JMCP Key Subjects

Promoting Interprofessional Collaboration: Pharmacy Students Teaching Current and Future Prescribers About Medicare Part D

AUTHORS: Cindy J. Lai, Amanda R. Smith, Marilyn R. Stebbins, Timothy W. Cutler, Helene L. Lipton

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SUMMARY:

BACKGROUND: Nearly all health professional students and prescribers, regardless of specialty, will care for older adults who are enrolled in or eligible for the Medicare Part D prescription drug benefit. Given the growing numbers of older adults, the increased burden of chronic disease, and the escalating costs of health care, health professional students and prescribers across disciplines should learn strategies to promote cost-effective prescribing and collaborate with pharmacists who are experts in medication use and costs.

OBJECTIVE: To describe and evaluate the impact of a statewide peer education program in which selected students at 7 California schools of pharmacy delivered a clinically relevant lecture on Part D to a multidisciplinary audience of health professional students and prescribers. METHODS: Trained pharmacy students delivered a case-based lecture on Medicare Part D to other health professional students and prescribers throughout the state of California. An 11-item survey designed to evaluate (a) self-assessed Part D knowledge, (b) opinion of pharmacists’ roles on the health care team, (c) intent to collaborate with pharmacists, and (d) awareness of cost-savings strategies to reduce patients’ out-of-pocket drug costs was administered before and after the lecture. Pre-lecture versus post-lecture results were tested for statistical significance using the Wilcoxon signed-rank test with Bonferroni adjustment of alpha to 0.004 because of multiple comparisons.

RESULTS: From October 2008 through May 2010, trained students from 7 pharmacy schools gave 58 presentations to a total of 1,490 current or future prescribers, including 304 nurse practitioner students and 279 resident physicians. At baseline pre-lecture, self-rated knowledge of Medicare Part D was generally poor; only 4.9% of respondents strongly agreed that “I understand the Medicare Part D benefit,” and 6.6% strongly agreed that they could “identify key Medicare Part D resources to help my patients.” Nine of 11 survey items showed statistically significant improvement (P < 0.001), including all 4 items in the Part D knowledge domain and all 5 items in the intent-to-collaborate domain (e.g., “I consult with pharmacists and/or pharmacy students about drug costs”). Outcomes were similar across the 7 schools.

CONCLUSION: At pre-lecture baseline, self-reported deficits in knowledge about Part D policy and drug cost-savings resources and strategies existed among medical, nursing and physician assistant students, resident physicians, and other health professionals. A pharmacy student-led peer education lecture can be used to bridge this gap, resulting in timely dissemination of geriatrics health policy information and increased awareness of pharmacists’ roles and expertise in pharmaceutical health policy and patient care.

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