A comparison of pharmacoeconomics topics in journals and entry-level pharmacy degree curricula

American Journal of Pharmaceutical Education, Spring 2001 by Carter, Jean T, Ebel, Justin A

The purpose of this study was to compare the pharmacoeconomic topics covered in schools of pharmacy with those appearing in professional journals and to determine whether a "gap" still exists. Articles, letters and editorials published in the 1998 volumes of seven selected journals were reviewed and an e-mail survey of schools of pharmacy was conducted. Ten percent (6/60) of the schools did not cover any of the topics. The percent of schools covering cost-effectiveness, cost-benefit, and cost-utility analyses increased from just over 30 percent in 1992 to almost 90 percent in 1998. Thirteen of the 18 topics were taught in over 70 percent (43/60) of the schools; eight of those 13 topics also appeared in over 70 percent (5/7) of the journals for a 62 percent (8/13) overlap. The increased coverage of pharmacoeconomic topics in entry-- level doctor of pharmacy programs has substantially reduced the gap between what is taught and what is needed to read and interpret the pharmacoeconomic literature.

INTRODUCTION

Schools of pharmacy strive to produce graduates who are prepared for current and future practice. As health care knowledge and practice change, schools adjust their curricula to reflect current trends and better prepare their students. During the past decade, schools have been busy adjusting their curricula to incorporate new knowledge and issues into student preparation.

Pharmacoeconomics is just one area in which schools have been incorporating topics into their curricula over the past ten years in an effort to prepare graduates for their professional role.

As pharmacoeconomic research grew, educators began to suggest including pharmacoeconomic topics in undergraduate pharmacy programs because reading and interpreting pharmacoeconomic research would require specific training that was not traditionally included in the professional curriculum. The ability to serve as managers and decision-makers would include the ability to interpret and use pharmacoeconomic information(1,2). Draugalis and Jones-Grizzle suggested incorporating pharmacoeconomic topics and concepts into existing courses in the curriculum(1). Kolassa took the recommendation a step further and suggested creating a separate course because of the importance of the subject(2). These recommendations focused on preparing pharmacists to interpret pharmacoeconomic information rather than actually perform the evaluations. Pharmacists interested in pursuing careers in pharmacoeconomic analysis were guided towards postgraduate training programs(3).

Apparently educators heeded this advice and began incorporating pharmacoeconomics training into their curricula. In 1996-97, undergraduate pharmacoeconomics training in U.S. schools of pharmacy was offered in 81 percent (64/79) of the schools of pharmacy(4). What is not known is whether the topics that are being taught in the schools are the same as those that appear in the professional literature.

To discover whether gaps existed between literature topics and educational preparation, studies by Moore et al., Hokansen et al., and Juergens et al. used parallel surveys of curricula and reviews of journals(5-7). In the late 1970s, the coverage of statistics topics in PharmD/MS curricula did not appear to meet the statistical education needs of students when compared to a representative sample of professional journals(5). Hokansen and colleagues reviewed the situation again in mid-1980s, and found that the quality of the statistics training would not prepare graduates to interpret the more sophisticated statistics found in journals. One pharmacoeconomic method, cost-benefit analysis (CBA), was included in the study(6).

The study by Juergens et al. (1992) found a "substantial gap" between the coverage of selected pharmacoeconomic topics in journals and classrooms. Again, educators were advised to increase curricular emphasis on statistical (quantitative) and pharmacoeconomic topics because students need those skills to make competent decisions(7).

Now, over 80 percent of the schools include pharmacoeconomic topics in their entry-level curricula(4). The question is whether this has decreased the "gap" between what is taught and what is needed to read the literature critically. Therefore, the purpose of this study was to compare the concepts and topics covered in schools of pharmacy with those appearing in professional journals to determine whether the gap still exists.

METHODS

Review of Selected Healthcare Journals

Seven pharmacy and medical journals were selected and reviewed to identify the number and frequency with which pharmacoeconomic topics appeared during 1998. The selected journals were American Journal of Health-System Pharmacy (AJHP), Annals of Pharmacotherapy, Journal of the American Pharmaceutical Association, U.S. Pharmacist, Pharmacotherapy, Journal of Managed Care Pharmacy (JMCP), and Journal of the American Medical Association (JAMA). The journals were selected to represent community, institutional, and managed care practices. Hokansen et al. and Juergens et al. used the first five of these selected journals in earlier studies(6,7).