The Missing Piece: The Intersection of Pharmacist Board Certification and Tobacco Use Disorder Treatment

To the Editor:

The Board of Pharmacy Specialties (BPS) was organized in 1976 as an autonomous certification agency of the American Pharmacists Association with a mission to improve patient care by promoting the recognition and value of specialized training, knowledge, and skills in pharmacy and specialty board certification of pharmacists. The BPS currently recognizes more than 60,000 active pharmacist certifications across 14 specialties, and we have recently recognized a 15th specialty, pain management.

The BPS commends the authors of “Education for Tobacco Use Disorder Treatment” (TUDT), published in ATS Scholar in December 2023, for conducting research to ascertain the current state of TUDT training for diverse professionals (1). The BPS agrees with the authors that tobacco use is undertreated in the healthcare setting and appreciates the thorough review the authors conducted in examining TUDT training, professional testing, and curriculum requirements. However, we are concerned with the number and type of examinations evaluated for the review.

When reviewing the TUDT article (1), the BPS noticed that the examination evaluated for pharmacist training was the North American Pharmacy Licensure Examination. BPS board certification examinations were not analyzed when reviewing pharmacy training. Although the North American Pharmacy Licensure Examination is required for licensure into the profession, it is not the sole examination used to evaluate competency in core areas. The BPS offers board-certification examinations used to validate that pharmacists have advanced knowledge and experience to optimize medication therapy for patients in a variety of settings. In contrast, for the nursing profession, multiple examinations were evaluated, specifically the National Council Licensure Examination and two primary-care advanced practice registered nurse examinations from the American Nurses Credentialing Center.

The BPS Ambulatory Care Pharmacy Examination Content Outline includes tobacco use and cessation competencies under the following three subdomain areas.

• •1.3 Create and implement an individualized patient-centered care plan
  • ○1.3.4 Lifestyle behaviors that impact chronic diseases and wellness (e.g., nutrition, exercise, tobacco use)
• •1.4 Follow-up to monitor and evaluate response to an individualized patient-centered care plan
  • ○1.4.4 Lifestyle behaviors that impact chronic diseases and wellness (e.g., nutrition, exercise, tobacco use)
• •1.5 Educate patients and caregivers regarding the care plan
  • ○1.5.3 Wellness, prevention, and self-care (e.g., tobacco cessation, dietary modification, exercise, non-pharmacologic therapy

The BPS understands that the primary focus of the article (1) was to review the education provided in medical didactic instruction. Still, because the study also included other disciplines, including pharmacy, the article would be enhanced by the inclusion of postlicensure certification examinations for pharmacists.

The BPS acknowledges that reviewing all certifying examinations for each healthcare discipline was beyond the scope of the article. However, the exclusion of postlicensure certification examinations for pharmacists could introduce an additional limitation to the study. Consequently, by not evaluating other certification examinations, the study might overlook data demonstrating more comprehensive verification of TUDT knowledge across various healthcare disciplines.

The BPS commends the authors for researching various techniques to improve education for TUDT training and agrees with their conclusion that integrating these techniques and strategies into clinical training is necessary to improve the treatment for patients with tobacco-related diseases. The BPS appreciates the opportunity to comment on the research done and hopes that it can be used to improve TUDT in didactic training, licensure examinations, and postlicensure certification examinations.