What is the biggest challenge PharmDs have faced during COVID-19?
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Personal and professional sustainability
As with society in general, COVID-19 has created varied challenges for the infectious disease pharmacist community. However, as identified, the challenge of pivoting work and a constantly shifting landscape of available therapies were universal.
In our own program, the shift away from traditional pharmacy work for pandemic response was significant (62%) and lasting, with more than half not returned to routine work 1 year into the pandemic. Although there are signs that some of this work is returning, a new trend is emerging in the ID pharmacy workforce. I hear nearly weekly from ID pharmacists — seasoned colleagues and relatively recent trainees alike — who are leaving front-line patient care positions or the profession entirely. I have not quantified this, but ID pharmacy positions were once keenly sought and hard to find. I receive an email from professional organizations almost weekly recruiting for these positions. Some admittedly are newly created positions as organizations realize the need for more ID pharmacist support in the ongoing pandemic, but many are vacancies created by colleagues needing to make a change.
So, I would pose that the biggest challenge was sustainability, both of a personal nature with numerous and continuous new therapies needing an implementation plan, and for our profession, which is suffering from the loss of tremendous talent.
- Reference:
- Dodds Ashely ES, et al. Open Forum Infect Dis. 2021;doi:10.1093/ofid/ofab466.308.
Elizabeth S. Dodds Ashley, PharmD, BCPS, is an Infectious Disease News Editorial Board Member and professor of medicine at Duke University School of Medicine.
There is no “biggest” challenge
I do not believe there is one “biggest” challenge relative to the pandemic for any one PharmD! I completely concur with Dr. Dodds, but would also make the point that there are multiple challenges.
As with most health care professionals, burnout is likely high on the list. ID pharmacists actively engage in stewardship, which was incredibly challenging early in the pandemic because therapeutics were limited, and much was unknown. They had an internal sense of obligation to provide information identifying evidence-based practice standards vs. anecdotal information, and several participated on guideline panels. This occurred while daily workloads were drastically increasing.
Those of us affiliated with academic institutions had to be nimble and pivot between remote learning and live education. Similarly, many pharmacists engage in experiential training of pharmacy students, which was extremely challenging because of time constraints, workload, and minimizing close contact.
Community pharmacists experienced logarithmic increases in workload because many patients avoided hospital care during the peak of the pandemic and, thus, relied on their accessible community pharmacist. Workload and frustration are compounded by opposition to pharmacists providing professional judgment relative to efficacy for and safety of anecdotal therapies touted by erroneous sources — hydroxychloroquine, ivermectin, etc. These can be tense interactions adding to stress and burnout.
Although well versed in vaccine administration, the availability of COVID-19 vaccines resulted in a tripling or quadrupling of the workload for most, particularly for those who also assumed the role of testing.
In addition to providing up-to-date, evidence-based practice recommendations, pharmacists are very much cognizant of the absolute necessity to always adhere to safe medication practices.
Lastly, pharmacists working on behalf of professional organizations were relentless in advocating for equity in access to COVID-19 vaccines and therapeutics and continue to do so for oral antivirals.
Margo Farber, PharmD, is executive director of the Society of Infectious Diseases Pharmacists and part-time faculty at Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences.
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