Phar 6716 Applied Pharmaceutical Care 3.2 Credits, Spring 2014

Phar 6716 Applied Pharmaceutical Care
3.2 Credits, Spring 2014
Course Directors
Tom Larson, Pharm.D., MT (ASCP), RPh, FCCP (Twin Cities)
Office: WDH 7-159
Phone: 612-626-5025
email: [email protected] (prefered contact method)
Office hours by appointment (preferred)
Tim Stratton, Ph.D., BCPS, FAPhA (Duluth)
Office location: Life Science 209
email: [email protected] (preferred contact method)
Phone: (218) 726-6018
Office Hours: When the door is open or by appointment. Students should not expect
immediate responses to email queries outside of normal business hours.
Course Coordinator
Works in conjunction with course faculty, department staff, and teaching assistants for
successful implementation of course.
Name: Amy Weber
Phone: 218-726-6016
Email: [email protected]
Course Instructional
Team
Name: Don Uden
Office location: 7-115 WDH
Phone: 612-624-9624
Email: [email protected]
Office Hours: By appointment
Name: Wendy St. Peter
Office location: 7-176 WDH
Phone: 612-625-5848
Email: [email protected]
Office Hours: By appointment
Name: Amanda Maderich
Office location: Walgreens Pharmacy
Email: [email protected]
Preferred method of contact: email
Office Hours: By appointment
Name: Ann Philbrick
Office location: 7-180 WDH
Phone: 612-626-8053
Email: [email protected]
Office Hours: By appointment
Name: Angela George
Office location: 217 Life Science
Phone: 218-726-6014
Email: [email protected]
Preferred method of contact: email
Office Hours: By appointment
Name: Kerry Fierke
Office location: 215 Life Science
Phone: 218-726-6027
Email: [email protected]
Office Hours: By appointment
Name: Caroline Gaither
Office location: 5-110E WDH
Phone: 612-626-0811
Email: [email protected]
Office Hours: By appointment
Name: Chrystian Pereira
Office location: 7-180 WDH
Phone: 612-625-7188
Email: [email protected]
Office Hours: By appointment
Name: Ron Hadsall
Office location: 7-159 WDH
Phone: 612-624-2487
Email: [email protected]
Office Hours: By appointment
Name: Shannon Reidt
Office location: 7-103 WDH
Phone: 612-626-4858
Email: [email protected]
Preferred method of contact: email
Office Hours: by appointment
Name: Courtney Aldrich
Office location: 8-174 WDH
email: [email protected]
Phone: 612-625-7956
Name: Dawn Carlson
Email: [email protected]
Phone: 218-245-1088
Name: Lowell Anderson
Email: [email protected]
Phone: 612-626-5158
Preferred method of contact: email
Office Hours: by appointment
Name: Oscar Garza
Email: [email protected]
Office: WDH 7-177
Phone: 612-624-0124
Preferred method of contact: email
Office Hours: by appointment
Teaching Assistants
Twin Cities
Dr. Debbie Pestka, Pharm.D.
Email: [email protected]
Office location: 7-191 WDH
Dr. Andrea Rosenberg, Pharm.D.
Email: [email protected]
Office Location:
Dr. Emily Herstine, Pharm.D.
Email: [email protected]
Dr. Ashley Feldman, Pharm.D.
Email: [email protected]
Trent West
Email: [email protected]
Duluth
Kehly Skoog
Email: [email protected]
Course Content
Alanna Naughton
Email: [email protected]
Evidence-based patient-centered pharmaceutical care involves:
a.
b.
c.
d.
assessing patients’ drug-related needs,
identifying, resolving, and preventing drug therapy problems,
developing a care plan and plan for follow-up,
communicating with a patient and the health care team.
These concepts will be applied to patient and population scenarios featuring common
medical conditions and medications students are likely to encounter during their
introductory pharmacy practice experiences (IPPEs).
Course Format
This ITV course, taught by a number of faculty, utilizes a combination of on-line
material, Breeze presentations, assigned readings, case discussions, team-based
learning and lectures. For every hour a student spends in the classroom in this
course, the student can expect to devote approximately 1-2 hours outside of class
either preparing for the class session or completing homework arising from the class
session. Students are expected to have completed assigned pre-readings to prepare
them to fully participate in in-class active and team-based learning exercises.
In class, students will have the opportunity to practice working up simulated patient
cases and live patients for disorders commonly encountered in the ambulatory care
setting.
Students will use their electronic devices to conduct real-time literature searches to
aid them in recommending treatment approaches. Audience response devices will
enable students to fully participate in in-class quizzes and surveys related to the topic
of the day.
Prerequisites
To be successful in this course, students should be able to apply the drug literature
evaluation and statistics skills they developed in Becoming a Pharmacist and in the
Drug Literature Review and Biostatistics portion of Foundations of Social and
Administrative Pharmacy to inform drug therapy decisions. To address simulated and
actual patient care situations, students should be able to apply the Philosophy of
Practice and the Pharmaceutical Care process to which they were introduced in
Becoming a Pharmacist and Foundations of Pharmaceutical Care. Students should
be able to apply the information gained in their General Microbiology pre-pharmacy
courses, in Biochemistry I, Medical Microbiology, Medicinal Agents and
Pharmacology to the areas of Antibiotics and antiviral therapies commonly
encountered in ambulatory care settings. Finally, students should be able to apply
the information they obtained in Cellular Physiology, Molecular Biology and Genetics
to the topics of Dermatology and Renal Function.
Computer/Technology
Requirements
The University of Minnesota computer requirements are listed here:
 http://www1.umn.edu/moodle/start/technical.html
 Students are required to bring laptop computers or electronic tablets to class
each day.
 Each day, students are required to bring a device to class that is capable of
interacting with the classroom’s audience response system.
Required Materials
The following materials are required in this course:
th
 APhA Handbook of Non-Prescription Drugs, 17 Edition (2012)
th
 Pharmacotherapy: A Pathophysiological Approach, 8 Edition (2011)
nd
 APhA Immunization Handbook, 2 Edition (2012)
Course Goals &
Objectives
GOAL: Assess individual patient and population drug-related needs and develop a
plan to meet those needs
Objectives:
1. Outline, collect, and interpret relevant subjective and objective data, including
patient/population characteristics and laboratory values, and medication
history to assess a patient’s drug-related needs
2. Describe the pathophysiology of selected common medical conditions.
3. Develop goals of therapy for treatment or prevention of selected common
medical conditions for individual patients or populations.
4. Define the characteristics of medications that are used to assess indication,
efficacy, safety, and convenience (e.g. structure-activity relationships,
pharmacology, kinetics, formulation, etc.).
5. Identify common drug therapy problems related to pharmacotherapy
discussed and list therapeutic alternatives to resolve and prevent these drug
therapy problems.
6. Select the best therapeutic option based on patient-specific factors.
7. Develop an evidence-based, patient-centered care plan that includes cultural,
religious, socioeconomic, and lifestyle considerations.
8. When presented with a patient who has more than one drug therapy problem,
prioritize drug therapy problems and establish relative timeline of when they
should be addressed [novice level]
9. Develop a plan for follow-up evaluation.
10. Document patient care (assessment, care plan, follow-up plan)
11. Communicate care plan to patient and care team
12. Orally present patient cases
13. Assess public health policy as it relates to patient-specific care
These Objectives collectively address all of the University of Minnesota College of
Pharmacy Competency Domains listed below:
Competency Domains
Domain 1: Patient-Centered Care
As a provider of care, the pharmacist is ethical, benevolent, empathetic, competent, open-minded, prudent in making judgments,
and devoted to serving others. The pharmacist applies knowledge, experience, and skills to protect the welfare of humanity. The
pharmacist willingly and respectfully cares for patients to assure optimal therapeutic outcomes
Domain 2: Population Health & Vulnerable Communities
As a promoter of public health, the pharmacist uses his/her expertise to partner with others to improve care for vulnerable
communities or at risk populations. The pharmacist recognizes the differences between populations of individuals and seeks to
alleviate disparities that exist.
Domain 3: Health Systems Management
As a manager of health system resources, the pharmacist examines critical issues, assumptions, and limitations to produce and
validate ways to deliver medications safely, effectively, and in a timely manner. The pharmacist demonstrates imagination,
inventiveness, and courage by undertaking new endeavors to produce improved quality, productivity, efficiency, effectiveness,
and innovation.
Domain 4: Leadership & Engagement
In leading, the pharmacist demonstrates integrity and is habitually resolute, focused on excellence, knowledgeable about the “big
picture,” strategic, focused, persuasive, open to feedback, decisive, visionary, empowering, and service-oriented.
Domain 5: Professional & Interprofessional Development
When collaborating, the pharmacist demonstrates critical thinking, excellent communication and leadership, and is goal-oriented,
cooperative, assertive, respectful, enthusiastic, and reliable. The pharmacist consistently and consciously demonstrates high
ethical and moral standards by considering how and when to act, acting in a manner that is clearly consistent with those
standards and exercising accountability for those actions.
Domain 6: Knowledge, Scientific Inquiry, and Scholarly Thinking
In making use of scientific knowledge, the pharmacist explains with thoroughly researched, evidence based accounts of facts
and data, and provides interpretations based on analysis of the importance, meaning, and significance. The pharmacist applies
knowledge fluently, flexibly, and efficiently in diverse contexts.
Course goal and/or learning objective
Domain &
competency
Scientific
Foundation
1
To assess a patient’s drug-related needs,
collect, organize and interpret relevant
subjective and objective data, including
patient/population characteristics and
laboratory values, and medication history
1.1,
2.0,
6.0,
6.4.6
1.1, 1.2, 2.2,
2.21.11, 5.8.4,
5.8.5, 5.8.6, 6.9.1,
6.9.2, 6.9.5
2
Describe the pathophysiology of selected
common medical conditions.
6.3.2,
6.3.3
1.3, 1.4, 1.5, 1.6,
1.7, 2.1
3
Develop goals of therapy for treatment or
prevention of selected common medical
conditions for individual patients or
populations.
1.1,
2.5
6.4
4
Define the characteristics of medications that
are used to assess indication, efficacy, safety,
and convenience (e.g. structure-activity
6.1,
6.3,
6.3.1,
6.4.1,
2.1, 2.2, 2.3, 3.1,
3.2, 3.3, 3.4, 4.1,
4.2
relationships, pharmacology, kinetics,
formulation, etc.).
6.4.2,
6.4.3,
6.4.4,
6.4.5
5
Identify common drug therapy problems related
to the pharmacotherapy agents discussed and
list therapeutic alternatives to resolve and
prevent these drug therapy problems.
1.2,
2.2,
6.0,
6.1,
6.3,
6.4
6.1.6, 6.4
6
Select the best therapeutic option based on
patient-specific factors.
1.1,
1.2,
2.2,
6.0,
6.1,
6.3,
6.4
6.4
7
Develop an evidence-based, patient-centered
care plan that includes cultural, religious,
socioeconomic, and lifestyle considerations.
1.2, 1.7, 2.2,
2.6, 6.0, 6.1,
6.3, 6.4
5.8.10, 5.8.11,
6.1.3, 6.1.5, 6.1.7,
6.4
8
When presented with a patient who has more
than one drug therapy problem, prioritize drug
therapy problems and establish relative
timeline of when they should be addressed
[novice level]
1.2,
2.2,
6.0,
6.1
6.4
9
Develop a plan for follow-up evaluation.
1.2, 1.5, 1.8,
2.2, 2.5, 2.7,
3.2
5.8.10, 5.8.11,
6.1.3, 6.1.5, 6.1.7,
6.4
10
Document patient care (assessment, care plan, 1.0, 1.1,1.2,
1.4, 1.5, 1.7,
follow-up plan)
1.8, 2.0, 2.3,
2.4, 2.5, 2.6,
2.7, 2,8
2.1.6, 2.2.2, 4.2,
5.2.2, 5.8.1, 5.8.3,
5.8.7, 5.8.10, 5.9.1,
5.9.4, 5.10.3, 6.1.3,
6.1.5, 6.1.6, 6.1.7,
6.1.9, 6.1.10,
6.1.13, 6.2.2, 6.2.4,
6.4.6 - 6.4.16, 6.5,
6.8.2, 6.8.5, 6.9.3,
6.9.7, 6.10, 6.11
11
Communicate care plan to patient and care
team
1.3, 1.4, 1.7,
2.3, 2.4, 2.6,
3.4, 4.5, 5.1,
5.7, 5.8, 5.9
5.7.1, 5.7.5, 5.8.1,
5.8.3
12
Orally present patient cases
1.3,
2.3
5.8.1, 5.8.8
13
Assess public health policy as it relates to
patient-specific care.
Honor Code
Grading Policy
2.0, 2.1, 2.3,
2.7 2.8, 3.0,
3.5, 3.6, 3.7,
3.8, 4.0, 4.6,
6.0, 6.1, 6.2,
6.3.3, 6.4.6
4.2.3, 4.3.5, 4.3.6,
5.1.2, 5.1.3, 5.1.5,
5.1.6, 5.1.7, 5.1.8,
5.2.3, 5.3.14,
5.3.16, 5.3.20,
5.4.1, 5.4.2, 5.4.3,
5.8.2, 5.10.2,
5.10.3, 6.4.10, 6.10
Each student is bound by the following specific provisions as part of the Code:
Academic misconduct is any unauthorized act which may give a student an unfair
advantage over other students, including but not limited to: falsification, plagiarism,
misuse of test materials, receiving unauthorized assistance and giving unauthorized
assistance. You are required to do your own work on all exams and quizzes.
≥ 93%
88 – <93
83 – <88
78 – <83
74 – <78
70 – <74
66 – <70
62 – <66
56 – <62
< 56%
A
AB+
B
BC+
C
CD
F
Statement on Extra Credit
Honors Credit will be awarded per prior arrangement with Course Directors.
Representative Honors projects could include developing and conducting a
presentation on a course-related topic, or developing and facilitating a course-related
case.
Minimum Passing Level
Per University and College Policy, students who receive a grade below D in this
course must successfully repeat the course before advancing to courses which
require this course as a prerequisite.
Policy for Late Work
Statement on Penalties for Late Work
1) Written assignments: Late work will be accepted for full credit only with prior
approval of the Course Directors and only for excused absences.
2) Written assignments submitted late without prior approval may be submitted within
24 hours to received 50% point deduction. After 24 hours, no points will be awarded.
3) In-class assignment: Students must be present to obtain credit for in-class
assessments (ie. iRAT, tRAT, etc.)
4) Students must complete all assignments to pass the course.
Exam Policy
Types of exams will include: iRAT, tRAT, in-class and/or online quizzes, and final
examination.
Exams may include multiple choice and short answer questions, and care plans.
Method of examination may include in-class audience response, scratch-off, or
written.
Exams may be posted online (Moodle) or held only during scheduled class times.
Absence from Exam
If a student cannot take an exam due to illness or other emergency the instructor
must be notified prior to the exam. In such cases, the student will take a make-up
exam at the earliest possible time. Arrangements for a make-up exam are to be
made with the specific faculty member responsible for the missed exam.
Disability Policy
See the Central Syllabus.
https://docs.google.com/a/umn.edu/document/d/1njXUaCO1RoFB9S5zq71hypXdB0I
wCFZN1dveX9wLcPM/edit
Mental Health
Services Statement
See the Central Syllabus.
https://docs.google.com/a/umn.edu/document/d/1njXUaCO1RoFB9S5zq71hypXdB0I
wCFZN1dveX9wLcPM/edit
If you encounter any difficulties that may affect your studies, please contact the Office
of Student Services. They can connect you with services to assist you and help you
manage these problems during your PharmD education.
Course Evaluation
Available online in the last week of the semester.
Detailed Course Outline & Schedule
Date
Agenda/Topics
Assignments/Assessments
Week 1
Jan 13
Jan 15
Jan 17
Jan 20
Jan 22
Jan 24
Jan 27
Jan 29
Introduction to course
(Larson, Stratton, Pestka)
Dermatitis - Contact Dermatitis,
Team-based Learning
Diaper Rash
(Larson, Maderich, Stratton)
Acne
Team-based Learning
(Larson, Stratton, Maderich)
Week 2
***No Class – University holiday***
Head lice, dry skin, sunscreens
Team-based Learning
(Larson)
Medication Experience
(Uden)
Week 3
Leadership Communication
(Fierke)
Patient Care Documentation:
Team-based Learning
Hrs
in/out
5/5
5/7
5/3.5
Jan 31
Feb 3
Feb 5
Feb 7
Feb 10
Feb 12
Feb 14
Feb 17
Feb 19
Feb 21
Feb 24
Feb 26
Feb 28
Mar 3
Communicating drug info and
care plan to patient and team
Practicing Excellence Model due
(Uden)
Documentation Template
Head lice care plan due
(Larson, Stratton, Uden)
Week 4
Motivational interviewing
Interviewing pre-assignment due
(Gaither)
Non-hormonal contraceptives
Team-based Learning
(Larson/Rosenberg)
Non-hormonal contraceptives
Patient/PCP letters due
(Larson/Rosenberg)
Week 5
Patient assessment
(Pereira)
Patient assessment continued
Critique a meta-analysis in class and
(Pereira)
submit at the end of class.
Drug Literature Evaluation:
Understanding meta-analysis
(Reidt)
TBA (Larson, Stratton)
Contraception care plan due
Week 6
Interpretation of Clinical Lab
Team-based Learning
Values
(Undeberg, Larson)
Lipids, Liver enzymes, Troponin, Team-based Learning
CK
(Undeberg, Larson)
Coagulation
Team-based Learning
(Undeberg, Larson)
Week 7
Interpretation of Clinical Lab
Team-based Learning
Values Continued
(Undeberg, Larson)
Interpretation of Clinical Lab
Team-based Learning
Values (Continued): Assessment
of kidney (Wendy St. Peter)
Interpretation of Clinical Lab
Team-based Learning
Values (Continued): Assessment
of kidney (Wendy St. Peter)
Renal assessment care plan due
Week 8
Placebo/Nocebo/Complementary Team-based learning
Medicine
(Larson, Uden)
5/5
5/2
5/5
5/8
5/8
Mar 5
Mar 7
Cultural and Ethical Issues
(Garza, Stratton)
Documentation Standards
(Uden)
Week 9
Mar 10 Law, Federal and State/National
Boards of Pharmacy and
Practice act
(Hadsall, Anderson)
Mar 12 Health Disparities/Promoting
Public Health Initiatives
(Garza, Pereira)
Mar 14 Adherence/Compliance issues
Online Moodle quiz
(Hadsall, Schommer)
***Week 10 (Mar 17-21) Spring break***
***Week 11 (Mar 24-28) Professional Development & Assessment***
Week 12
Mar 31 Penicillins, Cephalosporins
(Aldrich)
Apr 2
Carbapenems, Monobactams,
Macrolides
(Aldrich)
Apr 4
Tetracyclines
(Aldrich)
Week 13
Apr 7
Quinolones,
Trimethoprim/Sulfamethoxazole
(Aldrich)
Apr 9
Metronidazole, Clindamycin,
Fidaxomicin, Linezolid
(Aldrich)
Apr 11 Review, Online exam
Online antibiotics quiz
(Aldrich)
UTI care plan due
Week 14
Apr 14 Vaccines
(Philbrick)
Apr 16 Vaccines
(Philbrick)
Apr 18 Vaccines
Online vaccines quiz
(Philbrick)
Week 15
Apr 21 Pain
Team-based Learning
(Carlson)
Apr 23 Pain
Team-based Learning
(Carlson)
5/5
5/10
5/10
5/8
3/5
Apr 25
Apr 28
Apr 30
May 2
May 5
May 7
May 9
Pain
(Carlson)
Team-based Learning
Inventory of OTC pain products
assignment due
Week 16
Team-based Learning
GERD/PUD
(George)
Diarrhea/Constipation
(George)
TBA
Team-based Learning
GERD/PUD care plan due
Week 17
Team-based Learning
Cough/Cold
(Uden)
Cough/Cold
(Uden)
Cough/Cold
(Uden)
Team-based Learning
Finals Week
Schedule of Due-Dates and Point assignment of Final Grade *
Topic
Points
Format of
assessment
On or Due Dates
iRAT and tRAT Quizes
95
Five
point
per
session
In-class quiz
Using clickers
and Scratch-off
Jan 15, 17, 22, 29
Feb 5,17, 19, 21, 24, 26, 28,
Mar 3,
Apr 21, 23, 25, 28, 30, May
5, 7
5 Case Write-ups
Head Lice
Contraception
Renal assessment
UTI
GERD/PUD
Leadership assignment
Interview preassignment
Meta-analysis write-up
SAPH content
Patient/PCP letter
Oral Antibiotics Quiz
Vaccines
4/4
20
20
20
20
20
Rubric
Written
Written
Written
Written
Written
Jan 31
Feb 14
Feb 28
April 11
May 2
10
10
Written
Written
Jan 29
Feb 3
10
30
10
45
30
Written
On-line quiz
Written
On-line quiz
On-line quiz
Feb 12
Mar 14 (Posted)
Feb 7
April 11 (Posted)
April 18 (Posted)
5/3
Pain assignment
10
Written
Final Exam
Content
April 25
Finals week
TBL Content,
antibiotics, physical
assessment,
SAPH
Combined
150
Total Points
500
* Subject to change at course instructor’s discretion.