The impact of a provider motivational interviewing-based training on chronic pain management in a federally-qualified health center.

BACKGROUND: While the issue of opioid misuse is very complex, pharmacists have a unique opportunity to participate in interprofessional, team-based care. Motivational interviewing (MI) has been shown to be effective in chronic disease management and could improve patient engagement and chronic pain outcomes. OBJECTIVES: To determine the impact of an MI-based provider training on changes in chronic pain management prescribing and on provider and patient perceptions. METHODS: Providers participated in a pharmacist-led, 4-session educational intervention covering the CDC opioid prescribing guidelines, pain management, clinical pearls, and MI. Providers were then asked to implement the training in patient appointments for chronic pain management and refer appropriate patients for follow-up on goals. In the follow-up, student pharmacists called patients twice monthly for three months using MI. To address the primary outcome, the number of opioid prescriptions, morphine daily equivalents, and naloxone prescriptions were recorded and compared from the electronic medical record for the year preceding and following the intervention. Patients and providers completed surveys to assess the impact of these interventions. RESULTS: Providers (n = 11) reported increased confidence in MI from baseline to 12 months following the intervention but no change in satisfaction. Patients (n = 19) were able to set and accomplish 20 goals throughout the phone call intervention. Meanwhile, the number of opioid prescriptions significantly decreased from 569 to 368 prescriptions per year before and after the intervention, respectively. Morphine daily equivalents per prescription decreased from 26.8 to 26.4 for the year before versus the year following the intervention. CONCLUSIONS: MI interventions for providers and patients may positively impact goal setting and opioid prescribing. However, MI alone may not successfully address provider satisfaction and patient physical functioning. Pain management is an area that may benefit from a multi-faceted, interprofessional approach.

Stimulating and sustaining scholarly activity at teaching-intensive institutions.

INTRODUCTION: Research and scholarship are core elements of the academic mission. Yet fulfilling institutional and accreditation requirements for scholarly activity can be challenging, particularly for teaching-intensive institutions. This paper describes strategies for employing a teacher-scholar model to stimulate and sustain scholarly activity. METHODS: Metrics of scholarly productivity were programmatically assessed and reported for at least five years following implementation of sixteen different strategic initiatives at three teaching-intensive colleges of pharmacy. Data reported included publications (original peer-reviewed publications, case reports, review articles), presentations (posters, podiums, and continuing education sessions), peer-reviewed published abstracts, grants awarded, and total extramural funding per annum. Faculty and student engagement in scholarship was indicated by authorship on at least one scholarly work. RESULTS: Broad increases in metrics of scholarly productivity were observed, while the timing and degree of change varied (1.4-fold to 10.4-fold, across all institutions, all years). Notably, the most robust growth was observed in grantsmanship and the number of faculty and student contributors to scholarly works. A key observation was that increased scholarly output was sustained, as during the most recent three-year period publications increased 1.6-fold, grants and extramural funding increased 3.4- and 15.8-fold, respectively, and faculty and student contributors increased 1.8- and 4.5-fold, respectively. CONCLUSIONS: Overall, these data point to a substantive, detailed approach for increasing scholarship at diverse, teaching-intensive institutions by implementing cost-conscious strategies, including clear ties between scholarly effort/productivity and faculty performance/advancement, strong faculty development and mentoring, institutional commitments to infrastructure and research budgets, and student engagement in scholarly activities.

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

OBJECTIVE: To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. SETTING: Ohio. PRACTICE DESCRIPTION: Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. PRACTICE INNOVATION: Developed standards for preceptors and objectives for student experiences. INTERVENTIONS: Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. MAIN OUTCOME MEASURE: Not applicable. RESULTS: Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student-teacher relationship, which is fundamentally different from the more common employer-employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. CONCLUSION: Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.

Physician-pharmacist collaboration: a millennial paradigm to reduce medication errors.

The Institute of Medicine has reported that medication errors cause an estimated 7000 deaths annually. Additionally, drug-related adverse events increase the risk of mortality by 1.88, with approximately 27% of reported adverse drug events attributed to negligence. As the healthcare system is faced with the challenge of reducing medication errors and adverse drug events, one viable solution may be to increase physician-pharmacist collaboration. According to the recent literature, increasing physicianpharmacist collaboration may result in a reduction in total drug morbidity and mortality.