The widespread adoption of wearable devices (wearables) for monitoring vital signs, including blood pressure and glucose levels, has experienced a considerable surge in recent times. This surge has led to the generation of a substantial amount of health data, accessible to pharmacists during patient consultations as the healthcare sector advances in digitalization. To enhance the digital competencies of future pharmacists required by the rapidly changing digital health landscape, the Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University (HHU) Duesseldorf has developed an innovative elective practical course aimed to bolster pharmacy students' competencies in handling wearables and the health data generated. The three-week practical elective course employed wearables FreeStyle Libre® 3 (Continuous Glucose Monitoring, CGM) and Aktiia (Cuffless Blood Pressure Monitoring). The hands-on activities allowed participants to obtain and interpret wearable-generated health-related data and acquainted them with simulated patient cases. Final-year pharmacy students' subjective assessments before and after the course depicted the increased knowledge and competence regarding analysing wearables data.
Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students’ performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills.
In order to increase vaccination rates, the Government of Germany introduced vaccination against influenza and COVID-19 into the regular care administered by pharmacists. However, vaccination training is yet not integrated into the German pharmacy curriculum. Therefore, the Institute for Clinical Pharmacy and Pharmacotherapy in Duesseldorf had developed an innovative vaccination course using high-fidelity simulation for students. To investigate the acceptance further, the course was carried out at three different German universities (Bonn, Duesseldorf, Greifswald). Students were asked to give their self-assessment before and after and satisfaction only after the training course. Responses from 33 participants from the University of Bonn, 42 from the University of Duesseldorf and 49 from the University of Greifswald were analyzed. Every participant at the respective universities showed a significant increase in their self-assessment and indicated a high level of satisfaction with the course. The results also did not differ significantly between the respective universities. Consequently, the results lead to the hypothesis that the satisfaction of pharmacy students with this kind of training using high-fidelity simulation is very high and attractive, and can be recommended for other German universities. The integration of such vaccination training into the German pharmacy curriculum might be a future step.
Background: Clinical decision support systems (CDSSs) already support community pharmacists in conducting medication reviews (MRs) by identifying important information on interactions and suggesting clinical solutions. However, their impact in terms of quality and time savings is widely unexplored. The aim of our study was to investigate whether MRs are performed faster and better with or without using a CDSS. Methods: In a randomized controlled study with a cross-over design, 71 pharmacists performed a total of four MRs, two with and two without the use of a CDSS. The primary endpoint was defined as the time required for the MRs. The secondary endpoints were the number of predefined relevant drug-related problems (DRPs) detected and pharmacist satisfaction. Results: Without the use of a CDSS, pharmacists needed between 25.7% and 30.7% more time to perform a MR than with a CDSS. In addition, significantly more relevant DRPs were detected in the MRs with CDSS than without CDSS (70% vs. 50%; p = 0.0037). Furthermore, participants stated that they felt more confident using a CDSS for MRs than without. Conclusions: Our results demonstrate that MRs can be performed both faster and better when using a CDSS than without. Consequently, community pharmacists benefit from the use of CDSSs for MRs, as do patients in terms of their drug therapy safety.
Continuous glucose monitoring (CGM) in healthy adults is becoming part of healthy lifestyle activities for preventing cardio-vascular and metabolic diseases. However, there is a lack in describing individual glucose responses to everyday situations, with appropriate metrics. The aim of this study was to provide metrics which describe individual glucose responses to lifestyle factors including diet, exercise, and stress in healthy, young adults. Ten participants wore a CGM device (FreeStyle Libre3®) for 14 consecutive days while completing nine standardized interventions (challenges) consisting of food, anaerobic and aerobic sport, and the Trier Social Stress Test (TSST) in an exploratory, clinical trial. Individual glucose responses after each challenge were assessed over four hours, using the following metrics: AUC 0–4 , max glucose, time to max glucose, glucose excursion, and time required for glucose levels to return to baseline (Glucose Recovery Time to Baseline (GRTB)). The study has been registered in the German clinical trial registry (Study number: DRKS00032821). Anaerobic exercise resulted in a significantly greater glucose excursion (28.7 ± 21.46 mg/dL) compared to aerobic exercise (8.8 ± 4.91 mg/dL, p = 0.0228). Food with a rich carbohydrate content caused the highest glucose increase (161.4 ± 15.59 mg/dL). TSST resulted in a significant difference in baseline-corrected glucose concentrations over time as revealed by a two-factor repeated measures ANOVA ( p = 0.0113). We provide reference data of glucose response to lifestyle factors such as diet and exercise in healthy adults. Psychobiological stress revealed a substantial glucose response. Using GRTB metrics may quantify the lifestyle stimulus on the important metabolic pathway and can be utilized alongside kinetic metrics for describing individual glucose responses.
To enhance the digital competencies of pharmacy students, the Institute of Clinical Pharmacy and Pharmacotherapy at Heinrich-Heine University Duesseldorf developed and evaluated a theoretical module on digital health and data analysis. This innovative module integrated a continuous glucose-monitoring (CGM) wearable device into teaching, providing students with in-depth practical experience and a 2.5 h seminar on digital health and CGM systems. Students’ knowledge of CGM and self-assessment of their CGM competencies were assessed in a pre-post manner. Additionally, students’ satisfaction with the module and their perceptions of the future integration of digital health training and the role of wearables in pharmacy practice were also assessed after the module. A total of 39 final-year pharmacy students completed the module conducted in June 2024 as part of the clinical pharmacy seminar. In total, 32 students completed the pre- and post-knowledge tests and self-assessment questionnaires. Both the knowledge and the students’ self-assessment of CGM-related skills after the module increased significantly (p < 0.05). Students expanded their knowledge regarding digital health solutions, in particular the CGM systems, and increased their self-reported competence in CGM-related skills. With this module, an important foundation was laid, as this is the first theoretical module including the essentials of CGM digital health tools for pharmacy students in Germany.