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.
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