Ambulatory Care

Student pharmacist prepares an IV

Patient Criteria

  • Variety of adult, geriatric, and/or pediatric patients.
  • Commonly encountered disorders include the following:
    • Diabetes mellitus
    • Hypertension
    • Hyperlipidemia
    • Obesity
    • COPD
    • Smoking cessation
    • Anticoagulation management (atrial fibrillation, DVT, PE, etc.)
    • Common ambulatory infectious disorders (otitis media, UTIs, cough/cold, etc.)
    • Asthma/Allergic rhinitis
    • Depression/Anxiety
    • Pain management (back, sprains, strains, headache, osteoarthritis, etc.)
    • GI (GERO, N&V, constipation, diarrhea)
    • Common dermatological disorders
    • Women’s health (birth control, vaginitis, hormone therapy, incontinence)
    • Immunizations
    • Congestive heart failure
    • Men’s health (erectile dysfunction, BPH, incontinence)
    • Osteoporosis

Preceptor Criteria

  • Pharmacist with credentials which provide evidence of expertise in primary care and/or ambulatory care (e.g., BCPS, BCACP, primary or ambulatory care residency, COE, MTM certification) or equivalent practice experience with at least 2 years’ experience as a practicing pharmacist.
  • Provides patient-centered care/disease management (e.g. anticoagulation monitoring, diabetes management)
  • Actively participates as a member of the patient-care team.
  • Promotes continuity of care and wellness in addition to pharmacotherapy/medication therapy management.

Site Criteria

  • A primary care or ambulatory care clinic where patients present with disorders/diseases listed in the syllabus (at least 50% of the disorders/diseases are likely to be encountered by the student).
  • The unit uses a team-based approach or other inter-professional (or interdisciplinary) approach to patient care.
  • The site has a sufficient number of patients such that the student will be involved in direct patient care activities at least 50% of the time.
  • The site provides opportunities for face-to-face interactions with patients and providers at least 50% of the rotation experience. Interactions should offer students the opportunity to interview and counsel patients as well as present medication related recommendations to providers on a regular basis.
  • The site has sufficient space available (patient appointment room, etc) so the pharmacist and student can interview the patient and provide patient education.

Required Course Activities

To achieve the learning objectives, students completing the Ambulatory Care Advanced Pharmacy Practice Experience should complete the following activities/assignments:

  1. Perform and document, as appropriate to the practice site, patient medication histories as assigned by the preceptor.
  2. Perform patient medication counseling sessions as assigned by the preceptor.
  3. Present at least one formal patient case presentation, including analysis and interpretation of the primary medical literature as it applies to the case. The audience will be selected by the preceptor
  4. Present a journal club presentation, including analysis and interpretation of the primary medical literature.
  5. Complete at least two written drug information responses using appropriate institutional documentation or the Clinically Answerable Question Intake/Tracking Form.
  6. Demonstrate the ability to perform at least two of the following procedures on an ambulatory patient:
    • Blood pressure measurement
    • Radial and/or femoral pulse
    • Body weight
    • Body temperature
    • Point of care test: blood glucose and INR
    • Diabetic foot exam, when applicable to rotation site
  7. Discuss with preceptor the treatment of the following common ambulatory care patient conditions, with discussions based on actual or simulated patient cases and/or drug therapy problems:
    • Diabetes mellitus
    • Hypertension
    • Pulmonary disease (asthma, COPD)
    • Dyslipidemia
    • Heart failure
    • Atherosclerotic Cardiovascular Disease (ASCVD)
    • Anticoagulation
  8. Prepare pharmacist patient care plans* (SOAP notes, chart progress note, etc.) in a concise, organized, and clear format to be included in the patient record as permitted in the practice site.  Each care plan should focus on at least one of the following common ambulatory disease states, however documentation should address all active problems:
    • Diabetes mellitus
    • Hypertension
    • Pulmonary Diseases (Asthma, COPD)
    • Dyslipidemia
    • Heart Failure
    • Atherosclerotic Cardiovascular Disease (ASCVD)
    • Anticoagulation