Florida A&M University College of Pharmacy & Pharmaceutical Sciences Advanced Medication Therapy Management Preceptors: Angela Singh, Pharm.D. Angela Hill, Pharm.D., BCCP 1
Florida A&M University College of Pharmacy and Pharmaceutical Sciences Tallahassee Campus Course Title: MTM Advanced Pharmacy Practice Experience Course Number: Credit Hours: 4 Elective Course Prerequisites: Successful completion of didactic course work. Rationale This Advanced Pharmacy Practice Experience (formerly called rotation) is offered to 4 th year PharmD candidates in an effort to assist them in gaining knowledge with regards to all areas surrounding Medication Therapy Management (MTM). Preceptor: Angela Singh, Pharm.D. Assistant Professor of Pharmacy Practice Florida A&M University #345 New Pharmacy Building Tallahassee, Florida 32307 (850) 599-3369 Angela Hill, Pharm.D., BCCP Professor of Pharmacy Practice Florida A&M University Tallahassee, Florida 32307 (850) 599-8415 APPE Site: Florida A&M University College of Pharmacy 1415 South Martin Luther King Blvd. Tallahassee, Florida 32307 Description of the Advanced Pharmacy Practice Experience (APPE): The MTM rotation is designed to provide the student with general knowledge regarding various issues surrounding the development and implementation of MTM services. This APPE also assists in developing the students skills in pharmacotherapy, verbal and written communications, drug information retrieval and evaluation, patient monitoring and diagnostics as they apply to area of MTM. Goals of the APPE: 1. Develop a general knowledge of the steps required to develop a business model for MTM services. 2. Develop a general knowledge of the steps required to establish billing procedures for MTM services. 2
3. Demonstrate the ability to apply the five core elements of MTM to a patient interaction. 4. Demonstrate the ability to identify drug therapy problems within a patient s medication regimen. 5. Demonstrate the ability to apply current treatment guidelines to the management of patients utilizing MTM services. 6. Demonstrate the ability to communicate effectively with physicians and other healthcare providers. Competencies/Standards: The following competencies will be achieved from this APPE: 1. Gather and organize information in order to identify ongoing or potential drugrelated problems and the root cause of the problems. a. Collect accurate and comprehensive drug information from appropriate sources. b. Collect accurate and comprehensive information to be used in monitoring therapeutic outcomes. c. Identify the patient s primary complaint(s) and reason(s) for seeking medical care. d. Perform selected aspects of physical assessment. e. Identify appropriate information in profiles or medical records that will affect drug dose and schedule. 2. Provide counseling to patients and/or caregivers relative to proper therapeutic self-management. a. Use appropriate sources of patient education information to review indications, adverse effects, dosage, storage, and administration techniques. b. Use effective written, visual, verbal, and nonverbal communication skills when providing medication self-management counseling to patients and/or caregivers. c. Demonstrate proper administration technique for a given drug delivery system. d. Explain any action that should be taken in the event of a missed dose. e. Advise patients on how to avoid potential interactions with other therapies. f. Explain the signs and symptoms associated with the common and/or severe adverse reactions to a therapy. g. Explain the significance and frequency of adverse drug reactions and interactions associated with a given therapy. h. Encourage patients/caregivers to contact the pharmacist for further information or advice regarding therapy. 3. Provide counseling relative to the proper use of medical goods and devices. a. Identify manual, audiovisual, and/or computerized sources of patient education information on medical devices and goods appropriate to the specific patient s or caregiver s needs. 3
b. Demonstrate the proper use of the medical goods and devices to help ensure that the patient or caregiver can effectively implement the use of the medical goods and devices. c. Ensure that equipment specific requirements for maintenance, testing, etc., are effectively communicated to the patient or caregiver. 4. Document pharmaceutical care activity in the patient s medical record to facilitate communication and collaboration among providers. a. Record all patient information accurately, legibly, and succinctly. b. Observe legal and ethical guidelines for protecting the confidentiality of patient information. c. Consolidate and organize information that is already in the patient s medical record to facilitate its review. 5. Record information related to the provision of pharmaceutical care to individual patients. a. Record the patient care plan. b. Record decisions about appropriate drug therapy. c. Record actions taken to achieve desired therapeutic outcomes. d. Document the effectiveness of the drug therapy. 6. Display the attitudes, habits, and values required to render pharmaceutical care. a. Give the well being of the patient highest consideration in provision of pharmaceutical care. b. Exhibit empathy and a caring attitude when dealing with patients. c. Facilitate the resolution if ethical dilemmas in the provision of optimal pharmaceutical care. d. Respect the dignity and autonomy of individual patients. 7. Provide pharmaceutical care in a professional manner. a. Dress and speak in ways that convey a professional image. b. Maintain personal self-control and professional decorum. 8. Plan and perform ongoing patient evaluation to identify additional drug-related problems and implement changes in the pharmaceutical care plan. a. Assess patient therapeutic self-management. 1. Review patient profiles or medication administration records to determine the adequacy of patient therapeutic self-management. 2. Employ clinical assessment skills to determine the adequacy of patient therapeutic self-management. 3. Interview the patient/caregiver to help determine the adequacy of patient therapeutic self-management. b. Optimize patient therapeutic self-management. 1. Develop a plan to influence patients to effectively manage their therapy and reinforce appropriate behaviors. 2. Communicate an analysis of patient therapeutic self-management problems to the patient s physician or other relevant health care providers. 3. Communicate alternative dosage strategies to the prescriber to help resolve specific patient therapeutic self-management problems. c. Monitor the safety and efficacy of therapeutic plans. 4
1. Employ clinical assessment skills in order to evaluate therapeutic effectiveness or potential drug-related problems in the patient. 2. Communicate evidence of efficacy or potential for drug-related problems to the patient and/or caregiver and prescriber. 3. Communicate alternative therapeutic strategies to the prescriber to correct or prevent drug-related problems. 4. Recommend revisions of therapeutic plans based upon changes in patient status. d. Collaborate with physicians, other health care professional, patients, and/or their caregivers to formulate a pharmaceutical care plan. 1. Communicate pertinent information from the patient s medical record. 2. Recommend appropriate drug therapy. 3. Make referrals to other health care agencies or professionals where indicated. 9. Integrate basic knowledge as needed to design, implement, and evaluate patientproblems or to respond to information requests of specific pharmacotherapeutic regimens to prevent or resolve medication-related problems a. Apply knowledge of the pathophysiology of a specific disease to prevent medication-related problems. b. Apply pharmacologic approaches to the management of specific disease. c. Relate therapeutic principles to medication-related problems experienced by patients. d. Relate the psychosocial aspects of illness and health to the management of therapy-related problems. e. Apply preventive strategies and epidemiological research to manage public health problems. f. Apply basic principles of nutrition to the management of patient health. g. Relate the major components of the American health care system and their relationship to the delivery of pharmaceutical care. h. Relate the chemical, biochemical, and pharmacological mechanisms of drug action to the identification and resolution of medication-related problems. i. Relate the chemical and/or biochemical structure of drugs to their therapeutic action. 10. Recommend medication doses and dosage schedules based upon relevant patient factors, such as pharmacodynamic, physiologic, and pharmacokinetic parameters. a. Integrate patient and drug information with drug dosing methods to calculate appropriate dosage adjustments. b. Explain dosage recommendations and associated rationale to other health care team members. 11. Display the attitudes, habits, and values required to render pharmaceutical care. a. Provide pharmaceutical care ethically and compassionately. 1. Give the well being of the patient highest consideration in provision of pharmaceutical care. 2. Exhibit empathy and a caring attitude when dealing with patients. 3. Facilitate the resolution of ethical dilemmas in their provision of optimal pharmaceutical care. 4. Respect the dignity and autonomy of individual patients. 5
b. Provide pharmaceutical care in a professional manner. 1.Dress and speak in ways that convey a professional image. 2. Maintain personal self-control and professional decorum. 12. Design, develop, and present educational materials tailored to the needs and educational background of a given audience. a. Identify the educational needs and background of the intended audience. b. Choose appropriate media to communicate effectively. c. Choose health education strategies that are appropriate to the type of health care education program. d. Use health education strategies effectively. e. Demonstrate effective oral and written communication tailored to the individual needs of the audience and type of setting. Evaluate the impact of an educational program on the behaviors/performance of program participants. XII. Academic Learning Compacts (ALCS) 1. Critical Thinking: Graduating seniors will demonstrate the ability to critically think, analyze, and solve problems to make judgment and pharmacy decisions. 2. Communication and Interpersonal Skills: Graduates will demonstrate the ability to communicate verbally and in writing with patients, caregivers, and other healthcare practitioners. 3. Content Knowledge: Graduates will demonstrate an understanding of knowledge, concepts and skills necessary to become a pharmacist. 4. Ethics: The graduate shall provide high quality pharmaceutical care utilizing ethical and moral standards. 5. NAPLEX Pass Rates: Graduates will pass the NAPLEX on the first attempt. Goals of the Curriculum It is the Goal of the curriculum to prepare the graduate with the following professional and general abilities 1 : 1. Provide patient-centered and population-based pharmaceutical care in a professional and competent manner; 2. Manage and use resources in a health care system in accordance with legal, social, economic, and professional guidelines; 3. Promote health improvement within the community and in various health venues; 4. Communicate with patients, care givers, other health care professionals, and the community at-large; 5. Employ life-long learning techniques to maintain competence in a dynamic profession. 6
Attendance Attendance is a University requirement. The quality of the learning experience is directly related to contact hours spent in the patient care environment. Attendance is required for daily APPE schedule and weekly class sessions. 1. In case of absences or lateness please contact your preceptor directly and in advance. If the preceptor is unavailable please contact Mrs. Shirley Garrett at 599-3344. a. Unexcused absence: Each unexcused absence will result in a 10% decrease of the final grade. Four or more unexcused absences will result in dismissal from the rotation or an incomplete grade until the equivalent time is made up within the academic year. b. Excused absences: Each excused absence will be made up at the discretion of the preceptor. c. Lateness Two unexcused lateness will equate to 1 unexcused absence. Grading: A. Grades a. 90-100 = A b. 80-89 = B c. 70-79 = C d. < 70 = Failing B. Grading Determination: 1) Intellectual Attributes (40 points) i. Fund of knowledge (basic pharmacology, kinetics, therapeutics, clinical pharmacy). ii. Intellectual curiosity (searching questions, pursuit of literature, participation in rounds, conferences). iii. Concept of and ability to monitor patients drug therapy as to effectiveness, indications, adverse effects, Pharmacokinetics, precautions and contraindications. iv. Ability to provide/communicate accurate, comprehensive drug information evaluate reports, etc. 2) Attitudes and Personality (20 points) (i) Cooperativeness, motivation and initiative (willingness to learn, carry out assignments, clinical activities without complaining, or being hypocritical; dedicated, hardworking reliable). (ii) Professionalism (interprofessional relationship-patients, staff, physicians, nurses, pharmacists-appearance, neatness, manner, courteous, respectful) (iii)promptness and attention to clinical activities (rounds, conferences, drug information, presentations, etc,) 3) Tasks (40 points) (i) Case/Research presentations (ii) In-services (iii)journal Clubs 7
(iv) Assignments (v) Notebook (due the Monday following the completion of the APPE; lateness will result in the same consequences as unexcused absences) (vi) Final Exam Professionalism: The student should exhibit the high standard of quality professionalism that FAMU requires. Enthusiasm and initiative are a must in this and any APPE. Remember, you only get out of an APPE what you put in. If you put forth an effort, you will gain very insightful knowledge and clinical practice skills about psychiatry & neurology. 8