An Advanced Pharmacy Practice Experience in Transitional Care

Abstract

Objectives. To implement and assess a 4-week advanced pharmacy practice experience in transitional care. Design. Students participated in the transitional care planning of patients being discharged from 4 general medicine services. Students interviewed patients; assessed discharge medications; reconciled preadmission and discharge medications; provided medication counseling; and conducted postdischarge follow-up by phone to assist patients with medication-related problems and identify additional concerns. Assessment. Student involvement increased the number of patients who could be assessed and interviewed by the pharmacist preceptor from 10 patients/day to 15 to 20 patients/day. Students strengthened their provider-patient and provider-provider communication skills and developed skills in identifying and resolving barriers to medication adherence. Conclusion. This transitional care APPE provided students an opportunity to gain experience and selfconfidence in the application of pharmaceutical care skills in a transitional care setting, while also providing valuable patient care services to the hospital.

Impact of Students Pharmacists on the Medication Reconciliation Process in High-Risk Hospitalized General Medicine Patients

“…3,[6][7][8]10 However, Gleason and and Lubowski both identified that, for patients taking 7 or more medications prior to admission, the total number of discrepancies was higher than for those patients taking 6 or less medications. 3,6 Furthermore, several authors have published data comparing the accuracy of medication lists obtained by student pharmacists to physicians, or pharmacists to physicians, whereas our study compared lists obtained by student pharmacists vs those obtained by nurses and/or physicians.…”

“…7 Walker and colleagues evaluated the impact that student pharmacists can have on clinical interventions within a transition of care setting, with results similar to those from the other studies noted. 8 These studies show that student pharmacists can have a positive impact on patient care that is similar to that of licensed pharmacists. As the role of student pharmacists continues to expand, particularly as part of their clinical advanced pharmacy practice experiences, they are being asked to participate in a number of patient care areas previously limited to pharmacists, including medication reconciliation.…”

“…2 Aside from the literature regarding the impact of pharmacists in providing medication reconciliation, 3 publications have evaluated the impact of student pharmacists in providing medication reconciliation services at community hospitals. [6][7][8] Lubowski and colleagues demonstrated that, when student pharmacists performed medication reconciliation in over 300 patients, approximately 1000 discrepancies were identified. 6 These discrepancies largely consisted of omitted prescription medications.…”

Communications Training in Pharmacy Education, 1995-2010

“…In the studies identified in this review, a variety of pharmacy practice experiences are described. The most common is the advanced pharmacy practice experience (APPE), 22,45,48,50 which is a requirement of the ACPE in the United States. The APPE is performed in a variety of settings, including community pharmacies, 22,45,48 transitional care, 50 and hospital settings.…”

“…One study involved writing a script modeling different communication styles used when talking to a physician over the phone, 39 another involved acting out a conversation with fellow students using improvisation to improve interprofessional conversational skills, 11 while others involved engaging in telephone communication with an actual prescriber. 22,35,50 General interpersonal communications skills are those not directed at a specific type of interaction, but which can be used in all forms of conversation. General interpersonal communication training topics included cultural competency, 59 transactional analysis and personality assessment, 37 emotional intelligence, 60 and self-concept/self-confidence.…”