Student Projects

Student Project

During the Advanced Community Practice Rotation the student will be involved with:

• The design, development, significant modification and/or delivery of at least one pharmaceutical care service (preferred)

---OR---

• The delivery of several existing pharmaceutical care services. 

The following is a list of possible pharmaceutical care services that the student may implement.  The list is not exhaustive, and completion of a service on this list is not required.  The student should work with their preceptor to determine the specific needs of their practice site based on patient population and other programs at the pharmacy and in their community.  Although they will be under the direction and supervision of their preceptor at all times, the student will be responsible for implementing the service, marketing the service to patients and other health care professionals, actually performing the service, following up after the service, and evaluating the success of the service.  

Formal Project Ideas

• Brown bag medication review – have patients bring in all of their medications (including OTC, vitamins, and herbals) for review by the pharmacist.  Pharmacist will council patient on their medications, check for drug interactions, make sure nothing has expired, and make sure there is an indication for every drug. 

• Blood Pressure screening – Student will measure patient’s blood pressure using correct techniques and educate patient on lifestyle modifications to prevent hypertension.  For patients already diagnosed with hypertension or for those at high risk for developing hypertension, the student may invite the patient back to the pharmacy for regular blood pressure monitoring, education, and medication evaluation.  Downloadable booklet on the DASH diet with meal plans is available at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf . 

• Cholesterol screening – Student will either use the pharmacy’s Cholestech machine or will borrow a Cholestech machine and will measure patient’s cholesterol using appropriate techniques.  Student will educate patients on lifestyle modifications to prevent or treat hypercholesterolemia.  Students may also counsel on nutritional and dietary modifications that will maximize their therapeutic results from medications, such as:  plant stanols, policosanol, olive oil, fiber, fish oil, etc.  May also include counseling on food products to avoid with certain medications, like grapefruit. (see CLIA Information on "home" page).

• Osteoporosis screening – Student will measure patient’s bone mineral density and educate patient on osteoporosis prevention through lifestyle modification, diet, and calcium supplementation.  The student may calculate the amount of calcium the patient is getting in their diet and/or from supplements (calcium calculator available at http://www.tums.com/source_calculator.asp ), and determine if they are getting enough calcium for their individual circumstances. 

• Antibiotic call-back / follow up – Student will devise a system to call patients approximately 2 to 4 days after they fill a prescription for an antibiotic to screen for adverse effects, compliance, effectiveness, etc.  They can also counsel patient on the importance of finishing the course of treatment unless otherwise directed. 

• Diabetes education service – Student will educate patients getting a blood glucose monitor on how to use the device and what the results mean.  This service could also include counseling on signs/symptoms of hypo- and hyperglycemia, new diabetes medications, diet, exercise, possible future complications, and reminding them to schedule appointments for preventative care (i.e. dental visits, eye exams, foot exams, etc). 

• Immunization service – Student will compile protocol for influenza vaccinations, order supplies and vaccine necessary to start a vaccine clinic, and will screen patients and administer vaccines when appropriate.

• Women’s Health consultation service – Student will determine patient’s 10 year cardiovascular event risk and counsel patients on risks vs benefit of HRT.  Student will advise patient on the proper use of hormone replacement orally, topically, or vaginally, and will provide information on how to properly taper off hormones.  Student can recommend other medications and products that will help with menopause symptoms and will counsel on osteoporosis prevention.  (See the following website for a checkup checklist specifically for women:  www.ahrq.gov/ppip/healthywom.htm and see http://www.komen.org/intradoc-cgi/idc_cgi_isapi.dll?IdcService=SS_GET_PAGE&ssDocName=DownloadBSECards to either order self breast-exam cards or to print them out for distribution to patients.)

• Smoking Cessation – Student will determine patient’s level of addiction, provide educational materials, counsel patients on what to expect when they quit, assist patient in choosing appropriate nicotine replacement product or other cessation assistance.  Student will help patient choose a quit-date and will follow up with the patient regularly to monitor progress.  This service may also include group sessions with multiple patients.  (See the following website for free smoking cessation materials: www.ahrq.gov/consumer/tobacco/consorder.pdf or go to www.smokefree.gov/hp_hcsit.html to download smoking cessation software for Palm or Pocket PC). 

• Pain Management – Student will educate patients receiving pain medications on the possible side effects they will experience and how to prevent some side effects (i.e. constipation).  Student will follow up with patient to determine effectiveness of medication for pain relief and to screen for adverse reactions – the student will communicate the patient’s status with their physician when necessary. 

• Medicaid polypharmacy medication reviews – Students will devise a form to complete the medication reviews for NC Medicaid patients on more than 11 prescriptions per month.  Student will recommend changes to medication regimen when necessary for improved therapeutic outcomes or cost reduction. 

• Asthma education service – Student will educate patients on acute vs chronic asthma medications and will counsel on proper inhaler technique, trigger avoidance, allergy treatments, etc.  Student will demonstrate proper use of other equipment including spacers, masks, nebulizers, and peak flow meters.  Student will follow up with patient by phone and when they return for refills. 

• Nutritional / weight loss counseling – Student will counsel patient on the food pyramid, dietary supplements, nutritional products designed to assist with weight loss.  Student may also counsel on over the counter medications used for weight loss (i.e. orlistat – approved for OTC use in 2006) as well as possible prescription options.  Student will review patient’s medication regimen to ensure patient’s medications are not causing weight gain.  Body fat analysis may also be performed, as well as BMI calculation.  See the following website for a chart on drug-nutrient depletions and herb-drug interactions: http://www.vitaminherbuniversity.com/summary_chart.asp?num=1

• Migraine consultation service – Student will educate patients on causes of migraine, trigger avoidance, and prevention techniques.  Prescription and over the counter medications will also be reviewed, including prophylactic therapy.  Student will educate patient on the appropriate use of migraine medication and will review the risk for rebound headaches.  Student may have patient keep a migraine and medication use calendar detailing their pain levels, stress levels, and trigger exposure. 

• Insomnia consultation service – Student will get patient history related to insomnia and will educate patient on causes of insomnia and on proper sleep hygiene.  Nonprescription products for insomnia will also be reviewed and the appropriate product will be selected for patient, when indicated.  Student will monitor patient for improvement.  If prescription products are necessary student will refer patient to his/her primary care physician.  See this website for a downloadable educational brochure for patients with insomnia: http://www.doctorsforadults.com/sleep.htm?dfa .   This website also has tools and quizzes to use with patients when counseling them on insomnia:  http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2418861/k.B1A8/Tools_and_Quizzes.htm

• Anticoagulation education service – Student will counsel patients that have been started on anticoagulation (warfarin, low molecular weight heparins).  Demonstrations will be given on injection technique for injectable products.  Patients will be educated on dietary restrictions, lab follow-up, and drug interactions with warfarin.  Student will counsel patients on possible adverse events and signs and symptoms of bleeding. 

• Medication Compliance service – Student will counsel patients on importance of compliance with medication regimens and will implement the use of compliance aids (pill boxes, refill reminders, dosing calendars, unit of use packaging).  The patient’s physician and/or caregivers will be notified if the patient is not compliant with prescribed medication regimen so that adjustments may be made.