2026 Southeastern Residency Conference

Title: VOICES OF WOMEN’S HEALTH: A SURVEY TO SHAPE ACCESSIBLE, PHARMACIST-LED CARE 

Authors: MK Schwaemmle, Fallon Hartsell, Courtney E. Gamston, Kimberly B. Lloyd 

Background/Purpose: Women’s health has been a topic that has been historically neglected by the medical community at large, and limited research regarding specific conditions that primarily affect women, make it difficult for practitioners and patients to navigate and manage disease states such as endometriosis, menopause, migraines, pelvic floor disorders, and others. According to the Center for Disease Control and Prevention (CDC) in 2023, 15.6% of women 18 years old and older in the United States reported to be in fair or poor health. In addition, 3 out of 4 people diagnosed with an autoimmune disease are women. Many women lack consistent support for their health needs, providing pharmacists an opportunity for addressing health care needs in this underserved patient population. This survey seeks to identify which women's health services are needed and desired within a self-insured adult female population and the acceptability of having pharmacists provide these services. 

Methodology: An incentivized, anonymous online survey was distributed via email, social media, and flyers. Eligible participants were females covered by the employee insurance plan at a large, self-insured employer and were 18 years old and older. Survey domains included demographics, assessment of general health, gynecologic history, sexual health, current health concerns, facilitators and barriers to care, brief health history, and desire for pharmacist-led services.  The survey took participants between 20 and 30 minutes to complete. Data was reported as descriptive statistics. The results of this study will identify the status of women’s health needs in the community, characterize this patient population, and inform the development of pharmacy-provided services.  

Results: In progress 

Conclusions: In progress 

Authors: Savannah Odom, Lauren Freeman, Hannah Harpe
Objective: This study evaluates the effectiveness of a practice advisory alert in improving antibiotic prescribing at hospital discharge.
Background: Antimicrobial resistance is a major and growing global public health threat, driven largely by antimicrobial misuse and overuse. Inappropriate antibiotic prescribing at hospital discharge is a key contributor, with studies demonstrating that durations frequently exceed guideline recommendations. Prior research has shown that antibiotic overuse occurs in up to 75% of patients, primarily due to excessive treatment duration and failure to account for inpatient therapy. This highlights a critical opportunity for antimicrobial stewardship interventions targeting transitions of care to optimize antibiotic use and improve patient outcomes. Building on a prior institutional initiative in which a fluoroquinolone-specific alert significantly reduced treatment duration, this study assesses whether expanding the alert to additional antibiotic agents results in similar improvements in prescribing practices. The alert prompts providers to account for inpatient antibiotic days when determining discharge durations, supporting appropriate therapy length and antimicrobial stewardship efforts.
Self Assessment Question: What was the main finding after implementation of the practice advisory?
Methods: This retrospective, multi-center, quasi-experimental study evaluates adults discharged on oral antibiotics before (January 2025-February 2025) and after (January 2026-February 2026) implementation of a practice advisory. A random sample from the pre-intervention group is matched 1:1 to the post-intervention group by antibiotic and indication. Patients receiving antibiotics for prophylaxis or suppression, those immunocompromised, or those with severe or complicated infections were excluded. Data collected include demographics, antibiotic regimen and indication, infectious diseases consultation, and prescriber credentials. The primary outcome is the proportion of patients discharged with antibiotic durations consistent with guidelines or infectious diseases recommendations, adjusted for inpatient days of therapy. Secondary outcomes include 30-day treatment for Clostridioides difficile and 30-day all-cause readmission. 
Results: A total of 300 patients were included, with 150 patients in both the pre- and post-intervention groups. Baseline characteristics, including age, sex, infection type, and antibiotic selection, were well balanced between groups. Implementation of the practice advisory alert was associated with a significant improvement in guideline-concordant antibiotic prescribing at discharge, increasing from 53.3% in the pre-intervention group to 81.3% in the post-intervention group (p < 0.001). Thirty-day all-cause readmission rates were 13.3% in the pre-intervention group versus 12% in the post-intervention group (p = 0.73). Additionally, no patients in either group required treatment for Clostridioides difficile infection within 30 days of discharge.
Conclusion: Implementation of an electronic practice advisory alert that incorporates inpatient antibiotic days resulted in a clinically meaningful and statistically significant improvement in appropriate antibiotic duration at discharge. Expansion of this alert beyond fluoroquinolones to a broader range of antimicrobial agents successfully optimized prescribing practices. Importantly, these improvements were achieved without negatively impacting patient safety outcomes, as evidenced by unchanged readmission rates and absence of Clostridioides difficile infection events. Overall, this study demonstrates that targeted electronic clinical decision support tools are an effective and scalable antimicrobial stewardship strategy

Title: Evaluating the Impact of Clinical Pharmacist Interventions on the New Anticholinergic Measure in a Private Primary Care Setting

Authors: Sarah Emily Strickland, Leah A. Surbaugh, Whitney Aultman

Background: Ambulatory care clinical pharmacists have historically been involved in interventions to improve quality metrics set forth by the Centers for Medicare and Medicaid Services Star Ratings. The Centers for Medicare and Medicaid Services recently established a new star rating which includes patient’s 65 years or older, prescribed and filling 2 or more anticholinergic medications concurrently for 30 days or more on a Medicare Part D plan. The purpose of this study is to evaluate the impact on metric improvement following clinical pharmacists' interventions on the Polypharmacy: Use of Anticholinergic Medications (POLY-ACH) quality metric.

Methods: Patients evaluated for inclusion in the study were identified from data provided by BlueCross BlueShield and Humana Medicare Advantage Plans. Selection of these Medicare Advantage plans was based on those currently monitoring or tracking the anticholinergic metric as well as insurance plans holding a gain share contract with the private care practice site. Patients were included if they were 65 years or older, followed by a primary care provider within State of Franklin Healthcare Associates, which is a physician-led and employee-owned private medical group with over 30 practices across Northeast Tennessee and Southwest Virginia with the majority being internal medicine or family medicine practices. Patients must be prescribed 1 or more anticholinergic medication and there must have been communication of medication recommendations made to the provider from the clinical pharmacist related to the anticholinergic medication prescribed. All patients included needed an appointment scheduled on or before December 31, 2025. Data collection points included patient demographics, baseline and follow up anticholinergic burden score, anticholinergic medication use and duration, prescribing physician, and intervention response. The primary outcome was a composite endpoint of the impact of interventions made by the clinical pharmacist. This included medication changed based on pharmacist recommendations, patient declined alternative therapy despite provider encouragement, or the provider contacted an outside prescriber with alternative recommendation provided by clinical pharmacist. Data analysis included a one-sample proportion test for the primary outcome and descriptive statistics for the secondary outcomes, along with a paired t-test for anticholinergic burden score comparison.

Results: A total of 459 patients were screened for inclusion, and 99 patients were included in final analysis. The average patient was 76 years of age, and a majority of patients were female. The average number of baseline anticholinergic agents for each patient was 1.1. The result for the primary outcome was 73.7%. Most patients had been prescribed the anticholinergic agent for more than a year. The most common anticholinergic class prescribed was antihistamine followed by antidepressant and skeletal muscle relaxant. The average baseline anticholinergic burden score for patients enrolled was 4.6, with the follow up anticholinergic burden score showing a decrease to 3.1.

Conclusions: The results of this study highlight that clinical pharmacist interventions on anticholinergic medications led to an improvement in the Polypharmacy: Use of Anticholinergic Medications (POLY-ACH) quality metric and potentially increased reimbursement rates from Medicare Advantage Plans. The impact from the clinical pharmacist intervention also led to a reduction in patient’s anticholinergic burden score, showing a positive impact on patient outcomes. Future directions include developing educational materials based on prescribing trends identified to influence future prescribing practices.

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Authors: Rachel Denison; Danielle Lott; Eric K. Shaw; Audrey Johnson
Contact Information: [email protected]
Background
Burnout is a growing epidemic affecting healthcare professionals worldwide. A 2023 study found that 45% of pharmacists reported burnout. As a profession that relies heavily on hands-on learning, the need for assessment of burnout amongst pharmacy preceptors is critical. A 2022 survey-based study of pharmacy preceptors in northern California found that 57% of participants were experiencing burnout. Other studies have examined burnout amongst pharmacists and pharmacy leadership, but there remains limited information regarding burnout amongst pharmacy preceptors across the United States.
Methods
This survey-based study aimed to assess burnout amongst pharmacy preceptors across the United States. Preceptors were contacted by email through health system and professional society registries. Participants were included if they self-identified as a pharmacist preceptor for pharmacy students and/or residents. The primary outcome was the percentage of burnout amongst participating pharmacy preceptors using the Copenhagen Burnout Inventory. Burnout was defined as a Copenhagen Burnout Inventory score ≥ 50. Secondary outcomes included subcategories of burnout: personal, work-related, and learner-related. Secondary outcomes were analyzed by additional contributing factors related to pharmacy preceptors. Statistical analyses utilized were Pearson’s chi-square test and Fischer’s exact test.
Results
From the invitations sent, 638 participants across the United States completed the survey. A total of 311/638 (48.7%) pharmacy preceptors had scores that indicated burnout. Of the participants experiencing burnout, the following also indicated burnout in learner-related, personal, and work-related subcategories: 230/311 (74%) learner-related burnout, 283/311 (91%) personal burnout, and 281/311 (90.4 %) work-related burnout. Factors related to participants who scored above threshold for burnout include: highest level of postgraduate training, precepting at university-affiliated teaching hospitals, greater percentage of students/residents that were difficult to teach and/or unmotivated, greater average number of hours worked per week, preceptors who participate in daily rounding, and greater amount of free time spent on work-related responsibilities. Factors related to participants who scored below threshold for burnout were: precepting at non-teaching hospitals, compensation or rewards for precepting, having adequate time for administrative or precepting duties, and having children/dependents.
Conclusion
This study examined current burnout trends facing pharmacy preceptors across the United States. Our survey recognized that 48.7% of participating preceptors are experiencing burnout. These results provide information about contributing factors to burnout, specifically learner-related, personal, and work-related burnout factors. Due to different cultures amongst employers, this study could be replicated at individual sites to determine levels of burnout and site-specific risk factors. Limitations of this study include possible biases created by a survey-based study, underrepresentation in several regions of the U.S., inability to rule out duplicate responses, and inability to verify survey responses. Our survey illustrates the need to further develop processes and initiatives that could be incorporated to improve reduce preceptor burnout.

Title: Title: Impact of Integrating the BioFire® Meningitis/ Encephalitis (ME) Panel with Antimicrobial Stewardship in a Non-Teaching Community Hospital

Investigators: Ashtyn Keller; Brad Crane; Emily Duncan; Stephanie Grimes; Joy (Abby) Bussey 

Study Location: Prisma Health Blount Memorial Hospital, Maryville, TN – Department of Pharmacy 

Background: Limited data exists on the clinical and financial impact of rapid cerebrospinal fluid (CSF) diagnostic testing in non-academic community hospitals. This study evaluated the effect of implementing the BioFire® MEP on patient outcomes and hospital resource utilization.  

Methods: This IRB-approved, single-center, retrospective cohort study included adults hospitalized from July 2020 through June 2025 with an identified CSF culture ordered. Exclusion criteria were if less than 18 years old, test cancellation or non-completion, transfer to another facility, repeat CSF specimens from the same patient or infection, or treated outpatient only. The primary outcome was time to optimal antimicrobial therapy in patients without the BioFire® MEP or with the BioFire® MEP. Secondary outcomes compared duration of antimicrobial therapy, hospital length of stay, and hospital costs per visit. Student’s t-tests were used with significance defined as p < 0.05. 

Results: A total of one hundred and twenty-one patients were included: eighty-seven patients (72%) did not utilize the BioFire® MEP, and thirty-four patients (28%) utilized the BioFire® MEP. Median time to optimal antimicrobial therapy without the BioFire® MEP was 3.0 days compared to 2.0 days with the BioFire® MEP (absolute difference 1 day; 95% CI 0.004 to 1.96; p=0.04). Mean duration of antimicrobial therapy without the BioFire® MEP was 4.0 days compared to 2.9 days with the BioFire® MEP (absolute difference 1.1; 95% CI -2.72 to 0.56; p=0.19). Median hospital length of stay without the BioFire® MEP was 6.0 days compared to 4.5 days with the BioFire® MEP (absolute difference 1.5; 95% CI -1.74 to 4.74; p=0.36). Median hospital costs per visit without the BioFire® MEP were $8,456 compared to $9,854 with the BioFire® MEP (absolute difference $1,398). 

Conclusion: In conclusion, this retrospective cohort study in a non-academic, community hospital, demonstrated that the implementation of the BioFire® MEP was associated with a significantly significant reduction in time to optimal antimicrobial therapy and potentially shorter antimicrobial duration and hospital length of stay. Additional large-scale studies are recommended to confirm these findings.