A Multi-Site Qualitative Study Examining Pharmacy Student Perspectives on the Opioid Crisis.

Objective. To determine pharmacy students' perspectives regarding opioid use, the opioid crisis, and pharmacy education related to both topics.Methods. Students from each professional year at eight participating schools and colleges of pharmacy were invited to participate in focus groups and answer questions about their experiences with the opioid crisis. Faculty and/or staff moderated the focus groups and audio-recorded responses. Recordings were deidentified, transcribed, and analyzed.Results. One hundred fifty students participated in one of 29 focus groups conducted. Responses were categorized according to themes using consensual qualitative research (CQR) methodology. Sources impacting student views on the crisis included school, personal and work experience, and media. Perspective changes since starting school included increased knowledge and awareness and decreased bias/stigma.Conclusion. Conducting focus groups on the opioid crisis provided pharmacy schools with information on what student pharmacists are learning about the crisis, practices they see, and their recommendations to address the crisis. Pharmacy schools can better prepare students to combat the opioid crisis by providing them with training in opioid counseling, use of naloxone, and how to have difficult conversations with patients.

Prevalence, treatment, and control of hypertension in residents of skilled nursing facilities.

OBJECTIVE: To determine the prevalence, treatment, and control of hypertension (HTN) in elderly residents of skilled nursing facilities (SNFs). To determine variables that may influence the treatment and control of HTN in residents of SNFs. DESIGN: Concurrent medical record review of SNF residents who had resided at a facility for a minimum of 30 days. SETTING: Twelve SNFs in western Iowa and eastern Nebraska. PARTICIPANTS: All residents studied were living in one of the 12 SNFs, N=966. MAIN OUTCOME MEASURE(S): Data collected from each medical record included: demographic characteristics, past medical history, blood pressure (BP) taken over the preceding 30 days, and antihypertensive medications and their doses. The BP reading used to define BP control, or lack thereof, was based on the last recorded BP measurement in the medical record. RESULTS: The total percentage of patients with HTN was 77%. Of those with HTN, 71% had controlled BP and 29% had uncontrolled BP. The average number of antihypertensive drugs used was not significantly different between patients with controlled and uncontrolled BP. Multivariate analysis failed to identify any patient demographic characteristic or comorbidity that correlated with a higher rate of BP control. The number of antihypertensive drugs administered correlated significantly with BP control. The specific type of antihypertensive drug or drug combination did not correlate with BP control. Patients with controlled BP were significantly more likely to be receiving antihypertensive therapy at higher doses than patients with uncontrolled BP.

An advanced pharmacy practice experience in community engagement.

OBJECTIVE: To implement a 5-week advanced pharmacy practice experience (APPE) in community engagement and assess the impact of the APPE on students' confidence and ability to provide community-based services. DESIGN: Working with community partners, students provided medication reconciliation, attended interprofessional healthcare meetings, developed health-promotion activities, and conducted medication-therapy reviews. ASSESSMENT: Responses to pre- and post-APPE 10-item surveys, preceptor and practice-experience evaluations, and the documented number of pharmacy student recommendations were determined. CONCLUSION: This APPE provides students opportunities in nontraditional community settings to increase their confidence and enhance their skills in health-promotion activities, medication-therapy management, and interprofessional care of patients, all of which are essential to the practice of pharmacy.

Portfolio use and practices in US colleges and schools of pharmacy.

OBJECTIVES: To identify the prevalence of portfolio use in US pharmacy programs, common components of portfolios, and advantages of and limitations to using portfolios. METHODS: A cross-sectional electronic survey instrument was sent to experiential coordinators at US colleges and schools of pharmacy to collect data on portfolio content, methods, training and resource requirements, and benefits and challenges of portfolio use. RESULTS: Most colleges and schools of pharmacy (61.8%) use portfolios in experiential courses and the majority (67.1%) formally assess them, but there is wide variation regarding content and assessment. The majority of respondents used student portfolios as a formative evaluation primarily in the experiential curriculum. CONCLUSIONS: Although most colleges and schools of pharmacy have a portfolio system in place, few are using them to fulfill accreditation requirements. Colleges and schools need to carefully examine the intended purpose of their portfolio system and follow-through with implementation and maintenance of a system that meets their goals.

Medication therapy management training using case studies and the MirixaPro platform.

OBJECTIVE: To implement and assess a medication therapy management (MTM) training program for pharmacy students using the MirixaPro (Mirixa Corporation, Reston, VA) platform and case studies. DESIGN: Students received lectures introducing MTM and were given a demonstration of the MirixaPro platform. They were divided into teams and assigned cases and times to interview patients portrayed by faculty members. Using the MirixaPro system, students performed 2 comprehensive medication reviews during the semester, recording the patient's current medications, indications, side effects, allergies, health conditions, and laboratory test recommendations and developed a personal medication record and medication action plan. ASSESSMENT: Based on a rubric with a rating scale of 0-10, campus and distance pathway students received mean scores ranging from 6.3-7.4 for their performance on the second MTM exercise, an increase of 47%-54% over the first MTM exercise. In qualitative assessments, the majority of students believed that their confidence in providing MTM was enhanced by the activity, while faculty members recognized the advantage of using MirixaPro, which allowed students to experience what is required in processing a pharmacist led, billable MTM encounter. CONCLUSIONS: Use of the MirixaPro system and patient cases provides students with a "hands-on" experience that may encourage them to promote MTM during their APPEs and provide MTM services as practicing pharmacists.