Second and third-year pharmacy students enrolled in the Ambulatory Care Pharmacy Elective spent the past month learning about the difficulties of medication adherence first-hand. Nineteen students were given a pillbox and 15 candies representing medications with various schedules of administration. Students were required to fill their pillbox according to their medication list. At the midpoint, students were given two medication changes mimicking real-life scenarios. Following the four-week project, students submitted a focused reflection and discussed the experience with their classmates. Students consistently deemed the pillbox experience a positive one.

Second-year pharmacy student Erin Todd said, “Beyond getting to enjoy my favorite candy (Juicy Pear Jelly Belly®) twice a day, I enjoyed having the experience to put myself in a patient’s position. This project was highly effective in increasing my awareness of the difficulty of medication adherence and the complications of pill burdens. We have the advantage of missing medications that are only sugar, while the consequences of our patients missing a dose is much more serious.”

Chris Conkling, another second-year pharmacy student, said, “It has given me a greater sense of perspective for what some of our patients have to deal with. And, if nothing else, it has made me more conscious about my own health, as I have no desire to have to go through this experience with actual prescriptions. I really enjoyed how this project truly immersed me into a patient’s daily routine. I feel that I got a real sense of how their day would go along with all the struggles of balancing a life outside of the medications.”

Third-year pharmacy student Sara Rower, who will begin her Advanced Pharmacy Practice Experiences in May, said, “From the very first day of the project, I was already having difficulties remembering to take my doses consistently. One day and I was already having trouble- and most patients are on this many medications their whole lives. That was a real ‘ah-ha’ moment. Adherence and compliance are always concepts that we stress and emphasize to our patients but, up to this point, I could never really relate. Even though this was just a simulation, I have much more sympathy for patients taking multiple medications.”

Dr. Ashton Beggs, the course coordinator of the elective, was pleased with the students’ response to the assignment

“When patients are not adherent to their medication regimen, it can lead to adverse and costly health outcomes,” Beggs said. “Completion of this assignment allows students to empathize and identify with patients leading to better patient relationships and  ultimately improved healthcare for the patient.”

Students enrolled in the Ambulatory Care Pharmacy elective spend the spring semester focusing on topics pertinent to primary care, including financial considerations, patient education, health literacy, technology available to patients and health care providers, and medication adherence. Common primary care disease states, such as diabetes, hypertension and asthma, and pharmacists’ impact on the treatment and understanding of these conditions have been addressed in the course as well.

Fourth-year pharmacy student Shaneika Walker and pharmacy faculty member Ashton Beggs recently returned from a one-week medical mission trip to Gobert, Haiti. Walker was selected for this Advanced Pharmacy Practice Experience (APPE) last spring. Under the supervision of Beggs, Walker was involved in all medication-related aspects of the trip planning, which began summer 2013. The medical team purchased medications from Blessings International, and it was the responsibility of the pharmacy student and pharmacist to decide which medications and the appropriate quantities to order to treat the variety of disease states encountered. Medications were packaged and labeled appropriately for shipping to Haiti for both the general and health literacy of the Haitian population.  While in Gobert, Walker and Beggs were in charge of dispensing medications and counseling patients on each medication dispensed.

Walker and Beggs involved other pharmacy students in the trip preparation. During fall 2013, Belmont students had the opportunity to donate Tylenol® to be sent to Haiti for the medical mission. In addition, several volunteer opportunities were offered to pharmacy students to help count, package, and label the medications prior to shipment.

“Working with the Belmont community to help the people of Gobert was a valuable experience for all involved,” Walker said. “The trip was truly an amazing learning experience. For this APPE, I was able to apply pharmacotherapy knowledge from previous coursework while also expanding upon my knowledge of cultural sensitivity in a healthcare setting.”

Over 2,300 patients were cared for during this trip, which was organized and planned by St. Matthew Catholic Church in Franklin, Tenn. St. Matthew’s is affiliated with the Lady of Miracles Catholic Church in Gobert, Haiti through the Catholic Parish Twinning Program. St. Matthew’s serves the community of Gobert with agricultural assistance, livestock initiatives, clean water and medical care.

A medical team from St. Matthew’s has visited Gobert annually for the past eleven years to spread the love of Christ by addressing health care needs of the community. A full-time Haitian physician cares for the community throughout the year and works closely with St. Matthew’s. In 2014, the medical team consisted of physicians, nurses, dentists, pharmacists, an information technology expert, malaria researchers, engineer and other ancillary staff. Interpreters were utilized to communicate with the patients. An electronic medical record via iPads was utilized to collect data on this population and track changes in patient health.

Beggs plans to continue to offer this APPE to a fourth-year pharmacy student each January.