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

1
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 1Social Pharmacy Research Unit,
Faculty of Pharmacy, Mahasarakham University,
Thailand
Introduction Main 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
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
Methods

• 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 aged35 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

Results
Part II Knowledge scores Diabetes mellitus and
Hypertension between Experimental group and
Control group
Part I General characteristics of samples
Students characteristics Number () Number () Number ()
Students characteristics Experimental gr 3rd yr students (n 184) Control gr Control gr
Students characteristics Experimental gr 3rd yr students (n 184) 2nd yr students (n40) 4th yr students (n40)
Gender Female Male Accommodation Location In Municipality Out of Municipality Monthly Allowance 5,000 Baht 5,001 10,000 Baht 10,001 20,000 Baht Parents status Have parents (both dad and mom) Single dad or Single mom Parents dead Age (years) (MeanSD) 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) 20.90.63 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) 0 19.81.59 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) 0 21.70.47
Knowledge score Mean SD Mean SD Mean SD p value p value
Knowledge score Experimental group 3rd yr students (n 184) Control group Control group 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Knowledge score Experimental group 3rd yr students (n 184) 2nd yr students (n40) 4th yr students (n40) 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Diabetes Knowledge (10 items, 0-10 score) 9.52 0.32 7.53 2.58 9.60 0.49 0.038 0.655
Hypertension Knowledge (10 items, 0-10 score) 9.50 0.43 8.10 1.89 9.70 0.37 0.046 0.283
tested by Mann Whitney U test
Part III Screening and Community Visit Skills,
and Suitable Manner Score between Experimental
group and Control group
Skill score Mean SD Mean SD Mean SD p value p value
Skill score Experimental group 3rd yr students (n 184) Control group Control group 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Skill score Experimental group 3rd yr students (n 184) 2nd yr students (n40) 4th yr students (n40) 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Screening Skill and Community Skill (10 items, 0-10 score) 7.59 2.48 6.15 3.00 8.08 2.22 0.161 0.569
Suitable Manner during screening in community (5 items, 0-5 score) 4.45 0.24 3.95 0.10 4.93 0.11 lt0.001 lt0.001
Part VI Satisfaction of people in community on
students service
Satisfaction items Number () Number () Number () Mean (SD) population with high to highest level satisfaction
Satisfaction items Highest satisfied High satisfied Moderate satisfied Mean (SD) population with high to highest level satisfaction
1.I am satisfied on students 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 students invitation and persuasion my family to diabetes and hypertension screening campaign 4 (89.8) 5 (10.2) 0 4.90 (0.31) 99.8
4. I am satisfied on students suitable and clean uniform 41 (83.7) 7 (14.3) 1 (2.0) 4.82 (0.44) 98.0
5. I am satisfied on students 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
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 Mean SD Mean SD 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Attitude score Experimental group 3rd yr students (n 184) Control group Control group 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Attitude score Experimental group 3rd yr students (n 184) 2nd yr students (n40) 3rd yr students (n40) 3rd yr compared with 2nd yr 3rd yr compared with 4th yr
Good Attitude on practice in community (VAS 0-10 score) 7.551.86 6.621.59 7.622.37 0.302 0.841
Self-esteem on knowledge of Diabetes and Hypertension screening (VAS 0-10 score) 6.711.57 4.191.91 6.741.63 0.117 0.934
tested by Mann Whitney U test
Part V Students idea on the project
Part VII Effectiveness of the project
Screening coverage improvement and coverage
compared with MoPH target
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, communitys 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
Screening technique Number of screened person Number of screened person Effectiveness of this project
Screening technique Passive screening Active screening of Screening Coverage Improvement
People aged 35 years 1,043 1,043
Average per month (person/month) 41 127 209.8
Coverage in six months (MoPH target at gt60) 23.59 73.06
Conclusion Active screening from integrating
pharmacy education and academic service by
university pharmacy could fulfill the national
policy and mission of pharmacy education
institute.
Acknowledgements Thank you for Financial support
from The Health Promotion Foundation, and
contribution from all personnel of Faculty of
Pharmacy, MSU