Ambulatory Care Practice Rotation
Advanced Pharmacy Practice Experience (APPE)
Offered in a variety of ambulatory care settings, to include clinics and physician office practices, this experience emphasizes primary care using a case management approach with an out-patient population, to include: patient data collection, organization, and assessment; development of care plans that correspond to desired therapeutic objectives; patient monitoring, to include physical and laboratory assessment; communication with patients (and care givers) to acquire patient data, assess target outcomes and provide education and communication with prescribers, and other health care providers to optimize outcomes. Provision of preventive health education and screening services is expected in most settings.
Task List for Ambulatory Care Rotations
A list of specific tasks has been established for each of the core rotations to serve as a guide to the minimum requirements necessary to demonstrate competency. Provided below are samples of a few of the tasks defined for each specific core experiential rotation. (Note: Completion of this activity or task may be dependent on site expectations, practice of the preceptor and expectations of the preceptor. Reasonable effort should be made to accomplish these tasks when possible.)
- For all assigned patients, review the patient’s medical record and when possible conduct an interview. Evaluate current medication regimens and monitoring history. Be prepared to make therapeutic & monitoring recommendations. Be prepared to recommend & assess all new medication prescriptions.
- On selected patients, complete a detailed medication history. Assess achievement of treatment outcomes, ADRs, compliance etc. Make recommendations regarding drug therapy assessment and justify any proposed changes or interventions to preceptor or primary care provider.
- Assess doses for all applicable medications regarding renal function, pharmacokinetic evaluation of serum concentrations (if available) and other quantitative monitoring parameters (e.g. INR, blood glucose, etc): make dose or drug selection recommendations based on assessments.
- Prepare and present patients to preceptor (Pharmacotherapy Rounds): List patient problems, drug therapy, monitoring parameters, therapeutic end-points, dosage, potential ADRs and interactions. Discuss appropriateness of current and alternate medication therapies.