Dataset Information

Medication History Lab and Assessment using the Medication Mysteries Infinite Case Tool.

ABSTRACT:

Introduction

Teaching medication history taking or medication reconciliation to students requires practice for students to achieve competency. Practice makes students more confident with the process, but multiple practice opportunities require multiple cases, and creating these new cases can be a tedious and time-consuming process.

Methods

The Medication Mysteries Infinite Case Tool was designed to produce random patient cases using game-like features to allow students to practice medication history taking and medication reconciliation without the need to use and train standardized patients. The tool was created using a random draw card-based system to determine patient personality attributes, drugs they are taking, and confusions they have about their drug-taking behavior. This tool is used in a lab dedicated for the purpose of practicing medication history taking with students being assessed via simulation with standardized patients. This tool is currently used at the University of Florida College of Pharmacy as part of a training program for first-year pharmacy students.

Results

Since 2011, seven classes of first- and second-year pharmacy students have participated in this lab. Each year's class contained an average of 280 students divided into lab groups of 18-24 students. In our initial offering of the lab and assessment, 200 students on three campuses completed the individual assessments following the laboratory session. Fifty-eight percent achieved excellence, and 39% achieved competence on the individual assessment. Only 3% were assessed as being deficient on their performance and were required to repeat the assessment. Overall, 86.8% agreed or strongly agreed that the MMICT was an excellent way to experience how to reconcile medication.

Discussion

Students enjoy the practice and become proficient with the skills they learn through this process as evidenced by increased self-efficacy and achieved competence on a standardized assessment. The tool and the research associated with the outcome were awarded with the 2012 American Association of Colleges of Pharmacy Innovations in Teaching Award.

SUBMITTER: Sando KR

PROVIDER: S-EPMC6440429 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Medication History Lab and Assessment using the Medication Mysteries Infinite Case Tool.

Sando Karen R KR Doty Randell R Elliott Jennifer J Stanton Melonie L ML

MedEdPORTAL : the journal of teaching and learning resources 20161223

<h4>Introduction</h4>Teaching medication history taking or medication reconciliation to students requires practice for students to achieve competency. Practice makes students more confident with the process, but multiple practice opportunities require multiple cases, and creating these new cases can be a tedious and time-consuming process.<h4>Methods</h4>The Medication Mysteries Infinite Case Tool was designed to produce random patient cases using game-like features to allow students to practice ...[more]

PMID: 30984861

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Project description:BACKGROUND:Studies have shown that the quality of family health history (FHH) collection in primary care is inadequate to assess disease risk. To use FHH for risk assessment, collected data must have adequate detail. To address this issue, we developed a patient facing FHH assessment tool, MeTree. In this paper we report the content and quality of the FHH collected using MeTree. METHODS: DESIGN:A hybrid implementation-effectiveness study. Patients were recruited from 2009 to 2012. SETTING:Two community primary care clinics in Greensboro, NC. PARTICIPANTS:All non-adopted adult English speaking patients with upcoming appointments were invited to participate. INTERVENTION:Education about and collection of FHH with entry into MeTree. MEASURES:We report the proportion of pedigrees that were high-quality. High-quality pedigrees are defined as having all the following criteria: (1) three generations of relatives, (2) relatives' lineage, (3) relatives' gender, (4) an up-to-date FHH, (5) pertinent negatives noted, (6) age of disease onset in affected relatives, and for deceased relatives, (7) the age and (8) cause of death (Prim Care31:479-495, 2004.). RESULTS:Enrollment: 1,184. Participant demographics: age range 18-92 (mean 58.8, SD 11.79), 56% male, and 75% white. The median pedigree size was 21 (range 8-71) and the FHH entered into MeTree resulted in a database of 27,406 individuals. FHHs collected by MeTree were found to be high quality in 99.8% (N = 1,182/1,184) as compared to <4% at baseline. An average of 1.9 relatives per pedigree (range 0-50, SD 4.14) had no data reported. For pedigrees where at least one relative has no data (N = 497/1,184), 4.97 relatives per pedigree (range 1-50, SD 5.44) had no data. Talking with family members before using MeTree significantly decreased the proportion of relatives with no data reported (4.98% if you talked to your relative vs. 10.85% if you did not, p-value < 0.001.). CONCLUSION:Using MeTree improves the quantity and quality of the FHH data that is collected and talking with relatives prior to the collection of FHH significantly improves the quantity and quality of the data provided. This allows more patients to be accurately risk stratified and offered appropriate preventive care guided by their risk level. TRIAL NUMBER:NCT01372553.

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Project description:BackgroundThe presence of hereditary cancer syndromes in cancer patients can have an impact on current clinical care and post-treatment prevention and surveillance measures. Several barriers inhibit identification of hereditary cancer syndromes in routine practice. This paper describes the impact of using a patient-facing family health history risk assessment platform on the identification and referral of breast cancer patients to genetic counselling services.MethodsThis was a hybrid implementation-effectiveness study completed in breast cancer clinics. English-literate patients not previously referred for genetic counselling and/or gone through genetic testing were offered enrollment. Consented participants were provided educational materials on family health history collection, entered their family health history into the platform and completed a satisfaction survey. Upon completion, participants and their clinicians were given personalized risk reports. Chart abstraction was done to identify actions taken by patients, providers and genetic counsellors.ResultsOf 195 patients approached, 102 consented and completed the study (mean age 55.7, 100 % women). Sixty-six (65 %) met guideline criteria for genetic counseling of which 24 (36 %) were referred for genetic counseling. Of those referred, 13 (54 %) participants attended and eight (33 %) completed genetic testing. On multivariate logistic regression, referral was not associated with age, cancer stage, or race but was associated with clinical provider (p = 0.041). Most providers (71 %) had higher referral rates during the study compared to prior. The majority of participants found the experience useful (84 %), were more aware of their health risks (83 %), and were likely to recommend using a patient-facing platform to others (69 %).Conclusions65 % of patients attending breast cancer clinics in this study are at-risk for hereditary conditions based on current guidelines. Using a patient-facing risk assessment platform enhances the ability to identify these patients systematically and with widespread acceptability and recognized value by patients. As only a third of at-risk participants received referrals for genetic counseling, further understanding barriers to referral is needed to optimize hereditary risk assessment in oncology practices.Trial registrationNIH Clinical Trials registry, NCT04639934 . Registered Nov 23, 2020 -- Retrospectively registered.

Project description:Nigeria experiences wide heterogeneity in vaccination rates by vaccine and region. However, inequities in vaccination status extend beyond just geographic covariates. Traditionally, inequity is represented by a single metric pertaining to socioeconomic status. A growing body of literature suggests that this view is limiting, and a multi-factor approach is necessary to comprehensively evaluate relative disadvantage between individuals. The Vaccine Economics Research for Sustainability and Equity (VERSE) tool produces a composite equity metric, which accounts for multiple factors influencing inequity in vaccination coverage. We apply the VERSE tool to Nigeria's 2018 Demographic and Health Survey (DHS) to cross-sectionally evaluate equity in vaccination status for national immunization program (NIP) vaccines over the following contributing covariates: age of child, sex of child, maternal education level, socioeconomic status, health insurance status, state of residence, and urban or rural designation. We also assess equity for zero-dose, fully immunized for age, and completion of NIP. Results show that socioeconomic status contributes substantially to variation vaccination coverage, but it is not the most substantial factor. For all vaccination statuses, except for NIP completion, maternal education level is the greatest contributor towards a child's immunization status among model variables. We highlight the outputs for zero-dose, fully immunized at infancy, MCV1 and PENTA1. The percentage point gap in vaccination status between the top and bottom quintiles of disadvantage, as ranked by the composite indicator is 31.1 (29.5-32.7) for zero-dose status, 53.1 (51.3-54.9) for full immunization status, 48.9 (46.9-50.9) for MCV1, and 67.6 (66.0-69.2) for PENTA1. Though concentration indices indicate inequity for all statuses, full immunization coverage is very low at 31.5% suggesting significant gaps in reaching children after initial doses for routine immunizations. Applying the VERSE tool to future Nigeria DHS surveys can allow decisionmakers to track changes in vaccination coverage equity, in a standardized manner, over time.

Dataset Information

Medication History Lab and Assessment using the Medication Mysteries Infinite Case Tool.

Introduction

Methods

Results

Discussion

Publications

Medication History Lab and Assessment using the Medication Mysteries Infinite Case Tool.

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