Burnout is high among health care professionals. In physicians, burnout is linked to suboptimal well-being and patient care, but the overall landscape of pharmacist burnout is unknown. Synthesis of available data regarding pharmacist burnout is needed to better understand its effects on well-being and professional practice. This systematic review sought to determine the prevalence and intensity of burnout in pharmacists. The aim of the study was the systematic review of articles on pharmacist burnout. PubMed, Embase, Cochrane Central Register of Controlled Trials, and Psy-cINFO were searched for articles through February 13, 2019. Search strategies combined terms for pharmacists and burnout (including job satisfaction, stress, and resilience). The primary outcome was the proportion of pharmacists who met criteria for burnout. Secondary outcomes included the mean scores for Maslach Burnout Inventory (MBI) subscales, difference between pharmacist practice settings, and factors contributing to burnout. Raw scores and threshold proportions were pooled using a Hartung-Knapp random-effects model. Five articles reported the proportion of high emotional exhaustion (EE) and depersonalization (DP) and low personal accomplishment (PA), and nine articles reported individual MBI subscale scores, which were included for quantitative analysis. The proportion values of pharmacists with MBI subscale scores consistent with burnout were 41% (95% CI 27%-54%), 20% (95% CI 7%-32%), and 32% (95% 14%-50%) for high EE, high DP, and low PA, respectively. Mean MBI subscales scores were 23.53 (95% CI 21.68-25.39), 7.07 (95% CI 6.22-7.92), and 36.51 (95% CI 34.34-38.67) for EE, DP, and PA, respectively.Substantial heterogeneity was observed. The burnout prevalence among pharmacists is lower than previously reported, but notable. The average MBI subscale scores for high EE or DP or low PA in pharmacists did not meet criteria for burnout. K E Y W O R D S burnout, depersonalization, occupational health, pharmacists, pharmacy Burnout is a work-related syndrome defined by high emotional exhaustion and depersonalization, and a low sense of personal accomplishment. 1 In health care professionals, some of the factors contributing to burnout include a rapidly changing industry, declining reimbursement for services, increased clerical and documentation needs, and the emotionally intense role of patient care. 2 These

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Entrustable professional activities (EPAs) are units of measure for a particular profession that describe the professional's unique abilities and work. EPAs can be used in two ways: as a link between individual competencies for mastery and overall professional responsibilities in practice; and as a mechanism for faculty to assess the student's progression using levels of decreasing supervision. Currently used in medical education, implementation and utilization of EPAs within pharmacy education has potential benefits and challenges. This article will describe, highlight benefits of, and share mitigation strategies for implementing EPAs within pharmacy education.

The opioid crisis represents one of the largest failures of our current health care system as it continues to claim lives at an unprecedented rate and has caused a devastating range of preventable morbidity. Although the availability of highly potent synthetic opioids has amplified the urgency of the crisis for patients and communities, this problem has evolved over several decades. Pharmacists are in a position to offer many potential solutions due to their widespread accessibility, extensive drug knowledge, and integration into various health care settings. This opinion paper challenges the status quo by calling on all pharmacists to embrace evidence‐based opioid stewardship and harm reduction practices, contribute to the medical management of opioid use disorder, and address the misconceptions and prejudices that serve as barriers to effective, compassionate patient care. Regardless of practice setting or available resources, pharmacists can take deliberate and impactful steps to address the opioid crisis. Some pharmacists may be positioned to implement innovative and far‐reaching pharmacist‐led clinical services, while others may simply begin with careful consideration of the language they use when speaking to and about patients with substance use disorders. To optimize patient outcomes, the ineffective laws, regulations, and policies that negatively impact pain and addiction care must be addressed so that evidence‐based solutions can be widely disseminated. Pharmacists must aggressively advocate for the removal of barriers preventing high‐level clinical practice or policies that perpetuate patient harm and abandonment. Finally, there must be support for continued research on pain and opioid use disorder treatments and services, as well as the impacts of harm reduction practices and pharmacist‐led clinical services, so that resources can be allocated effectively.

Background Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors. Objective This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors. Methods The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms. Results The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity). Conclusions One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.