Pharmacy Students Provide Care Comparable to Pharmacists in an Outpatient Anticoagulation Setting

Abstract

Objective. To evaluate whether student participation in ambulatory clinics influenced the percentage of therapeutic international normalized ratio (INR) results among patients on chronic warfarin therapy. Methods. Medical records in outpatient anticoagulation clinics managed by pharmacists under physician protocol were reviewed retrospectively in 2 university-affiliated clinics in Amarillo and Lubbock, TX. Pharmacy student activities included patient interviews, vital sign measurements, fingersticks, counseling, and documentation. Patient visits were conducted by a precepted pharmacy student or a pharmacist without a student, and the INR was measured at the subsequent patient visit. Results. Records of 1,958 anticoagulation patient visits were reviewed; 865 patients were treated by pharmacists, and 1093 were treated by precepted students. The follow-up INR was therapeutic for 48.5% of third-year (P3) students' patients, 45.6% of fourth-year (P4) students' patients, 51.2% of residents' patients, and 44.7% of pharmacists's patients (p 5 0.23). Eight variables were associated with the followup INR (baseline INR, warfarin noncompliance, held warfarin doses, a warfarin dosage adjustment, diet change, alcohol use, tobacco use, and any medication changes). Conclusion. Student participation in the patient-care process did not compromise patient care and no significant difference in patient outcomes was found between patients in an anticoagulation clinic cared for by precepted students and those cared for by pharmacists.

Qualitative Evaluation of a Practice-based Experience Pilot Program for Master of Pharmacy Students in Scotland

“…[18][19][20][21][22] Acquisition of content knowledge is secondary to the approach to learning 23 as evidenced by multiple examples of pharmacy students at all stages in their education successfully undertaking responsibilities, including direct patient care responsibilities under preceptor supervision. [24][25][26][27][28][29][30] Competency develops slowly over time, 19,[31][32][33][34] and, accordingly, students must be given continuous opportunity from the earliest days of their pharmacy education to gain experience dealing with the limitless variety of challenges presented by pharmacy practice if they are to be practice ready at licensure.…”

A student pharmacist-led medication reconciliation service and its impact on the identification of drug-related problems in an ambulatory clinic

“…Identification of immunizations largely represented the majority (140, 43.75%) of interventions for untreated indications and was followed by interventions for the treatment of hypertension (27,8.4%) and hyperlipidemia (20, 6.25%) in patients not yet receiving therapy for these conditions. Of the interventions related to medication efficacy, the most common disease states represented were hypertension (42, 30%) and diabetes (27,18.9%).…”

“…Previous research has demonstrated the impact of student pharmacists in acute care settings through clinical interventions and recommendations. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] In these studies, students delivered recommendations through activities including chart review, rounds, and other pharmaceutical care programs; medication reconciliation was not a service students were typically engaged in. Lubowski et al 15 did specifically look at the impact of students delivering medication reconciliation in a community hospital and found that students were able to identify and resolve drug-related problems.…”

Pharmacy Student Learning During Advanced Pharmacy Practice Experiences in Relation to the CAPE 2013 Outcomes

“…Table 4 includes all articles that used assessment methods consistent with KH levels 3 (behavior change), 4a (change in organizational practice), or 4b (improvement in patient health/well-being). 22,23,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]51,52,59,60,62,64,67,68,[96][97][98] Nine of 15 CAPE outcomes (60%) were represented at these higher KH levels, and approximately 60% of the reports were comprised of subdomain 2.1 (patient-centered care). Assessment methods used were consistent with this subdomain and included medication reconciliation, identification of drug-related problems, and acceptance of clinical intervention recommendations, as well as other measures promoting quality and/or costeffectiveness.…”