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1.
J Am Pharm Assoc (2003) ; 63(5): 1646-1651, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36972735

RESUMEN

In 2012, the American Pharmacists Association Foundation (APhAF) recognized 17 women and three organizations for their work as pioneers and leaders among female pharmacists. In 2022, the APhAF selected ten additional leaders among contemporary women in American pharmacy to be honored in the Women in Pharmacy Exhibit and Conference Room on the top floor of the American Pharmacists Association (APhA) headquarters building in Washington, D.C. These ten leaders gathered at a symposium in their honor in October 2022 at APhA headquarters. This paper summarizes the accomplishments of the ten contemporary women and documents their comments at the symposium, where they discussed their perspectives on practice innovation, entrepreneurship, leadership, philanthropy, community service, and mentorship.


Asunto(s)
Educación en Farmacia , Servicios Farmacéuticos , Farmacias , Farmacia , Femenino , Humanos , Farmacéuticos
2.
J Am Pharm Assoc (2003) ; 63(6): 1689-1693, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37704064

RESUMEN

The history of American pharmacy contributions to pandemic responses can be described for five pandemics: 1918 (influenza A/H1N1 virus), 1957-1958 (H2N2 virus), 1968 (H3N2 virus), 2009 (H1N1pdm09 virus), and 2019-2023 (syndrome coronavirus-2 virus). Using historical surveillance data and published literature, this article provides opportunities to reflect on how the pharmacy profession played a role in preparedness and response.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana , Farmacia , Humanos , Gripe Humana/epidemiología , Subtipo H3N2 del Virus de la Influenza A , Subtipo H2N2 del Virus de la Influenza A
3.
J Am Pharm Assoc (2003) ; 62(5): 1524-1527, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35752603

RESUMEN

Immediate public health interventions and solutions, including the virtual provision of patient care via telehealth, were exponentially employed in response to the coronavirus disease 2019 pandemic. As a result, the U.S. Department of Health and Human Services temporarily waived Medicare telehealth restrictions. Dramatic increases in the provision of care via telehealth were observed, beginning in March 2020. Yet, despite these changes, there was a deficit in relevant telehealth readiness assessment, resources, and training that incorporated critical elements brought forth by the pandemic. This article describes the need for and provides a telehealth readiness assessment tool as a digital health strategy for health professional students, clinicians, and organizations to be prepared for patient care engagement during and beyond the pandemic.


Asunto(s)
COVID-19 , Telemedicina , Anciano , Humanos , Medicare , Pandemias , Estados Unidos
4.
Medicina (Kaunas) ; 58(3)2022 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-35334585

RESUMEN

Patients are often faced with challenges when it comes to safe therapeutic options. An 89-year-old female with a history of arrhythmias and refractory gastroparesis complained of adverse drug events from her benzodiazepine. While performing a comprehensive medication review and a medication safety review using an advanced clinical decision support system, the pharmacist successfully tapered off the benzodiazepine to a safer alternative antidepressant indicated for the treatment of gastroparesis. Special attention was given to selecting drugs with less QT prolongation risk, based on her age, current drug regimen, previous medical history, and presence of polypharmacy.


Asunto(s)
Gastroparesia , Síndrome de QT Prolongado , Anciano de 80 o más Años , Arritmias Cardíacas , Benzodiazepinas/efectos adversos , Electrocardiografía , Femenino , Gastroparesia/complicaciones , Gastroparesia/tratamiento farmacológico , Humanos , Síndrome de QT Prolongado/inducido químicamente , Síndrome de QT Prolongado/tratamiento farmacológico
5.
Medicina (Kaunas) ; 58(3)2022 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-35334614

RESUMEN

Polypharmacy of psychotropic medications predisposes older adults to adverse drug events (ADEs). One contributing factor is inhibition of metabolic pathways between substrates (competitive inhibition) or between substrates and inhibitors of the same cytochrome P450 (CYP450) isoforms. The purpose of this case report is to demonstrate observed sedation and difficulty concentrating from augmentation therapy for resistant major depressive disorder (MDD) and to highlight the value of clinical tools to identify opportunities for treatment optimization to reduce ADEs. The pharmacist identified significant medication burden and competitive inhibition of drug metabolism in the CYP450 system during a telehealth medication therapy management consultation with a 69-year-old male. The pharmacist recommended clinical monitoring and communicated concerns about medication-induced sedation, difficulty concentrating, and other medication-related problems (MRP) to providers. Several recommendations were implemented which helped improved patient's outcomes. Individualizing MDD pharmacotherapy based on pharmacokinetic and pharmacodynamic drug interactions and geriatric dosage considerations may lead to better outcomes and tolerability among older adults.


Asunto(s)
Trastorno Depresivo Mayor , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Anciano , Trastorno Depresivo Mayor/tratamiento farmacológico , Humanos , Masculino , Farmacéuticos , Polifarmacia , Psicotrópicos/uso terapéutico
6.
Ann Pharmacother ; 55(5): 637-649, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-32815400

RESUMEN

OBJECTIVE: To describe telehealth interventions and determine their effect on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia. DATA SOURCES: PubMed/MEDLINE, EMBASE, Cochrane, CINAHL Plus, PsycINFO, Academic Search Ultimate, International Pharmaceutical Abstracts, Scopus, Web of Science, WHO Global Index Medicus, association websites, and gray literature were searched from January 1, 1998, to December 31, 2019. STUDY SELECTION AND DATA EXTRACTION: Eligible studies reported eHealth, mobile health, and telehealth interventions for adult patients prescribed medications for chronic condition management (eg, type 2 diabetes, hypertension, and/or dyslipidemia). Studies were required to evaluate medication adherence outcomes (eg, medication possession ratio [MPR], proportion of days covered (PDC)]. Randomized controlled trials, cohort studies, and controlled before-and-after studies were included. Multiple reviewers independently extracted data and evaluated risk of bias. DATA SYNTHESIS: Of 8693 studies identified, 13 reported either an MPR or PDC and were included in the systematic review. The systematic review demonstrated that electronic health (eHealth) and telehealth interventions were successful at improving medication adherence, whereas mobile health interventions did not improve medication adherence. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: This systematic review highlighted the available research and findings of studies assessing interventions to improve medication nonadherence among patients with type 2 diabetes, hypertension, and/or dyslipidemia. The evaluated findings lend support to the need for targeted medication adherence interventions based on patient population and practice settings. CONCLUSIONS: Telehealth modalities include telephonic outreach and specialized tools designed to increase health literacy. eHealth and telehealth medication adherence interventions were associated with improved MPR and/or PDC rates.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Dislipidemias/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación , Telemedicina/métodos , Enfermedad Crónica , Diabetes Mellitus Tipo 2/epidemiología , Dislipidemias/epidemiología , Humanos , Hipertensión/epidemiología , Telemedicina/tendencias
7.
J Am Pharm Assoc (2003) ; 61(3): 240-247.e1, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33478927

RESUMEN

OBJECTIVE: To understand the perceived role and value of the clinical pharmacist in a southern Arizona concierge primary care practice (CPCP) by employees. METHODS: Semistructured face-to-face interviews were conducted with health care team members employed by the CPCP site in December 2019 and January 2020 for this study. The interviews were audio recorded, transcribed, and thematically analyzed using an inductive approach with ATLAS.ti (version 7). A qualitative assessment was performed by 2 independent reviewers to identify the themes, which included clinical, economic, and humanistic outcomes. RESULTS: Eleven CPCP employees were interviewed: physicians (n = 2), a nurse practitioner (n = 1), medical assistants (n = 4), and administrative staff (n = 4). The perceived role and value of the clinical pharmacist in this CPCP varied by employee position; yet, all expressed the pharmacist's positive impact on patient care. Five themes were identified. The most common pharmacist roles identified included providing medication knowledge to providers, preventing abuse of controlled substances, monitoring clinical response to medications and adverse drug events, aiding in prior authorizations, educating patients, and providing patient-centered care. CONCLUSION: These results demonstrate that the integration of a clinical pharmacist into a CPCP can be valuable. This study highlights that the pharmacist was positively received by the physicians and staff. This further supports the value of the pharmacist as a key interprofessional health care team member. Further study is warranted to assess the longitudinal impact of pharmacists' services in a CPCP.


Asunto(s)
Farmacéuticos , Rol Profesional , Arizona , Humanos , Grupo de Atención al Paciente , Atención Primaria de Salud
8.
J Am Pharm Assoc (2003) ; 60(4): e47-e51, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32037307

RESUMEN

OBJECTIVE: To evaluate provider acceptance of pharmacist interventions within the Discharge Companion Program (DCP) and its association with hospital readmissions. METHODS: This retrospective record review included patients referred to the DCP between January and October 2018. DCP pharmacists' interventions were assessed for provider acceptance on follow-up consultation or readmission. A chi-square test assessed the association between provider acceptance, communication modality, and technology used. A logistic regression model assessed the association between readmission risk and variables of interest. An a priori alpha level of 0.05 was used. RESULTS: Of the 197 patients referred to the DCP, 102 met inclusion criteria. DCP pharmacists made a total of 271 interventions; 185 (68.7%) required provider action. The most common intervention type was medication addition or discontinuation (n = 74, 40%); the communication mode was between DCP nurses and primary care provider offices or skilled nursing facilities (n = 56, 54.9%); and the preferred technology was the telephone (n = 58, 56.9%). Provider acceptance rate was 30.8% (n = 57) of actionable interventions, although it was not significantly associated with 30-day readmission reductions (P = 0.833) and did not differ significantly when interventions were communicated to other health care professionals (P = 0.53). The specific intervention communication mode (i.e., telephone, facsimile, or both) of pharmacist interventions did not significantly affect provider acceptance (P = 0.133). The overall readmission rate was 22.5% (n = 23), and the only significant predictor of 30-day readmission was the number of comorbidities (odds ratio 1.28 [95% CI 1.03-1.58], P = 0.024). CONCLUSION: Provider acceptance of pharmacists' interventions did not significantly affect 30-day readmission rates, regardless of communication mode (telephone or facsimile) or technology used. However, the DCP successfully identified numerous medication-related problems. Further study is warranted regarding provider acceptance of pharmacist recommendations on 30-day readmission reduction.


Asunto(s)
Alta del Paciente , Farmacéuticos , Personal de Salud , Humanos , Readmisión del Paciente , Estudios Retrospectivos
9.
Curr Pharm Teach Learn ; 16(9): 102104, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38789297

RESUMEN

INTRODUCTION: Student pharmacists made a considerable contribution to healthcare provision and public health efforts during the COVID-19 pandemic. However, little is known about student pharmacists' experiences working in community pharmacy during the COVID-19 pandemic. This study aimed to describe the perceived impact of the COVID-19 pandemic on student pharmacists working in community-based pharmacy settings. METHODS: Semi-structured interviews were conducted in Spring 2023 with student pharmacists enrolled in the Doctor of Pharmacy program at the University of Arizona R. Ken Coit College of Pharmacy who also worked at a community pharmacy during the COVID-19 pandemic. Students were asked five core questions with additional probing questions as necessary. Students were also asked to provide three words that described their experience working in community pharmacy through the COVID-19 pandemic. Interviews were audio-recorded and transcribed, then coded by two independent reviewers with differences resolved through consensus. RESULTS: Eighteen students participated in a semi-structured interview. Four key themes were identified: (1) health and wellness of self and others; (2) education (online didactic and experiential) and work experience; (3) pharmacy workforce; and (4) appreciation and value of the pharmacy profession. The most common words to describe working in community pharmacy through the COVID-19 pandemic were stressful (n = 7) and rewarding (n = 5). CONCLUSIONS: This study offers some insight into the experiences of student pharmacists from one United States school of pharmacy working in community pharmacy during the COVID-19 pandemic. Future work is warranted to assess the long-term impact on student pharmacist wellbeing, education, work experience, and appreciation of the profession.

10.
Pharmacy (Basel) ; 11(4)2023 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-37489341

RESUMEN

(1) Background: The use of telehealth in the United States during the coronavirus disease 2019 pandemic was accelerated and there was a lack of telehealth training programs available to clinicians of all levels. At the onset of the pandemic, the American Association of Colleges of Pharmacy (AACP) had no educational outcomes or professional activity standards for the inclusion of telehealth in the didactic Doctor of Pharmacy curriculum. Yet, in November 2022, the AACP encouraged colleges of pharmacy to include digital health and telehealth. The purpose of this study was to assess faculty perceptions in preparation for a nation-wide survey regarding telehealth integration into pharmacy practice curricula. (2) Methods: An exploratory questionnaire was developed to describe faculty perceptions and opinions of telehealth integration into the pharmacy practice curriculum at a single college of pharmacy. The questionnaire was emailed to 76 faculty members over six weeks in Summer 2022. Data were summarized descriptively. (3) Results: A total of 18 faculty members completed the survey (24% response rate). The responding faculty were typically very aware (median = 4) of telehealth, its benefits, and barriers, and were very comfortable (median = 4) discussing telehealth communication, benefits of telehealth, and barriers of telehealth. Yet, they were less comfortable discussing telehealth applications (median = 2.5). The faculty had a positive perception of telehealth in general (mean = 8.1 ± 1.5), telehealth services (mean = 8.6 ± 1.6), and the incorporation of telehealth instruction into the pharmacy practice curriculum (mean = 7.7 ± 2.7). Most respondents (67%) could discuss telehealth in their course. Lack of time to teach (50%) was the most reported reason by those who did not have plans to incorporate telehealth instruction into their course. (5) Conclusions: This exploratory survey of faculty at one college of pharmacy indicated positive perceptions and opinions of telehealth integration into the Doctor of Pharmacy curriculum. Further efforts to incorporate telehealth into the curriculum at other pharmacy schools is warranted.

11.
J Manag Care Spec Pharm ; 29(2): 210-215, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36705284

RESUMEN

BACKGROUND: Telehealth services that identify and address the social needs of patients can improve access to health care and social services. The social needs of medication therapy management (MTM)-eligible Medicare-Medicaid dual-enrolled patients are unknown. OBJECTIVE: To describe the social needs of Medicare-Medicaid dual-enrolled patients participating in a telephonic MTM program. METHODS: This study evaluated the findings of a social needs survey implemented within a telehealth MTM program. Surveys were offered telephonically to eligible Medicare-Medicaid patients of one insurance plan who were identified with medication nonadherence between July 13, 2020, and December 31, 2020. This study described patients who completed the survey during provision of a comprehensive medication review (CMR). Questions screened for social needs in the following social determinant of health domains: community and social context, economic stability, and neighborhood and physical environment. Descriptive statistics were used to describe results. RESULTS: Among 461 patients who completed CMRs, 358 completed the social needs survey. The most prevalent needs and concerns identified included lacking support to perform daily activities (165 [47%]), lacking companionship (81 [23%]), feeling left out (71 [20%]), feeling isolated (81 [23%]), not having enough money to pay bills (177 [49%]), worrying about running out of food (77 [22%]), or having run out of food within the last 12 months (81 [23%]). In this sample, 54 (15%) patients reported avoiding a provider visit because of transportation barriers. Certain individuals were without a steady place to live or were worried about losing their home (40 [11%]) and 35 (10%) reported struggling to keep a job. CONCLUSIONS: The identification of social needs among patient populations is necessary to reduce barriers to medication adherence and optimize health care utilization. This study described important social needs identified during the provision of a telehealth CMR among MTM-eligible Medicare-Medicaid dual-enrolled patients. DISCLOSURES: Dr Nahata was supported in part by the Avatar Foundation. Dr Silva Almodóvar works as a research pharmacist within a medication management program, which provides medication therapy management services.


Asunto(s)
Medicare Part D , Telemedicina , Anciano , Humanos , Estados Unidos , Administración del Tratamiento Farmacológico , Medicaid , Cumplimiento de la Medicación , Farmacéuticos
12.
Pharmacy (Basel) ; 11(2)2023 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-36961028

RESUMEN

Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists' knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists' knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education (CE) session. This pretest-posttest study evaluated the differences before and after a live CE session on COVID-19 vaccine confidence provided to pharmacists at a nationwide health technology company. Participants' total pretest and posttest scores were compared using paired t-tests, while pretest and posttest scores for each item were compared using chi-squared tests. A Bonferroni correction was applied, resulting in an alpha level of 0.005. A total of 279 pharmacists participated in this study. After the CE session, mean knowledge scores increased (5.2 ± 1.5 to 7.4 ± 1.35, p < 0.0001). After the CE session, there was no significant increase in pharmacists' knowledge about the approach that is not recommended when discussing vaccination beliefs with a patient (71.3% to 77.4%, p = 0.099), determinants of vaccine uptake (83.9% to 87.8%, p = 0.182), and social determinants of health that can influence vaccination rates (93.6% to 96.4%, p = 0.121). There was a significant change in pre- and posttest knowledge for the remaining seven items.

13.
J Clin Med ; 11(8)2022 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-35456163

RESUMEN

(1) Background: Adverse drug events and inappropriate use of medications lead to hospitalizations, medication-related morbidity, and mortality. This study examined whether a novel medication risk prediction tool, the MedWise Risk Score™, was associated with medication safety-related problem (MRP) identification and whether integration into an existing innovative transitions of care (TOC) service could decrease readmissions. (2) Methods: This retrospective comparator group study assessed patients discharged from a hospital in southern Arizona between January and December 2020. Participants were included in the study if they were 18 years of age or older, referred to the pharmacist for TOC services, and received a pharmacist consultation within one-week post discharge. Patients were categorized into two groups: (1) medication safety review (MSR)-TOC service (intervention) or (2) existing innovative TOC service (control). (3) Results: Of 164 participants, most were male (57%) and were between 70−79 years of age. Overall, there were significantly more drug-drug interactions (DDI) MRPs identified per patient in the intervention vs. control group for those who were readmitted (3.7 ± 1.5 vs. 0.9 ± 0.6, p < 0.001) and those who were not readmitted (2 ± 1.3 vs. 1.3 ± 1.2, p = 0.0120). Furthermore, of those who were readmitted, the average number of identified MRPs per patient was greater in the intervention group compared to the control (6.3 vs. 2.5, respectively, p > 0.05). Relative to the control, the readmission frequency was 30% lower in the treatment group; however, there was insufficient power to detect significant differences between groups. (4) Conclusions: The integration of a medication risk prediction tool into this existing TOC service identified more DDI MRPs compared to the previous innovative TOC service, which lends evidence that supports its ability to prevent readmissions. Future work is warranted to demonstrate the longitudinal impact of this intervention in a larger sample size.

14.
Clin Pract ; 12(3): 243-252, 2022 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-35645306

RESUMEN

This study evaluated a pharmacist-led telephonic Medication Therapy Management (MTM) program for rural patients in Arizona with poor access to healthcare services. A pharmacist provided telephonic MTM services to eligible adult patients living in rural Arizona communities with a diagnosis of diabetes and/or hypertension. Data were collected and summarized descriptively for demographic and health conditions, clinical values, and medication-related problems (MRPs) at the initial consultation, and follow-up data collected at 1 and 3 months. A total of 33 patients had baseline and one-month follow-up data, while 15 patients also had three-month follow-up data. At the initial consultation, the following MRPs were identified: medication adherence issues, dose-related concerns, adverse drug events (ADE), high-risk medications, and therapeutic duplications. Recommendations were made for patients to have the influenza, herpes zoster, and pneumonia vaccines; and to initiate a statin, angiotensin converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, and/or rescue inhaler. In conclusion, this study demonstrated that while pharmacists can identify and make clinical recommendations to patients, the value of these interventions is not fully realized due to recommendations not being implemented and difficulties with patient follow-up, which may have been due to the COVID-19 pandemic. Additional efforts to address these shortcomings are therefore required.

15.
Pharmacy (Basel) ; 9(3)2021 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-34449707

RESUMEN

Nearly half of all patients prescribed a chronic medication do not adhere to their regimen. Conversion from a 30- to 90-day medication refill is associated with improved adherence. The objective of the study was to assess the change in proportion of days covered (PDC) in those who converted to a 90-day fill and those who did not after a telehealth pharmacist-delivered, medication adherence intervention. This retrospective review involved data collected between May and December 2018. Patients with ≤85% baseline PDC rates were targeted. One group included patients who converted to a 90-day fill after the pharmacist intervention. The comparator group did not convert to a 90-day fill. Differences in median end-of-year (EOY) PDC rates for each medication class were compared between groups. An alpha level of 0.05 was set a priori. Overall, 237 patients converted to a 90-day fill and 501 did not. There was no significant difference in age, sex, and total number of drugs per patient. A Mann-Whitney U test revealed statistically significant improvements in median EOY PDC in the group that converted to a 90-day fill (+9% vs. -3%, p < 0.001). Pharmacist-delivered telehealth interventions were associated with improved PDC rates in those who converted to a 90-day fill.

16.
J Health Care Poor Underserved ; 32(3): 1301-1311, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34421032

RESUMEN

PURPOSE: Pharmacists provide comprehensive medication reviews (CMRs) to address provider shortages in medically underserved rural areas/populations (MUA/P). Currently, there are no studies regarding the proportions of CMRs completed directly with patients (here called, beneficiaries) from MUA/Ps themselves, or with others such as caregivers or primary care providers. METHODS: This retrospective study analyzed adults in 2018 who received a CMR from a telehealth pharmacist. Chi-square tests compared differences in the proportion of CMRs completed with beneficiaries versus others. Multivariable logistic regression determined predictors of CMRs completed with beneficiaries. FINDINGS: Of 19,655 participants, most were female (68%) and had Spanish preferred language (43%). The following had a greater likelihood of CMR completion with beneficiaries: age 65-74 years; non-rural residents; mental health prescription. These variables had less likelihood of CMR completion with beneficiaries: rural areas; men; and presence of medication nonadherence. CONCLUSION: The expansion of pharmacist-delivered CMRs occurred successfully in MUA/Ps. Further work is warranted to investigate the longitudinal effect on health markers.


Asunto(s)
Área sin Atención Médica , Medicare Part D , Adulto , Anciano , Femenino , Humanos , Masculino , Administración del Tratamiento Farmacológico , Farmacéuticos , Estudios Retrospectivos , Estados Unidos
17.
Artículo en Inglés | MEDLINE | ID: mdl-34207164

RESUMEN

(1) Background: Regular contact with a medication therapy management (MTM) pharmacist is shown to improve patients' understanding of their condition; however, continued demonstration of the value of a pharmacist delivered comprehensive medication review (CMR) using enhanced MTM services via telehealth is needed. The study aimed to describe a pilot program designed to improve type 2 diabetes mellitus (T2DM) management through enhanced condition specific MTM services. (2) Methods: This retrospective study included patients with T2DM aged 40-75 years who received a pharmacist-delivered CMR between January and December 2018. An evaluation of glycosylated hemoglobin (HbA1c) values 3 months pre- and post-CMR was performed. Wilcoxon signed-rank and chi-square tests were used. (3) Results: Of 444 eligible patients, a majority were female (58%) with a median age of 70 years. Median HbA1c values post-CMR were lower than pre-CMR (median 7.1% range 4.5-13.6; median 7.4% range 4.5-13.9, respectively; p = 0.009). There were fewer participants with HbA1c >9% post-CMR (n = 66) than pre-CMR (n = 80; p < 0.001) and more with HbA1C <6.5% post-CMR (n = 151) than pre-CMR (n = 130; p < 0.001). (4) Conclusion: This program evaluation highlighted the value of an enhanced condition specific MTM service via telehealth. Patients had improved HbA1c values three months after receiving a single pharmacist delivered CMR.


Asunto(s)
Diabetes Mellitus Tipo 2 , Telemedicina , Anciano , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Hemoglobina Glucada , Humanos , Masculino , Administración del Tratamiento Farmacológico , Farmacéuticos , Estudios Retrospectivos
18.
Pharmacy (Basel) ; 8(4)2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33255726

RESUMEN

(1) Background: There is limited evidence related to the efficacy of advanced clinical decision support systems (CDSS) on the quantity of high-quality clinical recommendations in a pharmacy-related medication therapy management (MTM) setting. The study aimed to assess the effect of an advanced CDSS on the quantity of relevant clinical pharmacist recommendations in a call center MTM setting. (2) Methods: This pre-test/post-test with comparator group study compared clinical skills assessment scores between certified MTM pharmacists in March 2020. A Wilcoxon Signed Rank test assessed the difference between pre- and post-test scores in both groups. (3) Results: Of 20 participants, the majority were less than 40 years old (85%) with a Doctor of Pharmacy degree (90%). Nine were female. Intervention group participants had less than three years of experience as a pharmacist. The control group had less than three years (40%) or seven to ten years (40%) of experience. There was a significant increase in intervention group scores between pre- (median = 3.0, IQR = 3.0) and post-test segments (median = 6.5, IQR = 4.0, p = 0.02). There was no significant change between control group pre- and post-test segments (p = 0.48). (4) Conclusion: Pharmacist exposure to an advanced CDSS was associated with significantly increased quantity of relevant clinical recommendations in an MTM pharmacy setting.

19.
Pharmacy (Basel) ; 8(1)2020 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-32098068

RESUMEN

Co-prescribing of opioids and benzodiazepines can lead to overdoses and mortality. This retrospective study analyzed prescription claims data collected in 2016. A national medication therapy management (MTM) program conducted prescriber-based outreach interventions for patients with concurrent opioid and benzodiazepine prescriptions. The pharmacist's direct-to-prescriber intervention was conducted following a targeted medication review. The pharmacist initiated interventions with the prescriber via facsimile to recommend discontinuation of concurrent use of these drugs. This study included 57,748 subjects who were predominantly female (67.83%) and aged ≥ 65 years (66.90%). Prescribers were most commonly located in the southern United States (46.88%). The top prescribed opioid medications were hydrocodone-acetaminophen (33.60%), tramadol (17.50%), and oxycodone-acetaminophen (15.66%). The top benzodiazepines prescribed concurrently with opioids were alprazolam (35.11%), clonazepam (21.16%), and lorazepam (20.09%). Based on the pharmacists' recommendations, 37,990 (65.79%) resulted in a medication discontinuation (benzodiazepines 40.23%; opioids 59.77%) by the provider. There were significant differences in the proportion of opioids discontinued by subject age (p < 0.001) and prescriber geographical region (p = 0.0148). The top medications discontinued by the prescriber were hydrocodone-acetaminophen (18.86%), alprazolam (14.19%), and tramadol HCl (13.51%). This study provides initial evidence for pharmacist-supported, direct-to-prescriber programs as an effective medication safety strategy.

20.
Pharmacy (Basel) ; 8(3)2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32751792

RESUMEN

Pharmacy residents must complete research as part of their program; however, challenges exist in providing experiences that result in successful research dissemination outcomes. A university-based research team, integrated into an ambulatory care pharmacy residency program aimed to improve presentation and publication rates of pharmacy resident research projects. Data on the number of postgraduate year-2 (PGY2) residents and their productivity were collected and summarized to assess progress. A total of 13 residents completed their residency over seven years. Each resident produced one regional presentation, and one national presentation beginning in year four. To date, three peer-reviewed papers have been published, with another one in-press. Responses from residents found lack of guidance, lack of data availability for projects and feedback fatigue were barriers to a positive research experience. To address these problems, a university-based research team was integrated to provide research mentor guided support, ensure study feasibility, and provide structured feedback. This program evaluation highlighted the integration of a PGY2 ambulatory care pharmacy residency with a designated, interprofessional university-based research team. Future work is warranted to reduce research-related barriers and formally evaluate resident post-program knowledge, skills, and subsequent dissemination rates.

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