Infective Endocarditis in Low- And Middle-Income Countries

Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of upto 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high income countries, conclusions on the state of IE in low and middle income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article is a review of IE studies conducted in LMICs documenting clinical experiences from the year 2000 to present. We present the causes of IE, management of patients with IE and the prevailing challenges in diagnosis and treatment of IE in LMICs

Implementation of a low-cost unna boot alternative as adjunctive treatment for Kaposi Sarcoma

There are 6 million people living with HIV; 70% reside in Sub-Saharan Africa (SSA). Furthermore, 1.1 million deaths occur due to opportunistic infections (OIs) that can be minimized with antiretroviral therapy. In Kenya, Kaposi Sarcoma (KS) is an especially debilitating OI that presents with dermatologic lesions; magnifying the stigma that patients with HIV face physically and psychosocially. Dermatology research is underway to determine the effectiveness of an unna boot (medicated, layered compression dressing) to speed the healing of these lesions with anecdotal success. Commercially available unna boot products are too expensive and not readily available in SSA. Clinicians from Purdue University College of Pharmacy and the AMPATH Consortium hope to address this need in SSA. A pharmacy student was tasked with developing a low-cost unna boot as a service learning project during an eight-week advanced pharmacy practice experience in Eldoret, Kenya. This project began with an extensive literature review to determine the utility and feasibility of an unna boot, and resulted in the development of a modified kit costing significantly less than commercial products, potentially improving quality of life for this population. This poster describes the implementation and methodology of the local unna boot’s creation, a summation of the service learning project, and the impact on a pharmacy student, clinicians, and patients in SSA

Learning to Sew: A Student Pharmacist’s Service-Learning Experience

Karolina Grzesiak is a fourth-year professional student in the College of Pharmacy at Purdue University and will earn her Doctor of Pharmacy degree in May 2017. She was raised in Poland but has called La Porte, Indiana home for the past eight years. Craig Vargo is a 2012 pharmacy graduate working as a clinical specialist pharmacist at the James Cancer Hospital at The Ohio State University Wexner Medical Center in Columbus, Ohio

Student Pharmacists’ Response to a Pandemic: Service-Learning through Contact Tracing

In March 2020, the SARS-CoV-2 (COVID-19) pandemic disrupted education nationwide. To safely deliver in-person classes, Purdue University contracted One-to-One Health, creating the Protect Purdue Health Center (PPHC). The PPHC was a central location for information, testing, and case management for Purdue students, staff, faculty and their dependents. Contact tracing is a proven public health measure that has been utilized to control the spread of infectious diseases by identifying and isolating potential active cases. The communicative nature of contact tracing, along with its need for clinical decision-making skills makes the student pharmacist an ideal candidate for aiding in this pandemic response. In an effort to support the PPHC in navigating the necessary protocols to keep Purdue open, operating, and safe, the College of Pharmacy formed Experiences in Public Health, a service-learning course which enrolled ten student pharmacists. The students served as contact tracers, participated in group discussions surrounding emerging COVID-19 health information, and reflected on their experiences as members of the community. As contact tracers, they aimed to decrease secondary spread of COVID-19 by identifying and following-up with close contacts of lab-confirmed cases, educating on quarantine/isolation protocols, and scheduling tests for those with symptoms or exposure history. Active participation in a pandemic response is a meaningful opportunity for professional growth in patient-centered care and communication. Students actively improved upon skills taught in the Doctor of Pharmacy program such as motivational interviewing, active listening, and open communication to fulfill their role as contact tracers. Additionally, the students gained proficiency in patient education and clinical decision-making, and through class discussions, enhanced their abilities to answer COVID-19-related questions with scientific resources. Through volunteering at the PPHC and engagement in peer-led topic discussions, the Experiences In Public Health service-learning course allowed student pharmacists to apply professional skills to become an active force in mitigating the spread of COVID-19. This service-learning opportunity provided several key takeaways. Student pharmacists who participated in this initiative attest that they are more comfortable providing patient care, better able to handle a rapidly developing clinical situation, and further prepared for their future careers in various fields of pharmacy practice

A Comparison of Student Pharmacist Clinical Interventions During an Internal Medicine Advanced Pharmacy Practice Experience (APPE) in a High-Income Versus Low-Income Setting

Objectives: Compare and contrast the number and type of interventions made by student pharmacists who participated in an adult internal medicine APPE in the US to an internal medicine APPE in Kenya. Methods: A US-based faculty-led, four-week internal medicine APPE with interprofessional team rounding that provides care for underserved patients in an urban setting and hosts 16 students annually was compared to a faculty-led, eight-week internal medicine APPE in Kenya that hosts on average 24 students annually. Starting May 2017 – January 2018 a standard clinical intervention collection form was used by all students on these two APPEs starting the first full week of the rotation and continued until the last day. Descriptive statistics were used to compare the intervention data. This study is Institutional Review Board approved. Results: Data was collected from 13 students for an average of 15 days for the US-based APPE and 23 days for the Kenya-based APPE. US-based students documented an average of 2.2 interventions per patient per day, while Kenya-based students documented 2.8 interventions per patient per day. The most common interventions were patient chart reviews and treatment sheet rewrites for the US-based and Kenya-based students, respectively. Two notable interventions that were documented on the Kenya-based APPE, but not the US-based APPE, were intravenous administration instructions and obtaining patients’ blood pressures and fasting blood sugars. Implications: Regardless of setting, student pharmacists are able to have a profound impact on patient care and further demonstrates that the Kenya-based internal medicine rotation is a comparable learning experience to its US-based counterpart

Wrapping Up In Kenya: A Student’s Learning Experience in Eldoret, Kenya

Alexander R. Mills received his Doctor of Pharmacy degree in May 2017 and has completed a PGY-1 community-based pharmacy practice resident with Walgreen Company and Purdue University College of Pharmacy. During his time at Purdue, he was heavily involved with Purdue’s chapter of The American Red Cross Club, serving as the president and coordinator of community outreach programs. Upon completing his PGY-1, he will continue to pursue his aspirations to care for the medically underserved while currently completing a PGY-2 residency specializing in ambulatory care and academia at the University of Mississippi in Jackson

Comparison of Clinical Interventions between Student Pharmacists on Advanced Pharmacy Practice Experiences in Indianapolis, Indiana versus Eldoret, Kenya

Student pharmacists can have a positive impact on patient care. The objective of this research was to compare clinical interventions made by Purdue University College of Pharmacy (PUCOP) student pharmacists completing internal medicine Advanced Pharmacy Practice Experiences (APPE) in Kenya and the US. A retrospective analysis of interventions made by PUCOP student pharmacists participating in either the 8-week global health APPE at Moi Teaching and Referral Hospital (MTRH-Kenya) or the 4-week adult medicine APPE at the Sydney & Lois Eskenazi Hospital (SLEH-US) was completed. Twenty-nine students (94%) documented interventions from the MTRH-Kenya cohort and 23 (82%) from the SLEH-US cohort. The median number of patients cared for per day was similar between the MTRH-Kenya (6.98 patients per day, interquartile range [IQR] = 5.75 to 8.15) and SLEH-US students (6.47 patients per day, IQR = 5.58 to 7.83). MTRH-Kenya students made a median number of 25.44 interventions per day (IQR = 20.80 to 28.95), while SLEH-US students made 14.77 (IQR = 9.80 to 17.72). The most common interventions were medication reconciliation/t-sheet rewrite and patient chart reviews for MTRH-Kenya and the SLEH-US, respectively. This research highlights how student pharmacists, supported in a well-designed, location-appropriate learning environment, can positively impact patient care

Meeting the Needs of Underserved Patients in Western Kenya by Creating the Next Generation of Global Health Pharmacists

Objective. To describe a novel training model used to create a sustainable public health-focused pharmacy residency based in Kenya and to describe the outcomes of this training program on underserved populations. Design. The postgraduate year 2 residency was designed to expose trainees to the unique public health facets of inpatient, outpatient, and community-based care delivery in low and middle-income countries. Public health areas of focus included supply chain management, reproductive health, pediatrics, HIV, chronic disease management, and teaching. Assessment. The outcomes of the residency were assessed based on the number of new clinical programs developed by residents, articles and abstracts written by residents, and resident participation in grant writing. To date, six residents from the United States and eight Kenyan residents have completed the residency. Eleven sustainable patient care services have been implemented as a result of the residency program. Conclusion. This pharmacy residency training model developed accomplished pharmacists in public health pharmacy, with each residency class expanding funding and clinical programming, contributing to curriculum development, and creating jobs