FDU School of Pharmacy Assignment #1: Health … L. Johnson, Pharm.D., is Clinical Pharmacy...

PHRM 8501 IPPE III Syllabus 11.5.14 v1a.docx 13

FDU School of Pharmacy Assignment #1: Health Literacy

Student: ________________________________ Date: _________________________ Site: __________________________________________________________________ Preceptor Signature: ____________________Print Name: _______________________

Watch the video “Health Literacy and Patient Safety: Help Patients Understand” at http://classes.kumc.edu/general/amaliteracy/AMA_NEW3.html, read the attached article “Health literacy: A primer for pharmacists” and complete the following questions:

1. Describe methods to assess the health literacy status of your patients.

2. Elaborate on challenges patients with low health literacy face when makinghealthcare-related decisions.


3. Outline counseling methods that can be used to improve patient understandingand medication adherence in a patient with limited health literacy.

4. Explain the similarities and differences between an individual with low literacyand an individual with low health literacy.

PRECEPTOR COMMENTS (OPTIONAL):

primer Health literacy

949Am J Health-Syst Pharm—Vol 70 Jun 1, 2013

p r i m e r

Health literacy: A primer for pharmacists Jennifer L. Johnson, Lynette Moser, and CandiCe L. Garwood

Jennifer L. Johnson, Pharm.D., is Clinical Pharmacy Specialist, De-partment of Pharmacy, Aleda E. Lutz Veterans Affairs Medical Center, Saginaw, MI; at the time of writing she was Pharmacy Practice Resi-dent, Department of Pharmacy, Harper University Hospital, Detroit Medical Center (DMC), Detroit, MI. Lynette moser, Pharm.D., is Clinical Assistant Professor, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University (WSU), Detroit, and Clinical Pharmacy Special-ist, Department of Pharmacy, Harper University Hospital, DMC. CanDiCe L. GarwooD, Pharm.D., BCPs, is Clinical Associate Profes-sor, Department of Pharmacy Practice, Eugene Applebaum College

of Pharmacy and Health Sciences, WSU, and Clinical Pharmacy Spe-cialist, Department of Pharmacy, Harper University Hospital, DMC.

Address correspondence to Dr. Johnson at the Department of Pharmacy, Aleda E. Lutz Veterans Affairs Medical Center, 1500 Weiss Street, Saginaw, MI 48602 ([email protected]).

The authors have declared no potential conflicts of interest.

Copyright © 2013, American Society of Health-System Pharma-cists, Inc. All rights reserved. 1079-2082/13/0601-0949$06.00.

DOI 10.2146/ajhp120306

Purpose. The literature surrounding health literacy and its importance in everyday practice are reviewed. Summary. Health literacy includes a patient’s reading, writing, and numeracy skills, as well as his or her cultural experi-ences, understanding of health concepts and pathophysiology, and basic com-munication skills. Over one third of the American population lack the skills neces-sary to understand health information, make health care decisions, or follow medication instructions. Independent risk factors for low health literacy include poor socioeconomic status, ethnicity, older age, and limited education. Mounting evidence suggests that low health literacy leads to poor health outcomes, increased mortality, increases in health care costs, and poorly self-managed chronic diseases. Communication with a pharmacist to gain clarification of medication instructions is often the last opportunity to ensure that patients understand how to use their

medications appropriately. Low health literacy is not always easily recognized, as patients use well-practiced coping mechanisms or avoidant behaviors. Clear communication strategies help patients become more involved in their care plans and increase positive interactions. Tools to assess health literacy have been de-veloped and can be used by pharmacists to guide education and counseling. Ad-vanced methods of written and oral com-munication should be used to improve pa-tient comprehension and understanding. Conclusion. Tools such as simple word-recognition tests or comprehensive tests of functional health literacy can be used in daily practice to assess patients’ health literacy. Being familiar with communica-tion techniques such as the Indian Health Service, teach back, and Ask Me 3 can help facilitate individualized medication-related education and maximize patient comprehension. Am J Health-Syst Pharm. 2013; 70:949-55

Health literacy is a vital compo-nent of communication be-tween pharmacists and pa-

tients. Health literacy is defined by the Institute of Medicine as “the de-gree to which individuals have the ca-pacity to obtain, process, and under-stand basic health information and services needed to make appropriate health decisions.”1 Health literacy is a unique form of literacy that includes a patient’s reading, writing, and nu-meracy skills, as well as his or her cultural experiences, understanding of health concepts and pathophysiol-ogy, and basic communication skills. A patient who functions very well in a nonhealth care environment with excellent literacy skills may still have trouble understanding his or her medications or medical diagnoses. Health literacy encompasses the skills a patient needs to successfully navigate through health care systems. As modern medicine places more demands on health care consumers, there will be a greater need for health literacy awareness among health care providers.

Health literacy among AmericansThe National Assessment of Adult

Literacy (NAAL), sponsored by the National Center for Education Sta-tistics, is a comprehensive measure of literacy among American adults. In 2003, the NAAL included an assess-ment of health literacy and revealed that over one third of the American population lack the skills necessary

to understand health information, make health care decisions, or follow medication instructions.2 Indepen-dent risk factors for low health litera-cy, as identified by the NAAL, include poor socioeconomic status, older age, and limited education. Ethnicity is also a risk factor, with half of the


950 Am J Health-Syst Pharm—Vol 70 Jun 1, 2013

Hispanic population and a quarter of the African-American population demonstrating low health literacy.2

Estimates of low health literacy among a selected patient population can be calculated using a free, easily accessible online tool which incor-porates demographics identified by the NAAL.3

The impact of low health literacy has been recognized by national organizations. The Healthy People initiative sets nationwide objectives every 10 years to outline health-improvement priorities, increase public awareness of important issues, and provide measurable objectives for researching these issues.4 One of the goals for 2020 is to improve communication between patients with low health literacy and health care providers through the use of easy-to-understand patient instruc-tions.5 The Joint Commission has stated that effective communication is the cornerstone of patient safety, and many of the National Patient Safety Goals were created to protect patients with low health literacy.6 One initiative of the Joint Commis-sion is to make health literacy a pri-ority of health systems. Yet, a survey conducted by the California Health Literacy Initiative found that 63% of hospital administrators knew there was a link between health literacy and medication errors, but only 25% made health literacy a priority in the provision of care for their patients or provided health literacy training to their staff.7

The average health care consumer accesses a majority of his or her health information in the home or community rather than from a health care provider, including decisions about preventive health services.2 In a survey of 2722 Medicare enrollees age 65–79 years, patients with low health literacy underutilized influen-za and pneumococcal vaccinations, mammograms, and Papanicolaou smears.8 Public health messages from multiple sources (television, schools,

social media sites, well-known ac-tors) make it difficult for patients to know which message to trust and how to act on the information. The Centers for Disease Control and Prevention (CDC) recognizes the impact of health literacy on public health and has an action plan to im-prove health literacy among Ameri-cans.9 Its goals are to provide access to accurate and actionable health information, deliver patient-centered health information and services, and support lifelong learning and skills to promote good health. In addi-tion, the Institute of Medicine has made health literacy 1 of the top 20 priorities by which quality improve-ment could transform health care in America.1

Health literacy and health-related outcomes

Mounting evidence suggests that low health literacy leads to poor health outcomes, increased mortal-ity, increases in health care costs, and poorly self-managed chronic diseas-es.10 A review of an Arizona Medicaid database found that the mean medi-cal costs for patients with low health literacy were almost $8000 more per year compared with patients with higher health literacy.11 Similarly, the Georgetown University Center on an Aging Society found a $73 bil-lion increase in aggregate direct and indirect health care spending annu-ally due to poor health literacy.12 A recently published population-based cohort study of 7857 adults identi-fied an association between mortality and low health literacy.13 The haz-ard ratio for all-cause mortality for participants with low health literacy was 1.40 (95% confidence interval [CI], 1.15–1.72). After adjustment for cognitive ability, this association was still significant, with a hazard ra-tio of 1.26 (95% CI, 1.02–1.55). In a prospective cohort of 3260 Medicare enrollees, mortality was found to be directly proportional to health lit-eracy status.14 Further, patients with

inadequate health literacy were more likely to be hospitalized (34.9% ver-sus 26.7%, p < 0.001) and rehospital-ized (19.9% versus 14%, p < 0.001) within one year than were patients with adequate health literacy. The majority of rehospitalizations were attributed to chronic diseases such as heart failure, unstable angina, chron-ic obstructive pulmonary disease, and asthma.15 Advances in technol-ogy, diagnostics, and pharmaceuti-cals have led to greater demands for self-management of these chronic conditions.

Many studies have investigated the impact of low health literacy on chronic disease outcomes.16-18 In a cross-sectional, observational study of 408 patients with diabetes, health literacy test scores were inversely proportional to glycosylated hemo-globin (HbA

1c) values, and patients

with an HbA1c

value of >9.5% were

twice as likely to have inadequate health literacy compared with those with an adequate health literacy level. Furthermore, retinopathy was more likely to be self-reported by patients with inadequate health literacy (ad-justed odds ratio, 2.33; 95% CI, 1.19–4.57; p = 0.01).17 The Heart Failure Society of America has estimated that 27–54% of patients with heart failure have low health literacy.18 In a retrospective cohort study, patients who had both heart failure and low health literacy had higher rates of all-cause mortality with an adjusted hazard ratio of 1.97 (95% CI, 1.3–2.97; p = 0.001).16 Because patient self-care plays such an essential role in the management of heart failure, the Centers for Medicare and Medi-caid Services, the American College of Cardiology, and the American Heart Association have mandated documentation of hospital discharge education in this population.19

Health literacy is also important to patients who take high-risk medi-cations, such as oral anticoagulants. One analysis found that as many as 60% of patients seen in pharmacist-



managed anticoagulation clinics have limited health literacy.20 Of these patients, 70% were unable to determine whether their Interna-tional Normalized Ratio (INR) was in goal range, compared with 42% of patients with adequate health literacy (p = 0.008).

Medication use and nonadherence

Communication with a pharma-cist to gain clarification of medica-tion instructions is often the last opportunity to ensure that patients understand how to use their medi-cations appropriately. Hospital dis-charge counseling by a pharmacist can improve medication adherence and follow-up with providers.21 Likewise, counseling by a com-munity pharmacist can increase medication adherence to long-term therapies such as hydroxymethyl-glutaryl–coenyzyme A reductase inhibitors (statins).22 The Indian Health Service (IHS) model is one of the most widely used and effective medication-counseling approaches.23 The IHS counseling method is based on the following three open-ended questions that assess a patient’s base-line knowledge: What were you told this medication is for?, How were you told to use it?, and What were you told to expect? A pharmacist’s delivery of medical information may vary based on a patient’s education level and prior communication with other health care providers, and the IHS counseling approach is flexible for various levels of health literacy, allowing the pharmacist to fill in gaps of understanding.

Medication labels pose another challenge for patients with low health literacy. Patients with low health lit-eracy are three times more likely to misinterpret common warning labels on medication bottles.24 The larg-est study to date evaluating health literacy and medication use (n = 5000) found that 42% of patients had trouble comprehending simple in-

structions such as “take on an empty stomach.”25 In a cross-sectional study of 395 patients, low health literacy was a predictor of difficulty compre-hending medication instructions.26 Approximately half of these partici-pants did not completely understand dosage instructions that included the word teaspoon or tablespoon, and 28% did not understand the instruc-tion “take twice daily.”

Assessing health literacyLow health literacy is not always

easily recognized, as patients use well-practiced coping mechanisms or avoidant behaviors. Patients may make excuses such as “I forgot my glasses” or postpone decisions by saying, “I will read this when I get home.” Patients with low health lit-eracy are often embarrassed by their lack of understanding, and less than 50% will openly share this with loved ones such as spouses or children.27 In a review of 182 patient and provider surveys from an internal medicine clinic, medical residents identified low health literacy in only 10% of the 32% of patients who had low health literacy.28 The prevalence of low health literacy is concerning enough to warrant the use of “universal pre-cautions” to minimize the risk that a patient may not understand the health information provided. Uni-versal precautions would assume that every patient may have low health literacy, and this creates an environ-ment where care is optimized for patients of all health literacy levels.29

Informal questions can be an ef-fective way to gain subjective knowl-edge about a person’s health literacy. The key is to use a neutral, non-judgmental approach. For example, the following questions can serve as strong predictors of low health literacy:

• How often do you have problemslearning about your medical condi-tion because of difficulty understand-ing written information?

• How often do you have someone(family member, friend, or hospi-tal worker) help you read hospitalmaterial?

• How confident are you when fillingout medical forms by yourself?

These questions can be used infor-mally as icebreakers, or the answers can be scored using a 5-point Likert-type scale (scaled answers would include always, often, sometimes, occasionally, and never).30,31 Closed-ended questions (e.g., Can you read this?, Did you understand what I just told you?) should be avoided, as these can make patients uncomfortable.

There are many well-validated tools to assess health literacy.32-42 An accurate assessment can be helpful to pharmacists by providing insight into a patient’s level of functioning within the health care environment and his or her understanding of medical concepts. Popular types of tools include word-recognition tests and tests of functional health literacy.

Word-recognition tests measure an individual’s ability to recognize and pronounce words in a list and are useful predictors of general reading ability. Such tests are used in health care settings because they can be individualized by using spe-cific medical terms. These tests are preferred for use as initial screening tools because they are quick and easy to administer at the bedside or in a busy clinic. The most commonly used word-recognition test is the Rapid Estimate of Adult Literacy in Medicine (REALM),36 which can be completed in two to three minutes. It is a list of 66 medical terms ar-ranged in order of syllable number and pronunciation difficulty. The REALM-SF37 and REALM-R38 are abbreviated but correlated versions of the REALM and are considered equivalent to the original REALM tool. The Wide Range Achievement Test—Revised (WRAT-R) is an-other word recognition test that uses nonmedical words and passages.35



WRAT-R assesses a greater level of reading difficulty compared with the REALM and takes slightly longer to administer (up to five minutes). De-spite their utilization in the literature and in practice, word-recognition tests are not considered to provide a comprehensive assessment of a pa-tient’s health literacy. They also can overestimate a person’s reading skills, because word recognition and pro-nunciation do not necessarily equate to comprehension.

Tests of functional health lit-eracy encompass word recognition, reading comprehension, numeracy skills, and application to real-life situations. These tests are more time-consuming and require health profes-sionals to have adequate training in administering the tests; however, they assess a person’s ability to function in the health care environment. The gold standard of functional health literacy assessments is the Test of Functional Health Literacy in Adults (TOFHLA).40 This test has limited use in clinical practice, because it takes a relatively long time to com-plete (22 minutes). As a result, it is most often used in clinical research. TOFHLA has a 50-item reading com-prehension component focused on health topics. Its second part includes a 17-item numeracy test with ques-tions related to reading prescription labels and evaluating appointment information. Even the shortened version, the s-TOFHLA, takes a relatively long time to complete, yet it is useful for clinical health literacy research since its results are well cor-related with the TOFHLA.41

Another test of functional health literacy is the Newest Vital Sign (NVS).42 It is the most recently de-veloped instrument and is a com-prehensive and relevant assessment of health literacy. This tool also has the advantage of quick administra-tion (3 minutes), similar to the time required for word-recognition tests, and has been easily incorporated into various ambulatory care prac-

tice settings.43 The NVS comprises a nutrition label from a pint of ice cream and 6 questions that measure a patient’s reading, comprehension, and abstract reasoning skills. A ma-jority of the questions in this tool are numeracy based, leaving some patients frustrated and unwilling to complete the test if they have a low ability to perform basic mathemati-cal skills.44 Despite this limitation, a cross-sectional study of individuals age 13–91 years in the primary care setting found the NVS to be generally accepted in family practice clinics, with only 2.5% of patients refusing to complete the assessment.43

Clear communicationPatients often need to remem-

ber a great deal of information after a visit with their health care provider to ensure that they use their medications correctly, ap-propriately manage their chronic diseases, and schedule follow-up appointments. Clear communica-tion strategies help patients become more involved in their care plans and increase positive interactions.29 Plain, nonmedical language is the central component of this process. A valuable resource on plain language is the federal website guiding the Plain Writing Act of 2010, which requires agencies to write in plain language when addressing patients or consumers.45 Another resource specific for health care providers is the Plain Language Thesaurus, com-piled by the CDC’s National Center for Health Marketing.46 Other useful techniques include keeping conver-sations short and simple and using pictures or illustrations to explain a concept. Finally, patients should be encouraged to ask questions and be proactive in their health care plans.29

Studies have shown that up to 80% of medical information pro-vided to patients in a health care setting is forgotten when they go home,47 and nearly 50% of the in-formation remembered is recalled

incorrectly.48 Patients with low health literacy can benefit from structured communication methods like the teach-back method49 or Ask Me 3.50 The teach-back method is a way to confirm the provider has explained what the patient needs to know in an understandable manner.29 It begins with a new concept presented to the patient, and because approximately 47% of the information will be im-mediately recalled incorrectly,51 a clinician then assesses a patient’s immediate recall by using open-ended questions. An example of an effective assessment question is, “If you had to explain to your husband how to use this medicine, what would you say?” Open-ended questions should be specific to indi-vidual points. For example, an ideal question could be “If your INR was too high, what side effect would you be at risk of experiencing?” rather than a generalized statement such as “Can you repeat what I just told you about your medication?” This type of question gives the patient more-explicit educational information, as there is a focus on recall and commit-ting details to memory. This method requires the patient to accurately re-peat the key concepts discussed with the health care provider. In a direct observational study, 92% of patients receiving teach-back education had an HbA

1c value of ≤8.6% versus 55%

of patients who did not receive this form of education.51

Ask Me 3 was created by the Part-nership for Clear Health Communi-cation at the National Patient Safety Foundation.50 This method promotes three simple but essential questions for patients to ask themselves in every type of health care interaction and environment: (1) What is my main problem?, (2) What do I need to do?, and (3) Why is it important for me to do this? These questions increase awareness of health literacy among clinicians and encourage patient-initiated communication by empowering patients to gather



knowledge about their health status and medications.

Written materialsOral communication is impor-

tant, but clinicians often use written communication to augment patient counseling and education, especially when time spent with the patient is limited. The complexity of diseases, modern medications, and liability concerns force many practitioners to provide patients with medication guides, package inserts, or instruc-tional handouts that often contain excessive information. Furthermore, these documents may not be tailored to the needs of patients with low health literacy. The average reading level of adults in the United States is 8th grade.52 Most printed health care materials are written at a 10th-grade level or higher,53 creating a gap in the average adult patient’s ability to un-derstand these documents.

There are several tools that can be used to assess a patient’s reading level; however, these tools rely solely on the numbers of syllables per word and words per sentence. Some com-mon examples of these tools include the Simplified Measure of Gobble-dygoop (SMOG) readability test54 and the Flesch-Kincaid scale.55 The Flesch-Kincaid scale is widely used in the health care setting because it is an easily accessible function in current versions of Microsoft Word.56

Improving readability of health-related materials for patients is challenging. Readability depends on cultural appropriateness, relevancy, context, and the audience for whom the message is created.57 Because of this complexity, a universal solution of reducing the reading level may not be optimal. The most widespread approach focuses on a simple reduc-tion of the reading level by reducing the number of syllables or words in a document. However, many times materials can become oversimplified and lead to gaps or deletions of im-portant facts in a message. In some

instances, this can make text harder to read, since the patient has to make assumptions about the information that was removed. Written materi-als deserve a more sophisticated approach, such as adding easy-to-understand pictures, phonetically spelling long words with multiple syllables, and strategically placing important points at the beginning of text.57

Health literacy in pharmacy education

The quest for improved com-munication between pharmacists and patients with low health literacy begins with pharmacy education. A 2004 Institute of Medicine report recommended that health literacy training be included in all health professional education.1 The Ac-creditation Council for Pharmacy Education responded in 2007 by incorporating health literacy into the curriculum section in the accredita-tion standards for doctor of pharma-cy programs.58 In fact, the ability to address health literacy is considered a minimum skill that students should attain in order to provide patient-centered care, and this skill should be incorporated into didactic and experiential courses. Several reports have been published that provide a full description of health literacy offerings for pharmacy students.59-61 One report described a research proj-ect in which pharmacy students col-lected data assessing health literacy in a community pharmacy setting.60 The students requested that patients read instructions for a nonprescrip-tion product and then evaluated the patients’ understanding of the infor-mation. The overwhelming majority of students (95%) reported that they were more aware of the issues sur-rounding health literacy after being involved in the project. A second study expanded on previous reports and described a required course for third-year pharmacy students that included nine hours of health lit-

eracy material with a significant ac-tive learning component.61 The time was divided between a video, didactic information, and activities related to identifying signs of low literacy, counseling patients, using readability formulas, evaluating information in drug advertisements, and designing patient education materials. With the relatively limited amount of infor-mation available regarding the most effective way to incorporate health literacy into pharmacy school edu-cation, it is recommended that each program provide a very intentional approach to teaching students about health literacy. Background informa-tion coupled with active learning provide students a practical perspec-tive as well as the ability to practice their skills.

ConclusionTools such as simple word-

recognition tests or comprehensive tests of functional health literacy can be used in daily practice to assess pa-tients’ health literacy. Being familiar with communication techniques such as the IHS, teach back, and Ask Me 3 can help facilitate individualized medication-related education and maximize patient comprehension.

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FDU School of Pharmacy Assignment #2: Medication Identification – Project Preparation


Identify five medications commonly prescribed at your site, for which additional counseling information would benefit the patient.

Medication Name Therapeutic Class Disease State

1.

2.

3.

4.

5.



FDU School of Pharmacy Assignment #3: Patient Education Information


Using one of the medications identified for Assignment #2, develop patient education information for the following patient populations:

1. General population (high literacy, but low health literacy)2. Aging/Elderly population or population unique to clinical site (e.g HIV patient,

Hepatitis C patient, etc.)3. Low-literacy population (reading level 5th grade and below)

Use your imagination and be creative in the development of the patient education material. The length and format of each educational piece can vary, but should include the following information (in any order):

1. A brief overview of the disease(s) for which the medication is used.2. Medication information including name (brand/generic), therapeutic class, dosage

form(s) and strength(s).3. How the medication works, expected benefits.4. How to properly use the medication.5. What to do if a dose is missed.6. Important contraindications, warnings, and side-effects.7. Any special precautions to follow.8. Foods, alcoholic beverages, OTC, herbal supplements, other medications to be

avoided.9. How to store the medication.10. How the patient will know that the medication is working

To assist in the development of the educational material for the low-literacy population, please use the Simple Measure of Gobbledygook (SMOG) readability formula at http://www.readabilityformulas.com/smog-readability-formula.php to determine the grade level readability of the material created. Record the SMOG score of your material below:

SMOG Index: ________________________________

**Please attach FINAL copies of your THREE projects to this assignment packet***



FDU School of Pharmacy Assignment #3: Patient Education Information (cont.)

It is recommended that students utilize the following information to aide in the completion of this assignment:

• CDC Simply Put: A Guide for Creating Easy-to-Understand Materialshttp://stacks.cdc.gov/view/cdc/11938

• CDC Plain Language Thesaurus for Health Communicationshttps://depts.washington.edu/respcare/public/info/Plain_Language_Thesaurus_for_Health_Communications.pdf

• ASHP Guidelines on Pharmacist-Conducted Patient Education and Counselinghttp://www.ashp.org/DocLibrary/BestPractices/OrgGdlPtEduc.aspx

• ASCP Guidelines for Pharmacist Counseling of Geriatric Patientshttp://www.ascp.com/resources/policy/upload/Gui98-Counseling Ger Pat.pdf

• Health Literacy Tools in Pharmacyhttp://drugtopics.modernmedicine.com/drug-topics/news/health-literacy-tools-pharmacy?page=full

• Communicating with Patients Who have Literacy Limitations: Introductionhttp://pharmacylibrary.com/content/418970

Designing low literacy materialshttp://www.euromedinfo.eu/designing-low-literacy-materials.html/

•

https://depts.washington.edu/respcare/public/info/Plain_Language_Thesaurus_for_Health_Communications.pdf

http://www.ascp.com/resources/policy/upload/Gui98-Counseling Ger Pat.pdf

http://www.euromedinfo.eu/designing-low-literacy-materials.html/


FDU School of Pharmacy Assignment #4: Indigent Patient Assistance Programs


Using one of the medications identified for Assignment #2 (other than the medication used for the development of patient educational material), identify the eligibility requirements that must be met for a patient with limited income to receive this medication through a pharmaceutical company sponsored indigent patient assistance program. If none of the four medications participate in a patient assistance program, the student will select one of the following medications to complete this assignment:

i. Advair Diskusii. Atriplaiii. Chantixiv. Combivent Respimatv. Coreg CRvi. Crestorvii. Namendaviii. Norvirix. Pegintronx. Sovaldi

1. Name of Medication:

2. Name of Manufacturer:

3. Address of Manufacturer:

4. Phone number of Manufacturer:

5. Fax number of Manufacturer:

6. Program Eligibility Requirements:


7. Patient Income Requirements:

8. Application Process:

9. Wait-time for Medication:

10. Medication shipped to whom?

11. Quantity of medication dispensed?

12. Re-application Policy:

13. Refill Policy:


FDU School of Pharmacy Assignment #1: Health … L. Johnson, Pharm.D., is Clinical Pharmacy...

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