Assessing Student Pharmacists’ Ability to Identify Drug-Related Problems in Patients Within a Patient-Centered Medical Home

Objective. To quantify, describe, and categorize patient drug-related problems (DRPs) and recommendations identified by fourth-year (P4) student pharmacists during a live medication reconciliation activity within a patient-centered medical home (PCMH). Methods. Fourth-year student pharmacists conducted chart reviews, identified and documented DRPs, obtained live medication histories, and immediately provided findings and recommendations to the attending physicians. Documentation of DRPs and recommendations were analyzed retrospectively. Results. Thirty-eight students completed 99 medication reconciliation sessions from June 2011 to October 2012 during their advanced pharmacy practice experience (APPE). The students obtained 676 patient medication histories and identified or intervened on 1308 DRPs. The most common DRPs reported were incomplete medication list and diagnostic/laboratory testing needed. Physicians accepted 1,018 (approximately 78%) recommendations. Conclusion. Student pharmacists successfully identified and reduced DRPs through a live medication reconciliation process within an academic-based PCMH model. Their medication history-taking skills improved and medication use was optimized.

[1]  S. Simon,et al.  Medication discrepancies in integrated electronic health records , 2012, BMJ quality & safety.

[2]  Kathleen A. Johnson,et al.  Diabetes: The Impact of Clinical Pharmacy Services Integrated into Medical Homes on Diabetes-Related Clinical Outcomes , 2010, The Annals of pharmacotherapy.

[3]  Adam C. Welch,et al.  The Pharmacists’ Role in the Patient-Centered Medical Home (PCMH) A white paper created by the Health Policy Committee of the Pennsylvania Pharmacists Association (PPA) , 2012, The Annals of pharmacotherapy.

[4]  D. Scheid,et al.  A Pharmacist Visit Improves Diabetes Standards in a Patient-Centered Medical Home (PCMH) , 2012, American journal of medical quality : the official journal of the American College of Medical Quality.

[5]  Jeffery D. Evans,et al.  Role of student pharmacists in the identification and prevention of medication-related problems. , 2011, Journal of the American Pharmacists Association : JAPhA.

[6]  Elizabeth A. Rechtsteiner,et al.  Ambulatory medical care utilization estimates for 2006. , 2008, National health statistics reports.

[7]  Seena L. Haines,et al.  Academic pharmacy and patient-centered health care: a model to prepare the next generation of pharmacists. , 2011, Journal of the American Pharmacists Association : JAPhA.

[8]  N. Laird,et al.  Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention , 1995 .

[9]  L. Lundquist,et al.  Resident physicians' acceptance of pharmacy students' pharmacotherapy recommendations during an ambulatory care advanced pharmacy practice experience. , 2009, American journal of pharmaceutical education.

[10]  Timothy Hoff,et al.  The Patient-Centered Medical Home , 2012, Medical care research and review : MCRR.

[11]  Wesley Nuffer,et al.  Physician acceptance of pharmacotherapy recommendations made by pharmacy students in a rural pharmacy-based diabetes care and education clinic. , 2009, American journal of pharmaceutical education.

[12]  P. McDonnell,et al.  Hospital Admissions Resulting from Preventable Adverse Drug Reactions , 2002, The Annals of pharmacotherapy.

[13]  D. Bates,et al.  Why pharmacists belong in the medical home. , 2010, Health affairs.

[14]  C. Poole,et al.  Preventable Drug-Related Hospital Admissions , 2002, The Annals of pharmacotherapy.

[15]  Joshua Borus,et al.  Adverse drug events in ambulatory care. , 2003, The New England journal of medicine.

[16]  James D. Scott,et al.  Medication Therapy Management Services Provided by Student Pharmacists , 2012, American Journal of Pharmaceutical Education.

[17]  B. Isetts,et al.  Managing Drug-related Morbidity and Mortality in the Patient-centered Medical Home , 2012, Medical care.

[18]  T. Mersfelder,et al.  Value of the Student Pharmacist to Experiential Practice Sites: A Review of the Literature , 2012, The Annals of pharmacotherapy.

[19]  K. Hersberger,et al.  Drug-Related Problem Classification Systems , 2004, The Annals of pharmacotherapy.

[20]  S D Small,et al.  Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. , 1995, JAMA.