1 PHA5244 Principles of Evidence-Based Practice Spring 2018 3 Credit Hours [A-E Grading] The goal of the course is to familiarize students with methods and tools to evaluate and select drugs and other medical technologies for evidence-based patient care. It has three components: formulating questions, searching available resources, and critical appraisal of pharmaceutical and medical literature. Teaching Partnership Leader Hong Xiao, Ph.D. Email: hxiao18@cop.ufl.edu Office: HPNP 3338/GNV Phone: 352-273-6711 Office Hours: By appointment ONLY. See Appendix A. for Course Directory of and Staff Information. Entrustable Professional Activities This course will prepare you to perform the following activities which the public entrusts a Pharmacist to perform: 1. EPA A3. Formulate evidence-based care plans (in collaboration with an interprofessional team). 2. EPA B1. Form clinical/practice-related questions and retrieve evidence to advance patient care. Course-Level Upon completion of this course, the student will be able to: 1. Define all key elements of the question that guides the successful search and appraisal of evidence to answer a given patient care problem. 2. Identify appropriate resources and search strategies to answer a specific patient care question. 3. Describe core elements of scientific reasoning and the research process in this context, and apply principles of study design, measurement, and biostatistics in the evaluation of published research studies.
2 4. Assess benefits and risk of therapeutic alternatives and formulate evidence-based recommendations for healthcare providers and/or patients. 5. Describe how clinical findings are summarized in evidence reports and apply them appropriately in clinical decision-making. 6. Translate evidence into information for patients that enhances comprehension of risk benefit and allows informed decision-making. Course Pre-requisites 1. Successful completion of Block 1, 2, and 3 courses. Course Co-requisites PHA 5781 Patient Care I PHA 5727 Principles of Systems Based Practice Course Outline Please routinely check your campus calendar and the Canvas course site for any messages about changes in the schedule including meeting dates/times, deadlines, and room changes. s for 1 Module 1: Evidence-Based Medicine and Drug Information 3/12/18 1.1 Watch: Principles of Evidence- Based Medicine 0.75hr Xiao 1, 2 3/12/18 1.2 Watch: Searching the Literature 3/12/18 1.3 Watch: Formulating Effective Questions 0.25hr 3/12/18 Complete: PubMed Tutorial 1.0hr 3/13/18 1:55-3:50pm Active Session 1: Searching the Literature, Case #1 3/13/18 Complete: Evaluating Internet Health Information Tutorial 2.0hr Xiao 1, 2
3 s for 3/14/18 1:55-3:50pm Active Session 2: Drug- Drug Interactions, Case #2 (No irat/trat) 2 Module 2: Adverse Drug Reactions and Uncontrolled Studies 2.0hr Xiao 1, 2 Xiao 2, 3 3/16/18 2.1 Watch: Causality in Case Reports 3/16/18 Read: Fulminant Liver Failure and Transplantation After Use of Dietary Supplements 3/20/18 8:30-10:25am Active Session 3: Adverse Drug Reaction Report, Case #3 3/21/18 2.2 Watch: Principles of Causal Inference 2.0hr Xiao 2, 3 3/21/18 2.3 Watch: Hierarchy of Evidence 3/21/18 2.4 Watch: Drug Literature Evaluation Template 3/21/18 Read: Enteral Fish Oil for Treatment of Parenteral Nutrition Associated Liver Disease in Six Infants with Short-Bowel Syndrome 3/23/18 1:55-3:50pm Active Session 4: Case Series, Case #4 3 Module 3: General Principles of Study Appraisals 3/23/18 3.1 Watch: Anatomy of a Research Paper 3/23/18 3.2 Watch: Examples of Literature Review 3/23/18 Read: Drug Literature Evaluation Template 2.0hr Xiao 2, 3 0.25hr 1.0hr Xiao 3
4 s for 3/23/18 Read: Combined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six- Month Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial 3/28/18 8:30-10:25am 4/3/18 8:30-10:30am 4/10/18 8:30-10:25am Active Session 5: Where to Find Information in a Paper, Case #5 0.75hr 1-3 Midterm Exam 2.0hr 2.0hr Xiao 3 4 Module 4: Experimental Studies Xiao 3 4/4/18 4.1 Watch: Randomized Clinical Controlled Trials 4/5/18 4.2 Watch: Patient Selection and Sampling 0.75hr 4/5/18 4.3 Watch: Attrition in RCTs 4/5/18 4.4 Watch: Measurement of Outcomes 0.75hr 4/5/18 4.5 Watch: Outcomes in Clinical Research 4/518 Read: Stopping vs. Continuing Aspirin before Coronary Artery Surgery Active Session 6: Large RCT Part 1, Case #6 2.0hr Xiao 3 4/11/18 4.6 Watch: Reliability and Validity 0.75hr 4/11/18 4.7 Watch: Measuring Differences 1.0hr
5 s for 4/12/18 4.8 Watch: Multiple Measurements 4/12/18 4.9 Watch: Measurement Bias 0.25hr 4/12/18 4.10 Watch: Applying Statistics 0.75hr 4/13/18 8:30-10:25am Active Session 7: Large RCT Part 2, Case #6 continued 2.0hr Xiao 3 5 Module 5: Observational Studies Xiao 4 4/16/18 5.1 Watch: Limitations of RCTs 4/16/18 5.2 Watch: Observational Studies 0.75hr 4/16/18 5.3 Watch: Cohort Studies 0.75hr 4/16/18 5.4 Watch: Revealing Unmeasured Confounding 4/16/18 5.5 Watch: Statistical Adjustments for Bias 4/17/18 Read: Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease 4/18/18 10:40-12:35pm Active Session 8: Cohort Study, Case #7 0.25hr 2.0hr Xiao 4 6 Module 6: Systematic Reviews Xiao 4, 5 4/18/18 6.1 Watch: Systematic Reviews 4/18/18 6.2 Watch: Meta-Analyses 1.0hr 4/19/18 Read: Effects of coenzyme Q10 on statin-induced myopathy: a metaanalysis of randomized controlled trials 4/20/18 8:30-10:25am Active Session 9: Meta- Analysis, Case #8 0.75hr 2.0hr Xiao 4, 5 4/20/18 6.3 Watch: Guidelines and Evidence 0.75hr
6 s for 4/24/18 Read: Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society 4/25/18 10:15am- 12:05pm **Note Time** 5/4/18 TBD Active Session 10: Guidelines, Case #9 2.0hr Xiao 4, 5 1-6 Final Exam 2.0hr 1-6 Total Hours in Course: Required Textbooks/Readings 45.25hr 1. Patrick M. Malone, PharmD, FASHP, Karen L. Kier, PhD, MSc, RPh, BCPS, BCACP, John E. Stanovich, RPh, Meghan J. Malone, PharmD, BCPS, CACP. Drug Information: A Guide for Pharmacists, 5 th edition, McGraw-Hill Medical, ISBN-10: 007180434X; ISBN-13:978-0071804349. Available via HSC Library Access Pharmacy o http://accesspharmacy.mhmedical.com/book.aspx?bookid=981 2. Gehlbach SH. Interpreting the Medical Literature. 5 th Edition. McGraw Hill: New York, NY. 2006. Not available via HSC Library Use UF VPN to access UF Libraries Resources when off-campus. The UF HSC library staff can assist you with questions or issues related to accessing online library materials. For assistance contact your College of Pharmacy librarian or visit the HSC Library Website at this URL: http://www.library.health.ufl.edu/ Suggested Textbooks/Readings Suggested reading materials will be posted in the Canvas site. Other Required Resources N/A
7 Materials & Supplies Fees None Student Evaluation & Grading Evaluation Methods and How Grades are calculated. Assessment Item Grade Percentage irats [9] 20% trats [9] 25% Midterm Exam 25% Final Exam 30% Total 100% Rounding of grades: Final grades in Canvas will be rounded to the 2 nd decimal place. If the decimal is X.495 or higher, Canvas will round the grade to X.50. The above scale depicts this policy and grades are determined accordingly. Grade assignment is made using this policy and NO EXCEPTIONS will be made in situations where a student s grade is close. Educational Technology Use Percentage Range 92.50-100% A 89.50-92.49% A- 86.50-89.49% B+ 82.50-86.49% B 79.50-82.49% B- 76.50-79.49% C+ 72.50-76.49% C The following technology below will be used during the course 69.50-72.49% C- and the student must have the appropriate technology and software. 66.50-69.49% D+ 1. ExamSoft Testing Platform 62.50-66.49% D 2. Canvas Management System 59.50-62.49% D- For technical support, navigate to Educational Technology and IT Support Information at this URL: < 59.50% E http://curriculum.pharmacy.ufl.edu/current-students/technical-help/ Table 1. Grading Scale Letter Grade
8 Pharm.D. Course Policies The Policies in the following link apply to this course. Review the Pharm.D. Course Policies carefully, at this URL: http://curriculum.pharmacy.ufl.edu/current-students/course-policies/
9 Appendix A. Course Directory Teaching Partnership Leader/Course Director: Hong Xiao, Ph.D. Email: hxiao18@cop.ufl.edu Office: HPNP 3338/GNV Phone: 352-273-6711 Office Hours: By appointment ONLY. Questions to Ask: Questions about grades Concerns about performance Guidance when there are performance problems (failing grades) General questions about content Academic Coordinator: Name: Candice Walker Email: Candice.walker@cop.ufl.edu Office: HPNP 4312/GNV Phone: 352-273-5558 Office Hours: By appointment ONLY. Questions to Ask: Issues related to course policies (absences, make up exams, missed attendance) Absence requests (Only the Academic Coordinator handles absence requests) Questions about dates, deadlines, meeting place Availability of handouts and other course materials Assignment directions Questions about grade entries gradebook (missing grades, wrong grade) Assistance with ExamSoft (Distant campus students may contact Education Coordinator for use of SofTest and assistance during exams. The Academic Coordinator is the contact person for issues related to grading and posting of ExamSoft grades.)
Addendum to the Syllabus s for 1 Module 1: Evidence-Based Medicine and Drug Information 3/12/18 1.1 Watch: Principles of Evidence- Based Medicine AND Reading: The literature 1hr Xiao 1, 2 3/12/18 1.2 Watch: Searching the Literature 3/12/18 1.3 Watch: Formulating Effective Questions 0.25hr 3/12/18 Complete: PubMed Tutorial 1.0hr 3/13/18 1:55-3:50pm Active Session 1: Searching the Literature, Case #1 2.0hr Xiao 1, 2 3/13/18 1.4 Watch: Drug Labeling 1.0hr 3/13/18 1.5 Watch: Drug Information Resources (The Literature) 3/13/18 Complete: Evaluating Internet Health Information Tutorial 1.0hr 3/14/18 1:55-3:50pm Active Session 2: Drug- Drug Interactions, Case #2 (No irat/trat) 2.0hr Xiao 1, 2