Opioid overdoses in Chicago are unevenly distributed, affecting medically underserved neighborhoods most acutely. Innovations in reaching patients perceived to be hard-to-reach (e.g., unstably housed, marginalized), especially in these underserved neighborhoods, are urgently needed to combat the overdose crisis. This study characterizes the pilot year of a mobile medical unit partnership between a large urban academic center and a community-based harm reduction organization in Chicago. This is a retrospective cohort study of all patients who were seen on a mobile medical unit focused on providing low-threshold buprenorphine and primary care in areas with high opioid overdose rates on Chicago's West Side. Treatment episodes were accrued between July 1, 2021, and June 30, 2022 in the first year of operation. The main outcomes were number of patients seen, demographic characteristics of patients, and reason(s) for visit over time. The study saw 587 unique patients on the mobile medical unit between July 1, 2021, and June 30, 2022. Approximately 64.6 % were African American, and more than half lacked active insurance or could not confirm insurance status at the time of visit. The most common reason for initial visit was COVID-19 vaccination (42.4 %), and the most common reason for follow-up visit was buprenorphine treatment (51.0 %). Eleven patients initially presented for other health concerns and later returned to initiate buprenorphine. The mobile medical unit successfully reached nearly 600 patients in traditionally medically underserved Chicago neighborhoods with the highest overdose rates. The mobile unit's integrated approach met a variety of health needs, including buprenorphine initiation, with a unique opportunity for postoverdose initiation. Several patients initiated buprenorphine after presenting for different health concerns, showing the potential of an integrated approach to build on past mobile outreach programs and reach people with opioid use disorder who are not yet ready to initiate treatment.

The fatal overdose crisis claims nearly 200 lives daily in the United States (U.S). Evolutions in the illicit drug supply, such as the addition of sedative adulterants and a shift to synthetic opioids such as fentanyl, have driven increasing rates of both fatal and non-fatal overdose. Specifically, synthetic opioid usage of fentanyl was implicated in 68 % of the U.S. drug overdose deaths in 2022 alone. This has placed tremendous burden on communities, emergency medical services, and healthcare systems, and contributed to tragedy and grief both in the U.S. and worldwide. Despite the availability of effective opioid antagonist medications and standards of care, there has been increased interest in research and development of alternative opioid overdose reversal agents by the National Institutes of Health (NIH) in partnership with pharmaceutical manufacturers over the last decade. The U.S. Food and Drug Administration (FDA) recently approved nalmefene (Opvee) a mu-opioid receptor antagonist that boasts an extended half-life and stronger mu-receptor affinity compared to the standard of care use of naloxone for opioid reversal. In this article, we explore the medical need and ramifications of the introduction of longer-acting opioid antagonists in the current opioid overdose landscape. Existing data highlight the effectiveness of already available naloxone products as a safe and effective standard of care. These data support the notion that stronger, longer-acting agents may be unnecessary, and their existence may cause undue harm, such as more severe and/or prolonged withdrawal symptoms, lead to challenging patient interactions, and complicate the initiation of medications for opioid use disorder. More evidence is needed before healthcare professionals should implement the use of stronger, longer-acting opioid antagonists for reversing opioid overdose over evidence-based, cost-effective naloxone.

Simulation, an educational, assessment, and research technique used to mimic real‐world situations, is increasingly used in pharmacy education. The most‐used simulation methods include high‐fidelity simulation (HFS), low‐fidelity simulation (LFS), standardized patients, and game‐based simulation. A common element of simulation is its ability to offer learners the chance to practice a skill or acquire knowledge in a safe and accessible space. Simulation methods differ in key aspects, including cost and other resource investment as well as ideal venue for use in education. HFS provides a more realistic simulation environment than LFS but is typically more expensive. Standardized patients offer learners the opportunity to engage with a live person but may elicit greater variability in responses to learners' input than HFS. Computer‐based simulation uses technology to supply a wide variety of learning opportunities; however, it may require the use of proprietary software and devices. Despite widespread use, literature describing learning outcomes of simulation in pharmacy education is limited. Some existing reports with positive findings have focused on learner satisfaction with or perceived benefit of simulation activities. The few existing publications summarizing changes in skills or knowledge demonstrate a positive impact. Simulation is a promising modality for educating pharmacy students and residents; however, more data summarizing the benefit of learning outcomes are needed.

Entrustable professional activities (EPAs) are specific tasks that a professional is entrusted to perform autonomously and, together, define the scope of a profession. There are specific attributes that a task must possess both structurally and conceptually to be classified as an EPA. A high-quality EPA must be an observable, measurable, and professional task that requires training to execute, is fit for entrustment, and can be performed independently. In 2017, the American Association of Colleges of Pharmacy (AACP) defined 15 Core EPAs expected of a pharmacy learner upon graduation (Core EPAs). Despite acceptance and implementation by pharmacy schools across the country, the Core EPAs have not been evaluated using an objective assessment tool to ensure that they meet specific EPA quality standards outlined in the literature. This article describes existing objective assessment tools for EPA quality and highlights the importance of high-quality EPAs in pharmacy education, which would be an important step for the AACP Academic Affairs Committee to utilize to further develop EPAs for implementation.

While pharmacy residencies are relatively unanimous in their focus on cultivating quality clinical pharmacists with exceptional clinical knowledge and practice skills, post‐graduate pharmacy fellowships offer training opportunities to develop skills for successful entry into other career types, with major differences between and within various types including pharmaceutical industry, clinical practice, academia/education, and other fellowship programs. In general, pharmaceutical industry fellowships are designed to prepare pharmacy graduates to primarily contribute to various aspects of pharmaceutical drug development and marketing with skills aligned with a specific functional area within pharmaceutical industry. Clinical practice, academia/education, and other research fellowships generally focus on developing research skills in targeted areas ranging from specific therapeutic areas, teaching and learning, or disciplines of research. Most fellowship programs provide training and experiences to develop vital translatable skills such as interpersonal, written, and verbal communication, time and project management, leadership, and teamwork. Conversely, fellowship training can differ considerably, even within individual fellowship types and programs, in specific purpose, structure, required activities, funding, collaborative affiliations, and the specific career a graduate may be qualified to pursue after program completion. The objectives of this article are to differentiate various types of post‐graduate pharmacy fellowship programs and to review strengths and potential areas for improvement across all post‐graduate pharmacy fellowship programs.

This study aimed to evaluate the quality of the American Association of Colleges of Pharmacy Core Entrustable Professional Activities (Core EPAs) for New Pharmacy Graduates according to standards outlined in competency-based education literature utilizing the Queen’s EPA Quality (EQual) rubric. A cohort of pharmacists with EPA expertise rated Core EPA quality with the EQual rubric and provided recommendations for revisions. A generalizability study determined the reliability of the EQual ratings with pharmacist users. Nine pharmacists responded (4.4%). Most EPAs (9/15) did not reach the overall cut-off score, indicating low quality. EPAs 1 through 5 and EPA 14 (fulfill a medication order) were deemed high quality. EPA 12 (use evidence-based information to advance patient care) scored the lowest at 3.47 (SEM 0.29). EPA 14 scored the highest at 4.60 (SEM 0.14). EPA 15 (create a written plan for continuous professional development) was the only EPA to fail to reach the cut-off across all EQual domains. EPAs in the Patient Care Provider Domain received significantly higher ratings than other EPAs. On average, three respondents recommended revision for each. Most comments aligned with the EPA’s EQual rubric performance. The generalizability study analysis revealed excellent reliability (G = 0.80). Determining EPA quality utilizing objective measurement tools should drive EPA development and revisions to more accurately reflect the roles, responsibilities, and expectations of pharmacists on the healthcare team.