Managing gestational diabetes: The clinical pharmacist’s role in a patient-centered medical home model

© 2014 Jobson Publishing Corporation. All rights reserved. Clinical pharmacists can play a vital role on a multidisciplinary team and assist with the management of patients with gestational diabetes. In this innovative practice model, implemented in a community health center working toward the designation of a patient-centered medical home, pharmacists collaborate with women’s health providers to educate patients and manage gestational diabetes. Pharmacists have the opportunity to contribute medication expertise in making pharmacotherapeutic decisions. By collaborating with the clinicians providing obstetric care, pharmacists can offer education on lifestyle modifications, self-monitoring of blood glucose, and drug therapy

Preparing Students to Serve a Refugee Population Through a Health-Focused Interprofessional Education Experience

Refugees may arrive to their destination country with complex mental and physical health challenges. However, healthcare providers often are unprepared to manage refugees\u27 health-related challenges. An interprofessional team of faculty developed an interprofessional education (IPE) training to help prepare health professions students to address refugees\u27 health needs. This paper describes the development and assessment of the training. A three-hour case-based training was created with the following format: online pre-assessment; introduction; radio story about the experience of local refugees; pre-recorded presentation about healthcare in a detention facility; interprofessional group work in small teams; large group discussion; profession-specific group reflections; and online post-assessment. The training was implemented twice (across two successive years), and an investigation of the study participants\u27 self-perceived learning was completed after each training. In the first training, 62 participants (representing medicine, occupational therapy, pharmacy, physical therapy, and social work) completed the assessments. In the second training, 151 participants (representing medicine, nursing, occupational therapy, physical therapy, public health, and social work) completed the assessments. In each study, a statistically significant increase in each of four outcome variables was found at post-assessment. The findings of each study suggested that perceived learning about refugees\u27 health and health care improved after participation in a three-hour IPE training

Human Papillomavirus Vaccine Acceptance (HPV-VA) and Vaccine Uptake (HPV-VU): assessing the impact of theory, culture, and trusted sources of information in a Hispanic community

Abstract Background Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with many types of cancers that disproportionately impact Hispanics. An HPV vaccine is available for individuals ages 9—45 that can prevent up to 90% of HPV-associated cancers. The current study investigates factors associated with accepting the HPV vaccine in a predominately Hispanic community. Methods A cross-sectional study design with an online questionnaire was used to collect data from a community sample of adults between the ages 18–65 residing in a U.S./Mexico border city, El Paso, Texas. Theory-based factors (e.g., the Health Belief Model), culture-based factors (e.g., familism), and trusted sources of information were examined as predictors of HPV-vaccine acceptance (HPV-VA) and HPV-vaccine uptake (HPV-VU). Results Community members (N = 602, M age = 34.65, SD = 9.79) who were predominately Hispanic (89.4%) and female (79.6%) participated in the study. Linear regression models revealed that HPV-VA was associated with household size, primary language, engagement in organizational activities, health-related community stigma, government trust, and the HBM theory-based factors: perceived benefits, perceived harm, and perceived severity. Logistic regression analyses revealed that HPV-VU was associated with household size, engagement in non-organizational activities, HPV trusted sources of information, and perceived safety. Conclusions Adequate HPV vaccination uptake among all vaccine-eligible Hispanics is an important step to lessen the HPV-attributed cancer burden. Our hypothesis that theory-based factors would be associated with HPV-VA and HPV-VU was supported. Our findings have implications for designing trusted, theory-based, and culturally sensitive health communications and interventions to promote vaccines in minority underrepresented communities

Assessing the impact of faculty research profile videos on students\u27 perceptions towards research at a school of pharmacy

© 2020 Background and purpose: Innovative delivery of research education and training in pharmacy education improves student perception of, and involvement in, professional pharmacy research. The purpose of this project was to utilize a flipped-classroom video technology approach to introduce our Capstone research experience and to assess the impact of the video technology on student\u27s perceptions of pharmacy research. Educational activity and setting: Faculty recorded one-min videos that provided an overview of current research. Each video included a research introduction, explanation of student incorporation into research, and impact of research on the field of expertise. Students were assigned to review faculty videos. To assess impact of the videos on students\u27 perceptions of research, t-tests compared five variables before and after students watched the videos. These variables included research curiosity, research interest, research inspiration, research motivation, and pharmacy research interest. Findings: Across all students, no differences were detected. A statistically significant interaction emerged that suggested prior pharmacy experience may impact research curiosity, interest, and inspiration. Summary: Findings demonstrated that the impact of research videos on pharmacy students\u27 attitudes and perceptions towards research may depend on students\u27 past experiences in a pharmacy setting. Further research is needed to identify factors that impact students\u27 perceptions of pharmacy research. The information from this study provided our faculty members with valuable insights that can be used to better prepare students in the laboratory, classroom, and beyond

A comparison of national immunization rates to immunization rates of Latino diabetic patients receiving clinical pharmacist interventions in a federally qualified community health centre (FQHC)

Objectives: To compare national immunization rates to immunization rates of Latino patients receiving clinical pharmacist interventions in a federally qualified community health centre (FQHC) in 2010. Methods: This is a retrospective electronic medical record (EMR) review conducted in an FQHC in El Paso, Texas. Adults (≥18) with diabetes who were seen by a clinical pharmacist between 1 January 2010 and 31 December 2010 were queried on the basis of 2010 vaccination criteria for the following vaccines: hepatitis A (HepA), hepatitis B, influenza, pneumococcal, tetanus-diphtheria-acellular pertussis (Tdap) and zoster. Each patient\u27s EMR was reviewed to calculate immunization rates. Study immunization rates (SIRs), overall national immunization rates (OIRs) and national Hispanic immunization rates (HIRs) were compared using z-tests for proportions. The SIRs for each vaccine were calculated using the following formula: number of patients vaccinated/number of eligible patients. OIRs and HIRs were obtained from the 2010 National Health Interview Survey. Key findings: Patients (n=330) were 56.1±12.7 years, primarily women (73.9%) and Latinos (96.7%). SIRs of HepA (33.3%), pneumococcal-ages 19-64 (46.2%) and Tdap (42.7%) were significantly (P\u3c0.0001) higher when compared with both HIRs (10.3%, 14.8%, 4.8% respectively) and OIRs (10.7%, 18.5%, 8.2% respectively). Regarding zoster, the SIR (10.0%) was significantly (P\u3c0.05) higher than the HIR (4.4%) but not significantly different from the OIR (14.4%). Conclusion: Clinical pharmacists can play a significant role in increasing adult vaccination rates. Providing access to vaccines and health education for patients have become more important with the growing needs of a culturally diverse and ageing population. © 2014 Royal Pharmaceutical Society

Co-curricular assessment plan for developing pharmacy professionals (RxPro) after the first professional year

© 2019 Elsevier Inc. Introduction: To measure changes in student professionalism from co-curricular activities. Methods: A prospective cohort study followed first-year pharmacy students at The University of Texas at El Paso School of Pharmacy. Students completed one co-curricular activity each semester. Learning was assessed using the RxPro VALUE rubric and Professionalism Assessment Tool (PAT) at the beginning and end of the first professional year. The RxPro VALUE rubric included six domains (connections to experience, lifelong learning, diversity of communities and cultures, civic identity and commitment, empathy, and reflection and self-assessment) and was rated from 0 (not yet applied) to 4 (exemplary). The PAT contained 33-items in five domains (reliability, responsibility, and accountability; lifelong learning and adaptability; relationships with others; upholding principles of integrity and respect; and citizenship and professional engagement) and was rated from 1 (knows) to 5 (teaches) (maximum score = 165). Results: Mean scores on the RxPro VALUE rubric increased (p \u3c 0.05) from baseline to end of year in five domains: connections to experience (1.44 vs. 2.07), diversity of communities and cultures (1.75 vs. 2.3), civic identity and commitment (1.34 vs. 2.33), empathy (1.44 vs. 2.37), and reflection and self-assessment (1.53 vs 2.19). No significant changes were seen in PAT scores from baseline (M = 114.19, standard deviation = 32.832) to end of year (M = 119.56, standard deviation = 29.63, p = 0.35). Conclusions: The RxPro VALUE rubric detected growth in professional behaviors among first-year doctor of pharmacy students, while no significant change was observed in the PAT

Evaluating the Types of Pharmacy Student Interventions Made During an Interprofessional 6-Week Adult Internal Medicine Rotation

© 2017, © The Author(s) 2017. Introduction: The new standards for pharmacy education require that pharmacy students are involved in direct and interprofessional team-based care in multiple practice settings, which include “real-time” interactions with physician prescribers and medical students. Methods: From April 2014 to December 2015, fourth-year Doctor of Pharmacy (PharmD) students at University Medical Center of El Paso, Texas were assigned to an interprofessional team that was comprised of physician prescribers, medical students, and a pharmacist faculty. They recorded their interventions that were analyzed for type, number, physician acceptance, clinical importance, and time requirements for intervention recommendation. Interventions were divided into 5 main types and further divided into specific categories. Results: Twelve PharmD students contributed 531 interventions, resulting in an average of 44 interventions per student with a physician acceptance rate of 87%. The most common types of interventions performed by PharmD students were under the categories of Therapy Needed (29.8%), Too Low Dose/Frequency (21.1%), Too High Dose/Frequency (8.3%), Therapeutic Level Monitoring (6.8%), and IV to PO Conversion (4.9%). A majority of interventions were of moderate clinical importance (56.1%) and took approximately 15 minutes to complete (92.5%). Conclusion: PharmD students under the supervision of clinical faculty on an interprofessional internal medicine team are valuable collaborators and contributors in decreasing the number of drug-related problems that can negatively impact patient care

Reliability of Point-of-Care International Normalized Ratio Testing in an Academic Family Medicine Clinic

© 2018 Wolters Kluwer Health, Inc. All rights reserved. A recent increase in the number of point-of-care (POC) international normalized ratio (INR) measurements greater than 4 and the need for venous confirmatory testing in an academic family medicine clinic has led to the further exploration of the accuracy of POC INRs greater than 4. The primary objective of this quality improvement project was to compare the POC INR measurements with confirmatory venipuncture INR measurements. Seventeen patients representing 41 separate encounters over a 20-month period were retrospectively reviewed. The median POC INR was 4.5 (interquartile range, 4.1 to 5.1) versus a median venous INR of 3.4 (interquartile range, 3 to 3.9) of the 27 patient encounters where a venous INR was available. This difference between POC and venous INR resulted in a change in therapy for over 80% of the patients, which is a higher-than-reported discrepancy between POC INRs and venous INRs in patients with a POC INR greater than 4. Clinicians using the results of these POC devices who are unaware of the potential positive bias in POC INR values compared with venous draw values are at risk for making warfarin dose reductions, which can put their patients at risk for thromboembolic events

Project DIS-IMPACT: Drug information in English and Spanish to improve patient preparation before colonoscopy

© 2015, American Pharmacists Association. All rights reserved. Objective: To create culturally appropriate colonoscopy education services and handouts for the Hispanic population undergoing a colonoscopy procedure to ensure correct bowel preparation. Setting: Project DIS-IMPACT was conducted at a federally qualified, nonprofit community health center along the United States-Mexico border. Practice description: Patients identified in the study included those who were at least 50 years of age and had not received a colonoscopy between July 1, 2012, and February 28, 2013. Participants included uninsured Hispanics, able to speak English or Spanish, registered with the clinic, and referred by a provider working at the health center. Practice innovation: The process of evaluating and developing colonoscopy screening education included creating a standing order, developing medication education handouts in both English and Spanish, and documenting areas of improvement at monthly pharmacy staff meetings. Main outcome measures: Outcomes of the program included a descriptive statistics analysis of the served population and culturally appropriate counseling recommendations used in the medication (polyethylene glycol electrolyte solution) education handouts. Results: A total of 143 participants received colonoscopy, including 49 men and 94 women. As the classes were conducted, the patient information handouts were adapted accordingly based on culturally appropriate recommendations from participants and providers. Conclusion: Pharmacists played a unique role in providing culturally appropriate precolonoscopy education material to assist in successful colonoscopy preparation

Development and preliminary assessment of interprofessional education focused on vulnerable populations

© 2018 Association of Schools of Allied Health Professions, Wash., DC. With the current state of the U.S. healthcare system, interprofessional collaborative practice (IPCP) has never been more important. Health professions educators are increasingly incorporating interprofessional education (IPE) in their curricula in order to prepare students for IPCP. The Health-Focused IPE Community of Practice (representing nursing, occupational therapy, pharmacy, physical therapy, rehabilitation counseling, social work, and speech-language pathology) at the University of Texas at El Paso has created a unique IPE model centered on vulnerable populations. The purposes of this paper are to describe the early development of this innovative IPE model and present findings from an evaluation of an IPE learning experience focused on a case involving a transgender individual. The evaluation of the first IPE activity demonstrated that the students\u27 knowledge and attitudes related to interprofessional collaboration improved for all participating professions. Additionally, the post-training evaluation revealed that students were more comfortable providing services to transgender individuals than interacting with them. This IPE model has leveraged the strengths of community-engaged faculty in order to infuse content related to vulnerable populations across multiple curricula. This holistic approach models to the students that complex problems require multifaceted solutions generated by IPCP