Resident Physicians’ Acceptance of Pharmacy Students’ Pharmacotherapy Recommendations During an Ambulatory Care Advanced Pharmacy Practice Experience

Abstract

Objective. To compare the acceptance rates of written versus verbal pharmacotherapy recommendations made by pharmacy students on an ambulatory care advanced pharmacy practice experience (APPE). Methods. Fourth-year pharmacy students made written and verbal pharmacotherapy recommendations to resident physicians in an internal medicine clinic at an urban, teaching hospital over a 10-month period. The types of recommendations and outcomes of the interventions were recorded using a data collection form to determine differences in acceptance rates for written versus verbal recommendations. The recommendation types and corresponding acceptance rates were also compared. Results. Of 542 pharmacotherapy recommendations made by 14 APPE students during the 10-month study period, 65.1% were written and 34.9% were verbal. Of the 189 verbal recommendations, 97.9% were accepted, compared with 83.6% of written recommendations (p , 0.0001). The most frequent types of recommendations and overall rates of acceptance were dosage change (87.0%), laboratory monitoring (85.8%), and medication initiation based on evidence-based medicine guidelines (79.3%). Conclusion. Verbal pharmacotherapy recommendations made by pharmacy students were accepted by resident physicians at a significantly higher rate than written recommendations in an outpatient internal medicine clinic.

Student Pharmacists’ Clinical Interventions in Advanced Pharmacy Practice Experiences at a Community Nonteaching Hospital

“…Most published studies report the impact of student pharmacists in teaching institutions, [3][4][7][8][9][10] although some do not specify the teaching status of the site. 2,6 These studies have evaluated students in a variety of APPEs, including ambulatory care, internal medicine, pediatrics, and psychiatry.…”

“…[2][3][4][5][6][7][8][9][10][11] Student pharmacists have had a significant impact in improving patient care and in providing cost savings to the institution. While at the experiential practice sites, each student pharmacist made an average of 1.2 to 16 recommendations per week to prescribers, with an acceptance rate of 32% to 98%.…”

Assessing Student Pharmacists’ Ability to Identify Drug-Related Problems in Patients Within a Patient-Centered Medical Home

“…Abdelhalim and Lundquist measured the acceptance rates of recommendations made by students who had direct contact with attending physicians in the primary care setting. 25,26 Acceptance rates by attending physician were 93.8% and 88.6%, respectively. These findings, along with our results, provide further evidence that direct interaction with physicians in a live environment may be the most effective method in which to resolve drug-related problems in an outpatient setting.…”

Impact of a Student-Supported Pharmacy Assessment Program on Venous Thromboembolism Prophylaxis Rates in Hospitalized Patients

“…Another observation from the study was the low physician acceptance rate for pharmacy student recommendations, which was even lower than rates found in the literature. 10 One explanation of this could be that most recommendations presented to physicians were in a written form, which is a less effective means of ensuring acceptance of recommendations. 10 At this community hospital, verbal recommendations were often difficult to communicate because formalized rounding did not occur on the general medicine units.…”