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1.
Sr Care Pharm ; 34(6): 363-369, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31164183

RESUMEN

Pharmacogenomics (PGx), the study of how an individual's genetic makeup affects his or her response to drugs, is a fast-growing field that gives health care providers a valuable tool to help safely and effectively manage medication. However, few providers have experience in applying the results of PGx tests to their practices, and this can lead to disregarding the data or unnecessarily modifying medication regimens. Pharmacists are uniquely positioned to become wellversed in the interpretation of PGx data, critically evaluating the "green-yellow-red" result categories that seemingly signal "go, caution, stop" regarding the use of a particular medication. Pharmacists also can evaluate genotype and phenotype information, commonly included in PGx laboratory reports, to optimize therapy. Using a case-based approach, this primer is intended to provide consultant pharmacists with practical direction to aid in PGx interpretation that will provide contextappropriate recommendations that contributes to positive patient outcomes.


Asunto(s)
Farmacéuticos , Farmacogenética , Femenino , Genotipo , Personal de Salud , Humanos , Masculino , Fenotipo
2.
Curr Pharm Teach Learn ; 10(9): 1160-1164, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30497616

RESUMEN

INTRODUCTION: The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards suggest integration and inclusion of interprofessional education in doctor of pharmacy programs. Although not directly mentioned by these Standards, intraprofessional education between student pharmacists and student pharmacy technicians may provide valuable preparation for comradery in practice. COMMENTARY: Given the prevalence of collaboration between pharmacists and pharmacy technicians in pharmacy practice, lack of intraprofessional education could be a vital gap in current programs. There have been previous calls within academic pharmacy and from key stakeholder groups for greater involvement of the profession in the training and education of pharmacy technicians, yet literature is sparse on successful models. This commentary includes a discussion of why intraprofessional training is vital, a brief commentary on example intraprofessional activities, as well as strategies for collaboration. IMPLICATIONS: A series of questions with the intention of evoking further conversations and awareness within academic pharmacy completes the commentary.

3.
Curr Pharm Teach Learn ; 10(8): 1062-1069, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30314542

RESUMEN

BACKGROUND: Traditional interprofessional educational (IPE) exercises are those where learning exists "about, from, and with" trainees in two or more professions in order to prepare health sciences professionals to work on interprofessional teams. One emerging difficulty with IPE is the paucity of health profession students at single institutions, and the geographic and financial constraints of multi-institutional collaboration. INTERPROFESSIONAL EDUCATION ACTIVITY: To circumvent these barriers, we developed a multi-institution telehealth team-based learning (TBL) event between medical and pharmacy students on the topic of pharmacogenomics (PGx). Using a validated pre-post survey design, student attitudes and perceptions were measured before and after an educational intervention designed to simulate interprofessional telehealth collaboration. The survey results showed significant improvement across all areas of student attitudes toward interprofessional collaboration. Also, medical student PGx confidence increased substantially during the exercise even though the only PGx instruction they received was from pharmacy students. DISCUSSION: These data demonstrate that learning exists "about, from, and with" trainees in other professions, even if they do not physically train in the same location. Free tools are available to create virtual interactions between students on different campuses, and telehealth exercises using these tools are a valid way to conduct IPE across different campuses. The instructional experience does not need to be identical for all participants in the IPE event; rather, tailoring the educational experience to each group of students provides opportunities for inter-student teaching.

4.
Pharmacotherapy ; 37(9): 1005-1013, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28654154

RESUMEN

Despite advances in technology and guidelines from the Clinical Pharmacogenetics Implementation Consortium (CPIC) that focus on how to use pharmacogene test results, hurdles remain that have delayed the widespread application of pharmacogenomics in clinical practice. These hurdles include a lack of prospective randomized controlled trials to address the utility of pharmacogenomics on clinical outcomes, what the clinical algorithm for pharmacogenomics should be, and whether pharmacogenomics is cost-effective. However, the implementation of clinical practice guidelines, such as those from professional organizations, is commonplace and often termed the application of evidence-based medicine. Here, we draw an analogy between the evidence supporting many commonly cited clinical practice guidelines and U.S. Food and Drug Administration-approved labeling recommendations and the evidence supporting recommendations from CPIC. Although many clinical practice guideline recommendations are supported by the results of randomized controlled clinical trials, we cite examples of common clinical practices that are supported by levels and types of evidence similar to the evidence supporting many of the CPIC recommendations. Specifically, we discuss clinical recommendations for guidance related to drug-drug interactions, drug-gene interactions, therapeutic range selection, and dosage adjustments based on patient-specific factors within the context of a select set of cardiovascular therapeutic topics.


Asunto(s)
Fármacos Cardiovasculares/uso terapéutico , Toma de Decisiones Clínicas/métodos , Medicina Basada en la Evidencia/métodos , Farmacogenética/métodos , Anticoagulantes/efectos adversos , Anticoagulantes/metabolismo , Anticoagulantes/uso terapéutico , Fármacos Cardiovasculares/efectos adversos , Fármacos Cardiovasculares/metabolismo , Interacciones de Drogas/fisiología , Medicina Basada en la Evidencia/normas , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/metabolismo , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Farmacogenética/normas , Inhibidores de la Bomba de Protones/efectos adversos , Inhibidores de la Bomba de Protones/metabolismo , Inhibidores de la Bomba de Protones/uso terapéutico
6.
J Am Pharm Assoc (2003) ; 57(1): 90-94.e1, 2017 Jan - Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27838391

RESUMEN

OBJECTIVES: To demonstrate the ability of a statewide network of community pharmacists to provide preconception care services with the use of targeted medication reviews (TMRs). Community pharmacists are well qualified and well positioned to assist in this public health priority; however, there are no documented case studies of pharmacists providing preconception care with the use of TMRs. METHODS: Through the demonstration project, pharmacists provided educational TMRs focused on 3 elements of preconception care to women aged 15 to 45 years enrolled in a nonprofit managed care plan: (1) medications that may cause fetal harm (category D/X); (2) folic acid use; and (3) immunizations. TMRs were generated and released to the individual pharmacy where that patient had prescriptions filled. Any practicing pharmacist in Ohio participating in the medication therapy management platform with a patient in the sample received a TMR notification. The pharmacists documented and billed for the service through this commercially available platform. RESULTS: Nineteen weeks after implementation of the TMRs, 1149 individual pharmacists from 818 different pharmacies had completed at least 1 TMR. Pharmacists completed 33% of all TMR opportunities with a 65% success rate. CONCLUSION: Establishing new services that were focused on preconception care resulted in rapid integration into existing medication therapy management processes in hundreds of pharmacies across Ohio. These results may help to provide justification for additional payers to reimburse for similar services. Through demonstrating the impact on preconception care, the role of the community pharmacist may continue to expand to include provision of additional preventive care services following the model developed in this initiative.


Asunto(s)
Servicios Comunitarios de Farmacia/organización & administración , Administración del Tratamiento Farmacológico/organización & administración , Farmacéuticos/organización & administración , Atención Preconceptiva/métodos , Adolescente , Adulto , Femenino , Ácido Fólico/administración & dosificación , Humanos , Inmunización/métodos , Programas Controlados de Atención en Salud/organización & administración , Persona de Mediana Edad , Ohio , Embarazo , Rol Profesional , Adulto Joven
7.
Prev Chronic Dis ; 13: E149, 2016 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-27788064

RESUMEN

Community pharmacists are highly accessible health care professionals, providing opportunities for partnerships with other health care and public health professionals to expand the population's access to clinical preventive services. To document examples of the community pharmacist's role in providing clinical preventive services to the general population, we conducted PubMed searches using the key word "community pharmacy" and key words from the US Preventive Services Task Force recommendations rated A or B. We present 4 descriptive summaries of clinical preventive services that can be offered by community pharmacists. Community pharmacists can provide clinical preventive services such as providing education, conducting screenings, and making referrals to improve population health.


Asunto(s)
Servicios Comunitarios de Farmacia/normas , Conocimientos, Actitudes y Práctica en Salud , Farmacéuticos , Servicios Preventivos de Salud/normas , Rol Profesional , Comités Consultivos , Infecciones por VIH/prevención & control , Humanos , Tamizaje Masivo/métodos , Osteoporosis/prevención & control , Derivación y Consulta , Estados Unidos
8.
J Infus Nurs ; 39(3): 139-48, 2016 May-Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27074990

RESUMEN

Pharmacogenomics (PGx) describes the relationship between an individual's genes and his or her response to drug therapy. Data are accumulating that indicate that PGx has application in the clinical setting for drugs across therapeutic categories, including drugs that are administered intravenously and are of greater familiarity to infusion nurses. This article provides an overview of the science and presents common examples of PGx as it relates to drug and/or drug dose selection. Additionally, there are brief summaries of the role infusion nurses can play relative to toxicity monitoring, patient education, and other aspects of PGx.


Asunto(s)
Biomarcadores Farmacológicos , Infusiones Intravenosas/métodos , Rol de la Enfermera , Farmacogenética , Medicina de Precisión/métodos , Humanos , Estados Unidos
9.
Artículo en Inglés | MEDLINE | ID: mdl-26604871

RESUMEN

One primary function of community pharmacies is to dispense medications to patients. In doing so, pharmacists frequently communicate with physicians' offices to clarify prescription orders and obtain additional information to ensure the safe and accurate dispensing of medications. Such communication is often done by telephone or fax, which is inefficient for both the pharmacy and the physician's office. This problem was highlighted in a recent American Medical Association resolution defining certain pharmacy inquiries as "interference with the practice of medicine and unwarranted." As a result, many are seeking to understand how to balance the needs of the patient care process with the need for operational efficiency in the physician's office and pharmacy. This study presents one example of a health information technology-based solution involving shared access to an electronic health record (EHR), and describes a case in which a physician's office and a community pharmacy experimented with this model to promote practice efficiency while also providing enhanced access to clinical information in both directions. The rationale behind the process change, a brief description of how the new process came into existence, and a description of how information sharing can be helpful in related clinical situations are provided. Similar models that involve sharing of EHRs may create valuable opportunities for collaboration between physicians and pharmacists to enhance patient care and improve workflow efficiency.


Asunto(s)
Eficiencia Organizacional , Registros Electrónicos de Salud/organización & administración , Relaciones Interprofesionales , Farmacéuticos , Médicos , Comunicación , Servicios Comunitarios de Farmacia/organización & administración , Intercambio de Información en Salud , Humanos , Capacitación en Servicio , Administración del Tratamiento Farmacológico/organización & administración , Calidad de la Atención de Salud
10.
Hosp Pharm ; 50(6): 467-76, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26405338

RESUMEN

Pharmacy residency programs have become increasingly competitive in recent years, and changes to the residency search and application process have altered the process for matching with a residency. In this article, major residency topics, from the benefits of residency training to searching for and ranking programs, are summarized. A discussion of tips and tricks for applying for residencies and interviewing for positions is included along with specific suggestions developed with data following the implementation of the Pharmacy Online Residency Centralized Application Service (PhORCAS). The article is organized in a question and answer format to help facilitate understanding of key concepts and common questions that may arise from applicants. Many changes have taken place in the residency search and application process in recent years, and the process of obtaining a residency is complex. Residency applicants and those advising applicants may find value in the answers to commonly asked residency application questions to help ensure the greatest chance of a successful residency match.

11.
Consult Pharm ; 30(4): 228-39, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25893701

RESUMEN

OBJECTIVE: To outline how the inclusion of pharmacogenetic data lends additional information in the overall decision making relative to drug therapy in the elderly patient. DATA SOURCES: The National Center for Biotechnology's PubMed database was searched for relevant pharmacogenetic-based dosing guidelines, as well as papers discussing drug use, and pharmacogenetics in the elderly. Google Scholar was also searched for the related documents. STUDY SELECTION: Papers cited were those that presented a rationale for drug therapy in the elderly, presented pharmacogenetic-based dosing guidelines with supporting information, and specifically discussed pharmacogenetics and other therapeutic principles relative to drug therapy in the elderly. DATA SYNTHESIS: Specific examples were extracted for presentation where data on drug use in the elderly corresponded with pharmacogenetic information. Specific examples were selected to illustrate pharmacogenetic influences on medications of clinical significance in the elderly population including meperidine, tramadol, amitriptyline, nortriptyline, flecainide, and propafenone. These medications were identified as intersecting points in the Beers criteria and pharmacogenetic guidelines provided by the Clinical Pharmacogenetics Implementation Consortium and the Dutch Pharmacogenetics Working Group, or where mechanisms of pharmacogenetic influences were applicable. CONCLUSIONS: Inclusion of pharmacogenetic data/information in the decision-making process may help the clinician to more appropriately guide therapy in the elderly patient.


Asunto(s)
Farmacogenética , Anciano , Antiarrítmicos/uso terapéutico , Antidepresivos/uso terapéutico , Humanos , Manejo del Dolor
12.
Per Med ; 12(6): 563-573, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29750615

RESUMEN

AIM: The aim of this study was to evaluate a pharmacogenomics certificate training program relative to pharmacist competencies in basic genetic concepts, genetics and disease, pharmacogenetics/pharmacogenomics and ethical, legal and social implication. METHODS: Participants, including pharmacists, pharmacy students and pharmacy educators completed a survey related to to the competency statements. Following the pre-program survey, participants completed a 6-week home self-study with subject matter including basic science (three chapters) and clinical application of pharmacogenomics (eight chapters). The participants completed a quiz for each of the self-study chapters. Following the self-study, participants completed a day-long, 7-h live program which included a review of the competency statements and counseling sessions with seven different simulated patients (primarily pharmacy students). Participants then completed a post-program survey which included the same items as the pre-program survey. RESULTS: Specifically, for the pharmacist participants, the average score of the self-study quizzes was 91%. For the pharmacists specifically, there was a statistically significant increase in self-assessed perception of competence related to pharmacogenomics. Additionally, it was observed that recommendations related to specific drug-gene interactions for the simulated patients were addressed correctly 95% of the time across all participant-patient encounters. CONCLUSION: Self-study and a live, interactive component in the certificate training program led to increased self-understanding of defined pharmacogenomics competencies. Additionally, pharmacy students, in the role of simulated patients gained knowledge during the live component of the program. This type of program, especially if made available through electronic-based platforms can serve to educate pharmacists and increase the uptake of pharmacogenomics in various healthcare settings.

13.
P T ; 39(9): 630-7, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25210416

RESUMEN

The influence of genetics on pharmacokinetics can introduce variability among individual patients that may cause treatment failure, toxicity, or both. Such variability, specifically in clearance rates, can influence drug maintenance dosing regimens.

14.
J Pharm Pract ; 27(4): 416-9, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24532818

RESUMEN

INTRODUCTION: Although antiplatelet therapy is a mainstay of post-percutaneous coronary intervention therapy, pharmacogenetic (PGt) considerations of therapy are often ignored despite related Food and Drug Administration warnings. Pharmacists are well situated to provide PGt guidance, and the community pharmacy is one setting where PGt testing, interpretation, and recommendations can take place to ensure optimal therapeutic outcomes. CASE REPORT: A 65-year-old man who had a myocardial infarction that was treated with PCI and stent placement was determined by a community pharmacist to be a candidate for PGt testing to ensure optimal antiplatelet therapy. The patient was seen in the pharmacy as a part of a medication therapy management encounter and underwent genetic testing. Results of the genetic testing indicated the need for modification of therapy. The community pharmacist interpreted the results and made the appropriate recommendation to the cardiologist who in turn modified antiplatelet therapy appropriately. CONCLUSION: This case describes the potential for collaboration between pharmacists and physicians to optimize antiplatelet therapy through PGt testing. Points of consideration for others looking to implement related PGt services are also discussed.


Asunto(s)
Farmacéuticos/organización & administración , Farmacogenética , Inhibidores de Agregación Plaquetaria/administración & dosificación , Tienopiridinas/administración & dosificación , Anciano , Servicios Comunitarios de Farmacia/organización & administración , Conducta Cooperativa , Pruebas Genéticas/métodos , Humanos , Masculino , Infarto del Miocardio/terapia , Intervención Coronaria Percutánea/métodos , Médicos/organización & administración , Rol Profesional , Stents
15.
J Pharm Pract ; 25(5): 530-6, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22572221

RESUMEN

PURPOSE: To conduct a needs assessment to determine employee attitudes and barriers toward participation in a multidisciplinary work site-based health and wellness clinic. METHODS: A 21-question survey was developed and sent electronically to all available (n = 874) employees of a self-insured employer. RESULTS: Of the 303 survey respondents (34.7% response rate), 67.3% (n = 204) individuals indicated a desire to meet with a pharmacist regarding medication information. Medication therapy management (MTM) services most often selected by survey respondents included basic education about each medication and its intended purpose (33%, n = 100); education on self-care (30%, n = 91); and information on generic or less expensive alternative medications and strategies for cost savings (25.1%, n = 76). Eighty-eight (29%) respondents indicated a desire for preventive care counseling to receive guidance on recommended disease screenings, immunizations, and other recommended services. Additional interest was observed in nutrition coaching (n = 131, 43.2%) and exercise programming (n = 272, 89.4%). CONCLUSIONS: The majority of respondents indicated a desire to participate in a work site-based health and wellness clinic, regardless of baseline health status or medication use. These data provide insight into the needs and preferences of participants in work site wellness programs and shows the value of a needs assessment.


Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Promoción de la Salud/métodos , Farmacéuticos , Rol Profesional , Autocuidado , Adolescente , Adulto , Anciano , Estudios Transversales , Medicamentos Genéricos/efectos adversos , Medicamentos Genéricos/economía , Medicamentos Genéricos/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ohio , Farmacología Clínica/educación , Servicios Preventivos de Salud , Lugar de Trabajo , Adulto Joven
16.
J Pharm Pract ; 25(2): 130-5, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22048927

RESUMEN

OBJECTIVE: To describe the implementation and evaluation of a pilot multidisciplinary disease state management (DSM) program for diabetes, hypertension, and hyperlipidemia at a private, self-insured university (over 900 covered lives). METHODS: Enrollees met with a pharmacist, nurse, exercise physiologist, and students in these disciplines to improve clinical outcomes and fitness parameters. Clinical values, quality of life, patient knowledge of disease states, and patient satisfaction were assessed. RESULTS: Of the 20 patients in the pilot program, 17 completed 1 nursing and 2 pharmacist visits; 8 completed exercise physiology visits. At baseline, elevated blood pressure readings were observed in 64.7% (11 of 17) of patients, 20% of those with diabetes (1 of 5) had an elevated hemoglobin A1c value (HbA1c), and 82.4% (14 of 17) had a cholesterol value that was not at goal. At least 1 medication-related problem was observed in 16 patients (94.1%). At 3 months, all patients with diabetes achieved HbA1c levels at or below 7%, 4 patients attained blood pressure control, and 1 achieved normal cholesterol readings. Patients characterized participation in the program as valuable and convenient. CONCLUSIONS: Patients involved in the multidisciplinary DSM showed improved clinical outcomes after 3 months. Ongoing analysis of patient outcomes will determine the long-term effectiveness of the DSM.


Asunto(s)
Diabetes Mellitus/terapia , Hiperlipidemias/terapia , Hipertensión/terapia , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , Adulto , Anciano , Biomarcadores/sangre , Presión Sanguínea , Colesterol/análisis , Diabetes Mellitus/economía , Manejo de la Enfermedad , Femenino , Hemoglobina A Glucada/análisis , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hiperlipidemias/economía , Hipertensión/economía , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Satisfacción del Paciente , Proyectos Piloto , Calidad de Vida , Resultado del Tratamiento
17.
Consult Pharm ; 26(7): 491-3, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21729850

RESUMEN

As pharmacists strive for tighter glucose control in their patients, several considerations exist including the selection of insulin delivery administration methods. Traditionally, insulin administration using vials and syringes has been common, but insulin pens are also a viable option. Insulin pens have been shown to increase patient autonomy, which may impact adherence. Elderly patients, who may suffer from dexterity and visual impairment, have been shown to prefer insulin pens because they are easier to use. Although insulin pens are more expensive per mL, some patients may find an economic advantage with insulin pens based on copays and beyond-use dating. In long-term care settings, the additional cost of insulin pens may be offset by the reduced insulin-administration time. Pharmacists are well suited to advocate for their patients and to help select the insulin administration method that considers individual limitations and fiscal realities, and will best support the patient's disease management.


Asunto(s)
Sistemas de Liberación de Medicamentos , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Farmacéuticos , Rol Profesional , Anciano , Costos y Análisis de Costo , Sistemas de Liberación de Medicamentos/economía , Humanos , Hipoglucemiantes/economía , Insulina/economía , Prioridad del Paciente , Medicina de Precisión , Autoadministración , Jeringas
18.
Consult Pharm ; 26(6): 426-9, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21628141

RESUMEN

Insulin therapy is crucial to the treatment of many patients with diabetes mellitus. Therefore, it is important for pharmacists to consider the clinical and economic implications of the decision between insulin pens and insulin vials and syringes. Clinically, insulin pens show an advantage through improved adherence and reduced hypoglycemic events. Furthermore, overall health care costs were either unchanged or improved in insulin pen users as compared with those using insulin vials and syringes, although little economic advantage was observed when switching from insulin vials to insulin pens. Patients tend to prefer insulin pen use based on patient satisfaction and ease of use. Through an understanding of the advantages and disadvantages of insulin pens and vials and syringes, pharmacists can help to advocate for the most appropriate insulin-delivery method to maximize clinical outcomes and to reduce overall health care spending.


Asunto(s)
Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/economía , Insulina/administración & dosificación , Insulina/economía , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/economía , Costos de la Atención en Salud , Humanos , Jeringas , Resultado del Tratamiento
19.
Ann Pharmacother ; 44(11): 1793-9, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20923943

RESUMEN

OBJECTIVE: To review recent literature regarding mandatory residencies in the perspective of the historical entry-level degree debate. DATA SOURCES: Articles were identified through searches of MEDLINE/PubMed, national pharmacy association Web sites, and a review of the references of related literature. STUDY SELECTION AND DATA EXTRACTION: Several studies, commentaries, and reviews are examined to discuss viewpoints from both the entry-level degree and mandatory residency debates. Similarities were observed between the 2 debates in regard to objectives and rationale for change, educational issues, pharmaceutical care issues, and economic issues. DATA SYNTHESIS: Fewer than 10 years ago, after many years of debate, colleges of pharmacy made the transition to offering the PharmD degree as the sole entry-level degree for licensure as a pharmacist. Similar debates have taken place over the past several years and continue to take place regarding the necessity for residency training. One key 2006 document by the American College of Clinical Pharmacy calls for mandatory residency training for entry into pharmacy practice by 2020. CONCLUSIONS: In parallel with the entry-level degree debate, consensus has yet to be reached among pharmacists and pharmacy organizations, but several have shown support for mandatory residency training for all pharmacists involved in direct patient care. Many questions have yet to be answered regarding the timeline, economics, and feasibility of such a mandate.


Asunto(s)
Educación en Farmacia/historia , Internado no Médico/organización & administración , Facultades de Farmacia/historia , Historia del Siglo XX , Humanos , Internado no Médico/historia , Farmacéuticos , Sociedades Farmacéuticas , Estudiantes de Farmacia/historia , Estados Unidos
20.
Am J Health Syst Pharm ; 67(11): 929-31, 2010 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-20484217

RESUMEN

PURPOSE: The implementation of a $4 generic drug program in a 340B pharmacy is described. SUMMARY: The Cordelia Martin Health Center (CMHC) pharmacy operates as part of the Neighborhood Health Association, a federally qualified health center in Toledo, Ohio. Clinic patients have prescription coverage through Medicaid or do not have prescription coverage, and 89% of prescriptions without any form of prescription coverage are for patients whose income is at or below 200% of the federal poverty line. Financial transaction data at CMHC were analyzed to determine the financial viability of a program for $4 generic medications. Once this was determined to be a financially viable option, the $4 lists of mass-merchant pharmacies were obtained, and the drugs from the CMHC formulary that appeared on any of these lists were included on the $4 list of the CMHC pharmacy. A total of 93 medications were included on CMHC's list. The new pricing structure became effective in January 2009. The total number of prescriptions filled at the CMHC pharmacy from January to March 2009 was 7134. For the same three-month period in 2008, 6166 prescriptions were filled. In January-March 2009, the average prescription volume increased by 9 prescriptions per day in January, by 19 prescriptions per day in February, and by 23 prescriptions per day in March, compared with those months in 2008. CONCLUSION: A $4 generic drug program implemented at a 340B pharmacy increased patients' access to medication and increased the pharmacy's prescription volume while contributing to an increase in the pharmacy's net revenue.


Asunto(s)
Medicamentos Genéricos/economía , Servicios Farmacéuticos/economía , Medicamentos bajo Prescripción/economía , Centros Comunitarios de Salud/economía , Centros Comunitarios de Salud/organización & administración , Costos de los Medicamentos/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/economía , Humanos , Servicios Farmacéuticos/organización & administración , Pobreza , Estados Unidos
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