and he discussed the advantages and disadvantages of recognizing addiction as a brain disease. By recognizing addiction as a disease, society goes from punishing the addict to help treat them out of addiction.  The disadvantage of recognizing addiction as a disease is that it allows the addict to escape responsibility for their addiction.  The session helped me realize that though recognizing addiction as a disease is important, there are certainly downfalls associated with this.
By far the most unique and perhaps even the weirdest general session of the week was by 
Jason Hewlett. In this session, he shared how he discovered his talent through a choir teacher and how he rejected a Las Vegas contract in order to do the work that he values. Though much of his presentation focused on Jason’s singing talents, his main message was how to recognize your own uniqueness to help make yourself standout and successfully develop your own path in life. He also encouraged us to be extraordinary no matter how ordinary a task we might be doing and he provided a great example of an airport shuttle driver who did just that. 
            I loved my time in Utah at the School and encourage all to attend next year!