Social and Administrative Sciences in Pharmacy Division, University of Wisconsin-Madison School of Pharmacy, United States.
PGY2 Pharmacy Resident - Ambulatory Care Setting, University of Iowa Hospitals and Clinics, United States.
Curr Pharm Teach Learn. 2021 Feb;13(2):146-151. doi: 10.1016/j.cptl.2020.09.006. Epub 2020 Oct 12.
This study explored the effect of a structured educational intervention for student pharmacists to counsel limited English proficiency (LEP) patients on risks and safety of opioid medications for chronic pain. Specific aims were to compare 2018 pre-intervention versus 2019 post-intervention groups regarding: (1) dose and side effects discussed, (2) opioid risks and safety measures covered, and (3) LEP specific communication practices.
Third-year student pharmacists (P3s) in a required communications course consulted LEP standardized patients (SPs) on opioid medications in 2018 and 2019. An educational intervention for the 2019 P3s consisted of a 50-min lecture, pre-lab instructions about techniques for communication about opioid risks and safety, and for LEP specific communication stressing teach-back. All consultations in the pre- and post-intervention phases were video recorded and quantitatively coded for verbal and non-verbal communication skills. Descriptive statistics and Fisher's exact tests were conducted on data.
Twenty-three consultations were recorded in 2018 for the pre-intervention phase and 49 consultations were recorded in 2019 for the post-intervention phase. Only 17% of students in the pre- intervention phase called the medication an "opioid" or "narcotic" in the consultation as compared to 84% in the post-intervention phase. While 100% of students in the post-intervention phase used teach-back, only 61% did so in the pre-intervention group. Significant differences between the two groups were observed for minimizing dependency and overdose, offering naloxone, teach-back, integrating a patient handout into the consultation, and discussing use of alternate pain medications.
本研究探讨了一项针对学生药剂师的结构化教育干预措施，以指导他们为有限英语水平（LEP）患者提供有关阿片类药物治疗慢性疼痛的风险和安全性方面的建议。具体目标是比较 2018 年干预前组和 2019 年干预后组在以下方面的差异：（1）讨论的剂量和副作用，（2）涵盖的阿片类药物风险和安全措施，以及（3）针对 LEP 患者的特定沟通实践。
在一门必修沟通课程中，三年级学生药剂师（P3）在 2018 年和 2019 年与 LEP 标准化患者（SP）就阿片类药物进行了咨询。针对 2019 年的 P3 学生，教育干预包括 50 分钟的讲座、关于沟通阿片类药物风险和安全以及针对 LEP 患者的特定沟通技巧（强调“回授教学法”）的预实验指导。在干预前和干预后阶段的所有咨询都进行了视频记录，并对言语和非言语沟通技巧进行了定量编码。对数据进行了描述性统计和 Fisher 精确检验。
在干预前阶段记录了 23 次咨询，在干预后阶段记录了 49 次咨询。在干预前阶段，只有 17%的学生在咨询中称药物为“阿片类药物”或“麻醉性药物”，而在干预后阶段，这一比例上升至 84%。尽管在后干预组中 100%的学生使用了“回授教学法”，但在前干预组中，只有 61%的学生使用了这种方法。在后干预组中，在最小化依赖性和过量、提供纳洛酮、使用“回授教学法”、将患者手册纳入咨询以及讨论替代疼痛药物的使用方面，两组之间存在显著差异。
