Discovering hidden reasons for nonadherence: A telehealth student experience addressing social determinants of health

Kelsey D. Frederick, Andrew Beard, Dawn E. Havrda, Kenneth C. Hohmeier, Christopher K. Finch, Danielle Case, Collin Albrecht, Catherine M. Crill
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Abstract

Objective

This study aimed to explore student perceptions and experiences addressing social determinants of health (SDOH) and medication adherence upon completion of a telehealth medication therapy management (MTM) introductory pharmacy practice experience (IPPE). Telehealth MTM has expanded rapidly, particularly since the coronavirus disease 2019 pandemic. MTM services play a crucial role in assessing medication adherence and SDOH affecting patient outcomes. Although student pharmacists should gain experience in this important aspect of patient care, guidance on effectively integrating SDOH training into pharmacy curricula remains limited.

Design, Setting, and Participants

A novel, 40-hour telehealth MTM experience was implemented in fall 2021 in collaboration with a nationwide MTM vendor as a required IPPE for all second-year student pharmacists at the University of Tennessee Health Science Center College of Pharmacy. Students engaged weekly in MTM outreach to address adherence barriers for patients with a proportion of days covered of less than 80% and gained experience in motivational interviewing, SDOH, patient counseling, interprofessional collaboration, and documentation.

Outcome Measures

Students completed a pre- and post-IPPE written reflection, and the post-IPPE reflection specifically asked about the impact of SDOH on medication adherence and how MTM services benefit patients and help pharmacists deliver high-quality patient care. Postreflections were analyzed qualitatively using inductive thematic analysis to capture and represent themes.

Results

A total of 174 second-year students completed the MTM IPPE between fall 2021 and spring 2022; 172 student reflections were completed and analyzed. Three themes were identified: students recognized the crucial impact of SDOH as a barrier to medication adherence, helped patients overcome adherence barriers related to SDOH, and recognized the value of MTM in addressing SDOH and improving patient care.

Conclusion

The telehealth MTM IPPE provided students with real-world insights into the impact of SDOH on medication adherence and empowered them to develop practical skills and interventions to improve patient care. Integrating an IPPE dedicated to MTM into pharmacy curricula can enhance student preparedness to address SDOH in practice.
发现不遵守规定的隐藏原因:远程保健学生处理健康的社会决定因素的经验
目的本研究旨在探讨学生在完成远程医疗药物治疗管理(MTM)介绍药房实践经验(IPPE)后,对健康的社会决定因素(SDOH)和药物依从性的看法和经验。远程医疗MTM迅速扩大,特别是自2019年冠状病毒病大流行以来。MTM服务在评估药物依从性和SDOH影响患者预后方面起着至关重要的作用。尽管学生药剂师应该在病人护理的这一重要方面获得经验,但有效地将SDOH培训纳入药学课程的指导仍然有限。设计、设置和参与者与一家全国性MTM供应商合作,于2021年秋季实施了一项新颖的40小时远程医疗MTM体验,作为田纳西大学健康科学中心药学院所有二年级学生药剂师的必修IPPE。学生每周参加MTM外展活动,以解决患者的依从性障碍,覆盖天数比例低于80%,并获得了动机访谈,SDOH,患者咨询,跨专业合作和记录方面的经验。结果测量学生完成了ippe前后的书面反思,ippe后的反思特别询问了SDOH对药物依从性的影响,以及MTM服务如何使患者受益并帮助药剂师提供高质量的患者护理。对后反射进行定性分析,采用归纳主题性分析来捕捉和表现主题性。结果在2021年秋季至2022年春季期间,共有174名二年级学生完成了MTM IPPE;完成并分析了172名学生的反馈。确定了三个主题:学生认识到SDOH作为药物依从性障碍的关键影响,帮助患者克服与SDOH相关的依从性障碍,并认识到MTM在解决SDOH和改善患者护理方面的价值。结论远程医疗MTM IPPE为学生提供了关于SDOH对药物依从性影响的真实见解,并使他们能够发展实用技能和干预措施,以改善患者护理。将专门用于MTM的IPPE纳入药学课程可以增强学生在实践中解决SDOH问题的准备。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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