Senior care clerkship: an innovative collaboration of pharmaceutical care and learning

To describe an advanced senior care practice experience (clerkship) that provides geriatric specialty training and outreach services.

Assisted living facility (ALF) and an adjoining medical clinic.

This report describes an experiential training program for doctor of pharmacy students taking place in a multidisciplinary setting involving a multiethnic population.

Students participate in activities in three settings--ALF, community, and ambulatory clinic. In the ALF, students conduct medication regimen review and provide recommendations in medication therapy, administer influenza vaccinations and participate in staff education. Clinic-based training includes anticoagulation, asthma, and diabetes management. Community outreach activities include hypertension monitoring, brown-bag medication reviews, and home visits.

Documentation of students' participation and pharmaceutical care activities included the number of letters, and the number and types of medication recommendations sent to the providers, the providers' response to these recommendations, the changes in immunization rates, and number of older adults who received care from the students.

Twenty-four students completed the clerkship over three years. They sent 154 letters to 50 physicians with 287 recommendations involving the care of 118 ALF residents and improved the average annual vaccination rate in the ALF to 68%, compared with zero before student involvement. In the clinic, students provided services to 125 patients under a preceptor's supervision during a 30-month period. In the community setting, a weekly average of 35 elders participated in student-conducted pharmaceutical activities.

Overall, the clerkship was a successful collaboration of learning and provision of care. The students were successful in improving the medication therapy of senior adults in the three settings.