Promoting interprofessional collaboration: pharmacy students teaching current and future prescribers about Medicare Part D

Student-Led discharge counseling program for High-Risk medications in a teaching hospital in Saudi Arabia: A pilot study

Discharge counseling by pharmacists reduces adverse medication events, emergency department visits, and readmissions. Studies indicate that pharmacy students in advanced pharmacy practice experiences (APPE) can deliver effective medication-related activities. An open label randomized controlled trial was conducted in adults discharged on warfarin, insulin, or both. Pharmacy students performed medication reconciliation, structured medication counseling, and follow-up calls 72-hours post-discharge. The usual care arm received traditional education. The primary outcome was the 30-day readmission rate post-discharge. Ninety-eight patients on high-risk medications were randomized to intervention (n = 51) or usual care (n = 47). The 30-day hospital readmission rate was lower in the intervention group (8/51, 15% vs. 11/47, 23%); (p = 0.48). There was no statistical difference in the time to first unplanned health care use (hazard ratio = 0.49 (95 %CI, 0.19–1.24), or the time-to-first clinic visit post-discharge (p = 0.94) between the two arms. Students identified 26 drug-related problems during reconciliation. Patients in the intervention arm reported high satisfaction with the service (mean 3.94; SD 0.11). Involving APPE students in the transition of care activities presents an excellent opportunity to minimize pharmacists' workload while maintaining patient care services.

Interprofessional education between dentistry and pharmacy students: delivery, barriers and facilitating implementation

Interprofessional education (IPE) between dentistry and pharmacy students is an approach to teach effective collaborative practice between a team of future health care providers. It relies on the support and motivation of students, staff and professionals to implement a variety of educational strategies and might involve evaluating student progression before and after delivery. Many barriers exist towards the implementation of IPE between dentistry and pharmacy health disciplines and outlining experiences across educational/clinical practice settings and possible solutions would assist in reducing those walls to realization. Implementation of IPE between pharmacy and dentistry undergraduate programs might lead to improved workplace collaborations and reduce medication errors, adverse events and increase in cross-referrals. Interprofessional education within undergraduate training forms the first steps towards reducing the burden on health care systems by enabling effective collaboration to improve patient outcomes. This narrative review describes IPE strategies used between pharmacy and dentistry undergraduate disciplines to enable collaboration, discusses the barriers and facilitators towards implementing IPE, and future directions for IPE education between these two disciplines.

Educational Approach to Increase Student Pharmacist Confidence with Medicare

Objective:

To describe a didactic, case-based approach to teach student pharmacists about Medicare enabling them to consider the spectrum of coverage options, as well as both medical and drug needs, when assessing insurance plans.

Innovation:

Education on Medicare often focuses on Part D. However, the growing popularity of Medicare Advantage plans requires students to have a more comprehensive understanding of Medicare. To address this gap, a didactic, case-based approach was developed where students received four 90-minute lectures on Medicare and then applied the information through a patient case. Data was collected on student-reported confidence with Medicare, and attitudes towards the importance of understanding insurance in improving patient care. Surveys were conducted at baseline, after the didactic lectures (interim survey), and upon project completion (final survey).

Key Findings:

Confidence with Medicare increased between the baseline and interim survey (all p ≤ 0.001). Additional gains were seen after completing the project in helping patients navigate financial assistance programs (p ≤ 0.001) and selecting specific plans (p ≤ 0.05). After the interim survey, students more strongly agreed with statements related to knowledge of insurance as an opportunity to help advocate for patients (p ≤ 0.001), and the need to consider Medicare coverage when making medication recommendations (p ≤ 0.05)

Conclusion:

The combination of didactic lectures and a case-based exercise positively impacted self-reported student confidence in their knowledge, as well as attitude towards Medicare. Increasing student confidence in Medicare and willingness to engage beneficiaries in conversations about insurance coverage may be a strategy to improve patient care and health outcomes.

Health Insurance Programs, Extended Social History Taking, and Resources to Overcome Health Care Barriers: Introduction for Medical Students

INTRODUCTION

Recognizing social determinants of health and addressing barriers to health care are an essential part of medical practice for which students' formal training is inadequate. The majority of medical students feel a professional responsibility to understand health policy, but their knowledge of health care legislation and health insurance is lacking, and their primary information sources are outside the medical education setting. This resource provides an easily implemented tool kit to begin to fill these educational gaps.

METHODS

During their first inpatient medicine clerkship, fourth-year students in a 6-year BA/MD program participated in a classroom activity that included instruction on taking a comprehensive social history and a lecture regarding government insurance. Through an interactive case-based discussion, students developed a list of specific resources and then compiled information to share with their classmates.

RESULTS

Thirty-seven students participated in this learning activity during a brief pilot period. Comparison of preclass and postclass survey data showed that students increased their knowledge regarding insurance programs. Students also increased their self-perceived skills in identifying barriers and arranging resources for patients. The majority of students (94%) intended to apply these skills and knowledge during future clinical rotations.

DISCUSSION

This resource provides a tool for introductory, interactive learning about health insurance, social history taking, and addressing barriers to health care, and requires minimal resources. The amount of time devoted to the activity, references, and discussion topics can be customized to fit within a school's specific learning goals and overall curriculum on health disparities.

Interprofessional Education on Medication Adherence: Peer-to-Peer Teaching of Osteopathic Medical Students

Context

Medication nonadherence is an important barrier to achieving optimal clinical outcomes. Currently, there are limited data on methods used to train medical students about medication adherence.

Objective

To evaluate the knowledge, confidence, and attitudes of first-year osteopathic medical students before and after a 30-minute peer-to-peer medication adherence education program led by a third-year pharmacy student.

Methods

All first-year medical students from Touro University California College of Osteopathic Medicine were invited to participate in 1 of 3 medication adherence educational sessions held in May 2019. A third-year pharmacy student who received training from Touro University California College of Pharmacy faculty served as the peer educator. Each session took approximately 1 hour to complete. The session included a preprogram survey, a 30-minute program, and a postprogram survey. Survey items included demographics; medication adherence knowledge, confidence, and attitudes; and attitudes toward the peer-to-peer educational format. Statistical comparisons of preprogram and postprogram knowledge, confidence, and attitudes were made using a paired t test, the McNemar test, and the Wilcoxon signed-rank test. P<.05 was considered statistically significant. A sample size calculation was performed using mean knowledge scores to determine whether the study achieved 80% power.

Results

Twenty-three students participated in the study. Medication adherence knowledge scores improved after the program (17.4 [77.4%] vs 9.98 [92.2%]; P<.001). Confidence scores also improved for all 7 survey items (P<.001). Medical students had more positive attitudes toward medication adherence after the program, with 8 of 10 survey items in this domain showing improvement. Most students had a positive attitude toward the peer-to-peer educational format. All participants reported that they would implement the medication adherence skills learned at the program with future patients.

Conclusion

A 30-minute peer-to-peer program led by a pharmacy student improved first-year medical students’ knowledge, confidence, and attitudes with regard to medication adherence and provided an effective format to enhance interprofessional learning and collaboration.

A collaborative approach to combining service, teaching, and research

OBJECTIVE

To describe a faculty-student collaborative model and its outcomes on teaching, service, and scholarship.

DESIGN

A Medicare Part D elective course was offered that consisted of classroom and experiential learning where pharmacy students participated in community outreach events to assist Medicare beneficiaries with Part D plan selection. The course training was expanded to include medication therapy management (MTM) and the administration of immunizations. At the completion of the course, students collaborated with faculty members on research endeavors.

EVALUATION

During the first 6 years of this course, the class size more than doubled from 20 to 42 students, and all students participating in the course met the IPPE requirements for community outreach. Over that same period, the number of beneficiaries receiving assistance with their Part D plan grew from 72 to 610; and with the help of students starting in 2011, faculty members had 28 poster presentations at national conferences, 7 invited podium presentations at national/international meetings, and published 8 manuscripts in peer-reviewed journals.

CONCLUSION

Through collaborative efforts, this model took an elective course and provided classroom and experiential learning for students, needed health services for the community, and opportunities to pursue wide ranging research projects for faculty members and students.