Medication Management in Schools: Pharmacist Involvement Can Improve Outcomes

Most pharmacists have little to no interactions with local schools concerning medications, but this is an area in which greater involvement could improve outcomes significantly. Between 10% and 20% of students in kindergarten through high school have chronic illness, and many others, if not most, will experience acute health problems. After all, children spend up to 50% of their waking hours at school. Among children who have chronic illnesses, 4% to 6% of them take medication during a typical school day.

School nurses bear the burden of ensuring that students receive increasingly complex medications. Two recent articles highlight medications in schools and emphasize the need for greater pharmacist involvement.

One, a comprehensive review of students’ medication needs at school, educates pharmacists about common conditions treated at school, such as asthma, attention deficit hyperactivity disorder, diabetes, food allergy, and opioid addiction, and the ins-and-outs of managing them during the school day.¹

The author discusses the most common challenges and adherence barriers in schools, noting the importance of educating parents and staff members about students’ conditions and management techniques. For example, pharmacists need to remind everyone that epinephrine pens must accompany children on field trips, and a responsible adult needs to know how to use the device.

The author identifies areas where the pharmacy team can be of most use to schools and families. Identifying potential problems, labeling medication appropriately, and suggesting alternatives that would promote adherence are key points. She also discusses counseling children and points out that most children can begin to learn about their medications by ages 5 to 7 years old.

Next, a study conducted in Minnesota and published in the Journal of the American Pharmacists Association, addresses school nurses’ medication management needs and explores how pharmacist-nurse partnerships can improve care for students.² Using a 32-item online survey of school nurses, the researchers found that 69% of nurses administered medications at their schools, though 29% of schools used unlicensed assistive personnel. In keeping with the previous article, the nurses identified stimulants (37.7%), asthma medications (25.7%), over-the-counter analgesics (17.8%), and insulin (6.6%) as the medications they administered most often.

More than 90% of nurses indicated interest in partnering with pharmacists, but just 12% said they have access to a pharmacist. The respondents identified 5 areas in which they could use consultation: new medications, drug-drug interactions, proper administration, and storage.

These articles point to an area where pharmacists can expand services and provide needed community services. Building liaisons with children, families, and schools is key.

References

1. Hutchinson K. The A-B-Cs of kids and medication: re-schooling pharmacists and families for best outcomes. ce.pharmacy.uconn.edu/wp-content/uploads/sites/2102/2017/09/FINAL-The-A-B-Cs-of-Kids-and-Medications-September-2017-3.pdf. Published September 2017. Accessed November 15, 2017.

2. Little MM, Eischens S, Martin MJ, et al. Medication management in Minnesota schools: The need for school nurse-pharmacist partnerships. J Am Pharm Assoc (2003). 2017;pii: S1544-3191(17)30939-1. doi: 10.1016/j.japh.2017.10.007.