Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy Problems for Patients:
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Manish Khullar Richard Slavik Sean Gorman Nicole Bruchet Sarah Murray Brett Hamilton Dawn Dalen PowerPoint PPT Presentation


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Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study. Manish Khullar Richard Slavik Sean Gorman Nicole Bruchet Sarah Murray Brett Hamilton Dawn Dalen. Background.

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Manish khullar richard slavik sean gorman nicole bruchet sarah murray brett hamilton dawn dalen

Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study

Manish Khullar

Richard Slavik

Sean Gorman

Nicole Bruchet

Sarah Murray

Brett Hamilton

Dawn Dalen


Background

Background

  • Clinical pharmacists resolving drug therapy problems (DTPs) for patients improve clinical and health economic outcomes

  • A Canadian National Working Group has recommended 8 clinical pharmacy key performance indicators (cpKPI) to advance pharmacy practice and improve patient care

Makowsky MK, et al. Med Care 2009;47:642-650.

Gillespie U, et al. Arch Intern Med 2009;169:894-900.


Background1

Background

  • Performing admission medication reconciliation

  • Participating in inter-professional patient care rounds

  • Initiating a pharmaceutical care plan

  • Resolving drug therapy problems (DTPs)

  • Providing in-person disease and medication education

  • Providing discharge medication education/counseling

  • Performing discharge medication reconciliation

  • Providing bundled, proactive patient care

Fernandes O, et al. Pharmacotherapy 2013; 33(10):e208.


Background2

Background

Total DTP

  • Any DTP resolved by a pharmacist

    DSEM-DTP

  • DTP resolved for a condition covered in priority disease state education modules (DSEMs)

    DSEM-KPI

  • A key pharmacist intervention proven to reduce morbidity, mortality, or health resource utilization for that disease


Background3

Background

  • Pharmacist-resolved DTP is a key clinical performance indicator for IH Pharmacy

Interior Health DTP Tracker Data (Jan 1 – Dec 31, 2013)


Rationale

Rationale

  • Resolving impactful DTPs for priority patients is a major professional development goal for the IH Pharmacy Practice Residency Program

  • Limited data suggest that U.S. entry to practice PharmD students and residents may contribute to clinical care during experiential rotations

Mersfelder TL, et al. Pharmacotherapy 2012; 46:541-548.

Taylor CT, et al. Ann Pharmacother2000; 34:843-846.


Rationale1

Rationale

  • There are no data on the contribution of Canadian pharmacy practice residents to resolved DTPs during experiential rotations

  • A recently completed IH study identified discordance on the perception of IH resident contributions to DTP resolution


Objectives

Objectives

  • To describe the contribution of IH pharmacy practice residents to clinical pharmacy care using resident-resolved DTPs

  • To describe resident satisfaction with tracking their resolved DTPs


Methods

Methods

Design

  • Prospective, observational, one group study

    Setting

  • Kelowna General Hospital (KGH), Royal Inland Hospital (RIH), Penticton Regional Hospital (PRH), East Kootenay Regional Hospital (EKH) and Kootenay Lake Hospital from Sept 2, 2013 to Jun 13, 2014


Methods1

Methods

Inclusion Criteria

  • DTP Tracker data collated from 4 IH pharmacy practice residents after completion of the first 4-week patient care rotation (i.e. Internal Medicine)

    Exclusion Criteria

  • DTP Tracker data that is uninterpretable or incomplete


Methods2

Methods

Primary Outcome

  • Number of resident-resolved DTPs

    Secondary Outcomes

  • Number of resident-resolved DSEM-DTPs

  • Number of resident-resolved DSEM-KPIs

  • Progression of resident-resolved DTPs, DSEM-DTPs, and DSEM-KPIs over time

  • Survey feedback on resident satisfaction with training, usability, efficiency, and time of DTP tracking


Results

Results

*Interim analysis of 12 clinical rotations (50%) for 4 residents:

Internal Medicine, community medicine, rural medicine (2), ambulatory care (2), nephrology (2), cardiology (3), critical care


Results1

Results

Monthly Counts

#4

#5

#1

#2

#3

#6

Rotation


Results2

Results

DTP Tracker Satisfaction Survey

Satisfaction Ratings

Training

Usability

Efficiency

Time

Survey Domains


Conclusions

Conclusions

  • IH Pharmacy practice residents are resolving DTPs, DSEM-DTPs, and DSEM-KPIs

  • Resident interventions have increased over time throughout the residency year

  • Resident interventions would be expected to improve clinical and health economic outcomes for patients

  • DTP tracking by residents was well-accepted based on training, usability, efficiency, and time requirements


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