Pharm. D. candidate Sumit Patel said that during his 4-week rotation in a CVS store in Richmond, Ind. last September, the question, “Do you have any insurance?” was answered “no” as many times as the question, “Do you have a drug allergy?”

The majority of patients in this rural area of Indiana have Medicaid or self pay for their medications. They’re part of an underserved population of people and one that the College of Pharmacy and Health Sciences (COPHS) wants their students to better understand.

“We (the College) believe that students cannot truly appreciate the situation a patient is in until they meet them where they live,” said Associate Pharmacy Professor Carriann Richey-Smith.

Since receiving a $25 million grant from Lilly Endowment Inc. in 2006, COPHS has been seeking opportunities for their Pharm.D. candidates to spend a minimum of four weeks (or one rotation) at an experiential site in an area designated as medically underserved. For the 2009-2010 academic year, 95 percent of students had performed at least one of these rotations.

To help increase the number of medically underserved rotation sites, in July 2010, COPHS started providing housing for students during their rotation in four Indiana counties – Parke, Scott, Vermillion and Wayne, where Richmond is located. These counties were chosen as a result of a three-year COPHS research study called R.E.A.C.H. – Resources to Enhance the Achievement of Community Health.

Through R.E.A.C.H., the College identified areas of Indiana receiving a federal designation for a shortage of healthcare professionals, and then surveyed the professionals and patients in each area to learn about the role of a pharmacist. Parke, Scott, Vermillion and Wayne counties were selected as the final sites because they were the most medically underserved, especially with regard to the number of pharmacists practicing there.

“We thought that our student pharmacists could play a significant role in not only helping patients, but in bringing awareness to the importance of improving public health in these counties,” said Richey-Smith.

And, they have.

In addition to spending time at the CVS store in Richmond, Patel – and the students that have come before and after him – worked at the Wayne County Health Department, a location that has never before had pharmacist involvement.

“It was a learning opportunity for them and us,” said Mona Dunckel, a Licensed Practical Nurse with the clinic. “I didn’t know how educated a pharmacist was and that we could ask a whole lot more help from them.”

At the clinic, that serves approximately 1,000 indigent patients, many of whom can’t pay for medication, students help educate patients about disease states and medication, order medications from patient assistance programs, call in medication refills, and even shadow the doctors.

To aid in patient compliance, Pharm.D. candidate Amy McManness designed a prototype medication information log that consisted of the patient’s personal information, allergies, vaccinations, doctor information, and a list of their over-the-counter and prescription medications.

“It’s really critical for pharmacists to stress the importance of compliance to prevent long-term damage from some chronic conditions,” said McManness.

At the CVS, students learn about the various drug discount programs across the state, as well as CVS’ own prescription savings program. They help fill out paperwork for drug assistance programs and submit it on behalf of patients, take and make doctor’s calls, fill prescriptions, and counsel patients on disease states and medication use.

Roger Mapes, CVS pharmacy manager and adjunct COPHS faculty member and preceptor, explained that one of the students was amazed that so many patients identified $0 as their income. “She couldn’t fathom how someone could exist with $0 income,” he said.

“Most of these students have not worked in an underserved area before. This rotation experience really gives them a view of the real world,” he said.

Media contact: Courtney Tuell317) 940-9807ctuell@butler.edu

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