Journal articles: 'Pharmacist-Provided' – Grafiati (2024)

Abstract:

Background Pharmacists in various settings have been effective in initiating diabetes treatment. Patients with diabetes require ongoing disease management, and community pharmacists are in a strategic position to provide such extended care. Little is known, however, about the effects of community pharmacist–provided interventions beyond the initial treatment period. Objective To evaluate the effect of community pharmacist–provided extended diabetes care service on primary clinical outcomes, including hemoglobin A1c (A1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure, and on patients' reported self-care activities. Methods A randomized controlled trial was conducted in patients with diabetes. Participants had already completed at least 2 diabetes education sessions at a local diabetes education center. Nine specially trained pharmacists administered interventions during up to 4 quarterly visits per patient. Interventions included discussing medications, clinical goals, and self-care activities with patients and recommending medication changes to physicians when appropriate. The main outcome measures were 12-month changes in A1C, LDL-C, blood pressure, and self-report of self-care activities. Results Seventy-eight patients participated in the study (36 intervention, 42 control); 66 were included in the final analysis (31 intervention, 35 control). Compared with changes in the control group, patients who received interventions significantly increased the number of days per week that they engaged in a set of diet and diabetes self-care activities (1.25 and 0.73 more days/wk, respectively). The mean 12-month changes for A1C, LDL-C, and blood pressure were not significantly different between the 2 study groups. Conclusions Although pharmacist-provided interventions did not demonstrate statistically significant improvements in clinical outcomes over the study period, study results did show that pharmacists were effective at increasing the number of days that patients spent engaging in healthy diet and diabetes self-care activities. Addressing lifestyle and self-care behaviors can be a beneficial component of a pharmacist-provided extended diabetes care service.

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237 Background: Pharmacist-provided patient education for oral chemotherapy is poorly documented in patient electronic medical records (EMR) at UIC Oncology Pharmacy. At baseline, 41% of patients who started new therapy with selected oral chemotherapies had a patient education note documented by a pharmacist in their EMR. Our aim is to provide and document patient education for at least 90% of patients who start new oral chemotherapy and fill their prescriptions at UIC Oncology Pharmacy over three months. The importance of patient counseling and documentation is recognized by the Quality Oncology Practice Initiative (QOPI) group. Approximately 25% of patients undergoing chemotherapy are on oral chemotherapy. (Deutsch S, Koerner P, Miller RT, Craft Z, Fancher K. Utilization patterns for oral oncology medications in a specialty pharmacy cycle management program. J Oncol Pharm Pract. 2014;0:1-8.) Methods: A multi-disciplinary team performed an affinity sort and created a process map to identify areas of intervention. The first intervention was labelling prescription bags to identify them as oral chemotherapy prescriptions that require counseling by a pharmacist. Data was collected after two weeks. Results: At the completion of the first PDSA cycle, 40% of patients who started new oral chemotherapy had a documented patient education note written by a pharmacist in their EMR. Documentation of education was performed on the day of pick-up in 89% of cases. Table 1 shows the percentage of notes that included the elements recognized by QOPI standards: documentation of start date, adherence, and adverse effects. Conclusions: Documentation of patient education for oral chemotherapy should be a well-integrated component of ambulatory pharmacy practice. A second PDSA cycle is planned to increase rates of documentation by utilizing the pharmacy resident to perform patient counseling and documentation. Future interventions will be aimed at improving the quality of the data included in the documented notes. [Table: see text]

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Background: The United States is spending an increasing share of its national income on health care while American citizens are not receiving the commensurate benefit of longer, healthier lives. Pharmacists are in a position to provide high-quality care; however, a paucity of data exists on payers’ perspectives on insurance reimbursem*nt for pharmacist-provided, community-delivered clinical services. Objective: To understand payers’ perspectives toward pharmacist-provided community-delivered advanced clinical services. Methods: A 15-minute online survey was administered to determine payers’ preferences and attitudes of impact about care being provided in a community pharmacy setting by a pharmacist. Results: The study recruited 50 payers from a diverse set of US organizations. The likelihood for reimbursem*nt for a suite of pharmacist-provided, community-delivered clinical services was likely/very likely (66%), neutral (22%), and unlikely/very unlikely (12%). Pharmacists were viewed positively by payers for the provision of these services. Payers think that more clinical services should be offered in the community pharmacy. Trust in pharmacist-provided information services on general health and medications, and pharmacist competency were strongly positive. Conclusions and Relevance: A quantitative assessment of payer attitudes for pharmacist-provided, community-delivered advanced clinical practice was positive. Payers were positive about pharmacist contributions to the provision of heath and medication information. Continued development and deployment of advanced clinical services at the community pharmacy appears to be a financially viable model.

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Purpose: Patient satisfaction with the use of telehealth in disease state management provided by pharmacists has not been fully studied. We hypothesized that patient satisfaction with pharmacist-provided consultations via clinical video teleconferencing (CVT) would not differ from face-to-face delivery. Methods: Patients were recruited from 2 primary care provider sites from September 2015 to May 2016. Patients completed a survey to evaluate their satisfaction and quality of provider–patient communication with the method in which consultation with a pharmacist was provided. The survey was a 10-item, patient self-reported questionnaire. The primary outcome evaluated patients’ scores on assessment of the provider’s use of patient-centered communication. The secondary outcome evaluated patients’ scores on assessment of the provider’s clinical competence and skills and interpersonal skills. Results: There were a total of 57 surveys collected. For both the primary outcome and secondary outcome, over 80% of collected responses for each question in both clinics were scored a 5 that indicates patients were very satisfied with the provider’s use of patient-centered communication and clinical competence and skills. For both the primary and secondary outcomes, there were no statistically significant differences in patients’ scores that assessed provider’s use of patient-centered communication nor the provider’s clinical competence and skill. Conclusion: The results of this study indicate patients are satisfied with pharmacists’ use of patient-centered communication and clinical competence and skills via both CVT and face-to-face consultations supporting our research hypothesis that patient satisfaction with care provided via CVT did not differ from face-to-face provided care.

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Abstract Purpose We describe the implementation of a pharmacist-provided pharmacogenomics (PGx) service in an executive health program (EHP) at an academic medical center. Summary As interest in genomic testing grows, pharmacists have the opportunity to advance the use of PGx in EHPs, in collaboration with other healthcare professionals. In November 2018, a pharmacist-provided PGx service was established in the EHP at the University of Colorado Hospital. The team members included 3 physicians, a pharmacist trained in PGx, a registered dietitian/exercise physiologist, a nurse, and 2 medical assistants. We conducted 4 preimplementation steps: (1) assessment of the patient population, (2) selection of a PGx test, (3) establishment of a visit structure, and (4) selection of a billing model. The PGx consultations involved two 1-hour visits. The first visit encompassed pretest PGx education, review of the patient’s current medications and previous medication intolerances, and DNA sample collection for genotyping. After this visit, the pharmacist developed a therapeutic plan based on the PGx test results, discussed the results and plan with the physician, and created a personalized PGx report. At the second visit, the pharmacist reviewed the PGx test results, personalized the PGx report, and discussed the PGx-guided therapeutic plan with the patient. Overall, the strategy worked well; minor challenges included evaluation of gene-drug pairs with limited PGx evidence, communication of information to non-EHP providers, scheduling issues, and reimbursem*nt. Conclusion The addition of a PGx service within an EHP was feasible and provided pharmacists the opportunity to lead PGx efforts and collaborate with physicians to expand the precision medicine footprint at an academic medical center.

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Background: Dengue is a self-limiting acute mosquito transmitted disease caused by an arbovirus and spread by Aedes mosquitoes, sever infections results in DHF & DSS. Hence school education has been described as a ‘social vaccine’, and it can serve as a powerful preventive tool. Aim & Objectives: To assess the prevalence of mosquito borne diseases among School children, to assess the knowledge level of high school children regarding dengue and its prevention before and after the administration of planned teaching programme and to provide health education regarding dengue fever among school children. Materials and Methods: A six months’ community based prospective observational study was conducted at selected schools of Gulbarga District. Total of 265 students were enrolled into the study by considering study criteria. Our inclusion criteria are all students of secondary school students of class 8th -10th. The data was collected from school children of RGEMS & AEMS in Gulbarga district. Results: In our study, most of the students were unaware of insect and species of mosquito which is responsible for causing DF, DHS & DSS and their knowledge was found to be excellent 3.6%, good 33.46%, average 37.90% and poor 25.00% before providing the knowledge. We pharmacist in our study played a vital role in providing education to the school children and their knowledge progress after our study was found, excellent 69.23%, good 30.76% and none of the students had average and poor knowledge. Conclusion: Our study concludes that the educational interventions by the pharmacist plays a vital role by educating the students and their by improving theirs and surrounding community health. Hence it is very imperative for pharmacists and other health care disciplinarians to carry out community based studies or educational interventions at all levels of students particularly in rural India where there is scope to improve their knowledge which helps students their parents and siblings and surrounding community.

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Background and aims. Patient education is a critical task that may be carried out by the pharmacists, especially in the context of contemporary pharmacists’ roles, which tend to be closer to patients and their needs. This study aimed to evaluate the counseling provided by the pharmacist in the community pharmacy, from the patient’s perspective.Patients and methods. We conducted a prospective, non-interventional study in 520 pharmacies from 10 Romanian counties across the country. The first 10 visitors of the pharmacy on a given day were asked to complete a questionnaire regarding the counseling provided by the pharmacist during the visit.Results. More than 90% of patients received advice from the pharmacist on the route of administration, use in relation to meals, dosage and length of treatment. More than 80% of the patients were counseled on the medicine contraindications and precautions, interactions with other medicines and food, side effects, additional changes in lifestyle and diet appropriate to the condition and the necessity to immediately consult a doctor/pharmacist in case of adverse drug reactions. Lower percentages were registered for advising the patient on the obligation to return to pharmacy the unused psychotropic drugs (38.04%) and the ability of the drug to modify the laboratory results (47.66).Conclusions. The results of the present study showed that the counseling activity in the community pharmacy is carried out by the pharmacists in a high proportion, according to the patients’ feedback.

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Objective: To compare the estimated cost avoidance (ECA) of pharmacist-provided medication therapy management (MTM) services among common disease states encountered in community pharmacy practice. Design: Retrospective analysis. Setting: Nine community pharmacies in North Carolina. Patients: Three hundred and sixty-four patients who are 65 years of age or older, a Medicare Part D beneficiary and a North Carolina resident. Interventions: An MTM pharmacist-provider conducted medication reviews to eligible patients between July 2009 and October 2009. For each encounter, patient interventions, pharmacist recommendations, and ECA were recorded. Main outcome measure: ECA. Results: In 9 pharmacy locations, 634 MTM interventions were documented during the study period. The ECA in a 4-month period yielded approximately $494 000. Comprehensive medication reviews, new prescription counseling and appropriate medication administration, and technique counseling made up nearly two-thirds of interventions. Overall, the probability that an MTM intervention would result in an ECA greater than $0 was .35. Conclusions: Pharmacist-provided MTM effectively reduced costs associated with patient medication use. Such interventions reduced costs in overall health care specifically in the areas of cardiovascular, gastroesophageal reflux disease, pulmonary, and diabetes groups.

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Menopause is described as the point of time when the last menstruation occurs in a woman. This is the period during which changes in the bleeding patterns due to alterations in the hormone levels were noticed. Due to alterations in these hormone levels, physical as well as mental health changes occur in women resulting in menopausal symptoms. Hence, this study was conducted to analyze the impact of counseling on MHS of postmenopausal women. This simple prospective interventional study was conducted in the Gynecology department of Tertiary Care Hospital for a period of 4 months in 200 patients divided into two groups. Mental health status (MHS) scores were calculated by using a validated questionnaire. Statistically significant difference in the score of baseline MHS was found between the two groups. Reduction in the score of MHS was seen in both the groups after counseling. Thus, this study revealed that providing counseling to postmenopausal women has positive impact on their mental health. Therefore, rendering effectual and repeated counseling to menopausal women depends on their need assist in leading a happy moreover healthy life. Keywords: Post menopause; Estrogen deficiency Mental health; Counseling