Incubator for new ideas: Patient care at community pharmacy residency sites

Abstract

The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study. The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study. Findings of the study revealed variability in the types of services provided at CPRP practice sites and the experiences offered for residents. There also appeared to be collaboration with other practice sites to enhance residents' training and experiences.■ Community Pharmacy Residency Program practice sites offer residents opportunities for advanced and innovative direct patient care.■Resident experiences vary among sites, including collaboration with other sites. ■ Community Pharmacy Residency Program practice sites offer residents opportunities for advanced and innovative direct patient care.■Resident experiences vary among sites, including collaboration with other sites. "It’s innovative practice sites with very eager and well-trained pharmacists as residents coming in," Schommer, Professor and Associate Department Head at the University of Minnesota School of Pharmacy, told Pharmacy Today. "And a lot of times, that creates this innovation and [it’s] almost like a little incubator for trying new ideas." The resident—who is at a lower resident’s salary—can be there for a year and try new things; then the pharmacy can make go or no-go decisions to continue those new things. "The data that we collected are supporting that," Schommer said. Funded by APhA, the study, "Patient care services provided at primary community pharmacy residency sites," was published with the March/April 2013 Journal of the American Pharmacists Association, available online at www.japha.org. CPRP was established by APhA in 1986. In June 1999, APhA and the American Society of Health-System Pharmacists announced a partnership to accredit community pharmacy residency programs. When this study was conducted, there were 83 community pharmacy residency programs in 36 states and Puerto Rico. More information on CPRP is available online at www.pharmacist.com/residency. For this study, 120 CPRP directors/preceptors and residents responded to a survey using a Web-based data collection form. The responders came from varied practice settings and geographical locations. The survey asked questions about 11 patient care services provided at the primary practice site for each community pharmacy residency location during the 2011–12 residency year. At these residency sites, the most commonly provided patient care services were related to medication reviews and immunizations. These services are part of what the pharmacy does regularly. But residents were often deployed in other ways. Residents contributed to more than 50% of services related to interventions incorporated into the dispensing process (69%), medication reconciliation (64%), and patient education (52%). They contributed to between 40% and 50% of services related to comprehensive medication reviews (49%), chronic disease management (47%), health and wellness screenings (46%), pharmacotherapy consults (45%), and targeted medication therapy review (44%). And they contributed to less than one-third of services related to point-of-care testing with medication monitoring and adjustment (28%), specialty pharmacy (27%), and immunizations (25%). In addition to providing services at the primary community practice site, 65% of respondents said that residents provided patient care at other sites, including hospital-based ambulatory care clinics, community health centers, patient-centered medical homes within physician offices, and community outreach events. Several trends and goals characterize the environment for community pharmacy residency sites. One is that the number of residencies is growing. "It’s becoming more and more common for people say, look, after my PharmD, I need to do a residency," Schommer said. Another is that while an increasing number of the nation’s 250,000 pharmacists are moving from being medication providers to taking care of patients directly, "community pharmacy really is still tied to dispensing," he said. Then, at least in Schommer’s home state of Minnesota, the trend in the community pharmacy space is toward more large mass merchandisers, supermarket pharmacies, clinic and medical center chains, and specialty pharmacies. "As those types of pharmacies become more common, I think the residencies will follow," he said. Also relevant is the role of the community pharmacist in accountable care organizations as players like Walgreens start to participate. Finally, there’s having access to the electronic health record as community practitioners, and achieving provider status for pharmacists. "That would really help bring pharmacists into being full-fledged members of the health care team," Schommer said. The types and intensity of services provided at Community Pharmacy Residency Program (CPRP) sites give residents opportunities for advanced patient care services training, direct patient contact, and opportunities to be engaged in practice innovation, according to Jon Schommer, PhD, and colleagues in a new study.