Telehealth diabetes services for non-English speaking patients.

BACKGROUND: Several studies have shown the use of telehealth in diabetes management to be as efficacious as traditional clinic visits; however, these studies focused on English-speaking populations. OBJECTIVES: The primary objective of this study was to evaluate whether telehealth is an effective approach for participation in pharmacist collaborative diabetes management services among non-English-speaking or limited English proficiency (LEP) patients at a federally qualified health center (FQHC). The secondary objective was to evaluate glycated hemoglobin (A1c) as a clinical outcome in patients participating in telehealth versus in-person visits. METHODS: This study was a retrospective chart review. Patients were non-English-speaking or LEP adults (≥ 18 years of age) with a diagnosis of type-2 diabetes (T2D) referred for pharmacist collaborative diabetes management services by a medical provider. This study reviewed patient participation and A1c values over 6 months (May to October) of 2 consecutive years (2019 and 2020). RESULTS: In this study, 40 patients in 2019 and 50 patients in 2020 met the inclusion criteria. In 2019, the primary visit model was in-person and 123 total visits were scheduled with a pharmacist. In 2020, the primary visit model was telehealth and 143 total visits were scheduled. In 2019, there were 28 no-show visits, which accounted for 22.8% of total visits. In 2020, there were 27 no-show visits, which accounted for 18.9% of total visits. The mean change in A1c from baseline to follow-up was found to decrease by 1.0% in 2019 and 0.95% in 2020. CONCLUSIONS: We concluded that telehealth participation in pharmacist-provided collaborative T2D services and decrease in A1c were similar during telehealth compared with in-person visits among non-English-speaking and LEP patients at a FQHC. However, further studies with larger sample sizes are necessary to determine the overall impact of telehealth in non-English-speaking or LEP patients.

Impact of early direct patient care introductory pharmacy practice experiences on student pharmacists' career exploration.

BACKGROUND AND PURPOSE: The University of Kentucky College of Pharmacy piloted a novel longitudinal introductory experiential program to provide second (P2) and third (P3) year professional students early exposure to pharmacist-provided direct patient care, opportunity to develop professionally expected behaviors, and ability to explore contemporary pharmacy career options. This paper describes the influence of the pilot on pre-advanced pharmacy practice experiences (APPEs) career interests and professional development. EDUCATIONAL ACTIVITY AND SETTING: Forty P2 and P3 students participated in the longitudinal experiential pilot course. Students were assigned to 32 pharmacist preceptors in a variety of direct patient care practices. Students completed 16 onsite hours over the fall semester. Influence of the pilot experience on APPE plans and future career interests was assessed by an end of experience reflective assignment and survey. FINDINGS: The pilot course served as the initial exposure for the majority of students to both direct patient care and specialized areas of pharmacy practice. Nearly half of students indicated the experience advanced their knowledge of pharmacists' scope of practice and potential career opportunities. Most students (85%) reported the experience influenced future career plans, with half indicating increased interest in their specific practice specialty. Over 75% planned to pursue an APPE in that practice area. Nearly all students reported making professional contacts through this experience. SUMMARY: Early exposure to direct patient care and specialized pharmacy practice areas through this IPPE provided students opportunity to inform career interest and develop professional contacts with preceptors in specialized practice areas.

Impact of Curricular Integration Between Patient Care Laboratory and Introductory Pharmacy Practice Experience on Documentation.

Objective. To assess the impact of curricular changes made through vertical integration between Patient Care Laboratory and Introductory Pharmacy Practice Experience (IPPE) courses on documentation outcomes. Methods. Curricular changes to address student pharmacist documentation deficiencies were developed by laboratory and experiential faculty members. A documentation activity using subjective, objective, assessment, plan (SOAP) notes completed in one IPPE rotation block, pre-intervention, were graded and compared to SOAP notes from the same IPPE rotation block in the subsequent year, post-intervention, using a standard checklist. Chi square test (or Fisher exact test when appropriate) was used to evaluate the relationship between each question's score and different timepoints. Wilcoxon rank sum test was used to compare total scores between the two groups of students. Results. Significant improvement among student pharmacists' SOAP note scores were observed in the post-intervention cohort (n=52) compared to pre-intervention cohort (n=52) following curricular changes. Specific SOAP note components that revealed significant improvements between years were drug therapy problem identified, proposed drug therapy problem resolution, follow-up plan identified, overall impression, and addressing a pharmacist-specific intervention. Conclusion. Collaboration between laboratory and experiential education faculty members are integral to the identification of gaps in student pharmacists' application of simulated activities into actual experiences and in the achievement of educational outcomes. Curricular quality improvements can be implemented and assessed quickly through vertically integrated courses.

Pharmacy Students' Ability to Identify the Steps of the Pharmacists' Patient Care Process During IPPE.

Objective. To determine the ability of first-year Doctor of Pharmacy (PharmD) students to describe patient care activities performed by pharmacists and accurately associate those activities with the five core steps of the Pharmacists' Patient Care Process (PPCP). Methods. First-year student pharmacists completed introductory practice experiences at ambulatory and institutional pharmacies. Students' ability to describe activities that occurred in these settings and align them with the five core steps (collect, assess, plan, implement, and follow-up) of the PPCP were assessed. Results. The students were more adept in describing patient care activities and aligning them to the appropriate PPCP steps in an ambulatory pharmacy setting than in an institutional pharmacy setting. Students achieved higher scores when describing and aligning patient care activities associated with the collect and implement steps in an ambulatory pharmacy setting and for the assess step in an institutional pharmacy setting. Conclusion. As institutions strive to adopt the PPCP in all areas of the curriculum, this application serves as an example of successful PPCP integration early in the introductory experiential curriculum. Our results challenge faculty to provide early opportunities for students to apply the PPCP in a variety of practice settings, including settings focused on the medication distribution system.