Academic journal article American Journal of Pharmaceutical Education

Comparison of Patients' Expectations and Experiences at Traditional Pharmacies and Pharmacies Offering Enhanced Advanced Pharmacy Practice Experiences

Academic journal article American Journal of Pharmaceutical Education

Comparison of Patients' Expectations and Experiences at Traditional Pharmacies and Pharmacies Offering Enhanced Advanced Pharmacy Practice Experiences

Article excerpt

INTRODUCTION

Over the past decade, colleges and schools of pharmacy across the United States and Canada have undertaken significant curriculum revisions to incorporate the philosophy and practice of pharmaceutical care. (1,2) Along with these revisions, the learning objectives and expected activities of the advanced pharmacy practice experience (APPE) component have also been revised. Today, within community pharmacy-based APPEs, students are expected to engage in activities that go well beyond dispensing and counseling to include management of acute and chronic diseases through the provision of pharmaceutical care. These processes commonly involve: conducting assessment of patients' drug and medical concerns when filling new or refill prescriptions; providing consultation on nonprescription products; providing individualized medication reviews; developing care plans; providing patient specific interventions; collaborating with other health professionals to optimize patients' drug therapy; and monitoring patients' progress through follow-up care to ensure desired outcomes are achieved. (1-3)

While considerable progress has been made in implementing patient-centered experiences within APPEs, many community pharmacy managers continue to do so reluctantly. (4-12) Given the limited reimbursement for pharmaceutical care services, the increased work pressures due to pharmacist shortages, the perceptions that experiential sites do not derive direct benefits from training students, and the belief that patient satisfaction is already being met based on studies involving traditional pharmacy practice models, many managers question the value of committing their pharmacists' time and effort to incorporate pharmaceutical care activities within their APPE programs. (4,8,13-15) Hence, if pharmacy schools are to succeed in engaging community pharmacy APPE stakeholders to expand students' learning opportunities to include pharmaceutical care, APPE program evaluation will need to employ strategies that demonstrate the value of such activities. This view was echoed in 2 editorials appearing in the Journal that suggested colleges and schools of pharmacy will need to incorporate evaluation processes to quantify the direct value offered by APPE students at experiential sites in order for managers to commit staff time to create meaningful experiences for students. (16,17)

As with community pharmacy APPE sites across North America, most of the community pharmacies affiliated with the University of British Columbia's (UBC) pharmacy program have yet to be convinced of the benefits of incorporating pharmaceutical care opportunities for students. Accordingly, the Structured Practice Education Program (SPEP) at the UBC Faculty of Pharmaceutical Sciences incorporated multiple measures to quantify the impact of its revised community-based APPE. Starting in 1999, the SPEP faculty undertook a collaborative and iterative process to enhance its community-based APPE by adding, deleting, and revising the syllabus, details of which have been published elsewhere. (18-22) As part of this process, 3 recommendations were made to enhanced the existing APPE: (1) the SPEP faculty was to provide preceptors with an educational program to support them in their role as educators and facilitators; (2) the SPEP faculty was to provide students with an onsite orientation program prior to the start of their APPE to ensure preparedness; and (3) the UBC Faculty was to consider restructuring its APPE from 4 weeks at 2 different community sites to 8 weeks at a single site. Working within the collaborative spirit of the new relationship between the SPEP faculty and the community pharmacy stakeholders, the partners made a strategic decision to undertake a pilot study to assess the impact of all 3 interventions at the outset, with the intent to use future studies to better understand the impact of each recommendation separately.

The partnership joined the university with 2 of Canada's national community pharmacy chains to pilot the enhanced APPE. …

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