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1.  Teaching Medication Adherence in US Colleges and Schools of Pharmacy 
Objective. To determine and describe the nature and extent of medication adherence education in US colleges and schools of pharmacy.
Methods. A mixed-methods research study was conducted that included a national survey of pharmacy faculty members, a national survey of pharmacy students, and phone interviews of 3 faculty members and 6 preceptors.
Results. The majority of faculty members and students agreed that background concepts in medication adherence are well covered in pharmacy curricula. Approximately 40% to 65% of the students sampled were not familiar with several adherence interventions. The 6 preceptors who were interviewed felt they were not well-informed on adherence interventions, unclear on what students knew about adherence, and challenged to provide adherence-related activities for students during practice experiences because of practice time constraints.
Conclusions. Intermediate and advanced concepts in medication adherence, such as conducting interventions, are not adequately covered in pharmacy curriculums; therefore stakeholders in pharmacy education must develop national standards and tools to ensure consistent and adequate medication adherence education.
doi:10.5688/ajpe76579
PMCID: PMC3386030  PMID: 22761520
medication adherence; curriculum; medication
2.  Pharmacy Student Knowledge and Communication of Medication Errors 
Objectives
To describe and evaluate pharmacy students' knowledge of and comfort in communicating, managing, and preventing medication errors.
Methods
Using a cross-sectional design, a survey instrument was administered to fifth-year pharmacy students. The survey instrument included both open- and close-ended questions to describe and examine factors associated with knowledge and comfort in communication of medication errors.
Results
Survey instruments were completed by 93 students (90% response rate). Nearly 80% reported not having received training in communicating medication errors. The perception of having more adequate training was related to greater knowledge in the communication of medication errors (p ≤ 0.001). Knowledge was also associated with students having greater comfort in communicating medication errors (p ≤ 0.05).
Conclusions
The need and value of additional training for pharmacy students in communicating medication errors was demonstrated. Educational interventions should be developed to provide consistent instruction on these communication issues.
PMCID: PMC2879111  PMID: 20585421
medication errors; training; communication
3.  The Impact of a Standardized Patient Program on Student Learning of Communication Skills 
Objective
Determine the quantitative and qualitative value of a lecture-laboratory course with standardized patients on student communication skills.
Methods
A blinded retrospective analysis was conducted on the counseling tapes of 127 students who took a lecture-laboratory course with standardized patients. A Communication Skills Assessment Form (CSAF) was used to evaluate baseline, midpoint and final tapes. Descriptive statistics and repeated measures analysis of variance were used to compare tapes. Students and standardized patients completed written survey instruments evaluating the laboratory at the end of the semester.
Results
Students had significant and progressively higher scores on the assessment across baseline, midpoint and final time points (p ≤ 0.001). Students had significantly higher final assessment scores across all subsections than at baseline (p ≤ 0.01). Students and standardized patients were favorable towards the laboratories and made useful recommendations.
Conclusions
A lecture-laboratory course with standardized patients had a significant impact on student communication skills across time and was well received by students and standardized patients.
PMCID: PMC2690873  PMID: 19513141
5.  Cognitive memory screening and referral program in community pharmacies in the United States 
Introduction 12 chain community pharmacy sites located in two geographic areas with the United States implemented easy-to-administer memory screening assessments for patients with risk factors of cognitive memory decline and referred at-risk patients to their physicians. Aim of the study To evaluate the impact of a pharmacy-based cognitive memory screening and referral program, measure patient satisfaction with these advanced clinical services, and assess willingness to pay for cognitive memory screening services. Setting 12 chain pharmacy sites located in two geographic areas—ten Fred Meyer Pharmacies located in the Portland, Oregon area and two Kerr Drug Pharmacies located in North Carolina. Method Pharmacists were educated on Alzheimer’s disease, trained on how to provide cognitive memory screening exams, and equipped with screening and documentation tools. Following each screening, pharmacist provided education and counseling to the patients and referred at-risk patients to physicians for follow-up as appropriate. Main outcome measures Results of screenings; satisfaction of patients; willingness to pay. Results Pharmacists delivered cognitive memory assessments to 161 patients from June to November 2008. 44.1 % of patients experienced at least one cognitive deficiency that required referral to a physician based on the screening conducted. The cognitive memory screening and referral program was highly regarded by patients who completed the satisfaction survey, with 98.4 % of respondents indicating that they were either very satisfied or satisfied with the program. Conclusion Cognitive memory screening can be easily incorporated into clinical service offerings in community pharmacy practice and provides a valuable opportunity to identify patients at-risk and refer them to a physician for appropriate testing and diagnosis.
doi:10.1007/s11096-013-9904-7
PMCID: PMC3984659  PMID: 24357467
Alzheimer’s disease; Ambulatory care; Clinical pharmacy services; Cognitive memory screening; Community pharmacy; Dementia; Physician referral
7.  Adherence: a review of education, research, practice, and policy in the United States 
Pharmacy Practice  2010;8(1):1-17.
Objective
To describe the education, research, practice, and policy related to pharmacist interventions to improve medication adherence in community settings in the United States.
Methods
Authors used MEDLINE and International Pharmaceutical Abstracts (since 1990) to identify community and ambulatory pharmacy intervention studies which aimed to improve medication adherence. The authors also searched the primary literature using Ovid to identify studies related to the pharmacy teaching of medication adherence. The bibliographies of relevant studies were reviewed in order to identify additional literature. We searched the tables of content of three US pharmacy education journals and reviewed the American Association of Colleges of Pharmacy website for materials on teaching adherence principles. Policies related to medication adherence were identified based on what was commonly known to the authors from professional experience, attendance at professional meetings, and pharmacy journals.
Results
Research and Practice: 29 studies were identified: 18 randomized controlled trials; 3 prospective cohort studies; 2 retrospective cohort studies; 5 case-controlled studies; and one other study. There was considerable variability in types of interventions and use of adherence measures. Many of the interventions were completed by pharmacists with advanced clinical backgrounds and not typical of pharmacists in community settings. The positive intervention effects had either decreased or not been sustained after interventions were removed. Although not formally assessed, in general, the average community pharmacy did not routinely assess and/or intervene on medication adherence.
Education
National pharmacy education groups support the need for pharmacists to learn and use adherence-related skills. Educational efforts involving adherence have focused on students’ awareness of adherence barriers and communication skills needed to engage patients in behavioral change.
Policy
Several changes in pharmacy practice and national legislation have provided pharmacists opportunities to intervene and monitor medication adherence. Some of these changes have involved the use of technologies and provision of specialized services to improve adherence.
Conclusions
Researchers and practitioners need to evaluate feasible and sustainable models for pharmacists in community settings to consistently and efficiently help patients better use their medications and improve their health outcomes.
PMCID: PMC4140572  PMID: 25152788
Medication Adherence; Pharmacists; Education; Pharmacy; United States

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