Sex specific Pharmacy Education Resources and Tools
This curricular framework outlines core competencies and performance-based learning objectives for use in either dedicated courses on women’s health or in conjunction with other pharmacy courses. The curriculum is designed to be flexible in order to keep up with the ever-changing knowledge about women’s health issues and provides multiple online resources to enhance discussions on the competencies and objectives. We will continually update and add to this framework and welcome your suggestions for topic areas and resource inclusion, which can be made by contacting Dr. Ruth E. Nemire, AACP associate executive vice president. We hope you and your students benefit from this curriculum, and use it and its resources in creative ways. Developed through a partnership between AACP and the FDA’s Office of Women’s Health
Learning and Performance Outcomes
I. General Women’s Health Concepts
- Develop the skills necessary for lifelong learning in the area of women’s health.
- Describe women’s health from a biopsychosocial perspective that includes the biologic, social, economic, political, and spiritual determinants of health.
- Utilize a standardized approach in determining health and social factors influencing treatment in women and apply to an individual patient.
- Develop and implement a pharmaceutical care plan for patients at each stage of a woman’s life span.
- Apply ethical principles to increase understanding of the importance of comprehensive access to healthcare for all women.
- Recommend appropriate resources (educational, community, etc.) for women’s health care needs.
II. Access to Healthcare
- Describe gender specific barriers to health care including access to insurance, public assistance programs and the interaction between self‐care and family care responsibilities with specific attention to underserved and marginalized communities including ethnic minorities, lesbian, transgender, rural, immigrant, disabled, and elderly women.
- Advocate for patients by providing health education to women on sexual health.
- Describe and debate ethical issues related to health care disparities and access to health care in women.
II. Sex and Gender Differences in Disease Presentation and Treatment
- Compare and contrast sex and gender differences in the etiology, epidemiology, course and treatment of chronic diseases in women (e.g., cancer, cardiovascular disease, mental health, gastrointestinal disorders, neurologic disorders).
- Biological Considerations and Basic Sciences ‐Describe sex differences that may exist in biochemical mechanisms, pharmacokinetics of drugs, and in the pathogenesis of disease and disease mechanisms.
- Identify disease states that are specific to women or that affect a disproportionate number of women compared to men and their treatment
- Therapeutic management of these disease states
- The role of the pharmacist in managing these disease states
IV. Mental Health/Psychosocial
- Identify issues related to domestic violence.
- Discuss psychosocial issues that impact women’s health across the lifespan
V. Therapeutic Care Plans
- Develop appropriate therapeutic care plans in the management of health care in women across the life span. Develop recommendation and explain rationale.
- Utilize information regarding ethnic, socioeconomic, cultural, physiologic and psychosocial factors in developing individual care plans for the provision of care in women.
- Identify treatment options and demonstrate differences in treatment of pregnant vs. non‐pregnant women.
- Make recommendations for healthy aging in women, taking into consideration changing hormone levels.
- Identify and make management recommendations for mental health issues affecting women (eating disorders, depression, post‐partum depression, psychosis).
VI. Clinical Trials
- Discuss issues (and history) regarding the inclusion of women in clinical trials.
- Apply research data in the treatment of diseases in women
- Identify and debate therapeutic controversies in women’s health
- VII. Communication Skills
- Use culturally competent, patient centered communication skills to obtain a comprehensive patient history including sexual and reproductive history, psychosocial history, and history of traumatic events (domestic violence/rape/incest).
- Utilize communication skills that are effective in the management of women’s health.
- Utilize communication skills that demonstrate empathy and compassion in appropriately addressing women’s health needs.
VIII. Pregnancy
- Explain the factors influencing the passage of drugs across the placenta.
- Explain the FDA pregnancy category ratings.
- State the four elements of developmental toxicity.
- List the known causes of structural anomalies in humans.
- Identify the gestational weeks when the embryo‐fetus is most vulnerable to drug‐induced injury and explain the rationale for this.
- Identify from a list of drugs those that are known to cause developmental toxicity in humans.
- Cite appropriate references containing information on the embryo‐fetal risk of drug
- exposures in pregnancy and appropriate references that cite the effects of drugs taken by the mother on a nursing infant.
- For a drug with no human pregnancy experience, estimate the risk of developmental toxicity (risk vs. low risk) to a human embryo or fetus.
- Provide guidance regarding the use of specific medications in pregnant and nursing women for major disease states.
- Assess the risk/benefit ratios of drug exposures during pregnancy and make clinical decisions regarding the use of medications in women who are pregnant.
- Given a drug known to cause developmental toxicity but required for the treatment of
- maternal disease, design a treatment plan representing the lowest risk to the embryo‐fetus.
- Refer pregnant women to specialists when appropriate.
- Discuss the treatment options for preventing disorders related to pregnancy.
- Discuss the pathophysiology and treatment options for managing disorders related to pregnancy.
- Encourage pregnant women on medications to speak to their doctor about enrolling in a pregnancy registry:
IX. Nursing/Breastfeeding
- Explain the factors that determine the passage of drugs into breast milk.
- Identify from a list of drugs those that, when taken by a mother, are known to cause or may potentially cause harm in a breastfeeding infant.
- Identify the period during which most adverse reactions occur in nursing infants from exposure to drugs in breast milk.
- Assess the risk/benefit ratios of drug use while breast feeding and make clinical decisions regarding the use of medications in women who are breastfeeding
- Refer nursing women to specialists when appropriate.
X. Wellness & Prevention
- Discuss the role of preventive care in women’s health such as:
- Screening for female‐specific cancers
- HPV vaccine
- Nutrition and vitamins
- Preparation for pregnancy
- Sexually transmitted diseases
- Opioid Use and Abuse
- Triage women’s health issues to assist patients in obtaining care from appropriate providers
- Utilize population level data to identify gender specific health care priorities and develop targeted interventions to address these priorities
- Conduct health screenings in women where appropriate.
XI. Sexual and Reproductive Function
- Describe the basic physiology of the reproductive system and develop appropriate pharmaceutical care plans for menstrual disorders, pregnancy prevention, and fertility promotion that address the cultural, social, and economic needs of the patient.
- Apply ethical principles and act on one’s professional obligation to provide access to reproductive health care to women that is in the best interest of the patient and is consistent with the patient’s belief system.
XII. Roles of Women in Healthcare
- Describe the progress of women’s involvement in health as it relates to historical, social, economic, religious, ethnic, and ethical perspectives.
- Discuss the significance of women’s (changing) roles in healthcare
- Changing role of women as providers of healthcare
- Women as the decision makers in the healthcare system
- Role of the government in enabling the role(s) of women in the healthcare system
- Disparities related to women ‐access to care, treatment, salaries, etc.Discuss the role of women as caregivers and their role in making health care decisions within the family unit.
Pharmacists Patient Care Encounters with Female Patients
Core Patient Assessment Data/Information (Core Database)
Sexual Health Assessment and Interviewing Methods
When interviewing women patients, there are often topics that are considered “sensitive” and that are sometimes difficult for both patients and providers to have comfortable conversations. A good comprehensive resource for learning about sexual health assessment and interviewing methods can be found in “Sexual Medicine and Primary Care” by William L. Maurice, M.D.
Interview methods are specifically addressed in Chapter 2 of the above reference at: Interview Tool
Another, much briefer, resource is the CDC’s Guide to Taking a Sexual History, which can be found here: Sexual Hx Tool1
However, it is more oriented toward STIs and offers little guidance about how to implement the suggested assessment questions. Another brief written resource on sexual history taking/assessment that may be helpful is: Sexual Hx Tool
General Assessment: Take Online Quiz