Impact of a health and wellness IPPE focused on immunizations and health assessments

BACKGROUND AND PURPOSE

Health and wellness principles are included in pharmacy education outcomes and standards, supporting the importance of integrating these concepts within pharmacy curricula. The objective of this study was to describe the development, implementation, and assessment of an intensive community pharmacy-based health and wellness introductory pharmacy practice experience (IPPE) focused on immunizations and health assessments.

EDUCATIONAL ACTIVITY AND SETTING

The health and wellness IPPE was a required, one-week rotation developed to provide second-year student pharmacists with direct patient care opportunities to reinforce knowledge, skills, and abilities related to health and wellness principles. Students administered immunizations, performed hypertension and diabetes assessments, and provided education to patients at community pharmacy training sites. Students completed pre- and post-rotation self-assessments. Preceptors completed individual summative student performance evaluations and were surveyed to obtain IPPE feedback.

FINDINGS

One hundred forty-seven students completed the IPPE across 89 sites. The pre-post analysis of student self-assessment results found statistically significant improvement in student confidence across all survey items. The largest improvements were found within the immunization items, specifically for preparing and administering immunizations. Ninety-nine percent of students agreed or strongly agreed participation in IPPE activities improved their ability to contribute to patient care. Qualitative analysis revealed students gained confidence and skills after practicing in a real-world setting.

SUMMARY

The integration of the health and wellness IPPE within the curriculum resulted in increased student confidence in providing preventative care services. This study provides a solution to integrating health and wellness principles into pharmacy curricula to meet accreditation standards.

Community Pharmacy Recruitment for Practice-Based Research: Challenges and Lessons Learned

To support the successful integration of community pharmacies into value-based care models, research on the feasibility and effectiveness of novel pharmacist-provided patient care services is needed. The UNC Eshelman School of Pharmacy, supported by the National Association of Chain Drug Stores (NACDS) Foundation, designed the Community-based Valued-driven Care Initiative (CVCI) to (1) identify effective value-based patient care interventions that could be provided by community pharmacists, (2) implement and evaluate the feasibility of the selected patient care interventions, and (3) develop resources and create collaborative sustainability opportunities. The purpose of this manuscript is to describe recruitment strategies for CVCI and share lessons learned. The project team identified pharmacies for recruitment through a mixed data analysis followed by a "fit" evaluation. A total of 42 pharmacy organizations were identified for recruitment, 24 were successfully contacted, and 9 signed on to the project. During recruitment, pharmacies cited concerns regarding the financial sustainability of implementing and delivering the patient care services, challenges with staffing and infrastructure, and pharmacists' comfort level. To foster participation, it was vital to have leadership buy-in, clear benefits from implementation, and assured sustainability beyond the research period.

Implementation and evaluation of a practice transformation advanced pharmacy practice experience

BACKGROUND AND PURPOSE

Advanced entrepreneurship opportunities are important to consider as entrepreneurial skills become increasingly important to develop in pharmacy students. This institution implemented a new practice transformation advanced pharmacy practice experience (APPE), pairing students with community partners to implement and/or evaluate pharmacy services, network with pharmacists, and receive mentorship. The purpose of this article is to describe the APPE and students' outcomes during this first pilot year.

EDUCATIONAL ACTIVITY AND SETTING

A faculty preceptor mentored and oversaw all APPE activities. Students were selected through an application process, and community partners were recruited based on alignment with students' goals and need for student assistance. Community partners prepared a list of practice transformation activities needed at their sites, and progress was tracked during weekly virtual meetings. APPE students completed a pre-APPE questionnaire, collecting background information and predictors of entrepreneurship: proactive personality, entrepreneurial self-efficacy, and individual entrepreneurial orientation (IEO). At the end of the APPE, IEO was measured again, and students reflected on what skills were developed.

FINDINGS

Three students participated in the first year and were paired with various community partners. IEO baseline scores ranged from 24 to 28 (mean = 25.3, SD = 2.3), and follow-up scores increased to 28 to 30 (mean = 29.0, SD = 1.0). Students reported development in both soft and technical skills.

SUMMARY

The practice transformation APPE offered students a unique opportunity to develop a diverse set of skills during a focused five-week experience. Based on positive feedback from students, this institution plans to continue to expand this APPE.

Redefining 'advanced': Supporting and promoting practice change through community advanced pharmacy practice experiences

INTRODUCTION

Community pharmacy practice in the United States (US) has faced several external pressures, threatening traditional practice models. Schools and colleges of pharmacy (S/COP), particularly through experiential rotations, are perfectly poised to help these practices create new sustainable business models. The purpose of this article is to highlight demonstrated, reproducible successes of community advanced pharmacy practice experience (APPE) advancement initiatives.

PERSPECTIVE

Despite community pharmacists being highly-trained health care providers with roughly equivalent educational backgrounds, community-based practices in the US are not all the same. Student pharmacists can contribute to the design and implementation of revenue-generating services helping individual pharmacies elevate their practice. Doing so involves new models for staffing, workflow, billing, and documentation. Students can help support practice change by focusing on implementation and sustainability. Example APPE integrations focused on community pharmacy practice transformation are described in detail from the University of Arkansas for Medical Sciences College of Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and Idaho State University.

IMPLICATIONS

Establishing intentional connections that focus on new sustainable community business models is a responsibility for S/COP. The examples provided serve to demonstrate the feasibility of these partnerships. Training students on innovative practice models and utilizing them is critical in moving community practice forward. As academicians, we must prepare students to be agents of change for the profession and intentionally integrate them into a systematic plan to help promote and change practice activities wherever possible, but especially in community practice.

Polish Pharmacy Students' Readiness, Qualifications, Competences, Relevance, Motivation and Effectiveness to Promote Health in Community Pharmacies

Background: One of the parts of the broadly understood pharmaceutical care is health promotion. Therefore, the study aimed to find out how pharmacy students in Poland assess their own readiness to promote health in pharmacies and their own qualifications, competences, relevance, motivation and effectiveness of health promotion in pharmacies. Methods: The study conducted in 2019 comprised 206 pharmacy students from Poland. The authors’ survey questionnaire had two parts: Readiness to promote health in pharmacies; and Qualifications, competences, relevance, motivation and effectiveness of health promotion in pharmacies. Results: The students assessed the system solutions regarding health promotion as insufficient. The highest assessment was given to their own readiness to promote health. In between those was assessment of readiness to promote health by pharmacists as an occupational group. Readiness to promote health at a workplace in a pharmacy was assessed higher than in a local community. The students gave the highest assessments to the relevance and motivation to promote health, and the lowest to their own competences to promote health. In between those, their qualifications and effectiveness to health promotion in pharmacies. were assessed. Conclusions: Pharmacy students consider themselves ready and motivated to promote health, that is of a great importance in their opinion, and they could potentially play an important role in improving the health care of patients.

A community-based partnership collaborative practice agreement project to disseminate and implement evidence-based practices in community pharmacy

BACKGROUND AND PURPOSE

The objective of this study is to explore the impact of an educational intervention including (1) collaborative practice agreement (CPA)-focused lecture and (2) a student project in partnership with a community-based pharmacy on dissemination and implementation of CPAs in community pharmacy practice.

EDUCATIONAL ACTIVITY AND SETTING

A CPA-focused classroom lecture and related project were given to five sequential years of second-year pharmacy students enrolled in a community pharmacy elective course. Community pharmacist feedback provided at the completion of the project was compared to present-day data collected via telephone survey. Responses for each survey question were summarized using frequencies, and chi-square analysis was conducted to assess the association between pharmacist perceptions at the time of the project vs. the present day.

FINDINGS

Forty-seven projects representing 47 unique CPAs were completed over five sequential years of the course. The most commonly targeted disease states by CPAs were influenza/streptococcus pharyngitis (25.5%), therapeutic interchange (6.4%), oral contraceptives (6.4%), and tobacco cessation (6.4%). Pharmacists noted that students facilitated their progress toward CPA implementation by serving as a means for CPA law education (23.4%) and by saving time in CPA development (12.8%).

SUMMARY

This study demonstrated that a student project partnering with a local community pharmacy improved knowledge dissemination but did not have any direct impact on implementation of CPAs in a community pharmacy. However, students may have a role in dissemination and implementation of evidence-based practices, such as CPAs, when appropriately matched to setting-specific implementation barriers.

How do Polish pharmacy staff evaluate own qualifications, competences, relevance, motivation, effectiveness in health promotion?

Health promotion programmes are complex and need to engage all health care specialists, including pharmacists. Pharmacies are considered as a potentially ideal place for health promotion and education. To evaluate own qualifications, competences, relevance, motivation and effectiveness of Polish pharmacy staff with regard to health-related information provided to patients, which contributes to health promotion. 308 pharmacy staff from Lublin (Poland) were surveyed with a questionnaire prepared by the researchers and piloted previously. It consisted of 5 domains: qualifications, competences, relevance, motivation, and effectiveness of health promotion. Items in each domain were scored by respondents in 1 − 10 scale where 1 is ‘very low’ and 10 is ‘very high’. Pharmacy staff rated the relevance of health promotion the highest, while the lowest—own competences and effectiveness in health promotion. Female pharmacy staff assessed the relevance of health promotion significantly higher than males (7.1 vs. 6.1, p = 0.005). Higher self-assessments of qualifications, competences, relevance, motivation and effectiveness in health promotion were provided by: the youngest pharmacy staff, those with a short period of employment, and pharmacy staff working in pharmacies employing up to 3 persons. Qualification and competences in health promotion were assessed higher by pharmacy technicians and masters of pharmacy with post-graduate studies or professional specialization, or Ph.D. than by masters of pharmacy. Relevance and effectiveness in health promotion were evaluated higher by pharmacy staff in pharmacies serving more than 100 customers daily. There is a need to improve qualifications, competences, relevance, motivation and effectiveness in health promotion conducted by Polish pharmacy staff.

Advanced pharmacy practice experience students at the intersection of education and practice transformation

BACKGROUND AND PURPOSE

Community pharmacy practice is transforming from traditional dispensing roles, and advanced pharmacy practice experiences (APPEs) could be a viable mechanism to assist pharmacies during transformation. A new type of APPE is described and the design, outcomes, and feedback from the first students and pharmacies piloting this rotation are discussed.

EDUCATIONAL ACTIVITY AND SETTING

A four-week elective APPE was designed to position fourth-year students as facilitators for community pharmacy transformation activities. The first transformation activity was clinical documentation using electronic care plans (eCare plans). Students spent a majority of the rotation in the pharmacy with only the first week and one day a week thereafter at the college of pharmacy. Students assessed current pharmacy workflow, developed an implementation plan, trained pharmacy staff, and created protocols and resources.

FINDINGS

Four student pharmacists completed the rotation during May, June, and August 2019. Student knowledge was assessed through a 12-question pre- and post-quiz on implementation science and the pharmacist eCare plan. Following orientation activities, students' scores increased from an average 44% to 86%. Course evaluations showed students learned about pharmacy business management and recognized challenges in teaching staff new concepts. All students indicated appreciation for innovative activity involvement and helping a pharmacy advance its practice.

SUMMARY

Early findings from this elective indicate a successful learning experience for students and pharmacy owners. The students gained skills in teaching, facilitation, and practice management, while pharmacy owners benefitted from staff training and implementation resources.

Self-assessment of Polish pharmacy staff's readiness to promote health

Background Nowadays, pharmacists are expected to focus not only on dispensing medicines but also on the wellness of the patient. In some developed countries a pharmacist is clearly defined as a health care professional that can make a contribution to improving the general health of the population. Objective To assess the readiness of Polish pharmacy staff to engage in health promotion and educational activities. Setting Community pharmacies in Poland. Method The study group consisted of 308 pharmacy staff (248 pharmacists and 60 pharmacy technicians) employed in Polish pharmacies. The survey questionnaire referred to three domains: systemic solutions for health promotion, readiness of pharmacy staff as a professional group to promote health, personal readiness to promote health. Responses about pharmacy staff’s readiness to promote health were scored using a 10-point scale. Scale reliability for all items (overall readiness), and for items within the three domains separately, were tested using Cronbach’s α and average inter-correlation coefficient among the items. Main outcome measure Pharmacy staff’s readiness to promote health (the questionnaire containing 32 items). Results The overall readiness of pharmacy staff to promote health was rather low (average of 4.6 ± 1.5 in 1–10 scale). The highest scores were obtained for pharmacy staff’s personal readiness to promote health (average of 5.5 ± 1.8) which was neutral on the scale. The lowest scores were obtained for systemic solutions for health promotion (average of 3.6 ± 1.4). Readiness of pharmacy staff as a professional group was ranked in the middle (average 4.8 ± 1.8). Surveyed pharmacy staff rated their readiness to promote health in the work environment significantly higher than promoting health in the local community. Female and younger pharmacy staff as well as those with job seniority of less than 5 years, or pharmacy technicians assessed their readiness to promote health significantly higher than others. Readiness to promote health was higher among pharmacy staff working in pharmacies employing up to 3 staff members and at pharmacies with over 200 customers daily. Conclusions The overall readiness of pharmacy staff to promote health was low, especially in the domain of systemic solutions in health promotion.

Community pharmacists' educational needs for implementing clinical pharmacogenomic services

OBJECTIVES

Pharmacist leadership and knowledge of pharmacogenomics is critical to the acceleration and enhancement of clinical pharmacogenomic services. This study aims for a qualitative description of community pharmacists' pharmacogenomic educational needs when implementing clinical pharmacogenomic services at community pharmacies.

METHODS

Pharmacists practicing at Rite Aid Pharmacy locations in the Greater Pittsburgh Area were recruited to participate in this qualitative analysis. Pharmacists from pharmacy locations offering pharmacogenomic testing and robust patient care services were eligible to participate in a semistructured, audio-recorded interview. The semistructured interview covered 4 domains crafted by the investigative team: (1) previous knowledge of pharmacogenomics; (2) implementation resources; (3) workflow adaptation; and (4) learning preferences. Interviews were transcribed verbatim and independently coded by 2 researchers. A thematic analysis by the investigative team followed. Supporting quotes were selected to illustrate each theme.

RESULTS

Eleven pharmacists from 9 unique pharmacy locations participated in this study. The average length of practice as a community pharmacist was 12 years (range, 1.5-31 years). Pharmacist's pharmacogenomic educational needs were categorized into 5 key themes: (1) enriched pharmacogenomic education and training; (2) active learning to build confidence in using pharmacogenomic data in practice; (3) robust and reputable clinical resources to effectively implement pharmacogenomic services; (4) team-based approach throughout implementation; (5) readily accessible network of pharmacogenomic experts.

CONCLUSION

This study describes the educational needs and preferences of community pharmacists for the successful provision of clinical pharmacogenomic services in community pharmacies. Pharmacists recognized their needs for enriched knowledge and instruction, practice applying pharmacogenomic principles with team-based approaches, robust clinical resources, and access to pharmacogenomic experts. This deeper understanding of pharmacist needs for pharmacogenomic education could help to accelerate and enhance the clinical implementation of pharmacogenomic services led by community pharmacists.

Student Perceptions of the Pharmacist's Approach Across the Varying Levels of Medication Therapy Management Services

Objective. To explore third-year pharmacy (P3) student perceptions of medication therapy management (MTM) after an introduction to the various levels of MTM services within an MTM course. Methods. A qualitative survey was conducted of 158 P3 students. Open-ended questions were used to explore students' thoughts, feelings, and perceptions related to the pharmacist's approach in MTM following a lecture establishing differences in roles and responsibilities between the varying levels of MTM. Emphasis was placed on the pharmacist's role when providing comprehensive medication management (CMM). CMM is a higher-level direct patient care service with a whole-patient focus that goes beyond medication or disease specific focuses of either a comprehensive medication review (CMR) or targeted medication review (TMR). Thematic analysis was performed and an inductive approach to data analysis was used. Results. The following five themes were identified: misperceptions entering the course, efficient delivery of MTM depends on understanding the differences between services, doctor of pharmacy education is a factor in confused MTM role expectations, role limitations exist and referrals to other providers, and the CMR meets unmet needs. Conclusion. Students noted initial confusion between their roles and responsibilities during a CMM versus a CMR. Pharmacy educators should address the varying roles and responsibility differences across MTM services within their curriculum.

A community-based partnership collaborative practice agreement project to teach innovation in care delivery

BACKGROUND AND PURPOSE

To explore students' perceptions (self-assessment) of their preparedness to develop collaborative practice agreements (CPAs) before and after delivery of one CPA-focused classroom lectures and 2) a CPA development student project in partnership with a local community-based pharmacy.

EDUCATIONAL ACTIVITY AND SETTING

A CPA-focused didactic lecture and subsequent project were given to second-year (P2) pharmacy students enrolled in a community pharmacy elective course at the University of Tennessee College of Pharmacy. Pre- and post-surveys were administered using an online survey platform to assess student perceptions. Responses for each survey question were summarized using frequencies, and chi-square analysis was conducted to assess the association between pre- and post-scores on each question.

FINDINGS

Students were significantly more likely to rate themselves as prepared or completely prepared to develop a CPA in a community pharmacy setting (χ²=61.21, p<0.01) after the course and project. Students also noted that they felt they were prepared or very prepared to work within a team to develop and implement a CPA in a community pharmacy setting (χ²=37.60, p<0.01).

SUMMARY

This study demonstrated that a didactic classroom lecture series followed by a student project partnered with a local community pharmacy improved perceived knowledge, preparedness, and ability to implement CPAs in a community pharmacy. Through intentional exposure of students to scope-of-practice expanding opportunities like CPAs, pharmacy educators can potentially accelerate the evolution of community pharmacy practice.