The impact of third year pharmacy students providing medication therapy management in community pharmacies

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2012-12

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Abstract

This retrospective study was conducted to examine the impact of third-year pharmacy students’ provision of medication therapy management (MTM) on medication and health-related outcomes of patients in community pharmacies. The study objectives were as follows: 1) describe patients’ socio-demographic and clinical characteristics; 2) describe the number and types of medication and health-related problems (MHRPs) identified by students, as well as students’ MTM interventions and recommendations; 3) describe medical provider/patient MTM recommendation acceptance rates; and 4) determine which factors (i.e., baseline MHRPs, medical conditions, prescription medications, over-the-counter (OTC) medications and herbal supplements, number of medical prescribers, MTM interventions, and MTM recommendations) were related to the number of MHRPs resolved. The study used data (MTM cases) from a required MTM course, taught at The University of Texas at Austin College of Pharmacy. The study included MTM cases provided by third-year pharmacy students enrolled in the Fall 2011 semester. MTM cases that were complete, unduplicated, and had patients aged ≥ 18 years were included the study. Descriptive statistics were used to address the first three study objectives. Multivariate linear regression was used to determine which factors were related to the number of MHRPs resolved. Out of the total number of MTM cases, 274 met the study inclusion criteria and served as the study’s final sample. The patients’ average age was 63.8 (±14.5), and the majority were female (60.4%) and Caucasian (53.2%). Almost one-third of the patients (30.7%) drank alcohol. The mean number of medical conditions and prescription medications was 6.0 (±2.7) and 9.0 (±4.0), respectively. Pharmacy students identified 1,370 MHRPs [935 medication-related problems (MRPs) and 435 health-related problems (HRPs)] and recommended 1,004 medication and health-related recommendations (MHRRs) [542 medication-related recommendations and 462 health- related recommendations]. Medical providers and/or patients accepted recommendations regarding drug discontinuation (34.8%) and OTC and herbal supplements (28.9%) at higher rates than other recommendations. Regarding the regression, the overall model was statistically significant, F=76.88, df=7, 240, p<0.001, and baseline MHRPs (β=0.127, t=2.09, p=0.04) and MTM recommendations (β =0.715, t=11.37, p<0.0001) were significantly related to MHRPs resolved. In conclusion, pharmacy students had a positive impact on patients’ medication and health-related outcomes through identifying MHRPs and providing MTM recommendations. The significant positive relationship between the number of MTM recommendations and MHRPs resolved should encourage pharmacists and pharmacy students to be more eager to provide MTM recommendations, given the evidence that they will lead to improving patients’ medication and health-related outcomes.

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