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Objective. To determine the impact of an advanced pharmacy practice experience (APPE) to develop skills needed to apply an evidence-based approach to population-level practice decisions. Design. A 4-week evidence-based medicine APPE was implemented that included active-learning techniques and online learning modules, participation in state drug-policy committee meetings, and completion of an evidence-based medicine review for a specific drug agent or class. Assessment. Students' mean score on application of principles related to biostatistics and information mastery on posttests increased 15.8% from pretest to posttest. Students' mean score on a 22-question information mastery quiz was 90.8%. Mean scores for course evaluation components ranged from 4.8 to 5.0 on a 5-point Likert scale. All respondents indicated they would recommend the APPE to other students.Conclusions. An APPE that incorporated content from active drug-policy committees increased students' evidence-based medicine skills and enhanced their understanding of, appreciation for, and confidence in evidence-based practice.Keywords: evidence-based medicine, advanced pharmacy practice experience, literature evaluation INTRODUCTIONApplying evidence-based medicine principles to patient care decisions ensures the conscientious, explicit, and judicious use of best evidence in practice. 1 Evidencebased medicine is the principle of incorporating information gained from the best available research evidence with clinical expertise and applying it to patient and policy decisions. 2,3 Healthcare providers face the daily challenge of providing the best possible care while controlling cost in today's environment of direct-to-consumer advertising and high-impact marketing. Therefore, pharmacy students must develop evaluative skills that differentiate therapeutic options with high-yield outcomes measures from those with inferred or surrogate endpoints.This course addresses curricular outcomes described in the Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines for the Professional Program in Pharmacy under Standard 12, Professional Competencies and Outcome Expectations. ACPE calls for graduates to be competent to provide evidence-based patient-centered and population-based pharmacy care. Evidence-based practice and decisionmaking are specifically outlined within the clinical sciences content in the pharmacy practice and pharmacist-provided care, and literature evaluation and research design sections for curricular content. 4 Taking an evidence-based approach to practicing pharmaceutical care is one way to ensure that patients and healthcare providers are satisfied that efforts target a therapeutic outcome that is sensitive to the needs and desires of the patient.In addition to the widely practiced 5-step approach for pharmacists to provide drug information to patients and other professionals, 5 information mastery skills aid the health care provider in developing a systematic and rapid approach to identifying the most useful in...

Published atrial fibrillation (AF) guidelines and decision tools offer oral anticoagulant (OAC) recommendations; however, they consider stroke and bleeding risk differently. The aims of our study are: (i) to compare the variation in OAC recommendations by the 2012 American College of Chest Physicians guidelines, the 2012 European Society of Cardiology (ESC) guidelines, the 2014 American Heart Association (AHA) guidelines and two published decision tools by Casciano and LaHaye; (ii) to compare the concordance with actual OAC use in the overall study population and the population stratified by stroke/bleed risk. A cross-sectional study using the 2001–2013 Lifelink claims data was used to contrast the treatment recommendations by these decision aids. CHA2DS2-VASc and HAS-BLED algorithms were used to stratify 15,129 AF patients into nine stroke/bleed risk groups to study the variation in treatment recommendations and concordance with actual OAC use/non-use. The AHA guidelines which were set to recommend OAC when CHA2DS2-VASc = 1 recommended OAC most often (86.30%) and the LaHaye tool recommended OAC the least often (14.91%). OAC treatment recommendations varied considerably when stroke risk was moderate or high (CHA2DS2-VASc > 0). Actual OAC use/non-use was highly discordant (>40%) with all of the guidelines or decision tools reflecting substantial opportunities to improve AF OAC decisions.

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