Volume 04, Number 1, 2013

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Psychometric Assessment of the PPDG: Utilizing Cronbach’s Alpha as a Means of Reliability
(University of Minnesota, College of Pharmacy, 2013) Marr-Lyon, Lisa R; Gupchup, Gireesh V; Anderson, Joe R
Introduction: Since the development of the 10 item Purdue Pharmacist Directive Guidance (PPDG) Scale several studies of the psychometric properties of the PPDG have been conducted. Although Cronbach’s alpha was calculated as a means of internal consistency reliability, a demonstration of the mean centering of the individual items from the instrument were not explored. Objectives: This study focused on investigating the mean stabilization of items within the PPDG as they pertain to Cronbach’s reliability coefficient calculation. Methods:Using item analysis procedures in SPSS, the mean stability of items within the general factor of directive guidance and subscales of instruction and feedback and goal setting were examined for the PPDG. Results: Mean stability scores for entire PPDG scale and the subscales of instruction and feedback and goal setting were strong. Also, corrected item-total correlations and Cronbach’s alphas following item deletion were good for the overall PPDG scale and the subscales. Conclusions: The results provide evidence to enhance understanding of the psychometric stability of the PPDG scale and its subscales.
Evaluation of a Patient Perspective Module in a Required Medication Safety and Quality Course at a College of Pharmacy
(University of Minnesota, College of Pharmacy, 2013) Battaglia, Jessica N; Lis, Jennifer E; Chui, Michelle A
Objectives: To develop and evaluate the impact of a module discussing the patient’s perspective on medication errors in a required medication safety course at a college of pharmacy. Methods: Students were required to read Josie’s Story, a true story written by a mother after her daughter died from a medical error, and attend an in-class discussion regarding the book. A questionnaire, which employed a pre-post retrospective method and extracted items from the Caring Ability Inventory, was then administered to measure the change in students’ perceptions of patient care. Additional questions gathered students’ perceptions of the assignment, their personal experiences with the topic, and the importance of medication safety. Results: 120 out of 138 students (response rate = 87%) completed the questionnaire. 56% of students indicated they would be more likely to speak with a patient directly about a medication error after reading the book, whereas only 3% were less likely, and 42% indicated they were just as likely. Most students (59%) reported that they felt more motivated to learn about medication safety after reading Josie’s Story. Implications: This course previously addressed strategies to prevent medication errors. Successfully adding a component that introduces how a medication error impacted a patient and her family may help motivate students to recognize the importance and need for a culture of safety, personalize how medication errors impact patients, and provide a venue for students to gain patient centeredness and caring skills.
Affordable Care Act: A review and discussion of its impact on healthcare today, and a primer for pharmacists
(University of Minnesota, College of Pharmacy, 2013) Lui, Leo Lai Ho; Wertheimer, Albert
In the midst of countless healthcare debates, the Patient Protection and Affordable Care Act is written into legislation as a possible solution to the United States's rising healthcare costs. Individualized into nine titles, the act sought to provide additional coverage to millions of Americans while cutting down healthcare costs through numerous provisions effective into 2020. While the act has been challenged publicly and privately by the states, many healthcare professionals today, let alone the average American, are unaware and uneducated of what comprises the act, as well as the impact in which it has on the future of healthcare in the United States. With an increasing role of patient care placed upon pharmacists today, an understanding of the PPACA allows us to provide extensive answers to questions in which our patients may have.
Effective Modification of a Nonprescription Medicines Course to Optimize Learning of Millennial Generation Students
(University of Minnesota, College of Pharmacy, 2013) Mehta, Bella H; Casper, Kristin A
Objective: To describe examples of effective teaching strategies utilized within a required nonprescription therapeutics course, in order to accommodate learning characteristics of Millennials. Case Study: Instructors identified unique characteristics of Millennial generation students through literature review and focused educational workshops. These characteristics include the desire for active learning where didactic lectures make a connection to life, the incorporation of technology, and assignments that focus on team work. Course modifications were then made based on these characteristics including redesign of large group course lectures with incorporation of patient cases, inclusion of a variety of online components including the opportunity to provide course feedback, and active learning small group projects within workshop sections. Evaluation: Student evaluation of the course and instructors significantly improved after introducing changes to the course compared to previous years. Each component of the student evaluation resulted in a statistically significant change in mean score. Verbal and written evaluations indicated a very positive learning experience for students. Grade mean (3.3 vs. 3.8, p<0.001) and range (0.00- 4.00 GPA in 2007 vs. 2.00-4.00 GPA in 2008, p <0.001) also improved compared to previous years. Conclusions: By identifying characteristics of Millennial generation student learners, traditional teaching methods can be modified in order to enhance retention of material and optimize their learning process. Course changes improved the learning experience for students and instructors. Instructors’ willingness to evaluate generational differences and adapt teaching enhances the learning experiences in the classroom for both students and instructors.
Lessons Learned from the Implementation of Two Transitions of Care Programs
(University of Minnesota, College of Pharmacy, 2013) Backes, Andrea C
The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic
(University of Minnesota, College of Pharmacy, 2013) Vanmali, Radha S; Mayer, Sallie D; Fugit, Ann M
Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV) clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: Types of interventions documented during the patient-pharmacist visit, categorized as medication review, patient education, or adherence monitoring. Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%), patient education (23.3%), and adherence monitoring (9.8%). Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS) (P = 0.01), have current or history of opportunistic infection (OI) (P=0.01), and have current or history of OI prophylaxis (P = 0.03). Adherence monitoring was less common amongst the non-Hispanics (7.1%) compared to the Hispanic sub-population (16.5%), (P = 0.04). Conclusion: The role of ambulatory care pharmacists in a free and bilingual clinic goes beyond adherence monitoring. Pharmacists can be a valuable part of the patient care team by providing medication review and patient education for HIV and other co-morbidities within free clinics. Further research is warranted to assess outcomes and to further explore the underlying barriers to early HIV diagnosis and adherence within the Hispanic population.
Landscape of Medication Management in the Minnesota Patient-Centered Medical Home (PCMH)
(University of Minnesota, College of Pharmacy, 2013) Wallace, Margaret L; Moon, Jean; Lounsbery, Jody L; Uden, Donald L
Purpose: To describe the landscape of medication management within the patient-centered medical homes (PCMH) in the state of Minnesota. Methods: An electronic survey of care coordinators within PCMHs certified with the Department of Health in state of Minnesota was conducted. The survey and follow up were distributed by the Minnesota Department of Health. At the time the survey was distributed, there were 161 certified PCMHs in the state. Results: The final analysis included 21 respondents. Size, setting, and time as a certified PCMH varied between practices. PCMHs reported a higher percentage of patients enrolled at lower complexity tiers (35.0 percent at tier I and 40.4 percent enrolled at tier II), with PCMHs with clinical pharmacist services reporting slightly increased frequency of higher complexity patients. The composition of the care team varied from clinic to clinic, but all clinics were multidisciplinary with a mean of 5.8 different provider types listed for each clinic. Physicians were the most common providers of medication management across all settings, and one respondent reported that medication management services are not formally provided in his/her clinic. The presence or absence of a clinical pharmacist did not significantly influence care coordination time dedicated to medication-related activities. Respondents residing in a clinic with clinical pharmacist services reported a high level of satisfaction with pharmacist-provided services. Conclusion: The implementation of the PCMH model in many of the participating clinics was relatively recent and there remains much to be learned regarding the landscape of comprehensive medication management in the PCMH. The reported distribution of patients in complexity tiers suggests that clinics may use different strategies to determine resource allocation. Although the presence of a clinical pharmacist did not influence care coordination time dedicated, care coordinators valued services provided by clinical pharmacists.
Community Pharmacists’ Awareness of Intimate Partner Violence: An Exploratory Study
(University of Minnesota, College of Pharmacy, 2013) Barnard, Marie; West-Strum, Donna; Holmes, Erin; Yang, Yi; Swain, Kristen Alley
Background: Intimate partner violence (IPV) is a serious public health problem, impacting more than 12 million people in the United States each year. The only know effective health care intervention is routine screening for IPV exposure; however, this intervention has been poorly adopted. Expansion of screening efforts to the community pharmacy setting provides an opportunity to have a substantial impact on the health and well-being of pharmacy patients. However, little is known about pharmacists’ knowledge, attitudes, and behaviors related to IPV. Objective: The objective of this study was to conduct an exploratory investigation of community pharmacists’ current level of knowledge, attitudes, behaviors, and intentions related to IPV and to IPV screening. Methods: A cross-sectional study using an online questionnaire was conducted. Surveys were distributed via email. Descriptive analyses of survey responses were conducted. Results: A total of 144 community pharmacists completed the survey. Results indicated most (67.4%) had no IPV education/training. Participants were significantly more willing to conduct screening with targeted patients compared to all patients. (X2=129.62; df=36; p<0.0001). There was strong agreement with interest in and willingness to participate in continuing education. Conclusions: Most respondents indicated relatively low levels of IPV knowledge and training and very little current IPV screening activity. Continuing education on IPV should be considered for pharmacists to increase knowledge and awareness of IPV.
Developing a Professionalism Plan
(University of Minnesota, College of Pharmacy, 2013) Grice, Gloria R; Monson, Kacie; Pitlick, Jamie; Chereson, Rasma; Duncan, Wendy; Geslani, Gemma; Kilgore, Kimberly; Patel, Puja B; Pautler, Heather
Professionalism is a way of being which underlies all the responsibilities of a pharmacist and associated general and professional abilities. The Student Affairs Committee was charged with developing a college-wide professionalism plan to meet the Accreditation Council for Pharmacy Education (ACPE) Standards 15.1 and 23. This plan was developed concurrently with a new curriculum. The plan was developed systematically with the following goals: 1) create a definition of professionalism, 2) determine outcomes of the plan, 3) identify existing components which should be continued and new components to be added, 4) ensure existing and new components are linked to outcomes and 5) develop a continuous assessment process for the plan. The proposed plan consists of curricular, co-curricular and extra-curricular activities designed to help students gain experience in three professionalism pillars: Competence, Connection and Character, as defined by Brown et al in “Taxonomy of Professionalism”. While knowledge and skills will be enhanced, the focus of development will be on student virtues, values and attitudes—that what they do defines who they are. The goal is to help students develop as people and professionals who value the high ideals expected of a pharmacist.
Development of an Active Follow-up Process in a Stand-alone Medication Therapy Management (MTM) Clinic
(University of Minnesota, College of Pharmacy, 2013) Hager, Keri D.
Without following-up with patients, one cannot determine the outcomes of interventions made with patients. To ensure follow-up was occurring in a stand-alone MTM clinic, a process for active follow-up and an easy-to-use way to trigger and document follow-up was developed.
Design and Evaluation of Health Literacy Instructional Video for Pharmacy Students
(University of Minnesota, College of Pharmacy, 2013) Butler, Lakesha M; Devraj, Radhika; Santanello, Catherine
Objectives: 1) To describe the development of a health literacy video tailored for pharmacy students. 2) To compare the use of a health literacy video as an instructional method to a previously used health literacy instructional strategy by using both and: a) assessing pharmacy students’ perceptions of their ability to communicate with low health literacy patients and b) assessing pharmacy students’ perceptions of their overall understanding of the role of health literacy in a pharmacy setting. Case Study: A novel pharmacy health literacy instructional video was created providing patient-pharmacist scenarios involving low literacy patients. A previously used role-play activity was performed in a required “Health Promotion and Literacy” course followed by the viewing of the newly designed health literacy instructional video. Two separate paper-based survey instruments were developed and administered to individually assess both active learning strategies and for comparison of the strategies. Statistically significant differences were noted on all five survey questions with the instructional video rating higher than the role play activity in the overall enhancement of students’ understanding of health literacy. Conclusions: A pharmacy health literacy instructional video was well received by students. It significantly improved students’ perception of their ability to communicate with low health literacy patients in a pharmacy setting and their overall understanding of health literacy.