Integrating Pharm.D. Education with University Pharmacies for Supporting Coverage of Diabetes and Hypertension Screening in Thai

Communities Ploylearmsang C.1 Sookaneknun.1 , Poophalee T1., Pongruea P.1 1:Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Thailand

IntroductionMain mission of Doctor of Pharmacy (Pharm.D.) education of Mahasarakham University (MSU), Thailand is to produce qualified

pharmacist who is able to integrate knowledge into real practice in community. One of activities of accredited university drugstore as a primary care provider is screening diseases. In 2009, Ministry of Public Health (MoPH) set a national campaign on

diabetes and hypertension screening in people aged ≥35 years in Thai communities. With low screening coverage due to unwillingness and unconcern of community, integrating education with role of university pharmacies on diabetes and

hypertension active screening were proposed to support both policy and school mission.

Objective

Methods

Results

Faculty of PharmacyMSU

Acknowledgements: Acknowledgements: Thank you for Financial support from The Health Promotion Foundation, and contribution from all personnel of Faculty of Pharmacy, MSU

3rd year(Good health starts at home)

to create the active screening by integrating Pharm.D. Education with University Pharmacies which could support the coverage of diabetes and hypertension screening in university communities

A 3-month prospective experimental study under the cooperation among faculty of pharmacy MSU, 2 university pharmacies and community hospitals 184 of 3rd year Pharm.D. students in a course of Integration1 were trained about diabetes and hypertension screening procedure and skill on community visit by pharmacist in university pharmacy and senior students. Students’ knowledge and skill were assessed after 3-time training and comparing with 160 of the 2nd year students as a control group After training, one student had to visit and screen a person aged≥35 years in community and persuading screened people with high risk factors to visit pharmacist in university drugstore for disease symptom confirmation and physician in hospital for diagnosis The coverage of this active screening was collected

Part I: General characteristics of samples

Students’ characteristics

Number (%)Experimental gr

3rd yr students (n=

184)

Control gr

2nd yr students (n=40)

4th yr students (n=40)

Gender Female MaleAccommodation Location In Municipality Out of MunicipalityMonthly Allowance ≤ 5,000 Baht 5,001 – 10,000 Baht 10,001 – 20,000 BahtParents status Have parents (both dad and mom) Single dad or Single mom Parents dead Age (years) (Mean±SD)

152 (82.6) 32 (17.4)

85 (46.2)97 (52.7)

82 (44.6)95 (51.6)5 (2.7)

157 (85.3)55 (29.9)1 (0.54)

20.9±0.63

35(87.5)5(12.5)

23 (60.5)15 (39.5)

22 (55.0)17 (42.5)1 (2.5)

38 (95.0)2 (5.0)

019.8±1.59

35 (87.5)5 (12.5)

30 (76.9)9 (23.1)

20 (50.0)20 (50.0)0 (0.0)

34 (85.0)6 (15.0)

021.7±0.47

Part II: Knowledge scores: Diabetes mellitus and Hypertension between Experimental group and Control group

Knowledge score

Mean ± SD p value*Experimental group 3rd yr

students (n= 184)

Control group3rd yr

compared with 2nd yr

3rd yr compared with 4th yr

2nd yr students (n=40)

4th yr students (n=40)

Diabetes Knowledge(10 items, 0-10 score)

9.52 ± 0.327.53 ± 2.58

9.60 ± 0.49

0.038** 0.655

Hypertension Knowledge(10 items, 0-10 score)

9.50 ± 0.438.10 ± 1.89

9.70 ± 0.37

0.046** 0.283

Part III: Screening and Community Visit Skills, and Suitable Manner Score between Experimental group and Control group

Skill score

Mean ± SD p value*Experimental group 3rd yr

students (n= 184)

Control group3rd yr

compared with 2nd yr

3rd yr compared with 4th yr

2nd yr students (n=40)

4th yr students (n=40)

Screening Skill and Community Skill(10 items, 0-10 score)

7.59 ± 2.486.15 ± 3.00

8.08 ± 2.22

0.161 0.569

Suitable Manner during screening in community (5 items, 0-5 score)

4.45 ± 0.243.95 ± 0.10

4.93 ± 0.11

<0.001 <0.001

*tested by Mann Whitney U test

*tested by Mann Whitney U test

Part IV: Attitude on community visit and Self-esteem on Diabetes and Hypertension Knowledge between Experimental group and Control group

Attitude score

Mean ± SD

3rd yr compared with 2nd yr

3rd yr compared with 4th yr

Experimental group

3rd yr students (n= 184)

Control group2nd yr

students

(n=40)

3rd yr students

(n=40)

Good Attitude on practice in community (VAS 0-10 score)

7.55±1.86 6.62±1.59 7.62±2.37 0.302 0.841

Self-esteem on knowledge of Diabetes and Hypertension screening (VAS 0-10 score)

6.71±1.57 4.19±1.91 6.74±1.63 0.117 0.934

Part VI: Satisfaction of people in community on students’ service

Satisfaction items

Number (%)

Mean (SD)

% population with high to highest

level satisfactio

n

Highest satisfied

Highsatisfied

Moderate

satisfied

1.I am satisfied on student’s communication skill with clear and easily understanding dialog

49 (100.0)

0 0 5.00 (0) 100.0

2. I am satisfied on student’ clearly explanation in all steps of screening

39 (79.6) 9 (18.4) 1 (2.0)4.78

(0.47)98.0

3. I am satisfied on student’s invitation and persuasion my family to diabetes and hypertension screening campaign

4 (89.8) 5 (10.2) 04.90

(0.31)99.8

4. I am satisfied on student’s suitable and clean uniform

41 (83.7) 7 (14.3) 1 (2.0)4.82

(0.44)98.0

5. I am satisfied on student’s behavior and his manner during community visit

44 (89.8) 4 (8.2) 1 (2.0)4.88

(0.39)98.0

6. I am satisfied on students’ information transfer about community health and diabetes and hypertension screening

39 (79.6)

9 (18.4)

1 (2.0)

4.78 (0.47)

98.0

7. In total, I am satisfied on this students’ project for my community 46(93.9) 3(6.1) 0 4.94(0.24) 100.0

Part VII: Effectiveness of the project: %Screening coverage improvement and %coverage compared with MoPH target

Screening technique

Number of screened person

Effectiveness of this project

Passive screening

Active screening

% of Screening Coverage Improvement

People aged ≥35 years 1,043 1,043Average per month (person/month) 41 127 209.8%% Coverage in six months(MoPH target at >60%)

23.59% 73.06%

Part V: Students’ idea on the project Student 11 “…I am glad to join in this project and con be one person who can help people in the community, this project makes me close to the community, see the health problem and really touch the community …”Student 3 “…I like this project, it can help pharmacy student understand real health problem and give our contribution to the community…” Student 13 “…This project help me to have more community skill, I know how to work with people in the community step by step…”Student 17 “…I am used to be a bad communicator especially with the older person because I am so shy, this project encouraged me to talk more and finally I can improve myself on communication skill…” Student 19 “…I gain a lot of experience and be so happy, we and people in the community have set health plan together, then we are both happy, this project enhances students’ harmony, students’ understanding about community, community’s understanding about students and our education and we are so happy with a good cooperation with many stakeholders for giving health care to the community …”

ConclusionActive screening from integrating pharmacy education and academic service by university pharmacy could fulfill the national policy and mission of pharmacy education institute.

*tested by Mann Whitney U test