Scholars Symposium 2025: Pharmacy

Cost Efficiency of Pharmacy Students in a Penicillin Allergy Clinic

by Allison Belmont (Graduate), Lucas Plas (Graduate), Nathalia De Faria Aildasani (Graduate), Matthew Young (Graduate), Dr. Zachary Jenkins (Faculty)

Background: Penicillin, a beta-lactam antibiotic, is widely used for its efficacy and safety. About 10% of the U.S. population report a penicillin-derived allergy, often leading to alternative antibiotic use. Pharmacists play a key role in patient education and penicillin allergy testing. However, the impact of these services may be limited by barriers such as time, personnel, and cost. Pharmacy students may support ambulatory care clinics by performing tasks typically handled by pharmacists, allowing pharmacists to focus on other care areas.

Objectives: The primary objective of this study was to determine if pharmacy students are a cost efficient alternative to pharmacists in a pharmacist-led penicillin allergy clinic. The secondary objective was to determine if pharmacy students are a time efficient alternative to pharmacists in a penicillin allergy clinic.

Methods: In this retrospective cohort study conducted at Miami Valley South Hospital Clinic in Dayton, Ohio, researchers reviewed data for patients who were referred to a penicillin allergy clinic from December 1, 2022 to November 30, 2023. The pharmacist-led program practices under a collaborative practice agreement, with advanced pharmacy practice (APPE) and intermediate pharmacy practice (IPPE) students working together in the clinic to assist patients. Twenty student pharmacists and one pharmacist participated in this study. Data collection included the pharmacist or student performing the test, the type of allergy test, test duration in hours, number of skin test attempts, number of errors made during the appointment, interventions made, time spent counseling patients, cost of supplies for training students, time spent calling patients, call success rate, and percent of allergies delabled. An excel spreadsheet was used to track each collection point per appointment. Data analysis included descriptive statistics to determine statistical differences. Cost was determined by the addition of cost per supply used, as well as the pharmacist’s hourly salary. Criteria for inclusion included patients who were referred to the clinic during the study interval, seen by a student pharmacist or pharmacist. Exclusion criteria were patients who were seen by a pharmacy resident or if they fell outside of the study timeframe.

Results: A total of 15 intermediate pharmacy practice experience (IPPE) students, 5 advanced pharmacy practice experience (APPE) students, and 1 pharmacist were included in the study. Students saved the clinic a net $5,567 in total over 9 months, while using the pharmacist hourly rate and deducting training supply cost and pharmacist time spent to train. Broken down more specifically, for phone calls, students saved $5,059. IPPE students spent 2,786 minutes on calls, while APPE students spent 2,273 minutes. Students spent more time making calls when compared to the pharmacist, as the pharmacist spent a total of 1,449 minutes.. For scratch tests, students saved $512. For intradermal tests, students saved $665. For discharge counseling, students saved $420. Students spent 4.04 (IPPE: 4.37 ; APPE: 3.71) minutes/phone call, while pharmacists spent 4.75 minutes/phone call. Students successfully scheduled an appointment per phone call encountered 22.32% (IPPE: 19.73% ; APPE: 24.90%) of the time while the pharmacist was successful 39.66% of the time. Students removed penicillin allergies per phone call encounter 5.54% (IPPE: 6.02% ; APPE: 5.06%) of the time while pharmacists removed allergies 5.59% of the time. Students took an average of 4.99 minutes/scratch test encounter (IPPE: 4.39 ; APPE: 5.59) while pharmacists took 6.11 minutes/encounter. For intradermal encounters, students took an average of 6.24 minutes (IPPE: 4.78 ; APPE: 7.70) while pharmacists took 7.44 minutes/encounter. Students averaged a 25.05% (IPPE: 4.65% ; APPE: 45.45%) intradermal miss stick rate while pharmacists averaged 28%. Additionally, students averaged 3.21 (IPPE: 2.86 ; APPE: 3.55) minutes/discharge encounter while pharmacists averaged 3.30 minutes/encounter.

Conclusion: Students are cost-efficient when assisting in a pharmacist-led clinic. Although they require training and supervision, they are able to perform tasks and allow pharmacists to work on other necessary duties. This study determined that students saved a net $5,567 in total over 9 months. The study also found that students were more efficient at performing skills such as discharge counseling and phone calls, allowing pharmacists time for other tasks. This information can help guide pharmacy managers into involving students in clinics to give them more experience, while saving money.

Effects of Motivational Interviewing by Pharmacist/Pharmacy Students on Patient Outcomes: A Systematic Review

by Blair Woodard (Graduate), Angela LaPresta (Graduate), Baylee Eastes (Graduate), Caroline Abdelmassih (Graduate), Yaw Antwi (Graduate), Dr. Aleda M. H. Chen (Faculty)

Objective: To describe the outcomes of motivational interviewing (MI) interventions by pharmacists/pharmacy students.

Methods: A systematic review was conducted using PRISMA methodology (PROSPERO CRD42024546509). The inclusion criteria were research studies, full-text available and written in English. They also had to include MI-based education and pharmacist/student pharmacist. A research librarian was used to refine the search terms and pilot the search strategy. The searches were performed in PubMed, CINAHL, and Web of Science from January 1, 2014 to April 9, 2024. All references were imported into Zotero for cleaning and then uploaded into COVIDENCE (a systematic review management system) for review. Two members independently screened each title and abstract and determined if they met the inclusion criteria. A third member was used for conflict resolution. If included, articles moved to full-text review by two members independently. A third member was again used for conflict resolution. Next, articles went to the extraction phase, where key information from each article was extracted independently by two members, with a third resolving conflicts.

Results: A total of 356 articles were identified for review, with 56 studies included involving MI performed by student pharmacists or pharmacists. Common study designs were randomized controlled trials or non-randomized quantitative studies (n=41, 73%), and the remainder were qualitative or mixed-method studies. This amounted to 28,940 participants among all studies. On average, these studies took place over a period of 10 months, and MI was used as a tool for interventions related to blood pressure measurement, medication therapy management, follow-up phone calls, educational handouts, portable pulmonary testing, and electronic or regular pill boxes. Most (73%) of the interventions consisted of multiple MI sessions or one lengthy session. MI was shown to make a statistically significant change on primary-endpoint patient outcomes in 77% of studies, most with a confidence interval of 95% and p value < 0.001.

Conclusion: MI by pharmacists or pharmacy students has been shown to have a positive impact on clinical outcomes, patient satisfaction, and medication adherence. Patients are most likely to see these improvements with long-term interventions as well as face-to-face interventions.

The Effect of Creative Integration of Top 200 Drug Information within Second Year Pharmacy Therapeutic Modules on Retention of Top 200 Knowledge

by Hannah Hoffer (Graduate), Morgan Metcalf (Graduate), Jonathan O'Brien (Graduate), Stephen Price (Graduate), Raymond Whorton (Graduate), Dr. Denise Jean-Louise (Faculty), Dr. Juanita A. Draime (Faculty), Dr. Stephanie Tubb (Faculty)

Background: Pharmacogenomics (PGx) is the study of the influence of genetic variation on drug response with the aim of increasing the efficacy and safety of current and future treatments. The application of pharmacist-led pharmacogenomics to everyday patient care has the potential to revolutionize how medication therapies are selected and optimized; however, implementation of these services has been slower than desired, despite clinical data suggesting many benefits. Studies support the clinical value of pharmacogenomic services in children with behavioral health conditions; however, there is a gap in evaluating the humanistic outcomes of these services. There has been minimal research validating whether pharmacist-led pharmacogenomic interventions are valued by health care providers of children with behavioral health diagnoses. The overall purpose of this research was to explore the value of pharmacist-provided pharmacogenomic services in the pediatric population while also incorporating the perceptions that providers have about PGx counseling. The Objectives of the project were to: (1) describe the key components and structure of a pharmacist-led pharmacogenomic education service in an ambulatory pediatric behavioral health program and (2) explore provider and staff perceptions of the counseling services. Methods: A descriptive case study was conducted to evaluate key components of a pharmacist-led PGx education program and provider and clinic staff perceptions of the PGx counseling services in a pediatric behavioral health clinic, Rocking Horse Community Health Center. The providers and staff included primary care physicians, collaborating psychiatrists, nurse practitioners, and nurses at the clinic responsible for treating pediatric patients for behavioral health issues, ordering pharmacogenomic testing, and referring patients to the pharmacist. Data was collected via personal interviews and observational checklists. Interviews were approximately 30-60 minutes in length using Microsoft Teams. Observational and demographic data were gathered using RedCap and analyzed using SPSS. Interview data was transcribed and independently coded manually in Word by two members of the research team. A third member was involved to review the codes and resolve any discrepancies. Theme statements were created to explore the provider and staff perceptions of the pharmacist-led PGx education program and services at the clinic. Results and Conclusions will be presented at the research symposium.

Effectiveness of an Integrated Pharmacist-Physician Model on Hepatitis C Outcomes in Underserved Patients in a Federally Qualified Healthcare Center

by Andrew Straw (Graduate), Ben Wolthoff (Graduate), Ben Johnson (Graduate), Adaline Johnson (Graduate), Brooke Hatton (Graduate), Hayden Lee (Graduate), Eliya Craig (Graduate)

Background: Hepatitis C (HCV) is a viral infection that causes liver inflammation. While collaborative healthcare models have proven effective in specialty settings, their impact within Federally Qualified Healthcare Centers (FQHCs) remains underexplored. Underserved patients may lack financial resources or medical literacy to navigate specialty care, making FQHC-based treatment a critical area of study.

Objectives: To assess the effectiveness of an integrated pharmacist-physician model in improving direct-acting antiviral (DAA) accessibility and sustained virologic response (SVR) rates in underserved HCV patients.

Methods: This retrospective chart review examined patients at Rocking Horse Community Health Center who were ≥18 years old, diagnosed with HCV, and had at least one HCV-related clinic visit. Data included demographics, HCV diagnosis details, treatment information, and outcomes. Medication access was evaluated through insurance, 340B programs, or patient assistance programs. Treatment outcomes, including SVR12 achievement, were tracked via RedCap. Missing data was retrieved from patient charts or external pharmacies.

Results: Seventy-three patients were include with an average age of 45.78 years. Genotype data was available for 31 patients, with the most common being genotype 1a (14 patients). Of the 73 patients referred for treatment, 21 completed therapy, 4 remained in treatment at the study end, 8 cleared the virus naturally, 3 were referred elsewhere, and 37 were lost to follow-up. All but one patient received their prescription on-site through Medicaid or Medicare. Undetectable viral levels were achieved in all patients who completed treatment and had completed their follow-up labs before the end of the study period. Correlation analysis found no connection between any patient demographic (age, ethnicity, sex) and their likelihood to come for the initial visit.

Conclusion: Patients who completed treatment at Rocking Horse achieved undetectable SVR levels. However, half of the patients were lost to follow-up, often due to missed initial labs or unresponsiveness to clinic outreach. These findings highlight the effectiveness of an integrated model while emphasizing the need for improved follow-up strategies, potentially through greater collaboration with social services.