Beth Zerr

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Courses

Scholarly Contributions

Chapters

• Zerr, B. (2023). Case 93. Superficial Fungal Infections. In Pharmacotherapy Principles and Practice Study Guide: A Case Based Care Plan Approach, 6th ed.. New York: McGraw Hill Medical.
• Zerr, B. (2023). Fall Prevention and Osteoporosis in the Older Adult. In Ambulatory Care Self-Assessment Program. American College of Clinical Pharmacy.
• Zerr, B., & Cooley, J. H. (2023). Acne. In Pharmacotherapy Principles and Practice Study Guide: A Case Based Care Plan Approach 6th Edition. McGraw-Hill.
• Cornelison, B. R., Zerr, B., & Villanueva, J. E. (2022). Utilizing SCHOLARMAC to Provide Self-Care Recommendations. In Pharmacy Practice Skills: A Guide for Students and Instructors.
• Villanueva, J. E., Zerr, B., & Cornelison, B. R. (2021). Utilizing SCHOLARMAC to Provide Self-Care Recommendations. In Pharmacy Practice Skills: A Guide for Students and Instructors. To be published online: McGraw-Hill.
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  Gupta V, Nguyen T, Clark M, Williams E, Cone C, Desselle S. eds. Pharmacy Practice Skills: A Guide for Students and Instructors. New York, NY: McGraw-Hill. (To be published online)
• Zerr, B., & Cooley, J. H. (2019). Case 70: Acne. In Pharmacotherapy Principles and Practice Study Guide: A Case Based Care Plan Approach 5th Edition. McGraw-Hill.

Journals/Publications

• Zerr, B., Kruse, J., & Glover, J. (2024). Evaluation of adherence to guideline-directed therapy and risk factors for exacerbation in mild asthma: a retrospective chart review. Allergy, Asthma and Clinical Immunology, 20(1). doi:10.1186/s13223-024-00888-6
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  Background: A significant update was made to both the Global Initiative for Asthma (GINA) in 2019 and the National Heart Lung and Blood Institute (NHLBI) asthma guidelines in 2020 for mild asthma. These groups no longer recommend short-acting beta-agonists (SABA) as monotherapy for mild (GINA) or mild-persistent (NHLBI) asthma. With the lag that can occur between guideline or evidence updates and changes in practice, this study sought to evaluate whether guideline adoption had occurred. Methods: In this retrospective chart review, patient electronic medical records from a large healthcare system were evaluated from July 1 of 2021 to July 1 of 2022 to determine how many patients with mild asthma were prescribed as needed or daily inhaled corticosteroids (ICS) in addition to as needed SABA. The secondary outcome was to evaluate the incidence of exacerbations in patients with mild asthma, comparing those on guideline-directed therapy or not. In addition, we evaluated other patient factors increasing exacerbation risk in mild asthma. Results: For the primary outcome, of the 1,107 patients meeting inclusion criteria, 284 patients (26%) did not have documentation of guideline-directed therapy for mild asthma during the study period, while 823 (74%) were on guideline-directed therapy (Diff:48.7%; 95% CI:45.1 to 52.3%, p < 0.001). For the secondary objective, 161 patients had an exacerbation (12% on guideline-directed therapy, 15.4% not on guideline-directed therapy). This difference in incidence of exacerbation between the two treatment groups was not statistically significant (Diff: -3.4%; 95% CI: -8 to 1.1%; p = 0.133). In addition, being female, having GERD, and being obese were all statistically significant factors associated with having asthma exacerbations among our patient population. Conclusions: Nearly one-fourth of patients with mild persistent asthma were not on guideline-directed therapy, despite updates in asthma guidelines (GINA 2019, NHLBI 2020). Factors such as being female, having GERD, and being obese were all statistically significant factors associated with having asthma exacerbations among patients with mild persistent asthma.
• Cornelison, B., & Zerr, B. (2023).

  Comparison of pharmacy student performance in a self-care therapeutics course conducted as a flipped classroom on-campus and remotely

  . BMC Medical Education. doi:10.1186/s12909-023-04581-x
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  Abstract Background The COVID-19 pandemic required the University of Arizona R. Ken Coit College of Pharmacy’s Self-Care Therapeutics course to be taught as a synchronous, live online course. The course has traditionally utilized a flipped-classroom to increase student engagement and improve learning performance. The goal of this study is to compare student performance in a flipped-classroom self-care therapeutics course taught to students attending class on-campus versus online via web-conferencing. Methods This study assessed examination performance of 118 students that took the class on-campus in 2019 and 125 students that took the class online in 2020. Course design was similar between the two cohorts, with each completing assigned pre-reading, an associated short multiple-choice quiz, in-class small group discussions and in-class large group faculty-led debrief. Both cohorts took pre-class quizzes and three examinations to assess their knowledge. Exam, quiz, overall class performance, and student experience was compared for the 2019 on-campus attending cohort and the 2020 online attending cohort. Results No statistical differences were seen in the overall exam performance, the final course score, and the student experience between cohorts. Statistical differences (p = 0.02) were found between cohorts for the overall quiz performance, with the on-campus attending cohort performing slightly better than the online attending cohort (mean score of 88% compared to 84.4%). Conclusion Examination performance was similar for students taking a flipped-classroom course online and on-campus. Further research using data from multiple courses or from the same cohort, randomized, is needed to improve the internal and external validity of these findings.
• Zerr, B., Vázquez, A., & Erstad, B. L. (2023).

  Infection risk and management strategies for patients with cirrhosis taking proton pump inhibitors

  . American Journal of Health-System Pharmacy. doi:10.1093/ajhp/zxad089
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  Abstract Purpose The purpose of this review is to discuss infectious disease–related adverse effects associated with long-term proton pump inhibitor (PPI) therapy in patients with cirrhosis and to provide recommendations for appropriate use and choice of PPI when such therapy is indicated. Summary Long-term PPI therapy in patients with cirrhosis increases the risk of infections, with infections in turn increasing the risk of mortality in this patient population. Expert recommendations include restricting long-term PPI use in cirrhosis to patients with appropriate gastrointestinal indications, using a PPI for the shortest possible duration and at the lowest possible dose, and avoiding PPIs with unfavorable pharmacogenetic properties. Conclusion Long-term PPI use in patients with cirrhosis has been associated with increased infections. The risk of adverse effects in observational studies, including decompensation, severe infection (especially spontaneous bacterial peritonitis), and increased mortality, appears to increase as the dose and duration of PPI increase.
• Lee, J. K., Fain, M. J., Ladziak, N. A., Zerr, B., Howe, C. L., & Vadiei, N. (2019). Psychotropic medication use patterns in home-based primary care: a scoping review. Drugs & Aging.
• Zerr, B., & Cornelison, B. R. (2021). Experiences and perceptions of pharmacy students and pharmacists with a community pharmacy‐based objective structured clinical examination. JACCP: journal of the American College of Clinical Pharmacy, 4(9), 1085-1092. doi:10.1002/jac5.1472
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  Introduction Self-care therapeutics teaches students how to apply the Pharmacists' Patient Care Process to determine if a patient's concern is appropriate for self-care and then independently prevent, diagnose, and treat the condition. Objective structured clinical examinations (OSCEs) have been shown to be a reliable and valid form of assessment used in pharmacy education. There is limited research examining the use of a community pharmacy-based OSCE to evaluate self-care clinical skills in first year pharmacy (P1) students. Objectives To evaluate P1 students' and facilitators' experiences and perceptions of a community pharmacy-based OSCE. Student performance on the OSCE was evaluated as a secondary objective. Methods Students completed an OSCE that consisted of two patient cases. Students' experiences with the OSCE were collected using a standardized questionnaire. The questionnaire consisted of 41 questions that assessed four areas: attributes of the OSCE, quality of the OSCE performance, OSCE scoring and objectivity, and comparison with other assessment methods. Facilitator experiences and perceived value of the OSCE were assessed using a questionnaire. The responses were evaluated using a chi-square test. Results Eighty-eight students completed the OSCE and questionnaire. Students found the OSCE to be fair (91%) and cover a wide range of skills (76%). The majority of the students (91%) agreed that the OSCE provided opportunities to learn and was a practical and useful experience (86%). Approximately two-thirds (66%) of the students felt that the OSCE provided a true measure of essential clinical skills needed in self-care therapeutics. Fourteen facilitators participated in the OSCE and completed the questionnaire. Community pharmacists represented most of the facilitators (57%). Facilitators agreed that the OSCE tests the knowledge and skills needed to practice in community pharmacy (100%). Conclusion A community pharmacy-based OSCE may be a valuable tool to assess clinical skills and provide clinical learning experiences for pharmacy students.
• Lee, J. K., Fain, M. J., Ladziak, N. A., Zerr, B., Howe, C. L., & Vadiei, N. (2020). Psychotropic medication use patterns in home-based primary care: a scoping review. Mental Health Clinician, 10(5), 282-290.
• Lee, J. K., Fain, M. J., Ladziak, N. A., Zerr, B., Howe, C. L., & Vadiei, N. (2020). Psychotropic medication use patterns in home-based primary care: a scoping review. Mental Health Clinician.
• Vadiei, N., Zerr, B., Ladziak, N., Fain, M. J., Lee, J. K., & Howe, C. L. (2020). Psychotropic medication use patterns in home-based primary care: A scoping review. The mental health clinician, 10(5), 282-290. doi:10.9740/mhc.2020.09.282
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  Abstract Introduction Up to a third of patients seen by home-based primary care (HBPC) providers suffer from mental health problems. These conditions tend to be underrecognized and undertreated for patients receiving HBPC. The purpose of this scoping review is to evaluate current psychotropic use patterns for patients receiving HBPC services. Methods The following databases were searched for articles reporting on studies conducted in HBPC settings that identified patterns of psychotropic medication prescription and use: Ovid/MEDLINE, Cochrane Library, Embase, Scopus, Web of Science, CINAHL, and PsycInfo. Studies that only reported on patients in hospice, rehabilitation, or long-term care facilities were excluded as were drug trials, opinion pieces, case studies, case series, meeting abstracts, and other reviews. Results Of 4542 articles initially identified, 74 were selected for full text screening. Of these, only 2 met full criteria and were included in the data extraction and analysis. In 1 study, 41.7% patients enrolled were prescribed an antidepressant, 21.5% were prescribed an antipsychotic (12.7% prescribed both), and 5% to 7% of patients were prescribed benzodiazepines/hypnotics. In the other study, 9% of patients were prescribed an antipsychotic, and 7% were prescribed a benzodiazepine. Discussion There are extremely limited data on psychotropic prescribing patterns in HBPC in published studies. Because a significant number of HBPC patients suffer from mental health conditions in addition to other chronic illnesses, treatment can be complex. More studies are needed on current psychotropic prescribing trends to help determine what type of interventions are needed to promote patient safety in this setting.
• Howe, C. L., Zerr, B., Lee, J. K., Ladziak, N., Fain, M. J., & Vadiei, N. (2019). PSYCHOTROPIC MEDICATION USE PATTERNS IN HOME-BASED PRIMARY CARE: A SYSTEMATIC REVIEW. American Journal of Geriatric Psychiatry. doi:10.1016/j.jagp.2019.01.058
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  Introduction Up to a third of patients seen by home-based primary care providers suffer from mental health problems, predominantly major depressive disorder. These conditions tend to be under-recognized and under-treated for patients receiving home-based care. This may be due to providers feeling inadequately trained on how to screen for various mental health disorders, and/or how to provide comprehensive mental health treatment. Given the high prevalence of patients suffering from mental health problems in this setting, the goal of this systematic review was to evaluate current psychotropic use patterns for patients receiving home-based primary care (HBPC). Methods Using controlled vocabulary terms (e.g. MeSH, Emtree) and keywords, a medical librarian conducted systematic literature searches in the following seven databases: Ovid/MEDLINE, Wiley/Cochrane Library, Elsevier/Embase, Elsevier/Scopus, Clarivate/Web of Science, EBSCO/CINAHL, and EBSCO/PsycInfo, limiting articles to those published between January 1, 2007 and January 5, 2018. Two independent reviewers screened all titles and abstracts and resolved differences by consensus. Two independent reviewers screened the full text of all publications selected in the screening phase. Differences were resolved by consensus with a third reviewer. Studies were selected if a) they were conducted in home-based primary care settings and b) identified psychotropic use/prescription patterns. We specifically did not include studies that were limited to patients in hospice care or nursing or rehabilitation facilities. Studies were excluded if they were: not in English; drug trials; limited to pediatric patients; or opinion pieces, case studies, case series, meeting abstracts, reviews, systematic reviews, or meta-analyses. Results Of the 2,675 publications identified through the seven database searches, 1,388 remained after duplicates were removed (Figure 1). Of these, 1,329 were eliminated because of irrelevance to the topic and 59 were selected for full text screening. Of these, four met full selection criteria and were included in the data extraction and analysis. Citation checking of these four, as well as of relevant review articles, resulted in the selection of an additional 15 articles for full text screening. None of these additional articles met the full selection criteria. Conclusions Pending ongoing investigation. This research was funded by This research did not receive any grants from funding agencies in the public, commercial, or not-for-profit sectors.

Presentations

• Hart, L., Zerr, B., Luli, A., Cornelison, B. R., & Mnatzaganian, C. (2023). Mnatzaganian C, Cornelison BR, Luli A, Zerr B, Hart L.  From small improvements to rebuilding curriculum: incorporating equity, diversity, and inclusion into a self-care therapeutics course. . AACP Annual Meeting.
• Mnatzaganian, C., Cornelison, B. R., Luli, A., Zerr, B., & Hart, L. (2023). From small improvements to rebuilding curriculum: incorporating equity, diversity, and inclusion into a self-care therapeutics course (as an encore presentation). . AACP Annual Meeting - post event webinar. Webinar.
• Zerr, B. (2023). Parathyroid Hormone's Role in Osteoporosis Therapy. ACCP Endocrine and Metabolism PRN.
• Zerr, B. (2023). PharmTECH, Improving Patient Care Through Utilization of Technology. PharmTalk Series. RKCCOP Tucson campus: RKCCOP.
• Zerr, B. (2019, Fall). Supplements, Vitamins and Minerals: Oh My!. On-Demand Webinar. Online: Arizona Pharmacists Association.
• Zerr, B., & Cornelison, B. R. (2022, June/Summer). Clearing up Confusion and Blemishes! Over-the-Counter Acne Treatments. AzPA Annual Convention. Phoenix, Arizona: Arizona Pharmacy Association.
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  This program aims to increase pharmacists' knowledge of the available medications approved to treat acne in the self-care setting, while also increasing their confidence in selecting specific products based on their ingredients, strengths, and vehicle formulations while also considering patient-specific characteristics such as skin pigmentation.
• Zerr, B., & Cornelison, B. R. (2021, February). Zooming Through a Virtual Rotation!. AzPA Spring Clinical Conference. Virtual: Arizona Pharmacy Association.
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  ACPE Activity # 0100-0000-21-001-L04-P (1.0 CPE)
• Zerr, B., & Cornelison, B. R. (2021, October). Over-the-Counter Treatment Paradigms for Pain Management: Adapting to the “New Normal”. Pharmacy Times Continuing Education Webinar & On Demand CE. Virtual: Pharmacy Times Continuing Education.
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  Program DescriptionEffective management of pain is needed to minimize the debilitating effects that it can have on patients’ quality of life. Pharmacists and pharmacy technicians can be key members of the pain management team and should be familiar with nonpharmacologic and over-the-counter (OTC) agents that adequately control pain while limiting adverse outcomes. Providing evidence-based treatment recommendations and individualized patient education for common pain disorders, including musculoskeletal disorders, injuries, and migraine, among others, will help to enable pharmacists to enhance patients’ health-related quality of life and may reduce direct and indirect costs associated with pain. It is important for pharmacy technicians to be aware of the various OTC options so they are better able to assist patients with questions or refer them to the pharmacist as needed. In the setting of the COVID-19 pandemic, there are new challenges and considerations for pharmacists and pharmacy technicians in managing patients with acute and chronic pain conditions and in ensuring patients have access to care. Approaches for pharmacists and pharmacy technicians to incorporate information and recommendations related to current and new OTC therapies including combination medications, and education about their appropriate use, will be presented.Target audience: Pharmacists, pharmacy techniciansType of activity: Application for pharmacists; Knowledge for pharmacy techniciansRelease date: October 15, 2021Expiration date: October 15, 2022Time to complete activity: 1 hour
• Zerr, B. (2020, October). When Clinic and Home Readings Don't Agree: Managing White Coat Hypertension and Home Monitoring of Blood Pressure. AZPA 2020 Annual Convention. Phoenix / Virtual: AZPA.
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  Learning Objectives:At the end of this presentation participants will be able to: Pharmacist objectives*Critique the data regarding cardiovascular risk associated with White Coat Hypertension *Describe the current recommendations for home blood pressure monitoring *Provide education to patients regarding best practices for home blood pressure monitoring, specifically focusing on device selection, timing of readings and timing of medication administration *Understand the implications of chronotherapy (timing of blood pressure medication administration) and discuss the potential impact on cardiovascular outcomes *Create a care plan for patients with White Coat Hypertension CPhT objectives *Describe the current recommendations for home blood pressure monitoring *Provide education to patients regarding best practices for home blood pressure monitoring, specifically focusing on device selection, timing of readings and timing of medication administration
• Zerr, B. (2019, June). Enhancing Diabetes Care Using Dietary Supplements. AzPA 2019 Annual Convention. Tucson, Arizona.
• Zerr, B., & Ladziak, N. A. (2019, February). To breathe or not to breathe?. AZPA SW Clinical Meeting. Phoenix: AZPA.

Poster Presentations

• Cornelison, B. R., & Zerr, B. (2022). Evaluation of Student Performance and Perceptions of a Flipped Classroom. AACP NMA ConferenceAACP Nonprescription Medicines Academy.
• Zerr, B. (2022, October). Effectiveness of polypharmacy comprehensive medication reviews. AZPA Annual Meeting.
• Zerr, B., & Cornelison, B. R. (2022, May). Comparison of a flipped classroom delivered on campus and online. ACCP Virtual Poster SymposiumACCP.
• Zerr, B., & Cornelison, B. R. (2021, July). Evaluating Patient Simulation Exercises as Learning Tools. AACP Annual Meeting, Virtual Pharmacy Education 2021. Virtual: American Association of Colleges of Pharmacy.
• Zerr, B., & Marian, M. J. (2021, September). Exploring pharmacy and dietetics students' knowledge and attitudes through collaborative care. Nexus Summit. virtual: Nexus.
• Zerr, B., & Cornelison, B. R. (2020, May). Utilizing the PPCP with structured peer review to increase knowledge retention. American College of Clinical Pharmacy (ACCP) Virtual Poster Symposium. Virtual Presentation: American College of Clinical Pharmacy.
• Ladziak, N. A., Zerr, B., Nguyen, V., & Hodgkins, D. (2019, October). Prevalence of Overbasalization in an Outpatient Family Medicine Clinic. American College of Clinical Pharmacy 2019 Annual Meeting. New York, NY.
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  Student presented poster at ACCP Annual meeting
• Vadiei, N., Howe, C., Zerr, B., Ladziak, N. A., Fain, M., & Lee, J. K. (2019, March). Psychotropic medication use patterns in home-based primary care: a scoping review. American Journal of Geriatric Psychiatry.
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  Scoping review to evaluate the current psychotropic use patterns for patients receiving home-based primary care.

Other Teaching Materials

• Zerr, B. (2020. ACCP Ambulatory Care Resource Guide. ACCP.
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  Reviewed the Women's Health section on menopause as subject matter expert.
• Zerr, B. (2019. Top 300 Pharmacy Drug Cards - 5th edition. McGraw Hill.
• Zerr, B. (2019. Top 300 Pharmacy Drug Cards. McGraw Hill.

Others

• Zerr, B. (2025, January). GLP-1 Agonist Patient Considerations.
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  TV interview on KTVK regarding use of GLP-1 agonists.
• Zerr, B. (2019, November). Top 300 Pharmacy Drug Cards 5th edition. McGraw Hill publications.
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  Faculty Advisory Panel member for the fifth edition of the Top 300 Pharmacy Drug Cards product. Responsible for reviewing selected drug cards for accuracy and contributing clinical pearls.