Revista de Cuidados Farmacêuticos e Sistemas de Saúde
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Aligning Experiential Opportunities with Institutional Needs: Focus on Chronic Obstructive Pulmonary Disease

Karen D Burgos, Ryan F Grant, Diane Rutkowski, Vincent De Ciantis, Elise Fodor, Sara Dadayan and Maureen A Smythe

Background: Our institution identified the COPD population as one in which greater pharmacy involvement may be beneficial. This report describes how the Department of Pharmacy aligned this broad goal with an experiential student rotation. The development and implementation of a COPD patient-pharmacist interaction sequence is described.
Methods: The student pharmacist created a sequenced program of three patient visits focused on disease state and medication education, adherence assessment, inhaler technique training, smoking cessation, eligibility assessment for free medications and discharge prescription filling. The program was piloted for one month in July of 2014 during the day shift on Mondays through Fridays. Patients completed a short satisfaction survey at discharge.
Results: The student pharmacist interacted with 35/69 (51%) of newly admitted pulmonary patients and completed the three-visit sequence in 24/35 patients (69%). Patients were missed secondary to unexpected discharge and weekend discharge. Medication adherence was assessed as moderate or high in 96%. Patient performance on a COPD knowledge assessment tool improved from 74% at baseline (visit 1) to 79% at discharge (visit 3). Smoking cessation education was provided to the 4/24 (16.7%) patients who were current smokers. Reflection by the student pharmacist identified the two most common and significant patient interactions as clarifying the role of rescue versus maintenance inhaler medications and correcting inhaler technique. Nine patients (38%) were eligible for, and received, a free inhaler. Only two patients had discharge medications filled. Many of the tools developed by the student pharmacist have been incorporated into the clinical pharmacist work plan. Patients rated interactions with the student pharmacist favorably.
Conclusions: The student pharmacist developed a series of educational interactions with the COPD patient, many of which have been incorporated into the pharmacy clinical practice model.