Authors :
Presenting Author: H. Steve White, PhD, BPharm – Center for Epilepsy Drug Discovery, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA
Michelle Guignet, PhD – Acting Assistant Professor, Center for Epilepsy Drug Discovery, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA; Edward Novotny, M.D. – Professor of Neurology and Pediatrics, School of Medicine, University of Washington; Seattle Children's Hospital, Seattle, WA, USA; Andy Stergachis, PhD, MS, BPharm – Professor of Pharmacy and Global Health; Associate Dean for Research, Graduate Programs and New Initiatives, School of Pharmacy & School of Public Health, University of Washington, Seattle, WA, USA; Sabra Zaraa, PhD, PharmD, MPH – Postdoctoral Fellow, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA; Ifechukwu Benedict Nwogu, B.S. – PhD Student, School of Pharmacy, University of Washington, Seattle, WA, USA; Derek Ems, MPH, CPHQ – HEOR Specialist, UCB Pharma, Smyrna, GA, USA; Jennifer Bacci, PharmD, MPH – Endowed Associate Professor of Innovative Pharmacy Practice, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA
Rationale:
Incorporating pharmacists into interdisciplinary healthcare teams can improve patient outcomes across disease states. However, there is little published evidence about pharmacists’ contributions to epilepsy care. Previous work from our group revealed that community pharmacists are well positioned to serve as patient advocates, monitor medications, and provide education for people living with epilepsy. However, pharmacists wished to receive additional training in epilepsy management. Advanced training in neurology is not a practical approach for community pharmacists who engage daily with patients having a variety of conditions and medications. We therefore developed and evaluated a flexible, community pharmacist-centered training program to update and improve both confidence and competence in delivering epilepsy care.
Methods:
The training program consists of five, one-hour self-paced online modules and two, 90-minute synchronous virtual sessions. Topics include the classification of epilepsies, comorbid conditions, antiseizure medicine (ASM) therapy, special populations (pregnancy, people of childbearing potential, older adults), seizure emergencies and SUDEP, and social determinants of health. The training program was provided to 6 pharmacists practicing in two community pharmacies in Washington State and delivered over six weeks (average one to two hours/week). Evaluation of learning was assessed using a pre- and post-training questionnaire. Questions were separated into mastery (n = 18) assessment and confidence (n=16) assessment of the material.
Results:
The training program did not significantly change pharmacists’ mastery of the material. Pharmacists had an average correct response rate of 84% [range: 33-100%] on all questions in the pre-test and 90% [range: 50-100%] upon completion of the post-test. Based on a scale of 1 (not at all confident) to 4 (extremely confident), pharmacists’ confidence of the material significantly improved in 14 of the 16 areas that were evaluated with an average of 1.73 (not/somewhat confident) before the program and 3.07 (confident) after completion (p< 0.01). Pharmacists’ mastery and confidence were strongest in areas around ASM management, SUDEP and seizure emergencies, people of child-bearing potential and older adults with epilepsy, and comorbidities, whereas social health disparities in epilepsy care remained an area that required further training.