BUFFALO, N.Y. -- Imagine having to take as many as 10 to 15
medications a day. Then add to that having to take them
exactly on time. And then after following this drug regimen
to a tee, you start to feel ill, but not from your disease
condition -- from one of the medications that treat it.
These are common challenges for individuals with HIV/AIDS, not
just in the U.S. but globally. Even with newer formulations and
simpler regimens, the drug management of these patients is so
knowledge intensive that it has become its own constantly changing
The University at Buffalo School of Pharmacy and Pharmaceutical
Sciences offers three unique HIV continuing education programs in
an online format to help pharmacists all over the world keep their
knowledge of HIV pharmacotherapy current.
Thus far, they have provided training to more than 3,800
individual pharmacists from the U.S., Japan, Zimbabwe, Puerto Rico,
the Netherlands and Canada.
UB has also partnered with Walgreen's drug stores to educate
many of their licensed pharmacists in the U.S.
"Our online HIV programs are designed to educate pharmacists on
current treatment principles and guidelines for the use of
antiretroviral therapy so they can more effectively advise HIV
patients and providers in their role as a pharmacist," said Linda
M. Catanzaro, PharmD and program chair of the UB HIV
Pharmacotherapy Continuing Education Center. "We offer them online
so that busy pharmacists don't have to travel and can work at their
While the average neighbourhood pharmacist -- the one we talk to
when we go to the drug store -- has to keep up to date on all drugs
and their side effects, HIV drug maintenance is especially
challenging due to the number of medications, higher risk of
adverse drug-drug interactions and complex patient factors,
"There is no typical patient with one set of symptoms; HIV/AIDS
manifests itself in many ways and the population is incredibly
diverse," she says.
The patients may range in age from birth to those over 60, may
be pregnant or nursing, may be IV drug users, may have hemophilia,
may have hepatitis or pneumonia, may be wealthy or homeless and may
feel healthy or be close to death.
"Therefore there is no simple approach; each patient's drug
regimen is truly individual," said UB pharmacy practice chair,
Edward M Bednarczyk, PharmD.
He adds, "There is a critical link between the patient's
physician and his pharmacist. The patient may see a number of
doctors but often gets all of his drugs in one place, making his
pharmacist a key point of contact who can tell if the patient is
adhering to the prescribed regimen by how often prescriptions are
Marsha M. Nelson, the program director, says that because
pharmacists work in a variety of settings, such as neighborhood
pharmacies, hospitals and clinics that specialize in treating
patients with HIV/AIDS, UB has created three distinct training
programs. Pharmacists can then use their practice setting to
determine which program best meets their continuing professional
"There is an annual update program, which is solely on the
Internet and is knowledge-based with a post-test; there is a
community pharmacy application-based program, which contains active
learning components -- a combination of home study and live
activities; and there is the practice-based program that combines
home study and live Internet material, along with an online case
submission component," said Nelson.
Pharmacists from outside the U.S. usually take the
practice-based program, Nelson adds.
The programs have pharmacists take a pre-test to assess their
baseline knowledge. The average score is 47 out of 100 on the
pre-test. After training, the average score on the post-test rises
to 82 percent.
"These scores have been consistent," says Nelson.
Walgreens is the first pharmacy to partner with UB to enrol its
pharmacists in the Community CE application-based program and now
has them follow up every year in the annual update program. The
federal prison system also has selected employees participate in
the practice-based program.
UB is accredited by the Accreditation Council for Pharmacy
Education (ACPE) and uses ACPE guidelines for continuing education.
Currently, there are no across-the-board standards in HIV
postgraduate continuing education programs for pharmacists, but
according to Bednarczyk and Catanzaro, UB's HIV programs are
helping to define credentialing for HIV CE and provide the model to
meet a range of practice experiences and educational needs.
"Our programs are helping to educate pharmacists here and
around the world about the best pharmacy practices in caring for
patients with HIV/AIDS," said Catanzaro.