Assessing the impact of a substance abuse educational program on pharmacy students' knowledge Base: A Controlled Study

American Journal of Pharmaceutical Education, Fall 1999 by McAuley, James W, Akers, Angela L, Mott, David A

Substance abuse among healthcare practitioners, including pharmacists and pharmacy students, is a sig

nificant problem. In response to a perceived student need, a didactic and experiential educational program

was developed to provide information and skills for participants to use when providing pharmaceutical

care for persons with substance abuse disorders. Our purpose was to evaluate the impact of that educa

tional program on the knowledge base of pharmacy students. A controlled, nonrandomized study design

was used. Students completed a pre- and post-intervention questionnaire to assess knowledge of sub

stance abuse. Participating students' responses were compared with a control group of students who did

not volunteer to participate in the program. Twenty-one participants were compared with 30 controls. In

comparison to the control group, participants' knowledge regarding alcohol abuse was significantly

increased after the program. Results demonstrated that participants' self-rated scores significantly

increased from baseline for overall knowledge of substance abuse, ability to handle a substance abuse

situation, and comfort level of handling persons with substance abuse problems. An implication of our

results may be that improving a person's comfort level and ability to handle a substance abuse situation

may be influenced by real life experiences.

INTRODUCTION

Substance abuse (at risk for addiction or addicted to drugs and/or alcohol) among health care practitioners, including pharmacists and pharmacy students, is a significant problem. McAuliffe and colleagues estimated the rates of reported drug dependence among pharmacy students, pharmacists, medical students, and physicians to be 3.9, 2.3. 5.2 and 3.3 percent, respectively(1,2). The use of alcohol by pharmacy students has been reported to range from 76.5-88.6 percent(3-5). These rates are comparable to general college student populations(3,4).

The education of pharmacy students and pharmacists concerning substance abuse and addiction can be a preventive measure to deter persons at risk from being affected and helping to treat patients. Tucker el al., reported that a majority (57.3 percent) of pharmacy students reported a need for a drug awareness program(4). In another sample of pharmacy students, nearly 68 percent identified a need for an alcohol and drug abuse awareness program(5). Few colleges of pharmacy provide their students with adequate educational courses about substance abuse and addiction disorders. Baldwin and colleagues polled 1,326 pharmacy faculty members and reported that only 32 percent of the respondents believed that the content of their curricula is adequate or excessive on the subject of substance abuse education(6).

Two educational programs on substance abuse designed for pharmacy students have previously been described. Giannetti et al., described a required chemical dependency seminar that is a part of a peer intervention program(7). This seminar entails a strong focus on education and prevention. Participating students showed a positive response toward the seminar. After completing the program, 91 percent of the students perceived an increased awareness of chemical dependency problems in the pharmacy profession, and 78 percent identified an increased ability to recognize signs and symptoms of dependency after completing the program.

Busto and colleagues have described a problem-based drug abuse and dependency elective course for fourth year pharmacy students(8). This course was implemented to increase student knowledge about substance abuse assessment and treatment, and to teach students the role they can have in detection and prevention of substance abuse. Evaluation scores have been high, and this course has consistently been rated by the students as one of the three best pharmacy courses at the University.

In January 1997, we conducted an informal poll of our fourth year BS pharmacy students. The data showed that 82 percent of respondents perceived a need for further education on substance abuse. To address this perceived need, our American Pharmaceutical Association-Academy of Students of Pharmacy (APhA-ASP) Chapter developed an educational program on the many facets of substance abuse. The overall objective for the program was to provide information and skills for participants to use in the provision of pharmaceutical care for persons with substance abuse disorders. The educational program proposal was funded-by an-APhA/Merck student Pharmacy Project Grant.

Our program entailed three half-day didactic/interactive sessions interspersed with a site visit to a local substance abuse treatment center. The first didactic session, led by a clinical pharmacist and a pharmacology professor, provided information on the pharmacology of dependence and was entitled, "Mechanisms and Treatment of Drug Dependence." Previous substance abuse programs did not include an experiential component. To facilitate experiential learning, participants were oriented to the recovery services at a local medical center and could attend evening outpatient group sessions. The second didactic session, led by another clinical pharmacist and a certified chemical dependency counselor level III, provided participants with information regarding "Integrating Medical Issues Into the Care Plan," and "Intervention" and "Enabling versus Supporting." The third session was led by a clinical psychologist and the president of Pharmacist Rehabilitation Program (PRO), and focused on how to serve effectively as a resource for persons with substance abuse and addiction disorders.