Clinical interventions provided by doctor of pharmacy students.
To assess the types, perceived benefit, and cost impact of the interactions provided by two-year post-B.S. Pharm.D. students on clerkship rotations. Information was obtained through voluntary reporting by students on a standardized data collection form. Cost analysis and peer review were performed on a subset of interventions. The setting of the study included hospital clerkship sites (general medicine and specialty rotations) and an ambulatory care site (general medicine). Six second-year Pharm.D. students. Reports that were completed totaled 951, including 612 intervention, 335 information, and 4 unknown events. Most events were drug related and student initiated. Follow-up was predominantly to physicians. Intervention events primarily involved changes in drug therapy regimens (63.5 percent), changes in dose (29.5 percent), and identification of potential adverse drug reactions (7 percent). Acceptance rate of recommendations was 78.7 percent. Antibiotics, cardiovascular agents, and central nervous system drugs accounted for 55.5 percent of all interventions. Almost 80 percent of disease states encountered included cardiovascular, infectious, neurologic, pulmonary, gastrointestinal, and endocrine diseases. Overall, peer review scores tended to show a positive impact, with physician scoring higher than pharmacy faculty scoring. Medication-related costs were reduced modestly by accepted student interventions. This study demonstrates substantial clinical involvement of two-year post-B.S. Pharm.D. students on clerkships. The results indicate that the curriculum of Pharm.D. programs should emphasize cardiology, infectious disease, neurology, and gerontology.