Ann Ryan Haddad

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 patients 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.

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.

The development of an instrument to evaluate interprofessional student team competency

ABSTRACT Healthcare institutions, accreditation agencies for higher learning, and organizations such as the National Academy of Medicine in the United States, support interprofessional education (IPE) opportunities. However, incorporating IPE opportunities into academic settings remains difficult. One challenge is assessing IPE learning and practice outcomes, especially at the level of student performance to ensure graduates are “collaboration-ready”. The Creighton-Interprofessional Collaborative Evaluation (C-ICE) instrument was developed to address the need for a measurement tool for interprofessional student team performance. Four interprofessional competency domains provide the framework for the C-ICE instrument. Twenty-six items were identified as essential to include in the C-ICE instrument. This instrument was found to be both a reliable and a valid instrument to measure interprofessional interactions of student teams. Inter-rater reliability as measured by Krippendorff’s nominal alpha (nKALPHA) ranged from .558 to .887; with four of the five independent assessments achieving nKALPHA greater than or equal to 0.796. The findings indicated that the instrument is understandable (Gwet’s alpha coefficient (gAC) 0.63), comprehensive (gAC = 0.62), useful and applicable (gAC = 0.54) in a variety of educational settings. The C-ICE instrument provides educators a comprehensive evaluation tool for assessing student team behaviors, skills, and performance.

Use of a multidisciplinary tool to achieve target outcomes in Native American patients with diabetes: Treat-to-target.

Purpose Our purpose was to test a communication tool used in a multidisciplinary setting to more effectively achieve the recommended goals for glucose, blood pressure, lipids, and prophylactic aspirin use in a Native American population with type 2 diabetes. Methods One hundred randomly selected patients were included in this observational, pre-intervention, post-intervention study design. The team began with a chart audit documenting hemoglobin A1c (Hgb A1c), blood pressure, cholesterol levels, and aspirin use. The intervention included the development of a one page form used to prompt providers to intensify therapy when the patient was not meeting evidence-based goals. The audit was repeated one year later. Results Analysis of 74 patients completing the study showed a decrease in Hgb A1C from 8.812% pre-intervention to a mean 8.214% post-intervention (p < 0.007). At the time of pre-intervention audit, patients were already at target for blood pressure and no significant further decrease was found. Measures of total cholesterol, triglycerides, and aspirin use showed improvement, but statistical significance was not met. Conclusion The one-page multidisciplinary tool used to intensify therapy significantly improved glucose control. More consistent interaction of the multidisciplinary team is necessary to reach other desired goals.