Design and Assessment of Telepharmacy and Telehealth Training in Two Pharmacy Programs

Objective. To develop and assess the impact of a learning module through the evaluation of students' knowledge of, perceptions of, and intent to provide telepharmacy and telehealth services.Methods. Second- and third-year students from two schools of pharmacy completed a telepharmacy and telehealth learning module and discussion questions. A postsurvey measured their knowledge, perceptions of, and intent to provide remote services.Results. Students scored an average of 94.8% on a post-knowledge assessment. The theory of planned behavior was used to develop a survey measuring intent to provide remote services. Mean scores (1=strongly disagree to 4=strongly agree) were attitude (mean=3.18, SD=0.36), subjective norm (mean=3.02, SD=0.43), behavioral control (mean=2.67, SD=0.41), and intent (mean=2.63, SD=0.59). Thematic analysis of discussion question responses found that students felt the delivery and quality of care was similar between in-person and remote care. Students felt that differences with face-to-face care included technology use and troubleshooting, perceived difficulty in building relationships, and, finally, the inability to provide device training, medication show-and-tell, and physical examinations. They felt telehealth services would expand in the next five years due to increased access, convenience, and cost savings.Conclusion. Upon completion of a learning module, students were knowledgeable about telepharmacy and telehealth. Students agreed that remote services positively impact patient care and would be well received by patients and providers. Students had lower intent to offer remote services upon graduation; thus, simulations and service management information should be added to curricula to prepare students for and develop student interest in telepharmacy and telehealth.

Expanded Pharmacy Practice Implementation: Lessons from Remote Practice

AIM

The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities.

METHOD

A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP-Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist's perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research.

RESULTS

A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted.

DISCUSSION/CONCLUSION

Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.

Financial Incentive Required for Pharmacy Students to Accept a Post-Graduation Position in Rural and Undesirable Pharmacy Settings

Background: It has been estimated that in 2018, 20% of pharmacy students were unemployed following graduation. However, many pharmacy positions go vacant each year, with the majority of these positions existing in rural areas. Methods: Pharmacy students completed a one-time, anonymous, online questionnaire. Measures of interest included: subject characteristics and preference in a variety job offers. Discrete Choice Experiment methodology of questionnaire design was used and Conditional Logit models were conducted to analyze the data to determine the financial incentive required for pharmacy students to take a post-graduate job with particular traits. Conclusions: A total of 283 students completed questionnaires from Iowa, North Dakota, South Dakota, Saskatchewan, and Manitoba. The majority of subjects were female, P3 students, and from a non-rural hometown. American students would need to be paid an additional $18,738 in salary to practice in a rural area, while Canadian students would require an additional $17,156. Canadian respondents would require an additional $7125 in salary to work in a community pharmacy with a low level of patient interaction compared to a community position with a large amount of patient interaction. Overall, pharmacy student preferences in post-graduation job attributes vary significantly between states and provinces.

Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D

The objective of this study was to perform a nationwide investigation of the financial performance of community pharmacies in the United States since the inception of Medicare Part D. A nationwide, cross-sectional survey of pharmacists was conducted in 2013. The 43-item online survey collected information about demographics, financial implications of Part D on community pharmacy and patients, provision of Medication Therapy Management (MTM) services and opinions about Medicare Part D 2010 updates. The adjusted response rate was 22.3% (419/1885). A majority of respondents (75.6%) reported a stable or increased prescription volume since 2006 but only 40.4% indicated that the financial performance of their pharmacy as either excellent or good during the same period. Owners and part-owners of rural independent pharmacies were more likely to report a below average or poor financial performance (75.0%). The provision of MTM services was not related to the financial performance of the pharmacy. Nearly half (44.7%) of pharmacy owners or part-owners indicated that they were considering selling their pharmacy, with most (94.1%) reporting that their decision to sell was due to the Part D financial pressures. However, the decision to sell was not related to the change in financial performance since 2006 or the volume of prescriptions dispensed.

An interprofessional rural health education program

OBJECTIVES

To develop, implement, and assess an interprofessional rural health professions program for pharmacy and medical students.

DESIGN

A recruitment and admissions process was developed that targeted students likely to practice in rural areas. Pharmacy students participated alongside medical students in completing the Rural Health Professions program curriculum, which included monthly lecture sessions and assignments, and a capstone clinical requirement in the final year.Assessment. Fourteen pharmacy students and 33 medical students were accepted into the program during the first 2 years of the Rural Health Professions program. Approximately 90% of the rural health professions students were originally from rural areas.

CONCLUSIONS

The rural health professions program is an interprofessional approach to preparing healthcare providers to practice in rural communities.