Geriatric Pharmacotherapy Case Series: Poly-Provider Leading to Polypharmacy.

Background: This case study reviews the complicated treatment of an older person under the care of numerous specialists in the ambulatory care setting. As various providers made concurrent changes in pharmacotherapy without communication with other providers, the patient experienced acute changes and decompensation. Assessment: Polypharmacy played a significant role in the acute decompensation of the patient. Changes made in the context of specific specialties inadvertently had a negative impact on other disease states. Outcome: Intentional communication between all providers on the patient's health care team resulted in a deeper understanding of the overall plan and therapeutic goals. Care synchronization ultimately improved patient outcomes. The clinical pharmacy team provided multiple pharmacotherapy recommendations to improve pain and anxiety without jeopardizing safety and therapeutics for other disease states. These interventions provided a key element that streamlined and improved patient-centered care. Conclusion: In this case, poly-provider was responsible for polypharmacy that significantly impacted the patient's care and quality of life. Pharmacists and the pharmacists' patient care process play a significant role in improving patient-centered care by identifying medication changes and potential side effects, especially in the wake of interventions by multiple providers.

Assessment of the impact of co-curricular activities on achievement of Doctor of Pharmacy program outcomes.

INTRODUCTION: Co-curricular activities are recognized as an increasingly important aspect of pharmacy education. However, the impact of these activities on student learning is not well understood compared to that of curricular learning. The purpose of this study was to assess student-perceived progress in achieving program outcomes through voluntary co-curricular activities compared with learning of the same outcomes through mandatory curricular activities. METHODS: The study was performed over six semesters between fall 2017 and spring 2020 at the University of Southern California School of Pharmacy. Separate surveys were sent to all first- through third-year doctor of pharmacy students each semester to assess the impact of curricular and co-curricular activities on improvement in six program outcomes. Graduating student survey data were also mapped to learning outcomes to assess improvement of these outcomes upon graduation. RESULTS: Three main results emerged from these data. First, there was greater variation in the impact of co-curricular activities on different learning outcomes compared to the effect of curricular activities on the same outcomes. Second, co-curricular activities had a greater impact on "soft skills," including leadership and professionalism, compared to concrete knowledge in areas such as therapeutic mechanisms. Finally, the impact of co-curricular activities on most learning outcomes diminished with progression through the curriculum while the impact of curricular activities remained relatively constant. CONCLUSIONS: Student-perceived improvement in learning of program outcomes differs when based on co-curricular compared to curricular activities. These results show how these activities can complement each other in achievement of program outcomes.