Kelsey D. Frederick, Andrew Beard, Dawn E. Havrda, Kenneth C. Hohmeier, Christopher K. Finch, Danielle Case, Collin Albrecht, Catherine M. Crill
{"title":"Discovering hidden reasons for nonadherence: A telehealth student experience addressing social determinants of health","authors":"Kelsey D. Frederick, Andrew Beard, Dawn E. Havrda, Kenneth C. Hohmeier, Christopher K. Finch, Danielle Case, Collin Albrecht, Catherine M. Crill","doi":"10.1016/j.japhpi.2025.100074","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design, Setting, and Participants</h3><div>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.</div></div><div><h3>Outcome Measures</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 4","pages":"Article 100074"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAPhA Practice Innovations","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949969025000491","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
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.