Transitions of Care: Medication-Related Barriers Identified by Low Socioeconomic Patients of a Federally Qualified Health Center Following Hospital Discharge

This article describes a qualitative research study using a semi-structured interview process to describe barriers surrounding medication access, use, and adherence for recently discharged patients of a federally qualified health center. Common themes which emerged were: 1) Team assumptions regarding patient plans to access or appropriately use discharge medications negatively impact adherence; 2) Unmet expectation for care coordination between primary care physician (PCP) and hospital; 3) Disconnect between patients and health care workers leads to disengagement; and 4) Lack of personal contact hinders access to services

User-centered design and evaluation of RxMAGIC: A Prescription Management And General Inventory Control system for free clinic dispensaries

Medication management is a complex and expensive multistage process that covers the prescribing and ordering, order communication, dispensing, administering, and monitoring and use of prescription medications. While challenges in medication management are ubiquitous across all settings, they can be particularly exacerbated in a free clinic that serves a medically vulnerable population. These patients suffer from financial constraints, poor health literacy, multiple chronic conditions, and medication non-adherence. Clinical pharmacists play an integral role in the provision of healthcare services to these patients and could benefit from the use of medication management information technology (MMIT) to provide efficiencies in the tracking, provision, and use of medications. While MMITs exist, they are not designed to support the unique needs of pharmacists in these settings

Street Medicine at Pitt: Medication Formulary and Dispensing Process

Street Medicine at Pitt is an interdisciplinary organization that focuses on providing resources to the homeless population in Pittsburgh. The organization typically receives medications from the Birmingham Clinic, but a standardized dispensing process was not previously established. Both a medication formulary and medication dispensing process were created for the organization and customized to meet the needs of the specific population. Both resources were created as a result of attending street medicine rounds, gathering preferences from the providers through surveys, and volunteering at the Birmingham Clini

Assessing Perspectives of a Global Health Area of Concentration Within the PharmD Curriculum

Introduction While global health education in pharmacy expands, limited research has described the outcome of completing a global health area of concentration on career decisions, perceptions on cultural sensitivity, health disparity awareness, and global health competencies among pharmacists and students. Methods This mixed methods study enrolled 21 graduates and 17 student pharmacists who participated in a global health concentration at one school of pharmacy in the United States. Data sources included graduate interviews and surveys, student pharmacist focus groups, and global health competency self-assessments. Results Five themes emerged among graduates: (1) skills were applicable to diverse settings, (2) early exposure to underserved care prepared graduates for current practice, (3) participation impacted the lens through which graduates viewed careers, (4) participation influenced patient care in current practice, and (5) graduates gained insight on complex global health issues. Three themes were identified among student pharmacists: (1) the program provided opportunities to personalize education, (2) participants gained insight through hands-on experience, and (3) participants developed new perspectives on approaching underserved care. Many graduates (77.4%) currently practiced in an underserved setting. Graduates and fourth professional year students reported improvement in all seven global health competency domains. Conclusions A global health concentration in pharmacy curricula can facilitate skills and global health competencies that are applicable across a wide variety of patient care contexts. This concentrated experience provided opportunities to further develop career interests and personalize education, creating a cadre of pharmacists dedicated towards addressing health disparities and serving the underserved

Evaluating Students’ COVID-19 Knowledge, Attitudes and Practices (COVKAP) during the COVID-19 Pandemic

The COVID-19 pandemic led to significant disruption in students’ lives through lockdowns, restricted movement, remote instruction, and mixed information. Therefore, this study aimed to capture the knowledge, attitudes, and practices of student pharmacists during 2020–2021. A 43-item COVID-19 Knowledge, Attitudes, and Practices (COVKAP) survey previously developed was administered at four schools of pharmacy across the U.S. during Fall 2020 and Spring 2021. A total of 418 responses were analyzed from graduating classes of 2021–2024. There were no significant differences in correct COVID-19 knowledge responses across the four graduating years. Respondents’ attitudes around COVID-19 were homogenous with the exception for their belief in their preparedness to administer COVID-19 vaccines. Respondents reported wearing masks daily (76.8%), infrequently visiting restaurants (82.1%), practicing social distancing daily (45.7%), and referring to medical journals for information (72%). In conclusion, during the pandemic, student pharmacists experienced significant changes in their academic lives. Their knowledge and subsequent attitudes and practices were consistent with the state of evidence during Fall 2020 and Spring 2021. Subsequently, as newer information has emerged, the authors suggest that the COVKAP survey may be modified and administered frequently to address student needs and concerns as the pandemic evolves

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey

Background: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states—Tennessee, Ohio, and Pennsylvania. Methods: The COVKAP survey—an online cross-sectional survey—was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman’s recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose® software. Results: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. Conclusions: Preliminary study findings indicate that student pharmacists’ concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey

Background: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states—Tennessee, Ohio, and Pennsylvania. Methods: The COVKAP survey—an online cross-sectional survey—was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman’s recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose® software. Results: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. Conclusions: Preliminary study findings indicate that student pharmacists’ concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners

User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries

Abstract Background To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or RxMAGIC, in collaboration with the Birmingham Free Clinic in Pittsburgh, Pennsylvania. RxMAGIC is an interoperable, web-based medication management system designed to standardize and streamline the dispensing practice and improve inventory control in a free clinic setting. This manuscript describes the processes used to design, develop, and deploy RxMAGIC. Methods We transformed data from previously performed mixed-methods needs assessment studies into functional user requirements using agile development methods. Requirements took the form of user stories that were prioritized to drive implementation of RxMAGIC as a web-application. A functional prototype was developed and tested to understand its perceived usefulness before developing a production system. Prior to deployment, we evaluated the usability of RxMAGIC with six users to diagnose potential interaction challenges that may be avoided through redesign. The results from this study were similarly prioritized and informed the final features of the production system. Results We developed 45 user stories that acted as functional requirements to incrementally build RxMAGIC. Integrating with the electronic health record at the clinic was a requirement for deployment. We utilized health data standards to communicate with the existing order entry system; an outgoing electronic prescribing framework was leveraged to send prescription data to RxMAGIC. The results of the usability study were positive, with all tested features receiving a mean score of four or five (i.e. somewhat easy or easy, respectively) on a five-point Likert scale assessing ease of completion, thus demonstrating the system’s simplicity and high learnability. RxMAGIC was deployed at the clinic in October 2016 over a two-week period. Conclusions We built RxMAGIC, an open-source, pharmacist-facing dispensary management information system that augments the pharmacist’s ability to efficiently deliver medication services in a free clinic setting. RxMAGIC provides electronic dispensing and automated inventory management and alerting capabilities. We deployed RxMAGIC at the Birmingham Free Clinic and measured its usability with potential users. In future work, we plan to continue to measure the impact of RxMAGIC on pharmacist efficiency and satisfaction

A Systematic Review of Global Health Assessment for Education in Healthcare Professions

Objective: Emphasis on global health education is growing, with schools/colleges developing relevant courses, areas of concentration, and other didactic content. Organizations such as the Consortium of Universities for Global Health (CUGH) provide guidance for competencies in global health, but evaluation strategies are lacking. Accordingly, the purpose of this study was to identify methods and tools utilized to assess knowledge, skills, and attitudes in global health courses for health science students. Methods: A systematic review was conducted according to the PRISMA guidelines. The initial search was conducted using controlled vocabularies to screen PubMed, EMBASE, Global Health using Ovid, CINAHL, and ERIC from January 1997 to March 2020. Included articles detailed students in health professions, described a didactic educational intervention related to global health, and described assessment strategies and results. Results: A total of 12,113 titles/abstracts were identified. Based on the study inclusion criteria, 545 full texts were reviewed, and 79 full-text articles were selected for qualitative synthesis. Findings of the research revealed that cultural competence (70.9%) was evaluated most often, followed by health disparities (26.6%) and global health itself (12.7%). Most articles used quantitative assessment methods (86.1%), with surveys being the predominant method. A total of 91.1% of studies assessed perceptions, attitudes, and beliefs, while fewer evaluated knowledge (43.0%) and skills (19.0%). The most common validated tool employed was the Inventory for Assessing the Process of Cultural Competence (IAPCC). Conclusions: Based of the results of this study, the majority of the assessment tools utilized for global health education focused on cultural competence. One of the important findings of this research is the lack of validated instruments to assess students\u27 skills in health disparities and global health. Given the recent global pandemic, these skills are essential for educating health care professionals to enhance global health