Resident Physicians’ Acceptance of Pharmacy Students’ Pharmacotherapy Recommendations During an Ambulatory Care Advanced Pharmacy Practice Experience

Abstract

To compare the acceptance rates of written versus verbal pharmacotherapy recommendations made by pharmacy students on an ambulatory care advanced pharmacy practice experience (APPE). Fourth-year pharmacy students made written and verbal pharmacotherapy recommendations to resident physicians in an internal medicine clinic at an urban, teaching hospital over a 10-month period. The types of recommendations and outcomes of the interventions were recorded using a data collection form to determine differences in acceptance rates for written versus verbal recommendations. The recommendation types and corresponding acceptance rates were also compared. Of 542 pharmacotherapy recommendations made by 14 APPE students during the 10-month study period, 65.1% were written and 34.9% were verbal. Of the 189 verbal recommendations, 97.9% were accepted, compared with 83.6% of written recommendations (p < 0.0001). The most frequent types of recommendations and overall rates of acceptance were dosage change (87.0%), laboratory monitoring (85.8%), and medication initiation based on evidence-based medicine guidelines (79.3%). Verbal pharmacotherapy recommendations made by pharmacy students were accepted by resident physicians at a significantly higher rate than written recommendations in an outpatient internal medicine clinic.