Laney Owings, Pharm.D.
PGY-2 Psychiatric Pharmacy Resident, University of North Carolina Hospitals
Over time, the profession of pharmacy has transformed from the ‘apothecaries’ of earlier centuries, to the ‘druggists’ from several decades ago, to the clinical practitioners of today. Pharmacists are making positive contributions to healthcare in more ways than ever before. They are expanding access to care and providing beneficial services to patients using novel methods, such as chronic disease management and counseling, health and wellness testing, immunizations, and transitional care services. With these additional responsibilities, pharmacists need extenders, or personnel who have the skillset to complete duties that can be overseen by the pharmacist, to maintain a high level of patient care.
Pharmacy students can be engaged as pharmacist extenders via patient medication education groups (PMEGs.) PMEGs are a way for pharmacists and student pharmacists to educate patients on fundamental medication knowledge. These groups are educational or supportive in nature, and cover a wide range of topics pertinent to persons with psychiatric disorders. At the University of North Carolina Hospitals, PMEGs are widely utilized on the psychiatric units to improve medication adherence and educate patients on the purpose of medications, side effects management, dosing, and inaccurate beliefs regarding medications. Examples of PMEGs learning methods include games, interactive activities, visual aids, group discussions, and puzzles.
Aside from the medication education aspect, PMEGs offer other benefits to patients. They allow patients to share their experiences with peers, which can be less intimidating in a group setting. Development of socialization skills is also an important advantage to patients that can be gained from PMEG involvement. PMEGs also give patients the opportunity to learn about the progressive role of pharmacists through the therapeutic relationships established. These relationships are built in a safe, trusting, and confidential environment. The patient is treated with respect, and is accepted, supported, and encouraged in a non-judgmental way.
Participating in PMEGs is not only beneficial to the patients, but also pharmacy students. Participating in and leading PMEGs offers the student the opportunity to practice communicating with patients in a hospital setting. It also provides students the opportunity to communicate with patients of all cognitive levels and mental health diagnoses. This allows the student to learn from the challenges that can be presented by this patient population. For example, students may encounter a disruptive behaviors, short attention spans, over-active or under-active participation, low literacy, or poor insight into illness. The pharmacy student learns that these communication skills will be useful in many different pharmacy practice areas, as patients with mental health disorders are not solely encountered in the inpatient psychiatric setting. Involvement in PMEGs improves student understanding of mental illnesses and reduces the stigma often associated with mental illness. Additionally, leading PMEGs allows students to impact a larger number of patients, and thus improves access to care for patients with mental illness.
Pharmacy students of any year in their curriculum are incorporated into the PMEG model. PY1 students are permitted to shadow and design content. PY2 and PY3 students may do the above and deliver content with a preceptor present. PY4 students on rotation participate in content design, delivery, and documentation in the medical record. This experience gives the fourth year student an opportunity to practice using psychiatric terms to characterize behavior and appearance. Writing notes documenting patient participation also allows the student to quantify medication effects, either adverse or beneficial.
Benefits from student involvement in PMEGs do not end with that provided to the patient and the student. The hospital also benefits from this service as student involvement increases the number of PMEGs that can be delivered, and thus increases the number of patients impacted. Incorporating students into PMEGs has allowed the hospital to expand services and has increased access to quality healthcare.
Student involvement in PMEGs provides numerous benefits to the patients, the students, and the healthcare system. As you consider PMEGs at your institution, do not forget the role students can play in this initiative.