Interventions by student pharmacists in an outpatient teaching family medicine center

Purpose: Data describing student pharmacist interventions have primarily been documented in the inpatient setting.  Justification of the value of student pharmacists in outpatient settings is needed.  This study describes the clinical interventions of student pharmacists in an outpatient teaching family medicine center.

Methods: All clinical interventions of 4^th year student pharmacists at this school are documented in a single, commercially-available, web-based, documentation system.  Reports generated in 2011 for one faculty member and corresponding students in an outpatient teaching family medicine center were analyzed.  Students at this site see patients for individual appointments with the pharmacist, see patients with resident physicians, and perform medication reconciliation activities.

Results: In 2011, 2900 clinical interventions were documented at this practice site by one clinical pharmacist and 21 student pharmacists. This included 206 individual patient appointments with the pharmacist in which a comprehensive medication history, adherence assessment, pharmacotherapy assessment, related laboratory assessment and patient counseling were performed.  Outside of these scheduled visits, another 855 patient medication histories and 581 chart reviews were performed.  In addition, 322 patients were counseled, 89 drug information questions answered, and 105 vaccines recommended.   Drug therapy was adjusted, discontinued or initiated 254 times. Patient safety interventions (including allergies clarified, drug interactions identified, clarification of orders, ADRs prevented and therapeutic duplication avoided) were documented 83 times. Approximately 1500 hours were spent on these interventions. The clinical pharmacist documented 6% of these interventions independently from students.

Conclusions: Student pharmacists can have a significant impact on patient care in an outpatient teaching family medicine center.  Incorporation of student pharmacists into outpatient practices is a cost-effective way to expand clinical pharmacy services, assist with teaching medical residents, and improve patient safety.