ISHP Spring Student Poster Virtual Sessions, April 2020
2020 Spring Poster Abstracts & Virtual Posters
Poster Title: Billing and coding: disparities in healthcare provider training
Poster Authors: Brittany Romans, Pharm.D. candidate; Michael Biddle, Pharm.D.; Elaine Nguyen, Pharm.D., MPH; Andrew Hibbard, Pharm.D.; Thomas Wadswor th, Pharm.D.; Renee Robinson, Pharm.D., MPH, MSPharm
This project was performed to identify billing/coding training disparities between five healthcare practices. Eighteen manuscripts were identified within a literature review, and a survey including questions on whether billing was taught and what resources were used was sent to the top U.S. schools. One-hundred thirty-one out of 493 schools (27%) responded. Most dietetic schools (n=39) responded “yes” to teaching billing (92%). No social work schools taught billing (n=36, 0%) and one medical school did (n=20, 5%). Nursing (n=23) and pharmacy (n=13) schools reported 52% and 23%. Dietetic schools taught billing due to accreditation requirements, while few nursing and pharmacy schools offered training. Physicians likely receive training outside of school or during residency. This study was exempt from IRB approval because it didn’t directly involve experimentation on human subjects. As pharmacy develops, more billable services will require reimbursement, and hopefully this study will encourage more schools to teach students this topic.
Poster Title: Student pharmacist medication tasting lab (SPECIAL): student’s evaluation and perceptions of a medication palatability exercise
Poster Authors: April Smith, PharmD Candidate, Renee Robinson, PharmD, MPH, MSPharm; Nate Spann, PharmD; Kevin Cleveland, PharmD, ANP; Rob Myers, RPh, PhD
Pharmacists are uniquely positioned to improve medication adherence by providing practical strategies that improve palatability. To enhance student understanding of medication characteristics and preparation to offer taste-masking strategies for non-prescription medications, additional hands-on training was added during the Special Populations Pharmacotherapy Module entitled Student Pharmacist mEdiCatIon tAsting Lab (SPECIAL). Non-prescription medications with poor palatability were selected to assess students’ perceptions of taste and texture with and without commonly available flavoring agents. SPECIAL provided students (n=80) a hands-on experience and clinical pearls on integrating masking strategies to improve medication adherence. Most (95%) students agreed that the activity was valuable to their learning and would impact counselling. Students suggested that the number of agents trialed be adjusted, with additional palate cleansers, taste masking strategies, and prescription medications added. SPECIAL was effective in meeting established learning goals based on student feedback and serves as a template for future student pharmacist learning.
Poster Title: Anticholinergic prescribing in the elderly
Poster Authors: Heather Walser, PharmD Candidate, Megan Seewald, PharmD Candidate; Andrea Winterswyk, PharmD
Anticholinergic antidepressants (AChAD) are widely used in patients 65 and older, despite warnings against their use from the American Geriatrics Society’s Beer’s Criteria. This cross-sectional, retrospective medication use evaluation evaluated 100 eligible patients for AChAD deprescribing candidacy. Secondary endpoints included percentage of patients initiated at age 65 or older, and percentage of patients given education, appropriate follow-up, and medication reconciliation. 36% of patients were determined to qualify for less anticholinergic alternative therapy trials, and only 3% were prescribed AChAD appropriately due to prior therapy failures. 58% of patients had begun AChAD therapy over age 65, 68% had insufficient documentation upon initiation. When documentation was present, less than 50% included patient education, adverse effects, psychotherapy, and adherence. AChAD use continues to be an area of concern among patients age 65 and older. It is recommended that patients continue to be evaluated for deprescribing candidacy. Approval by the Medication Utilization Evaluation Committee.
Poster Title: Evaluation of the role of emergency department pharmacists in management of sepsis
Poster Authors: Jazmin Agee, PharmD Candidate, Arielle Arnold PharmD, BCPS , Kathy Eroschenko, PharmD, Cathy Oliphant, PharmD
This study evaluated the impact ED pharmacists had in treating patients meeting sepsis criteria when compared to unstaffed hours. The primary objective was to determine if septic patients were treated appropriately according to CMS guidelines as determined by SEP-1 compliance, and the secondary objective was to determine the time from sepsis presentation to antibiotic administration. A retrospective chart review was conducted in patients 18 years and older who met severe sepsis criteria. Data collection included vitals, diagnosis, the antibiotic ordered, and the time the antibiotic was administered. CMS SEP-1 criteria was met 76% of the time during pharmacist staffed hours compared to 83% during unstaffed hours. The most common reason for fallout was missing the three-hour antibiotic administration window. Overall, pharmacists had a positive impact on the secondary objective, but had a higher percentage of CMS SEP-1 fallouts. This data can be used by pharmacists for education and quality improvement.
Poster Title: Multidisciplinary care delivery practices in Idaho for patients with chronic diseases
Poster Authors: Matthew Fuit, PharmD Candidate 2021
Purpose: To describe multidisciplinary care practices in Idaho for patients with chronic diseases.
Methods: We administered an electronic survey (April-June 2019) to Idaho primary care providers (PCPs)/clinic managers working in clinics that provide preventive services and/or chronic disease management for patients with diabetes, hypertension, and/or hyperlipidemia. Data are reported with descriptive statistics. Work was considered non-research and exempt from IRB review.
Results: We include data from 116 respondents. Most clinics did not use community health workers (n=83) and did not have collaborative practice agreements with pharmacists (n=73). The most common in-house and referral services were tobacco cessation and behavioral health, respectively. Commonly cited barriers to making referrals were patient cost (n=73) and motivation (n=70). Less than half of respondents used the electronic health record to exchange information with others.
Conclusion: While Idaho PCPs utilize multidisciplinary team members to support patients with chronic diseases, there is opportunity for increased team collaboration.
Poster Title: Comparison of rural versus urban fluoroquinolone prescribing rates in Idaho Medicare beneficiaries
Poster Authors: Caden Alder, PharmD Candidate, Karl Madaras-Kelly PharmD, MPH
This study sought to determine if there are differences in fluoroquinolone prescribing rates in rural vs. urban settings. Secondary analyses of antibiotics commonly used to treat UTIs were also performed. Relevant data were extracted from the Centers for Medicare (CMS) Part D Provider Utilization for 2017. Location was classified as rural or urban based on CMS Zip Code definitions. Data were summarized with descriptive statistics and one-way ANOVA was used for analysis. Of 2,984 Idaho providers, the mean (SD) of fluoroquinolone prescriptions was 28.0 (57.9) versus 22.2 (63.5) for rural and urban providers (P<0.05), respectively. Prescribing rates for alternative antibiotics utilized to treat UTI were not different in rural vs. urban settings: trimethoprim/sulfamethoxazole [P=0.60] and nitrofurantoin [P=0.26]. Fluoroquinolone prescribing was higher in rural practice settings. No differences were observed between rural and urban prescribing rates for other commonly used UTI antibiotics. These data may aid in designing antimicrobial stewardship interventions.