Fourth-year Student Pharmacists' Perceptions of a Required Student-run Free Clinic Experience.

Objective: The University of Michigan Student-Run Free Clinic (UMSRFC) provides quality preventive, acute, and chronic care free of charge to uninsured and underinsured community members. We sought to assess fourth-year student pharmacists' (P4) attitudes toward providing care as part of a required experience at the UMSRFC during their Ambulatory Care Advanced Pharmacy Practice Experience.

Methods: All P4s in the 2023-2024 academic year completed an 8-hour experience at the UMSRFC.

An interdisciplinary intervention for detection of sexual dysfunction associated with antidepressants: A pilot study.

Introduction: Treatment-emergent sexual dysfunction (TESD) is a commonly reported side effect of antidepressant medications in clinical trials. Limited literature exists exploring the role of routine use of the Arizona Sexual Experience Scale (ASEX) in identification of TESD in clinical practice. Therefore, we completed a retrospective study with the primary goal of capturing the rates of sexual dysfunction associated with antidepressant use among adult patients at an outpatient encounter with a psychiatric clinical pharmacist between June 2020 and March 2022.

Health screenings with a medical interpreter in a required Ambulatory Care Introductory Pharmacy Practice Experience.

Background And Purpose: This study aimed to assess second year student pharmacists' (P2) confidence in communicating with patients with limited English proficiency before and after a required community-based health screening experience.

Educational Activity And Setting: All P2s were required to complete a 0.5 credit hour Ambulatory Care Introductory Pharmacy Practice Experience (IPPE).

Transitioning From Points-Based Grading to a Modified Pass/Fail Grading Approach in a Simulated Patient Program.

Objective: To determine the impact of transitioning from points-based grading to a modified pass/fail grading approach in a simulated patient (SP) program on first year pharmacy (P1) student performance in a PharmD curriculum.

Methods: Course-level data from the 2021-2022 and 2022-2023 academic years were collected to assess the impact of transitioning to a modified pass/fail grading approach on P1 student performance. During the 2021-2022 academic year, points-based grading was used.

Relative exposure to psychiatric conditions and medications in pharmacy education.

Introduction: Common psychiatric conditions occur at rates similar to chronic medical conditions. This study aimed to evaluate the exposure to psychiatric disease states as comorbidities in relation to other common chronic conditions within the curriculum at one college of pharmacy.

Methods: Researchers reviewed course activities for instances of specific conditions as comorbidities.

Comparison of Transplant Pharmacist Treatment Decisions Between Telehealth and Clinic Visits.

Implementation of telehealth in high-risk patient populations provides opportunities for continuous interactions and has previously been shown to positively impact practice. However, there is a paucity of studies focused on telehealth in the liver transplant population specific to pharmacist care. Describe the importance of transplant pharmacist treatment decisions between telehealth, in-clinic, and asynchronous (eg chart review and electronic message support) visit types.

Feasibility of a comprehensive medication review to improve medication use for patients with cancer and comorbid conditions.

Purpose: A focus on oral medications for patients receiving care from both oncologists and primary care providers elicits an opportunity for improvement in patient outcomes. The purpose of this pilot study was to explore the feasibility and appropriateness of a comprehensive medication review (CMR) by a primary care pharmacist in a population of patients with cancer and chronic conditions.

Methods: Adult patients who received both cancer and primary care at Michigan Medicine, received active systemic cancer treatment, and had a comorbid condition of diabetes, hypertension, chronic heart failure, depression, and/or anxiety were eligible to receive a CMR by the primary care clinical pharmacist.

Impact of a pharmacist in an interdisciplinary post-cardiac intensive care unit clinic.

Background: The complex needs of cardiac patients shortly after discharge from a cardiac intensive care unit (CICU) provides a unique opportunity for a pharmacist to help optimize medication management and guideline-directed medical therapy (GDMT).

Objective: This study describes the impact of a pharmacist in a multidisciplinary post-CICU clinic.

Methods: We performed a retrospective cohort study of patients ≥18 years of age who completed a visit in the University of Michigan Post Intensive Cardiac Care Outpatient Long-Term Outreach (PICCOLO) Clinic from July 2018 to May 2020.

The Impact of an Early Clinical Experience on Pharmacy Student Learning About Ambulatory Care Practice.

To determine whether student confidence in their knowledge of ambulatory care pharmacy and ability to contribute to patient care in this setting increased after participating in an ambulatory care introductory pharmacy practice experience (IPPE), and whether it changed student interest in pursuing a career in ambulatory care pharmacy. Second-year pharmacy students (n=86) completed a required ambulatory care experience which included four hours of didactic work and 13.5 hours of clinic experience with an ambulatory care pharmacist.

Primary care provider perceptions of an integrated community pharmacy hypertension management program.

Background: Trained community pharmacists provided hypertension (HTN) management services in collaboration with a patient-centered medical home (PCMH).

Objective: To explore primary care provider (PCP) perceptions of a HTN management program in which patients at the PCMH with elevated blood pressure could choose to receive follow-up care with a trained community pharmacist at a chain community pharmacy.

Methods: We conducted informal interviews with 8 PCPs with a range of level of involvement with the collaborative HTN management program to inform the development of a 13-question online survey that was distributed to PCPs at 10 participating Michigan Medicine PCMH clinics.

Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center.

Multiple groups have described strategies for clinical implementation of pharmacogenetics (PGx) that often include internal laboratory tests that are specifically developed for their implementation needs. However, many institutions are not able to follow this practice and instead must utilize external laboratories to obtain PGx testing results. As each external laboratory might have different ordering and reporting workflows, consistent reporting and storing of PGx results within the medical record can be a challenge.

The Prescribing and Education of Naloxone in a Large Academic Medical Center.

The opioid epidemic has led to increased needs for opioid reversal agents which require education and counseling for proper use. The purpose of this study was to evaluate outpatient naloxone prescribing and education practices at an academic medical center to understand the current state and inform quality improvement measures. This retrospective chart review study included 439 patients that were at least 18 years old and received an outpatient prescription for naloxone between 1 July 2017 and 30 June 2018.

Impact of Dosing Conversion From Basal Insulin to Follow-On Insulin Glargine.

Background: Several basal insulins have recently come to market including follow-on insulin glargine (Basaglar®). Currently, there is no real-world data published on the implications of conversion to Basaglar on dosing or glycemic control.

Objective: To identify differences in basal insulin dosing requirements, hemoglobin A1c (HbA1c), and incidence of hypoglycemia or weight gain when converting a patient to Basaglar from another basal insulin.

Provider perceptions of pharmacists providing mental health medication support in patient-centered medical homes.

Objectives: To identify primary care providers' (PCPs') comfort level, potential barriers to management of patients with mental health disorders, and attitudes around clinical pharmacist-provided mental health medication-related support.

Methods: A 16-item cross-sectional survey was completed by PCPs in 14 patient-centered medical homes (PCMHs) at 1 academic medical center. Items assessed include PCPs' perceptions of the proportion of patients with a mental health condition, access to psychiatry services, confidence in mental health condition management, clinical pharmacist-provided mental health medication support, and demographics.

Implementation and barriers to uptake of interactive voice response technology aimed to improve blood pressure control at a large academic medical center.

Objectives: Blood pressure control among patients with hypertension is a widely recognized quality metric, but many large health systems fail to reach targets set by the Healthcare Effectiveness Data and Information Set. We developed an interactive voice response (IVR) system called the "Mobile You Blood Pressure Program" at a large academic medical center and linked it to the health system's electronic health record (EHR). The goal of the program was to capture home blood pressure readings in the EHR and to alert ambulatory care clinical pharmacists automatically of readings below or above clinical thresholds through direct messaging in the EHR.

Assessment of Self-monitoring of Blood Glucose in Individuals With Type 2 Diabetes Not Using Insulin.

This database analysis quantifies the rate of use and cost of self-monitoring blood glucose supplies that are potentially used inappropriately, specifically focusing on test strips.

Description of pharmacist-led quality improvement huddles in the patient-centered medical home model.

Objectives: This case study describes the implementation of pharmacist-led quality improvement team huddles in the patient-centered medical home clinic model. The purpose of these huddles is to have an impact on clinic-based quality metrics.

Setting: Pharmacists embedded into primary care clinics at 2 separate health centers, within a large academic medical center, were funded by the clinics to lead their quality improvement (QI) team huddles.

Implementation of a Medication Reconciliation Process in an Internal Medicine Clinic at an Academic Medical Center.

Discrepancies in medication orders at transitions of care have been shown to affect patient outcomes in a negative way. The Joint Commission recognizes the importance of medication reconciliation through their National Patient Safety Goals, with an emphasis placed on maintaining accurate medication information for each patient. The primary objective of this study was to assess the effectiveness of implementing a medication reconciliation process in an internal medicine clinic at an academic medical center.

Making the Transition from Student to Resident: A Method to Individualize a PGY1 Program.

A Postgraduate Year One (PGY1) resident's concerns, limitations, and strengths may be self-identified early in the residency year but are reliant on self-awareness and insight. Program directors commonly find difficulty in identifying a resident's specific knowledge deficits at the beginning of the program. A standardized resident examination can identify limitations early in training and these results can be incorporated into a tailored resident development plan.

Pharmacy residency training measured through a standardized knowledge test.

Purpose: The use of a standardized knowledge test to assess postgraduate year 1 (PGY1) pharmacy residency training was evaluated.

Methods: This was a retrospective review of a prospectively administered exam. A bank of questions was developed by preceptors from each of the core rotation disciplines: general medicine (including ambulatory care and oncology), pediatrics, critical care (including transplantation), drug information, operations, practice management, and psychiatry.

Olanzapine and baclofen for the treatment of intractable hiccups.

Intractable hiccups are a relatively uncommon condition characterized by involuntary, spasmodic contractions of the diaphragm. This type of hiccups generally has a duration of more than 1 month. We describe a 59-year-old kidney transplant recipient with a complicated medical history (atrial fibrillation, chronic renal failure, type 2 diabetes mellitus, gastroesophageal reflux, gout, hypertension, hyperlipidemia, and obstructive sleep apnea) who developed intractable hiccups that significantly affected his quality of life.

Medication use and associated risk of falling in a geriatric outpatient population.

Background: Studies have shown that approximately one third of community-dwelling people aged 65 years and older will experience a fall each year. Many studies indicate that use of multiple medications may put patients at an increased risk of falling, but few studies have been conducted to correlate the number of medications with the risk of falls.

Objective: To determine the medications most frequently used in patients aged 65 years or older who have experienced a fall within the past year, with particular attention to type or number of medications most commonly associated with multiple falls or a fall with injury.

Pharmaceuticals in drinking water: local analysis of the problem and finding a solution through awareness.

Objectives: To evaluate public awareness of pharmaceuticals in drinking water and to develop educational efforts to promote awareness in our community.

Methods: A review of the literature was conducted to gain a full perspective of the current issue. Questionnaires, interviews, and website feedback were used to assess awareness of the problem and the most commonly used medication disposal methods.