Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool

Assessing Confidence and Competence of Student Pharmacists in a Virtual Medication Adherence Training Program

OBJECTIVE

To assess the impact of a virtual medication adherence training (VMAT) program on students' perceived confidence and perceived competency in delivering medication adherence services via telehealth.

METHODS

This pilot pre-/post-observational study consisted of 2 subsequent sections: (1) 4 asynchronous self-study modules via Canvas (Instructure, Inc.) learning management system, and (2) 2 live application-based sessions involving virtual and telephonic standardized patients. A pre-/post-survey was given to first-, second-, and third-year Doctor of Pharmacy students to assess perceived confidence and perceived competence. Participants completed a 5-question multiple-choice quiz before and after each module to assess knowledge.

RESULTS

Students' overall perceived confidence and perceived competency significantly increased upon completing VMAT. Knowledge in each module assessment also significantly improved. During the assessment of performance throughout the live sessions, most participants lost points when resolving issues within the interaction, addressing the need for patient follow-up, and assessing patient knowledge of medication adherence.

CONCLUSION

This novel VMAT suggests that this or similar programs would be beneficial to improve pharmacy students' perceived confidence, perceived competence, and knowledge in delivering virtual medication adherence services in the telehealth setting. The incorporation of such training within the didactic curriculum of doctoral pharmacy programs should be considered to improve patient care skills for future medication experts.

Participation in emergency preparedness and response: a national survey of pharmacists and pharmacist extenders

Background

The COVID-19 pandemic highlights the critical role of pharmacists in pandemic response. To enhance pharmacist’s involvement in future emergency situations, there is a critical need to understand pharmacists’ knowledge, willingness and preparedness in response to various emergency situations.

Objective

This study aimed to describe pharmacists and pharmacist extenders on their participation in emergency response activities and training, preparedness and willingness to respond in emergency situations, and knowledge of the Memorandum of Understanding (MOU) and their pharmacy’s emergency preparedness plans.

Methods

A cross-sectional design with an online survey of pharmacist, pharmacy owner, and pharmacy technician members of the National Community Pharmacists Association was employed in the United States in July – August 2020. Descriptive statistics summarized participants’ level of actual participation and their willingness to participate in emergency situations and training and their knowledge of MOU and their pharmacy’s emergency plans. A non-response bias investigation was conducted by comparing the early and late responders.

Results

Of the 6,486 members, 255 completed the questionnaire (RR1 = 4.0%). With the confidence level of 95%, the margin of error was 6%. About 60% were independently owned and in urban areas. More than 80% and 64% of the participants have not volunteered in any emergency or participated in any emergency training program, respectively. Over 60% were very willing to assist with the distribution of medications and vaccine administration. Less than 10% had MOUs with health departments. More than 60% of respondents were not aware of what MOU is.

Conclusion

Despite limited involvement in actual emergency activities and training, pharmacists and pharmacist extenders exhibited a high level of willingness to participate in emergency training and assist in case of emergencies. This study recommends the development of programs aimed at increasing pharmacists’ and pharmacist extenders’ participation in emergency training and in future public health emergencies.

Strategy to Improve Efficiency of Comprehensive Medication Reviews in a Community Pharmacy

Background: Comprehensive medication reviews (CMRs) provide opportunities for pharmacists to perform clinical services to their patients. However, pharmacists are often not able to perform CMRs due to time constraints. Studies have shown that incorporating support staff into the CMR workflow may lead to increases in the completion of CMRs. Objective: The primary objective was to examine the change in the number of CMRs completed at the pharmacy after a new strategy was implemented to perform and prepare for CMRs. The secondary objective was to examine the changes in the revenue generated from CMRs. Methods: This study was a pre-post retrospective, observational study performed at an independent pharmacy. Data were collected and analyzed 10 months before and after implementation of a new strategy. The new strategy called for pharmacy interns to use a template for working up patients prior to CMRs. Wilcoxon signed-rank tests were run on IBM SPSS, Version 24.0, to determine the significance of the changes. Results that generated P values <.05 were considered statistically significant. Results: The total number of CMRs completed increased from 29 before the intervention to 158 after the intervention (P = .009). The revenue generated from CMRs improved statistically (P = .007). Conclusions: Implementing a strategic workflow that uses pharmacy interns and a patient workup template can significantly increase the number of CMRs completed in a community pharmacy. Appropriate delegation of such tasks may allow more time for pharmacists to deliver more CMRs. Additional benefits include increased compensation from delivering more CMRs.

Pharmacist-provided services and community pharmacist integration into a patient-centered medical home: A qualitative study of primary care clinic staff perceptions

OBJECTIVES

To describe patient-centered medical home (PCMH) staff members' views toward community pharmacist involvement in patient care within the PCMH and to identify areas in which pharmacist-provided services can improve the quality of care in their clinics.

DESIGN

Qualitative semistructured interview study.

SETTING

One primary care clinic.

PARTICIPANTS

Multidisciplinary clinic staff members.

OUTCOME MEASURES

Views of staff toward implementing a community pharmacist into their clinic and top pharmacist services to help improve medication management within the clinic.

RESULTS

A total of 14 staff members of the clinic participated in the study. Participants included physicians, clinical staff members such as registered nurse assistants, licensed practical nurses, and medical assistants, and clinic management. Key themes included the following: the clinic was open to implementing pharmacy services; the providers would be very receptive to pharmacist recommendations; the clinic is willing to try different pharmacist integration models to see what works best within the workflow; the pharmacist must be readily available for consultation; the pharmacist should hold an introductory meeting with the clinic; opinions vary on the best timing of pharmacist appointments with patients; and ideas vary about the best location for pharmacist consultations. The top 5 pharmacist services mentioned by participants included chronic condition management, medication reconciliation training, Beers List education, diabetes education, and adherence counseling.

CONCLUSION

Primary care clinic staff support the integration of pharmacy services. Further research is needed to apply the results to other clinics and to identify barriers and opportunities in the implementation process.

Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study

BACKGROUND

The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed.

OBJECTIVE

The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults.

DESIGN

Randomized, controlled trial.

SETTING

One community pharmacy.

PARTICIPANTS

Eighty older adults who completed a fall prevention workshop.

MAIN OUTCOME MEASURES

The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers.

RESULTS

Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P < 0.05). There were no significant changes between the study groups in the risk and rate of falling. Medication recommendations in the intervention group had a 75% acceptance rate by patients and prescribers.

CONCLUSION

A targeted MTM intervention provided by a community pharmacist and focused on FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults.