Type of Submission
Poster
Keywords
Penicillin allergy, clinic, pharmacy student, cost efficiency, time efficiency
Proposal
Background
Penicillin, a beta-lactam antibiotic, is widely used for its efficacy and safety. About 10% of the U.S. population report a penicillin-derived allergy, often leading to alternative antibiotic use. Pharmacists play a key role in patient education and penicillin allergy testing. However, the impact of these services may be limited by barriers such as time, personnel, and cost. Pharmacy students may support ambulatory care clinics by performing tasks typically handled by pharmacists, allowing pharmacists to focus on other care areas.
Objectives
The primary objective of this study was to determine if pharmacy students are a cost efficient alternative to pharmacists in a pharmacist-led penicillin allergy clinic. The secondary objective was to determine if pharmacy students are a time efficient alternative to pharmacists in a penicillin allergy clinic.
Methods
In this retrospective cohort study conducted at Miami Valley South Hospital Clinic in Dayton, Ohio, researchers reviewed data for patients who were referred to a penicillin allergy clinic from December 1, 2022 to November 30, 2023. The pharmacist-led program practices under a collaborative practice agreement, with advanced pharmacy practice (APPE) and intermediate pharmacy practice (IPPE) students working together in the clinic to assist patients. Twenty student pharmacists and one pharmacist participated in this study. Data collection included the pharmacist or student performing the test, the type of allergy test, test duration in hours, number of skin test attempts, number of errors made during the appointment, interventions made, time spent counseling patients, cost of supplies for training students, time spent calling patients, call success rate, and percent of allergies delabled. An excel spreadsheet was used to track each collection point per appointment.
Data analysis included descriptive statistics to determine statistical differences. Cost was determined by the addition of cost per supply used, as well as the pharmacist’s hourly salary.
Criteria for inclusion included patients who were referred to the clinic during the study interval, seen by a student pharmacist or pharmacist. Exclusion criteria were patients who were seen by a pharmacy resident or if they fell outside of the study timeframe.
Results
A total of 15 intermediate pharmacy practice experience (IPPE) students, 5 advanced pharmacy practice experience (APPE) students, and 1 pharmacist were included in the study. Students saved the clinic a net $5,567 in total over 9 months, while using the pharmacist hourly rate and deducting training supply cost and pharmacist time spent to train. Broken down more specifically, for phone calls, students saved $5,059. IPPE students spent 2,786 minutes on calls, while APPE students spent 2,273 minutes. Students spent more time making calls when compared to the pharmacist, as the pharmacist spent a total of 1,449 minutes.. For scratch tests, students saved $512. For intradermal tests, students saved $665. For discharge counseling, students saved $420.
Students spent 4.04 (IPPE: 4.37 ; APPE: 3.71) minutes/phone call, while pharmacists spent 4.75 minutes/phone call. Students successfully scheduled an appointment per phone call encountered 22.32% (IPPE: 19.73% ; APPE: 24.90%) of the time while the pharmacist was successful 39.66% of the time. Students removed penicillin allergies per phone call encounter 5.54% (IPPE: 6.02% ; APPE: 5.06%) of the time while pharmacists removed allergies 5.59% of the time.
Students took an average of 4.99 minutes/scratch test encounter (IPPE: 4.39 ; APPE: 5.59) while pharmacists took 6.11 minutes/encounter. For intradermal encounters, students took an average of 6.24 minutes (IPPE: 4.78 ; APPE: 7.70) while pharmacists took 7.44 minutes/encounter.
Students averaged a 25.05% (IPPE: 4.65% ; APPE: 45.45%) intradermal miss stick rate while pharmacists averaged 28%. Additionally, students averaged 3.21 (IPPE: 2.86 ; APPE: 3.55) minutes/discharge encounter while pharmacists averaged 3.30 minutes/encounter.
Conclusion
Students are cost-efficient when assisting in a pharmacist-led clinic. Although they require training and supervision, they are able to perform tasks and allow pharmacists to work on other necessary duties. This study determined that students saved a net $5,567 in total over 9 months. The study also found that students were more efficient at performing skills such as discharge counseling and phone calls, allowing pharmacists time for other tasks. This information can help guide pharmacy managers into involving students in clinics to give them more experience, while saving money.
Copyright
© 2025 Allison P. Belmont. All rights reserved.
Publication Date
2-8-2025
Cost Efficiency of Pharmacy Students in a Penicillin Allergy Clinic
Background
Penicillin, a beta-lactam antibiotic, is widely used for its efficacy and safety. About 10% of the U.S. population report a penicillin-derived allergy, often leading to alternative antibiotic use. Pharmacists play a key role in patient education and penicillin allergy testing. However, the impact of these services may be limited by barriers such as time, personnel, and cost. Pharmacy students may support ambulatory care clinics by performing tasks typically handled by pharmacists, allowing pharmacists to focus on other care areas.
Objectives
The primary objective of this study was to determine if pharmacy students are a cost efficient alternative to pharmacists in a pharmacist-led penicillin allergy clinic. The secondary objective was to determine if pharmacy students are a time efficient alternative to pharmacists in a penicillin allergy clinic.
Methods
In this retrospective cohort study conducted at Miami Valley South Hospital Clinic in Dayton, Ohio, researchers reviewed data for patients who were referred to a penicillin allergy clinic from December 1, 2022 to November 30, 2023. The pharmacist-led program practices under a collaborative practice agreement, with advanced pharmacy practice (APPE) and intermediate pharmacy practice (IPPE) students working together in the clinic to assist patients. Twenty student pharmacists and one pharmacist participated in this study. Data collection included the pharmacist or student performing the test, the type of allergy test, test duration in hours, number of skin test attempts, number of errors made during the appointment, interventions made, time spent counseling patients, cost of supplies for training students, time spent calling patients, call success rate, and percent of allergies delabled. An excel spreadsheet was used to track each collection point per appointment.
Data analysis included descriptive statistics to determine statistical differences. Cost was determined by the addition of cost per supply used, as well as the pharmacist’s hourly salary.
Criteria for inclusion included patients who were referred to the clinic during the study interval, seen by a student pharmacist or pharmacist. Exclusion criteria were patients who were seen by a pharmacy resident or if they fell outside of the study timeframe.
Results
A total of 15 intermediate pharmacy practice experience (IPPE) students, 5 advanced pharmacy practice experience (APPE) students, and 1 pharmacist were included in the study. Students saved the clinic a net $5,567 in total over 9 months, while using the pharmacist hourly rate and deducting training supply cost and pharmacist time spent to train. Broken down more specifically, for phone calls, students saved $5,059. IPPE students spent 2,786 minutes on calls, while APPE students spent 2,273 minutes. Students spent more time making calls when compared to the pharmacist, as the pharmacist spent a total of 1,449 minutes.. For scratch tests, students saved $512. For intradermal tests, students saved $665. For discharge counseling, students saved $420.
Students spent 4.04 (IPPE: 4.37 ; APPE: 3.71) minutes/phone call, while pharmacists spent 4.75 minutes/phone call. Students successfully scheduled an appointment per phone call encountered 22.32% (IPPE: 19.73% ; APPE: 24.90%) of the time while the pharmacist was successful 39.66% of the time. Students removed penicillin allergies per phone call encounter 5.54% (IPPE: 6.02% ; APPE: 5.06%) of the time while pharmacists removed allergies 5.59% of the time.
Students took an average of 4.99 minutes/scratch test encounter (IPPE: 4.39 ; APPE: 5.59) while pharmacists took 6.11 minutes/encounter. For intradermal encounters, students took an average of 6.24 minutes (IPPE: 4.78 ; APPE: 7.70) while pharmacists took 7.44 minutes/encounter.
Students averaged a 25.05% (IPPE: 4.65% ; APPE: 45.45%) intradermal miss stick rate while pharmacists averaged 28%. Additionally, students averaged 3.21 (IPPE: 2.86 ; APPE: 3.55) minutes/discharge encounter while pharmacists averaged 3.30 minutes/encounter.
Conclusion
Students are cost-efficient when assisting in a pharmacist-led clinic. Although they require training and supervision, they are able to perform tasks and allow pharmacists to work on other necessary duties. This study determined that students saved a net $5,567 in total over 9 months. The study also found that students were more efficient at performing skills such as discharge counseling and phone calls, allowing pharmacists time for other tasks. This information can help guide pharmacy managers into involving students in clinics to give them more experience, while saving money.
