Integration and Outcomes of Entrustable Professional Activities Performed by PharmD Trainees at Hospital Practice Sites

Objectives: Our primary objectives were to evaluate the integration and impact of Entrustable Professional Activities (EPAs) within a competency-based add-on PharmD curriculum and to describe the types and frequency of EPAs performed by PharmD trainees as an assessment tool during their placements at secondary and tertiary care practice sites. A secondary objective was to report, categorize, and quantify patients’ drug therapy problems (DTPs) with the rate of recommendations’ acceptance by preceptors. Methods: A descriptive study for 2437 EPAs (concerning 1295 patients) was performed by 56 PharmD trainees during their experiential training year from January 2018 to November 2021. Results: The most frequent EPA performed by trainees was Medication Therapy Management (MTM) (718; 29.5%), followed by Medication Reconciliation (MedRec) (636; 26.1%), prescription/order review (546; 22.4%), and medication counseling (284; 11.7%). A total of 1224 DTPs were encountered through MTM, MedRec, and prescription/order reviews, with “drug not indicated” being the most common DTP (16.7%). Anti-infectives (25.1%), cardiovascular (21.8%), endocrine (12.5%), and gastrointestinal (12.1%) agents made up most of the 1612 medicines involved in medication-related DTPs. The majority of interventions were accepted by preceptors (91%). The rejection rate was 3.6%, owing primarily to medical expertise, clinical judgment, and the personal opinion of preceptors. Patients’ age (older adults), gender (females), and admission type (newly admitted patients) were associated with a higher risk of experiencing DTPs. Conclusions: Our findings demonstrate that incorporating EPA-based practice and assessment into pharmacy training can ensure graduates are not only knowledgeable but also trusted to perform essential tasks independently, ultimately optimizing the safety and quality of patient care.