Academic journal article American Journal of Pharmaceutical Education

Using Collaborative Drug Therapy Agreements to Train Student Pharmacists to Provide Clinical Patient Care Services

Academic journal article American Journal of Pharmaceutical Education

Using Collaborative Drug Therapy Agreements to Train Student Pharmacists to Provide Clinical Patient Care Services

Article excerpt

Objective. To assess the impact of a new course designed to train student pharmacists to provide clinical patient care services delivered through collaborative drug practice agreements.

Design. An intensive two-credit, one-week course with a combined self-study and interactive pedagogical approach was developed. Content from the online Washington State Pharmacy Association Clinical Community Pharmacist training program was integrated with a live, eight-hour seminar.

Assessment. Student-pharmacist learning, effectiveness of content presented, and perceived value of the material were evaluated. Scores on quizzes, a knowledge assessment, a patient-case examination, pre- and post-seminar surveys, and voluntary student certification rate were collected and analyzed. Of 132 student pharmacists enrolled in the course, 121 students met competency on their first attempt at completing the knowledge assessment and 126 students met competency on their first attempt at completing the practical examination. A pre- and post-training survey found that student pharmacists were significantly more comfortable performing and recommending implementation of services after completing the course.

Conclusions. Training student pharmacists who are competent and comfortable providing clinical patient care services can improve access to care and reduce the impact of the impending physician shortage.

Keywords: collaborative drug therapy agreement, collaborative pharmacy practice agreement, community pharmacy, education, student pharmacist

INTRODUCTION

The American Association of Medical Colleges predicts that by 2025 our nation will have a shortage of 90,000 physicians, including 31,000 primary care providers. The impact of this shortage is likely to be most pronounced in underserved populations. In the state of Washington, many patients, particularly in rural and underserved areas, lack full access to health care services. In Washington, 27 out of 37 counties are classified as medically underserved areas by the Health Resources and Services Administration because of "too few primary care providers, high infant mortality, high poverty or a high elderly population." (2,3)

Providers in other health care disciplines are looking for ways to reduce the impact of this projected physician shortage. Increasing primary care and specialized physician residency slots and using nurse practitioners (NPs) and physician assistants (PAs) to their fullest extent as providers are two current trends in addressing the physician shortage. (4,5) The latter solution becomes complex because the legal scope of practice is regulated by each state and those regulations may not align with the professional competencies of NPs and PAs. (6) The same is true for pharmacists and the practice of pharmacy. The average American lives within five miles of the nearest community pharmacy, making pharmacists and the care they provide highly accessible. (7) A collaborative approach is necessary to increase patient access to care.

State pharmacy boards and commissions regulate the practice of pharmacy at the state level, resulting in variation across the country as to the use of collaborative drug therapy agreements (CDTA) also called collaborative practice agreements (CPA). While many states have CDTAs or CPAs there is wide variation in how they can be used. Some states place restrictions on the conditions pharmacists can treat, the medications they can prescribe, and additional training they must have. (8) In Washington, the Pharmacy Practice Act has allowed all pharmacists to prescribe medication under CDTAs since 1979. (9) There is no limitation on the population or disease states they are allowed to treat outlined in the agreements. In the past several years, many states' pharmacy practice acts have been modified to match the evolving role of pharmacists as members of integrated health care teams. In California, Montana, New Mexico, and North Carolina an advanced practice pharmacy designation is awarded to qualified pharmacists that authorizes them to prescribe, monitor, manage, and dispense medications. …

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