By Victoria Schlesinger
The successful implementation of health care reform in the U.S. will require a significant boost in the policy literacy of all health care professionals and will require that they work together to provide their patients the best possible care at the lowest cost.
UCSF’s School of Pharmacy is not waiting for passage of national health care legislation to change the status quo. Instead, it is three years into an innovative research project to demonstrate the value of health policy education and interprofessional teamwork using the 2006 implementation of the federal Medicare Part D as the topic for peer-to-peer lectures.
In the UCSF-led statewide research program — called Partners in D — student pharmacists from seven pharmacy schools in California who are trained in the details of Medicare Part D share their expertise in special lectures for health professional students and practitioners, including physicians, nurses, nurse practitioners, and physician assistants.
“While Part D was a welcome federal health policy change, we saw that its successful application cried for the expertise of pharmacists who understood it, could manage it, knew how to help underserved Medicare patients navigate it, and could help physicians understand it in light of how they prescribed,” said Marilyn Stebbins, PharmD, UCSF School of Pharmacy clinical pharmacist and co-leader of the Partners in D program. “So, we began working with seniors directly — and also teaching our colleagues in medicine and nursing what they needed to know.”
As of March 2010, students in the seven California pharmacy schools have given 44 Medicare Part D lectures to 1,187 attendees in states across the country.
The student pharmacists explain the health policy implications of Part D, how the program is structured, and what health care providers need to know to ensure their patients get access to optimal prescription drug plans and medications. “What’s more, we bring a lot of clinical experiences to the classroom,” said student pharmacist lecturer Allison Lam.
Expanding Knowledge Nationwide
Based on a review of the published literature, the Partners in D peer-to-peer lecture program is unique, said Helene Levens Lipton, PhD, UCSF School of Pharmacy health policy expert who co-leads the program with Stebbins.
“We haven’t seen this kind of sustained innovation in the classroom anywhere. You have student pharmacists — the drug experts — teaching providers and health professional students about a federal drug policy and how they and their patients can get the most from it. We faculty could have offered this ourselves, but chose instead to put our students in front of the classroom. The dynamic is terrific.”
According to the results of a pre- and post-lecture survey filled out by 950 attendees of the lectures, about 60 percent reported having no prior instruction on Medicare Part D.
“I would venture to say that the vast majority of physicians have no idea what the basic outline of Medicare Part D is, and therefore have no ability to guide their patients through this morass,” said Alice Chen, MD, director of the internal medicine clinic at the UCSF-affiliated San Francisco General Hospital (SFGH) and Trauma Center who helped bring the lecture to SFGH twice as medical grand rounds.
UCSF student pharmacists conduct a lecture on Medicare Part D, a federal program which went into effect in 2006, but is not widely understood among health care professionals.
“With new and complex health reform imminent, training of health professional students and faculty on health policy issues is more important than ever,” said Lipton. “We have a successful model to do just that with Medicare Part D being our initial health policy focus. As millions more of the uninsured gain access to health care services, our focus on the underserved becomes especially important.”
And collaboration with pharmacists ultimately will save doctors time and produce better care, Lipton added. The combination of a primary care physician shortage, baby boomers joining Medicare, and health care reform, will require medical professionals to work together in new ways.
“At this point, we really have no choice but to look for team-based collaborations,” Lipton said. “We often pay lip service to the importance of interprofessional education. Our peer-to-peer Part D lecture delivers the goods.”
Lipton measures the program’s success by the increasing demand and positive participant responses and post-survey results, which will be presented at the Society of General Internal Medicine in April 2010.
UCSF student pharmacists have already lectured at UCSF, UC Davis, Stanford University, the University of Southern California, and at two Harvard University teaching affiliates —Massachusetts General Hospital and Beth Israel Deaconnes Hospital. They will present to internal medicine residents and faculty members at New York University, Cornell University, and Memorial Sloan Kettering medical centers in May 2010.
“The goal is not to keep our drug and medication policy knowledge to ourselves but to expand that base of knowledge to health care practitioners nationwide,” said Stebbins.
“All pharmacists are highly trained in drug interactions and side affects, an expertise that physicians commonly overlook,” said Cindy Lai, MD, assistant clinical professor in the UCSF School of Medicine and a co-investigator for Partners in D. “We’re trying to promote that it’s OK to pick up the phone and call a pharmacist. Our pharmacists are very knowledgeable; they are important in clinical medicine and in taking care of these patients on the frontlines.”
The Partners in D peer education program is part of a multi-part grant led by Stebbins and Lipton and funded by $3.7 million grant from The Amgen Foundation. The three-and-a-half year grant started in fall 2006 and has been extended through spring 2011.
For their work to improve public health, Lipton and Stebbins received the 2010 Jane Boggess Advancement of Pharmacy Practice Award from the Pharmacy Foundation of California during the California Pharmacists Association meeting in February 2010.
Stebbins and Lipton Receive Boggess Award
UCSF School of Pharmacy website