Value of Pharmacy Students Performing Population Management Activity Interventions as an Advanced Pharmacy Practice Experience

Abstract

Objective. To assess the value of an advanced pharmacy practice experience in which students engaged in population health management (PHM) activities for a managed care setting. Methods. Students were provided with a list of patients, trained on the requirements for each PHM activity and completed them independently. The students reviewed the electronic record for each patient on their list to identify those who were non-adherent to dual antiplatelet therapy (DAPT) within one year of coronary stent placement, non-adherent to beta blockers (BB) within six months post-acute myocardial infarction, or with renal dysfunction and requiring dose adjustment of lipid-lowering therapy. Students coded each intervention based on predefined categories such as patient education, medication discontinuation, or medication reconciliation, and then if necessary were reviewed with the pharmacy preceptor. The primary investigator determined the intervention to be either actionable or non-actionable. The primary outcome was the proportion and type of interventions made by each student. The secondary outcome was clinical pharmacist time offset. A retrospective, data-only pilot study was conducted to determine the outcomes from the program over four years. Results. Forty-six students made 3,774 interventions over the study period, 37% of which were categorized as actionable. The most common actionable interventions were providing patient education (52%), verifying prescription adherence (23%), and medication therapy adjustment (10.5%). Over the study period, an estimated 765.6 hours of clinical pharmacist time was offset, or approximately 191.4 hours per academic year. Conclusion. This study demonstrated that a population health management approach can be used successfully within an APPE. This approach can result in offset pharmacist time for precepting organizations, while offering meaningful clinical interventions for patients and learning opportunities for students.

Student pharmacists’ role in enhancing ambulatory care pharmacy practice

“…20 Preceptor time may need to be invested up front to ensure students are properly trained; however, as described throughout, when the experiences are wellplanned, there is a potential for a large impact on student growth, patient care, revenue generation, and time-savings later on. [17][18][19][20][21][22][23]32,42,43…”

“…Kaiser Permanente Colorado incorporated population health management activities for rotation students that entailed students reviewing patient records and identifying interventions that could be made by the student or a clinical pharmacist. 32 Of the 1,406 actionable interventions documented by approximately 46 students, 52% pertained to patient education (e.g., student contacts the patient via telephone or letter for sole purpose of education), 23% to verification (e.g., calling a pharmacy to verify a patient refill history), and 10.5% to medication therapy adjustment (e.g., any dose or medication change within the same medication class). 32 The chart reviews, and subsequent completed interventions, when applicable, conducted by pharmacy students accounted for approximately 765 hours of clinical pharmacist time that would have been required over the four-year study period.…”

“… 32 Of the 1,406 actionable interventions documented by approximately 46 students, 52% pertained to patient education (e.g., student contacts the patient via telephone or letter for sole purpose of education), 23% to verification (e.g., calling a pharmacy to verify a patient refill history), and 10.5% to medication therapy adjustment (e.g., any dose or medication change within the same medication class). 32 The chart reviews, and subsequent completed interventions, when applicable, conducted by pharmacy students accounted for approximately 765 hours of clinical pharmacist time that would have been required over the four-year study period. 32 These innovative ways for engaging students allow student pharmacists to be exposed to ambulatory care practice, while offsetting pharmacist time.…”

“… 32 The chart reviews, and subsequent completed interventions, when applicable, conducted by pharmacy students accounted for approximately 765 hours of clinical pharmacist time that would have been required over the four-year study period. 32 These innovative ways for engaging students allow student pharmacists to be exposed to ambulatory care practice, while offsetting pharmacist time. 29 - 32 …”

“… 32 These innovative ways for engaging students allow student pharmacists to be exposed to ambulatory care practice, while offsetting pharmacist time. 29 - 32 …”