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1.
J Am Pharm Assoc (2003) ; : 102113, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38705467

RESUMO

BACKGROUND: Tricyclic antidepressants (TCAs) are a treatment option for diabetic peripheral neuropathy (DPN). Existing evidence demonstrates the prolonged use of TCA therapy increases the risk of cognitive decline and dementia, likely due to the anticholinergic effects of these medications. The anticholinergic activity is thought to contribute significantly to the observed increase in cognitive decline and dementia risks associated with long-term TCA use. There is little information available to describe the usage patterns of TCAs in DPN, particularly within underserved populations who receive care at Federally Qualified Health Centers (FQHCs). OBJECTIVES: The objective of this study was to characterize: 1) prescribing patterns of TCAs as a treatment for DPN and 2) evidence of deprescribing attempts in a FQHC population. METHODS: A retrospective chart review of electronic medical record (EMR) data for patients at two different FQHCs was performed. A convenience sample of 100 adults ≥ 18 years of age was stratified into two age groups, 18-55 years, and 55+ years. All patients had a diagnosis of Type 1 or Type 2 diabetes mellitus and had been prescribed TCAs in the previous four years and had a visit with a primary care provider (PCP) in the past 12 months. RESULTS: The study population was comprised of 100 individuals. Seventy-four of 100 were persistent users of TCAs at the time of data collection, and the mean duration of utilization was 54.8 months. In total, 104 TCAs were prescribed across 100 individual patients. Of all 104 prescribed TCAs, 66 (63%) were prescribed at a rate that exceeded thresholds associated with a higher risk of dementia. Black older adults prescribed TCAs were more likely to exceed this dose threshold. CONCLUSION: 65% of patients used TCAs with a strength, frequency, and duration that exceeded risk thresholds for dementia in an older adult population. Interventions preventing use of or deprescribing TCAs in patients with DPN should be conducted for the potential benefits of preventing or delaying cognitive impairment and promoting equitable care.

2.
J Clin Transl Sci ; 8(1): e66, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38690220

RESUMO

A decline in routine vaccinations, attributed to vaccine hesitancy, undermines preventative healthcare, impacting health and exacerbating vaccine disparities. University-public health partnerships can improve vaccination services. This study describes and evaluates a university-public health use case employing social determinants of health (SDoH)-based strategies to address vaccination disparities. Guided by the Translational Science Benefits Logic Model, the partnership offered no-cost preventative vaccines at community-based organization (CBO) sites, collected CBO clientele's vaccination interest, hesitancy, and demographic data, and conducted descriptive analyses. One hundred seven vaccination events were held, administering 3,021 vaccines. This partnership enhanced health outcomes by addressing disparities through co-located vaccination and SDoH services.

3.
Pharmacy (Basel) ; 11(2)2023 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-37104078

RESUMO

To address gaps in care for individuals from under-resourced communities disproportionately affected by tobacco use, this pharmacist-led demonstration project evaluated the feasibility of implementing tobacco use screening and brief cessation interventions during mobile health access events. A brief tobacco use survey was administered verbally during events at two food pantries and one homeless shelter in Indiana to assess the interest and potential demand for tobacco cessation assistance. Individuals currently using tobacco were advised to quit, assessed for their readiness to quit, and, if interested, offered a tobacco quitline card. Data were logged prospectively, analyzed using descriptive statistics, and group differences were assessed by site type (pantry versus shelter). Across 11 events (7 at food pantries and 4 at the homeless shelter), 639 individuals were assessed for tobacco use (n = 552 at food pantries; n = 87 at the homeless shelter). Among these, 189 self-reported current use (29.6%); 23.7% at food pantries, and 66.7% at the homeless shelter (p < 0.0001). About half indicated readiness to quit within 2 months; of these, 9 out of 10 accepted a tobacco quitline card. The results suggest that pharmacist-led health events at sites serving populations that are under-resourced afford unique opportunities to interface with and provide brief interventions for people who use tobacco.

4.
PLoS One ; 18(3): e0282940, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36920963

RESUMO

BACKGROUND: Reductions in hemoglobin A1c (HbA1C) have been associated with improved cardiovascular outcomes and savings in medical expenditures. One public health approach has involved pharmacists within primary care settings. The objective was to assess change in HbA1C from baseline after 3-5 months of follow up in pharmacist-managed cardiovascular risk reduction (CVRR) clinics. METHODS: This retrospective cohort chart review occurred in eight pharmacist-managed CVRR federally qualified health clinics (FQHC) in Indiana, United States. Data were collected from patients seen by a CVRR pharmacist within the timeframe of January 1, 2015 through February 28, 2020. Data collected include: demographic characteristics and clinical markers between baseline and follow-up. HbA1C from baseline after 3 to 5 months was assessed with pared t-tests analysis. Other clinical variables were assessed and additional analysis were performed at 6-8 months. Additional results are reported between 9 months and 36 months of follow up. RESULTS: The primary outcome evaluation included 445 patients. Over 36 months of evaluation, 3,803 encounters were described. Compared to baseline, HbA1C was reduced by 1.6% (95%CI -1.8, -1.4, p<0.01) after 3-5 months of CVRR care. Reductions in HbA1C persisted at 6-8 months with a reduction of 1.8% ([95%CI -2.0, -1.5] p<0.01). The follow-up losses were 29.5% at 3-5 months and 93.2% at 33-36 months. CONCLUSIONS: Our study augments the existing literature by demonstrating the health improvement of pharmacist-managed CVRR clinics. The great proportion of loss to follow-up is a limitation of this study to be considered. Additional studies exploring the expansion of similar models may amplify the public health impact of pharmacist-managed CVRR services in primary care sites.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Humanos , Estudos Retrospectivos , Farmacêuticos , Hemoglobinas Glicadas , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco , Biomarcadores , Fatores de Risco de Doenças Cardíacas
5.
Diabetes Care ; 46(2): e24-e38, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36701595

RESUMO

The etiology of type 2 diabetes is rooted in a myriad of factors and exposures at individual, community, and societal levels, many of which also affect the control of type 1 and type 2 diabetes. Not only do such factors impact risk and treatment at the time of diagnosis but they also can accumulate biologically from preconception, in utero, and across the life course. These factors include inadequate nutritional quality, poor access to physical activity resources, chronic stress (e.g., adverse childhood experiences, racism, and poverty), and exposures to environmental toxins. The National Clinical Care Commission (NCCC) concluded that the diabetes epidemic cannot be treated solely as a biomedical problem but must also be treated as a societal problem that requires an all-of-government approach. The NCCC determined that it is critical to design, leverage, and coordinate federal policies and programs to foster social and environmental conditions that facilitate the prevention and treatment of diabetes. This article reviews the rationale, scientific evidence base, and content of the NCCC's population-wide recommendations that address food systems; consumption of water over sugar-sweetened beverages; food and beverage labeling; marketing and advertising; workplace, ambient, and built environments; and research. Recommendations relate to specific federal policies, programs, agencies, and departments, including the U.S. Department of Agriculture, the Food and Drug Administration, the Federal Trade Commission, the Department of Housing and Urban Development, the Environmental Protection Agency, and others. These population-level recommendations are transformative. By recommending health-in-all-policies and an equity-based approach to governance, the NCCC Report to Congress has the potential to contribute to meaningful change across the diabetes continuum and beyond. Adopting these recommendations could significantly reduce diabetes incidence, complications, costs, and inequities. Substantial political resolve will be needed to translate recommendations into policy. Engagement by diverse members of the diabetes stakeholder community will be critical to such efforts.


Assuntos
Diabetes Mellitus Tipo 2 , Bebidas Adoçadas com Açúcar , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Políticas , Bebidas , Habitação
6.
J Oncol Pharm Pract ; 29(1): 66-73, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34726099

RESUMO

INTRODUCTION: Eskenazi Health in Indianapolis, Indiana, USA. services diverse communities in Central Indiana, including the Hispanic/Latinx community. It has been postulated that this population experiences toxicities at a higher rate and with a faster onset than the general population when treated with chemotherapy or biotherapy. The published clinical trials that have evaluated chemotherapy/biotherapy efficacy and toxicity have not adequately represented the Hispanic/Latinx population. This retrospective analysis aims to analyze the incidence and severity of adverse drug events in the Hispanic/Latinx population compared to the general study population. METHODS: A retrospective chart review included patients reported as Hispanic/Latinx in the electronic medical record who had breast cancer, colon cancer, acute myeloid leukemia, or multiple myeloma currently receiving chemotherapy/biotherapy and/or received chemotherapy/biotherapy during the study period. Seventy-three instances of patients receiving chemotherapy/biotherapy and 46 unique patients were included in the final analysis. RESULTS: Of the 73 instances, 29 (40%) had toxicity at baseline prior to chemotherapy/biotherapy received during the study period. Of those 29 baseline toxicities, 26 (90%) of them had new toxicity during the study period. Of the 73 instances, 62 (85%) experienced toxicities during the study period. CONCLUSION: Ethnicity has a proven effect on medication efficacy and safety, but the specific impact of ethnicity on chemotherapy/biotherapy toxicity risk has not been well elucidated. This study found that a majority (85%) of Hispanic/Latinx patients treated with chemotherapy/biotherapy experienced toxicity of any grade, and the majority (90%) patients who had prior toxicity experienced another toxicity.


Assuntos
Neoplasias da Mama , Leucemia Mieloide Aguda , Mieloma Múltiplo , Humanos , Feminino , Protocolos de Quimioterapia Combinada Antineoplásica , Estudos Retrospectivos , Neoplasias da Mama/tratamento farmacológico , Mieloma Múltiplo/tratamento farmacológico , Leucemia Mieloide Aguda/tratamento farmacológico
7.
J Pharm Pract ; : 8971900221136897, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36325719

RESUMO

There are three major microvascular complications of diabetes, retinopathy, nephropathy, and neuropathy, among which diabetic retinopathy (DR) is the most common. Several studies suggest that the Hispanic/LatinX population exhibit the highest cases of both diabetes and DR. Strategies aimed at reducing risk factors that could minimize the likelihood of DR development or progression could be beneficial. This retrospective study assessed DR in the Hispanic/LatinX population in pharmacist-managed cardiovascular risk reduction services. A chart review was conducted for 60 individuals who visited clinics led by both a pharmacist and a primary care physician (intervention group) and 178 individuals who saw physicians only (control group). Demographics, metabolic parameters, DR severity, and pharmacist appointment data were collected. The highest benefit of pharmacist intervention was observed in terms of a greater but insignificant decrease in HbA1c; however, there was no benefit of pharmacist's intervention on DR in general, likely due to the longer duration of diabetes and higher HbA1c at the beginning of the study. When the DR progression was examined based on the frequency of pharmacy visits, individuals who met a pharmacist more than two times per year showed more stable and lesser worsening of DR. Overall, our studies suggest that pharmacist intervention could benefit retinopathy outcome; however, well-known determinants of DR such as good glycemic control and duration of diabetes still play a critical role, in addition to challenges in receiving healthcare by the Hispanic/LatinX population. Future strategies in a prospective manner could help retinopathy outcomes in these at-risk patient populations.

8.
BMC Health Serv Res ; 22(1): 117, 2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-35086545

RESUMO

BACKGROUND: An interest in, and the need for, Community Health Workers (CHWs) in the United States is growing exponentially. CHWs possess a unique ability to relate to and build trust with communities in order to improve clinical outcomes, while building individual and community capacity. Given their critical role in addressing social determinants of health, expanding the CHW workforce is crucial. However, creating CHW jobs, facilitating training and certification, and establishing sustainable financing models to support this workforce has been challenging. METHODS: A mixed-methods study consisting of an online survey and focus group discussions assessed the strengths, practices, and challenges to CHW workforce sustainability and expansion in the state of Indiana, including perspectives from both CHWs and employers. RESULTS: Across 8 topics, mixed data analysis revealed 28 findings that were both complementary and unique across focus group and survey results. Results highlighted CHW skills and attributes, illustrated the recruitment and hiring process, and provided insight into measuring outcomes and outputs. Findings also indicated a need to build position validation, professional development, and billing and reimbursement capacity. CONCLUSION: Building and sustaining the CHW workforce will require creating an evidence base of roles and impact, increasing awareness of existing reimbursement mechanisms, and sharing best practices across employer organizations to promote optimal recruitment, training, supervision, career development, and funding strategies.


Assuntos
Agentes Comunitários de Saúde , Desenvolvimento de Pessoal , Certificação , Humanos , Indiana , Estados Unidos , Recursos Humanos
9.
J Eval Clin Pract ; 27(2): 365-370, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32548871

RESUMO

RATIONALE, AIMS AND OBJECTIVES: Clinical inertia, defined as a delay in treatment intensification, is prevalent in people with diabetes. Treatment intensification rates are as low as 37.1% in people with haemoglobin A1c (HbA1c) values >7%. Intensification by addition of medication therapy may take 1.6 to more than 7 years. Clinical inertia increases the risk of cardiovascular events. The primary objective was to evaluate rates of clinical inertia in people whose diabetes is managed by both pharmacists and primary care providers (PCPs). Secondary objectives included characterizing types of treatment intensification, HbA1c reduction, and time between treatment intensifications. METHOD: Retrospective chart review of persons with diabetes managed by pharmacists at an academic, safety-net institution. Eligible subjects were referred to a pharmacist-managed cardiovascular risk reduction clinic while continuing to see their PCP between October 1, 2016 and June 30, 2018. All progress notes were evaluated for treatment intensification, HbA1c value, and type of medication intensification. RESULTS: Three hundred sixty-three eligible patients were identified; baseline HbA1c 9.6% (7.9, 11.6) (median interquartile range [IQR]). One thousand one hundred ninety-two pharmacist and 1739 PCP visits were included in data analysis. Therapy was intensified at 60.5% (n = 721) pharmacist visits and 39.3% (n = 684) PCP visits (P < .001). The median (IQR) time between interventions was 49 (28, 92) days for pharmacists and 105 (38, 182) days for PCPs (P < .001). Pharmacists more frequently intensified treatment with glucagon-like peptide-1 agonists and sodium glucose cotransporter-2 inhibitors. CONCLUSION: Pharmacist involvement in diabetes management may reduce the clinical inertia patients may otherwise experience in the primary care setting.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes , Farmacêuticos , Atenção Primária à Saúde , Estudos Retrospectivos
10.
J Am Pharm Assoc (2003) ; 60(5S): S88-S92, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32513507

RESUMO

OBJECTIVE: Second-generation antipsychotic therapy can lead to metabolic abnormalities, increasing the risk of cardiovascular disease and death in patients with serious mental illness. However, the literature suggests there is a lack of appropriate monitoring in individuals receiving these therapies. This study aims to evaluate whether the implementation of a pharmacist- and nurse-driven metabolic monitoring protocol will increase monitoring in patients prescribed second-generation antipsychotic therapy in an outpatient community mental health clinic. METHODS: A retrospective review of adult outpatients in a community mental health clinic who were prescribed second-generation antipsychotics was conducted from October 1, 2017, to March 31, 2019. Pre- and postprotocol implementation groups were compared to assess the impact of the protocol on the primary outcome of appropriateness in monitoring for metabolic parameters. RESULTS: A total of 160 patients who met the inclusion criteria were randomly selected and reviewed, allowing for 80 individuals in each group. Improvement in the appropriateness of monitoring was found for 4 of 5 metabolic parameters after protocol implementation, including blood pressure (17.5% to 43.8%, P < 0.001), weight (17.5% to 43.8%, P < 0.001), hemoglobin A1C (27.5% to 42.5%, P = 0.044), and lipid levels (17.5% to 31.3%, P = 0.04). Primary care physicians ordered most of the laboratory values (44.5% to 46.2%); however, pharmacists and nurses ordered 7% of laboratory tests after the protocol implementation. CONCLUSION: Despite the knowledge that second-generation antipsychotic therapies commonly lead to metabolic syndrome and therefore increased cardiovascular disease risk, monitoring for metabolic effects remains poor, and there is a lack in diversity of strategies to improve this monitoring. Although further research on the effectiveness of a pharmacist- and nurse-driven metabolic monitoring protocol in this setting is warranted, this protocol serves as an example of a novel strategy with the potential to improve metabolic monitoring of second-generation antipsychotic therapy.


Assuntos
Antipsicóticos , Doenças Cardiovasculares , Adulto , Antipsicóticos/efeitos adversos , Hemoglobinas Glicadas/análise , Humanos , Farmacêuticos , Estudos Retrospectivos
11.
Curr Pharm Teach Learn ; 12(3): 307-312, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32273068

RESUMO

BACKGROUND AND PURPOSE: The Indiana Pharmacy Teaching Certificate Program (IPTeC) offered a live, two-day conference to pharmacy residents, fellows, and preceptors in Indiana, while simultaneously live-streaming to participants in Doha, Qatar. Participants engaged in longitudinal activities for a one-year period. The purpose is to evaluate this pilot extension of a teaching and learning curriculum (TLC) to experienced preceptors in a global partnership and determine whether global and local participants perceive similar quality of programming. EDUCATIONAL ACTIVITY AND SETTING: Upon completion of the two-day conference, all pharmacists from two years of the program were encouraged to complete the standard course evaluations, consisting of nine items, in order to obtain continuing education (CE) credit. Evaluations of the program were analyzed by location cohort. FINDINGS: A total of 206 eligible pharmacists attended the program, with 154 completing the course evaluations (response rate 75%). "Good" or "outstanding" median ratings were given to each learning objective by both location cohorts, with domestic participants more likely to give "outstanding" ratings (6/9 items versus 0/9 items). SUMMARY: This pilot extension was successful in providing educational content satisfying learning objectives from the perspective of domestic participants and remote participants in Qatar. This type of global collaboration can meet the needs of trainees and experienced preceptors to advance pharmacy education and training.


Assuntos
Currículo/tendências , Educação em Farmácia/métodos , Currículo/normas , Educação em Farmácia/tendências , Educação de Pós-Graduação em Farmácia/métodos , Humanos , Indiana , Internacionalidade , Catar
12.
J Clin Endocrinol Metab ; 105(4)2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31825487

RESUMO

CONTEXT: Hypoglycemia in the outpatient setting has a significant financial impact on the health care system and negative impact on a person's quality of life. Primary care physicians must address a multitude of issues in a visit with a person with type 2 diabetes mellitus (T2DM), often leaving little time to ask about hypoglycemia. OBJECTIVE: To develop quality measures that focus on outpatient hypoglycemia episodes for patients 65 and older with T2DM, which facilitate a clinician's ability to identify opportunities to improve the quality of care and reduce hypoglycemic episodes. PARTICIPANTS AND PROCESS: A technical expert panel established by the Endocrine Society in March 2019, which includes endocrinologists, primary care physicians, a diabetes care and education specialist/pharmacist, and a patient, developed 3 outpatient hypoglycemia quality measures. The measure set is intended to improve quality of care for patients with T2DM who are at greatest risk for hypoglycemia. The measures were available for public comment in July 2019. A fourth measure on shared decision-making was removed from the final measure set based on public feedback. CONCLUSION: A lack of outpatient hypoglycemia measures focusing on older adults with T2DM is a barrier to improving care of people with diabetes and reducing hypoglycemic episodes. This paper provides measure specifications for 3 measures that may be used to focus quality improvement efforts on patients at greatest risk for hypoglycemia.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Endocrinologia/normas , Hipoglicemia/diagnóstico , Hipoglicemiantes/efeitos adversos , Guias de Prática Clínica como Assunto/normas , Qualidade de Vida , Idoso , Humanos , Hipoglicemia/sangue , Hipoglicemia/induzido quimicamente , Prognóstico , Sociedades Médicas
13.
J Am Pharm Assoc (2003) ; 59(5): 698-703, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31324536

RESUMO

OBJECTIVES: This retrospective analysis sought to: (1) characterize a cardiovascular risk-reduction clinic (CVRRC) patient population with serious mental illness (SMI); (2) analyze clinical outcomes of CVRRC patients over a 2-year period; and (3) compare outcomes for individuals prescribed different antipsychotic treatments in the CVRRC patient population over a 2-year period. EVALUATION METHODS: In 2016, A pharmacist-managed CVRRC was implemented within a primary care clinic for patients with SMI. The CVRRC operates under a collaborative practice agreement allowing the pharmacist to initiate and change medications and order laboratory tests. Baseline data collected included demographic information, referring provider, tobacco use, and 10-year atherosclerotic cardiovascular disease risk. Data collected at subsequent visits included date of visit, A1C, estimated average glucose (eAG), blood pressure, weight, body mass index, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, statin and dose, tobacco use, amount smoked, and current antipsychotic treatment. Number of times that treatment for diabetes was initiated or intensified by the pharmacist or primary care provider was also collected. IMPACT OF INNOVATION: A total of 101 patients were referred to the CVRRC over the 2-year period. Of these, 81 (80.2%) had at least 1 subsequent visit and were included in the A1C analysis. CVRRC patients had a statistically significant improvement in A1C over time. Mean A1C decreased by an increment of 0.06% for each month increase in follow-up time (P < 0.0001). There was no significant difference in A1C values between patients on different antipsychotic treatments (P = 0.74). CONCLUSION: The pharmacist-managed CVRRC demonstrated beneficial outcomes for individuals diagnosed with diabetes and SMI. Results provide promising evidence supporting future larger studies to confirm these findings. Considering the morbidity and mortality disparities for individuals with SMI, health care organizations should consider similar models to improve diabetes outcomes.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Transtornos Mentais/complicações , Assistência Farmacêutica/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hemoglobinas Glicadas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Assistência Farmacêutica/tendências , Farmacêuticos , Gravidez , Atenção Primária à Saúde/organização & administração , Estudos Retrospectivos , Fatores de Risco , Comportamento de Redução do Risco
14.
Clin Teach ; 16(6): 630-635, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30746845

RESUMO

BACKGROUND: Web-based learning (WBL), instruction facilitated through the Internet, has demonstrated utility in classroom and clinical education settings; however, there is a void of literature about the use of WBL by clinical educators within pharmacy. The purpose of this research is to evaluate a WBL initiative within clinical pharmacy education. METHODS: Based on the results of a pilot survey, 10 asynchronous WBL clinical modules (videos and interactive patient cases) were developed for pharmacy educators and students in clinical education affiliated with two schools of pharmacy in the midwest USA. A 21-item, cross-sectional, electronic survey was administered to pharmacy educators within acute and primary care to assess the use of WBL within clinical pharmacy education. RESULTS: Of the 115 eligible clinical educators, 69 participated in the survey (60% response rate), with the majority working within acute care; 38% of educators encouraged the use of WBL. Respondents not using WBL stated a lack of awareness (48%) or existing student time commitments (33%) as reasons. For educators encouraging WBL, 87% agreed that it enhanced student clinical knowledge, 68% stated that it decreased direct instruction time commitments and 100% stated they would encourage its use for future clinical education. CONCLUSIONS: Clinical pharmacy educators reported that the WBL initiative resulted in a perceived stronger student clinical foundation, and all pharmacy educators using WBL encouraged its continued use for future clinical education. Web-based learning provides clinical educators with a learning tool to augment clinical experiences by reinforcing student knowledge, at the same time minimising direct instruction time.


Assuntos
Atitude do Pessoal de Saúde , Instrução por Computador/métodos , Educação em Farmácia/métodos , Avaliação Educacional/métodos , Docentes de Medicina/psicologia , Internet , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
15.
Curr Pharm Teach Learn ; 10(4): 427-432, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29793703

RESUMO

OBJECTIVES: To evaluate participants' satisfaction with their teaching mentor relationship in a teaching and learning curriculum (TLC) and determine characteristics that are associated with high mentee satisfaction. METHODS: A 31-item survey instrument was administered to all 2015-2016 participants of the Teaching Certificate Program. RESULTS: Seventy percent of program participants (n = 60/86) responded to the survey. Overall, 80% of program participants were satisfied or very satisfied with their mentor relationship. Characteristics associated with participants reporting that they were very satisfied with their teaching mentor relationship included mentor availability for face-to-face contact and affiliation with the same institution. Mentor actions associated with high mentee satisfaction included reviewing lecture slides, providing midpoint feedback, providing career advice, and attending mentee lectures. CONCLUSIONS: Teaching certificate program participants perceive increased mentor accessibility and frequent interaction as key factors to a satisfying mentor-mentee relationship. Optimizing and standardizing mentorship programs are essential to the success of postgraduate teaching curriculums.


Assuntos
Atitude , Currículo , Docentes de Farmácia/educação , Tutoria , Mentores , Satisfação Pessoal , Ensino/educação , Adulto , Certificação , Educação em Farmácia , Retroalimentação , Feminino , Humanos , Aprendizagem , Masculino , Inquéritos e Questionários , Adulto Jovem
16.
Am J Manag Care ; 24(6 Suppl): S87-S92, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29620816

RESUMO

Diabetes is a series of metabolic conditions associated with many serious comorbidities, such as heart disease and stroke, peripheral arterial disease and lower-extremity amputations, retinopathy, nephropathy, and peripheral neuropathy. The American Diabetes Association, the American Association of Clinical Endocrinologists, and the International Diabetes Federation recommend that individuals with diabetes be as near to normoglycemic as possible. There are many glycemic management barriers among patients, such as cost, patient perceptions, and clinical inertia. Advancements in the treatment of diabetes with novel pharmacotherapeutic products have changed the therapeutic landscape of diabetes. Newer longer-acting insulin products that closely resemble endogenous insulin secretion patterns are demonstrating some improvements in clinical outcomes.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Insulina/uso terapêutico , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Insulina/administração & dosagem
17.
Diabetes Educ ; 44(3): 278-292, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29577816

RESUMO

Purpose The purpose of the study was to identify current practice settings for Certified Diabetes Educators (CDEs) who are pharmacists. Following nurses and dietitians, pharmacists are the third largest group of health professionals who hold the CDE credential. The growing number of CDE pharmacists highlights the increasing involvement of pharmacists in diabetes care. What remains unknown is the specific settings in which pharmacist CDEs practice. Methods A cross-sectional, nationwide electronic survey was sent to all CDE pharmacists in the United States. Questions regarding demographics, practice setting characteristics, certification information, and common diabetes-related counseling topics were asked of all respondents. Survey items also sought to determine pharmacists' perceptions of the benefits and barriers to obtaining the CDE credential. The questions were dichotomous, Likert-scale response, or open-ended. Results A total of 462 survey responses were included in the analysis for a response rate of (462/1275) 36.2%. Respondents identified hospital or health system as the most common practice setting (n = 311), followed by academia (n = 100), community (n = 81), managed care (n = 44), and other settings. Conclusions Study findings provide important data that describe where CDE pharmacists are practicing to provide diabetes education. The continued steady growth of CDE pharmacists suggests a consistent increase of pharmacists practicing diabetes education. Diabetes educators should recognize that CDE pharmacists practice in a variety of different settings.


Assuntos
Diabetes Mellitus , Educação em Saúde/métodos , Educadores em Saúde/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Farmácia/estatística & dados numéricos , Adulto , Certificação , Estudos Transversais , Feminino , Educação em Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
18.
Clin Diabetes ; 35(5): 313-320, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29263574

RESUMO

IN BRIEF Patients with serious mental illness (SMI) have markedly higher mortality rates than those without SMI. A large portion of this disparity is explained by higher rates of diabetes and cardiovascular illness, highlighting the need for people with diabetes and SMI to have access to the highest quality diabetes care. This article applies principles of patient-centered diabetes care to those with SMI, exploring a novel approach to diabetes care embedded within a community mental health setting.

19.
Fed Pract ; 34(Suppl 8): S38-S43, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30766315

RESUMO

For diabetes mellitus patients who require higher doses of insulin, pen-delivered concentrated insulins offer smaller volumes and potentially a lower risk of dosing errors.

20.
Am J Pharm Educ ; 80(3): 42, 2016 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-27170813

RESUMO

Objective. To assess teaching certificate program (TCP) participants' perceptions of mentor-mentee relationships. Methods. A 15-item survey instrument was administered to all 2014-2015 participants of the Indiana Pharmacy Teaching Certificate (IPTeC) program. Results. One hundred percent of IPTeC program participants (83/83) responded to the survey. The majority of participants indicated that having a professional mentor was either very important (52%) or important (47%) to their professional development and preferred to choose their own professional mentor (53%). Mentor characteristics rated as highly important by mentees included having similar clinical practice interests (82%), having similar research interests (66%), and being available to meet face-to-face (90%). Age, race, and gender of the mentor were not rated by mentees as important. Conclusion. Teaching certificate program participants place high importance on having a professional mentor. Mentorship of pharmacists completing TCPs should be a priority for current pharmacy faculty members so adequate guidance is available to future pharmacy educators.


Assuntos
Certificação/normas , Docentes de Farmácia/psicologia , Mentores/psicologia , Percepção , Residências em Farmácia/normas , Estudantes de Farmácia/psicologia , Certificação/métodos , Educação em Farmácia/métodos , Educação em Farmácia/normas , Humanos , Residências em Farmácia/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/normas , Ensino/psicologia
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