(72) Impact of a Medication-Related Problem Identification (MRP-ID) Tool on the Pharmacists’ Patient Care Process (PPCP)

Objective : To assess the effectiveness of an MRP-ID Tool on second-year pharmacy (P2) students’ ability to complete the PPCP collect, assess, and plan steps.

Methods: Using a pre-post design, P2 students’ ability to identify medication related problems (MRPs) for a complex patient case in a simulated electronic medical record before and after introduction of the MRP-ID Tool was evaluated. The pre- and post- patient cases were similar with the exception of small changes that did not affect the MRPs to ensure consistency, reduce potential for confounders, and minimize the practice-effect. A grading rubric was developed through an iterative process with multiple testing phases and updates ensuring accuracy. Benchmark interrater agreement was established between two evaluators using a random sample of 20% of the data. Analysis of pre-case/post-case performance included descriptive statistics and paired T-tests using SPSS.

Results: Complete pre- and post-test data were available for 69% of the P2 class (n=96). When comparing performance in totality (maximum score=30 points), students improved an average of 6.7 points (5.3-8.1; p < 0.001) in their identification, prioritization, assessment, and plan development for identified MRPs. Performance also improved for assessment (3.5 points [2.7-4.4; p < 0.001]), plan development (3.1 points [2.5-3.8; p < 0.001]), problem prioritization (1.4 points [1.0-1.8; p < 0.001]), problem explanation (1.4 points [0.9-1.8, p < 0.001]), plan recommendations (2.5 points [1.9-3.0; p < 0.001]), and monitoring (0.7 points [0.4-0.9; p < 0.001]).

Conclusions: Utilizing the MRP-ID Tool, P2 students demonstrated significant improvement in application of the PPCP for complex patient case workup, assessment, and plan development. Implementation and assessment of this tool in other skill-based courses across the PharmD curriculum are ongoing.