Student Pharmacist Perspectives of a Remote Ambulatory Care and Community Pharmacy Dual-Cohort APPE.

OBJECTIVE: The primary aim of the study is to describe the development and implementation of a remote required ambulatory care and required community pharmacy dual-cohort Advanced Pharmacy Practice Experience (APPE) rotation from the student pharmacist perspective. The secondary objective is to identify elements of a remote APPE to integrate into traditional onsite rotations. METHODS: An electronic post-survey was developed to evaluate rotation effectiveness based on the Center for the Advancement of Pharmacy Education (CAPE) outcomes, and to identify rotation attributes to inform future rotations. Students from different graduating classes on rotation between April and June 2020 participated in the survey. Likert-scale, ranked-response, and fixed-answer-choice questions were analyzed using descriptive statistics, and comparisons between cohorts and rotation groups were completed using the Chi-squared statistic (alpha .05). Open-ended questions were assessed for recurring themes. Study was exempted by university's Institutional Review Board. RESULTS: Twenty-four of 45 invited students completed the survey (53% response rate). Of the surveyed CAPE outcomes, agreement was highest (95.7%) that the rotation improved students' abilities within 1.1 Learner, 2.2 Manager, and 4.4 Professional subdomains. Diversity of experiences and topic discussions were elements most frequently identified for inclusion in future rotations. CONCLUSION: Student feedback was largely positive and indicated the remote APPE rotation experience was meaningful and improved abilities on key CAPE outcomes. Although remote rotations are unique, aspects including diverse learning experiences and preceptor collaboration may be considered for integration into traditional onsite rotations.

The impact of clinical pharmacy services on pneumococcal vaccine frequency and appropriateness in a family medicine clinic.

OBJECTIVE: To evaluate the impact of an ambulatory clinical pharmacy service (inclusive of immunization needs assessments) on the frequency and appropriateness of pneumococcal vaccine administration in a family medicine clinic. METHODS: This cohort study had an observational and retrospective design and included patients who received pneumococcal vaccines at a family medicine clinic in a medically underserved area in Southwestern Pennsylvania across a 42-month period from January 1, 2015, to June 30, 2018. The outcome measures included the administration and appropriateness of pneumococcal 13-valent conjugate (PCV13) and pneumococcal 23-valent polysaccharide (PPSV23) vaccines across 3 time cohorts including before, during, and after the establishment of a clinical pharmacy service. RESULTS: A total of 457 pneumococcal vaccines were administered, including 198 (43.3%) PCV13 and 259 (56.7%) PPSV23, across all time cohorts. Overall vaccine administration per month increased by 143% with the introduction of a dedicated clinical pharmacy service, including a 270% increase for PCV13 and an 87% increase for PPSV23. A strong correlation was found between recommendations made and doses administered for both pneumococcal vaccines (r = 0.89; P < 0.003). Across the entire time frame, PPSV23 administrations were appropriate in more than 96% of instances, whereas the appropriateness of PCV13 administrations were statistically significantly improved after the introduction of a fully dedicated clinical pharmacy service (58.5% vs. 90.8%; P < 0.05). The appropriateness of vaccine administration remained high even after the reduction of clinical pharmacy services. CONCLUSION: Clinical pharmacy service implementation in a family medicine clinic was associated with increased pneumococcal vaccine administration and increased appropriateness of PCV13 administrations.