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1.
Curr Pharm Teach Learn ; 16(11): 102169, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39121812

RESUMEN

BACKGROUND AND PURPOSE: To describe student pharmacist's application of the Pharmacists' Patient Care Process (PPCP) during participation in an interprofessional introductory pharmacy practice experience (IPPE) at a Type 1 Diabetes (T1D) pediatric summer camp. EDUCATIONAL ACTIVITY AND SETTING: Student pharmacists entering professional year two (P2) and three (P3) attended a one-week, overnight T1D summer camp as part of the longitudinal IPPE curriculum between June 2021 and July 2023. They completed two PPCP assignments, a reflective assignment and a self-evaluation following the experience. FINDINGS: Thirty-seven students attended camp. The most common PPCP assignments submitted corresponded to the collaborate core competency (75.6%) and the implement (51.4%) and collect (27.0%) steps. Written reflections revealed students learned about therapeutic monitoring of diabetes, hypoglycemia and hyperglycemia management, insulin dose adjustment, and lifestyle strategies such as carbohydrate counting. Many students expressed feeling increased empathy (59.5%) and inspiration (56.8%) toward individuals with T1D. Students reflected positively on their experience working with an interprofessional team. Self-evaluations indicated perceived competency in all steps and core areas of the PPCP, especially in communication. DISCUSSION: Overall, student feedback indicates inclusion of camp as a non-traditional pharmacy practice site provides ample opportunity to apply the PPCP through participation and interprofessional decision-making opportunities in patient care. Our findings demonstrate camp provided the ability to partake in activities that encompass every step and core component of the PPCP. Immersion in the camp environment allowed early learners to feel competent in their ability to engage in the PPCP and communicate with patients and healthcare professionals. SUMMARY: Participation in a T1D summer camp provided early student pharmacists exposure to direct patient care and opportunity to apply the PPCP in an interprofessional education environment. Students learned clinical diabetes knowledge and skills, in addition to increased empathy and a feeling of inspiration. Students felt highly competent in their ability to communicate with patients, pharmacists, and other healthcare providers.

2.
J Am Pharm Assoc (2003) ; 62(4): 1394-1399, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35382984

RESUMEN

BACKGROUND: Several studies have shown the use of telehealth in diabetes management to be as efficacious as traditional clinic visits; however, these studies focused on English-speaking populations. OBJECTIVES: The primary objective of this study was to evaluate whether telehealth is an effective approach for participation in pharmacist collaborative diabetes management services among non-English-speaking or limited English proficiency (LEP) patients at a federally qualified health center (FQHC). The secondary objective was to evaluate glycated hemoglobin (A1c) as a clinical outcome in patients participating in telehealth versus in-person visits. METHODS: This study was a retrospective chart review. Patients were non-English-speaking or LEP adults (≥ 18 years of age) with a diagnosis of type-2 diabetes (T2D) referred for pharmacist collaborative diabetes management services by a medical provider. This study reviewed patient participation and A1c values over 6 months (May to October) of 2 consecutive years (2019 and 2020). RESULTS: In this study, 40 patients in 2019 and 50 patients in 2020 met the inclusion criteria. In 2019, the primary visit model was in-person and 123 total visits were scheduled with a pharmacist. In 2020, the primary visit model was telehealth and 143 total visits were scheduled. In 2019, there were 28 no-show visits, which accounted for 22.8% of total visits. In 2020, there were 27 no-show visits, which accounted for 18.9% of total visits. The mean change in A1c from baseline to follow-up was found to decrease by 1.0% in 2019 and 0.95% in 2020. CONCLUSIONS: We concluded that telehealth participation in pharmacist-provided collaborative T2D services and decrease in A1c were similar during telehealth compared with in-person visits among non-English-speaking and LEP patients at a FQHC. However, further studies with larger sample sizes are necessary to determine the overall impact of telehealth in non-English-speaking or LEP patients.


Asunto(s)
Diabetes Mellitus Tipo 2 , Telemedicina , Adulto , Diabetes Mellitus Tipo 2/terapia , Hemoglobina Glucada/análisis , Humanos , Farmacéuticos , Estudios Retrospectivos
3.
Am J Pharm Educ ; 84(4): 7453, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32431304

RESUMEN

Objective. To determine the ability of first-year Doctor of Pharmacy (PharmD) students to describe patient care activities performed by pharmacists and accurately associate those activities with the five core steps of the Pharmacists' Patient Care Process (PPCP). Methods. First-year student pharmacists completed introductory practice experiences at ambulatory and institutional pharmacies. Students' ability to describe activities that occurred in these settings and align them with the five core steps (collect, assess, plan, implement, and follow-up) of the PPCP were assessed. Results. The students were more adept in describing patient care activities and aligning them to the appropriate PPCP steps in an ambulatory pharmacy setting than in an institutional pharmacy setting. Students achieved higher scores when describing and aligning patient care activities associated with the collect and implement steps in an ambulatory pharmacy setting and for the assess step in an institutional pharmacy setting. Conclusion. As institutions strive to adopt the PPCP in all areas of the curriculum, this application serves as an example of successful PPCP integration early in the introductory experiential curriculum. Our results challenge faculty to provide early opportunities for students to apply the PPCP in a variety of practice settings, including settings focused on the medication distribution system.


Asunto(s)
Competencia Clínica , Educación Basada en Competencias , Educación en Farmacia , Atención Dirigida al Paciente , Aprendizaje Basado en Problemas , Rol Profesional , Estudiantes de Farmacia , Curriculum , Escolaridad , Humanos
4.
Am J Pharm Educ ; 84(2): 7232, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32226066

RESUMEN

Objective. To assess the impact of curricular changes made through vertical integration between Patient Care Laboratory and Introductory Pharmacy Practice Experience (IPPE) courses on documentation outcomes. Methods. Curricular changes to address student pharmacist documentation deficiencies were developed by laboratory and experiential faculty members. A documentation activity using subjective, objective, assessment, plan (SOAP) notes completed in one IPPE rotation block, pre-intervention, were graded and compared to SOAP notes from the same IPPE rotation block in the subsequent year, post-intervention, using a standard checklist. Chi square test (or Fisher exact test when appropriate) was used to evaluate the relationship between each question's score and different timepoints. Wilcoxon rank sum test was used to compare total scores between the two groups of students. Results. Significant improvement among student pharmacists' SOAP note scores were observed in the post-intervention cohort (n=52) compared to pre-intervention cohort (n=52) following curricular changes. Specific SOAP note components that revealed significant improvements between years were drug therapy problem identified, proposed drug therapy problem resolution, follow-up plan identified, overall impression, and addressing a pharmacist-specific intervention. Conclusion. Collaboration between laboratory and experiential education faculty members are integral to the identification of gaps in student pharmacists' application of simulated activities into actual experiences and in the achievement of educational outcomes. Curricular quality improvements can be implemented and assessed quickly through vertically integrated courses.


Asunto(s)
Educación Basada en Competencias/métodos , Curriculum/normas , Educación en Farmacia/métodos , Facultades de Farmacia/normas , Documentación , Evaluación Educacional , Humanos , Laboratorios , Atención al Paciente , Aprendizaje Basado en Problemas , Desarrollo de Programa , Mejoramiento de la Calidad , Estudiantes de Farmacia , Integración de Sistemas
5.
J Am Pharm Assoc (2003) ; 59(4S): S81-S84, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31203016

RESUMEN

OBJECTIVES: To describe the adequacy of health record information available to community pharmacists when completing medication therapy management (MTM) interventions and to quantify the time spent on interventions that are ultimately revealed as invalid. METHODS: This prospective cross-sectional study analyzed cases of high-risk medication use in the elderly and statin use in persons with diabetes identified by 3 MTM platforms across 15 grocery chain pharmacies. MTM interventions were completed by phone and fax following a usual care protocol. Collected data included case validity (defined as the case truly requiring a pharmacist's involvement), case success (defined as achieving the targeted goal of the intervention), time spent on the intervention, and a determination of whether information from an electronic health record (EHR) could have eliminated patient or prescriber contact. RESULTS: Among 163 cases analyzed, 54% were found to be valid and 30% successful. The most common reasons for invalidity were allergy or contraindication, patient already taking a statin, and patient not having the targeted condition. Overall, 14% of cases were valid and successful, 40% valid and unsuccessful, 17% invalid and successful, and 29% invalid and unsuccessful. Valid successful cases averaged 15.3 minutes per case, valid unsuccessful cases averaged 9.2 minutes, invalid successful cases averaged 4.2 minutes, and invalid unsuccessful cases averaged 5.1 minutes. Based on the case-by-case determination of the researchers, EHR information would have completed 39% of cases without patient or prescriber contact. The average time spent on cases needing EHR access was 5.5 minutes, compared with 9.5 minutes for cases in which EHR access would not have helped. CONCLUSION: Community pharmacists performing MTM interventions are hindered by lack of access to patient health information, imprecise patient targeting by MTM platforms, and cumbersome communication between pharmacists and prescribers.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Registros Electrónicos de Salud/estadística & datos numéricos , Administración del Tratamiento Farmacológico/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Recolección de Datos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
6.
Ann Pharmacother ; 53(1): 95-100, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30019916

RESUMEN

Millions of Americans use over-the-counter analgesics on a daily basis, and nearly 100 million nonsteroidal anti-inflammatory drug (NSAID) prescriptions are filled per year. In high-risk patients, these medications can disrupt kidney hemodynamics and precipitate community-acquired acute kidney injury (CA-AKI). The risk of NSAID-associated CA-AKI increases 3- to 5-fold in patients taking renin-angiotensin system inhibitors and diuretics concurrently. CA-AKI increases the risk of developing chronic kidney disease (CKD) or accelerating progression of pre-existing CKD. Importantly, many cases of NSAID-induced CA-AKI may be avoided by identifying high-risk patients and providing patient and provider education on when to avoid these medications and minimize risk.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Antiinflamatorios no Esteroideos/efectos adversos , Antiinflamatorios no Esteroideos/farmacología , Femenino , Humanos , Masculino , Factores de Riesgo
7.
J Am Pharm Assoc (2003) ; 58(4S): S69-S72.e1, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30006188

RESUMEN

OBJECTIVES: To determine patients' awareness of the screening recommendations for hepatitis C virus (HCV) in "Baby Boomers," to assess patients' willingness to receive a point-of-care HCV screening test in the pharmacy, and to determine patients' barriers to receiving a point-of-care HCV screening test in a community pharmacy. METHODS: An anonymous 12-question survey was developed. Five shareholder pharmacies of American Pharmacy Services Corporation (APSC) volunteered to participate. Surveys were mailed to participating pharmacies with instructions to distribute to patients born in 1945 to 1965 at the pharmacy point-of-sale. Data were collected over a 12-week period from October 2016 to January 2017. Completed surveys were collected by participating pharmacies and mailed to the primary investigator. Data were analyzed with the use of descriptive statistics. RESULTS: Ninety-five eligible surveys were returned and analyzed. A majority of respondents were female (63.00%) and held a bachelor degree or higher (63.16%); 38.95% of patients were aware of HCV age-based risk factors and screening recommendations. Only 9.80% of patients were aware of the fingerstick point-of-care testing (POCT) option for HCV. Nearly three-fourths (71.70%) were willing to receive POCT at a community pharmacy. A majority of patients (65.52%) were unwilling to pay an amount that would cover the cost of testing. Descriptive statistics, including a Pearson chi-square test, were used to analyze the data. Significant differences in the distribution of the percentages of people willing to receive testing and to pay for testing were found among levels of annual household income. CONCLUSION: A majority of patients are willing to receive POCT at a community pharmacy. Patients were unwilling to pay for testing, however, so pharmacies looking to offer point-of-care HCV screening would need to secure further financial resources, such as insurance reimbursement or grant funding, for this service to be financially feasible.


Asunto(s)
Concienciación/fisiología , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Hepatitis C/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Sistemas de Atención de Punto/estadística & datos numéricos , Pruebas en el Punto de Atención/estadística & datos numéricos , Anciano , Actitud Frente a la Salud , Femenino , Hepacivirus/patogenicidad , Humanos , Masculino , Persona de Mediana Edad , Percepción , Encuestas y Cuestionarios
8.
Pharmacy (Basel) ; 5(2)2017 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-28970432

RESUMEN

This study sought to understand the medication adherence and quality of life (QOL) of recipients of a pharmacist-based medication management program among independently living older adults. Using a cross-sectional, quasi-experimental study design, we compared older adults enrolled in the program to older adults not enrolled in the program. Data were collected via face-to-face interviews in independent-living facilities and in participants' homes. Independently living older adults who were enrolled in the medication management program (n = 38) were compared to older adults not enrolled in the program (control group (n = 41)). All participants were asked to complete questionnaires on health-related quality of life (QOL, using the SF-36) and medication adherence (using the four-item Morisky scale). The medication management program recipients reported significantly more prescribed medications (p < 0.0001) and were more likely to report living alone (p = 0.01) than the control group. The medication management program recipients had a significantly lower SF-36 physical functioning score (p = 0.03) compared to the control group, although other SF-36 domains and self-reported medication adherence were similar between the groups. Despite taking more medications and more commonly living alone, independent living older adults enrolled in a pharmacist-based medication management program had similar QOL and self-reported medication adherence when compared to older adults not enrolled in the program. This study provides initial evidence for the characteristics of older adults receiving a pharmacist-based medication management program, which may contribute to prolonged independent living and positive health outcomes.

9.
J Am Pharm Assoc (2003) ; 54(5): 510-7, 5 p following 517, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25148656

RESUMEN

OBJECTIVES: To evaluate the perceptions of independent community pharmacists within a regional independent community pharmacy cooperative on implementing personalized medicine services at their pharmacies and to gauge the pharmacists' self-reported knowledge of pharmacogenomic principles. DESIGN: Descriptive, exploratory, nonexperimental study. SETTING: American Pharmacy Services Corporation (APSC), 2011-12. PARTICIPANTS: Pharmacists (n = 101) affiliated with the independent pharmacies of APSC. INTERVENTION: Single-mode survey. MAIN OUTCOME MEASURES: Independent community pharmacists' interest in implementing personalized medicine services, perceived readiness to provide such services, and perceived barriers to implementation. RESULTS: 101 completed surveys were returned for data analysis. The majority of pharmacists surveyed (75%) expressed interest in offering personalized medicine services. When asked to describe their knowledge of pharmacogenomics and readiness to implement such services, more than 50% said they were not knowledgeable on the subject and would not currently be comfortable making drug therapy recommendations to physicians or confident counseling patients based on results of genetic screenings without further training and education. Respondents identified cost of providing the service, reimbursement issues, current knowledge of pharmacogenomics, and time to devote to the program as the greatest barriers to implementing personalized medicine services. CONCLUSION: The majority of independent community pharmacists are interested in incorporating personalized medicine services into their practices, but they require further education before this is possible. Future initiatives should focus on the development of comprehensive education programs to further train pharmacists for provision of these services.


Asunto(s)
Servicios Comunitarios de Farmacia/organización & administración , Farmacéuticos/organización & administración , Farmacogenética/métodos , Medicina de Precisión/métodos , Adulto , Actitud del Personal de Salud , Femenino , Encuestas de Atención de la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Rol Profesional , Estados Unidos , Adulto Joven
10.
Pharm Pract (Granada) ; 11(4): 203-10, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24367460

RESUMEN

BACKGROUND: Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of "clinical inertia" or "recognition of the problem but failure to act." OBJECTIVE: THE AIM OF THIS STUDY IS TO QUANTIFY THE RATE OF CLINICAL INERTIA BETWEEN TWO MODELS OF CARE: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC). METHODS: Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time to achieve goal hemoglobin A1c (A1c), systolic blood pressure (SBP) and low-density lipoprotein (LDL) was compared in the two models of care. RESULTS: A total of 113 patients were included in the analysis of this study, 54 patients were in the PMDC and 59 patients were in the UMC group. Median time (days) to intervention for A1c values >7% was 8 days and 9 days in the PMDC and UMC groups, respectively (p>0.05). In patients with baseline A1c values >8%, median time to achieving A1c<7% was 259 days vs. 403 days in the PMDC and UMC groups, respectively (p<0.05). Median time to goal SBP was 124 days in the PMDC group and 532 days in the UMC group (p<0.05). Median time to goal LDL was 412 days in the PMDC group vs. 506 days in the UMC group (p<0.05). CONCLUSIONS: Rates of clinical inertia, defined as time to intervention of suboptimal clinical values, did not differ significantly between patients enrolled in a PMDC compared to patients with UMC with respect to A1c, SBP and LDL. Participation in PMDC, however, was associated with achieving goal A1c, SBP, and LDL levels sooner compared to UMC.

11.
Pharm. pract. (Granada, Internet) ; 11(4): 203-210, oct.-dic. 2013.
Artículo en Inglés | IBECS | ID: ibc-118174

RESUMEN

BACKGROUND: Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of "clinical inertia" or "recognition of the problem but failure to act." OBJECTIVE: The aim of this study is to quantify therate of clinical inertia between two models of care: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC). METHODS: Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time to achieve goal hemoglobin A1c (A1c), systolic blood pressure (SBP) and low-density lipoprotein (LDL) was compared in the two models of care. RESULTS: A total of 113 patients were included in the analysis of this study, 54 patients were in the PMDC and 59 patients were in the UMC group. Median time (days) to intervention for A1c values >7% was 8 days and 9 days in the PMDC and UMC groups, respectively (p > 0.05). In patients with baseline A1c values >8%, median time to achieving A1c<7% was 259 days vs. 403 days in the PMDC and UMC groups, respectively (p < 0.05). Median time to goal SBP was 124 days in the PMDC group and 532 days in the UMC group (p < 0.05). Median time to goal LDL was 412 days in the PMDC group vs. 506 days in the UMC group (p < 0.05). CONCLUSIONS: Rates of clinical inertia, defined as time to intervention of suboptimal clinical values, did not differ significantly between patients enrolled in a PMDC compared to patients with UMC with respectto A1c, SBP and LDL. Participation in PMDC, however, was associated with achieving goal A1c, SBP, and LDL levels sooner compared to UMC (AU)


ANTECEDENTES: La evidencia sugiere que los pacientes con diabetes tipo 2 (T2DM) padecen elevada "inercia clínica" o "reconocimiento del problema pero fracaso en la actuación". OBJETIVO: El objetivo de este estudio es cuantificar la tasa de inercia clínica entre dos modelos de cuidados: consulta de diabetes gestionada por farmacéutico (PMDC) vs. cuidados médicos habituales (UMC). MÉTODOS: Se analizó en este estudio de cohorte retrospectiva a los pacientes con diabetes tipo 2 de una clínica médica universitaria. Los pacientes estuvieron expuestos a PMDC o a UMC. Se comparó la diferencia entro los dos modelos de cuidados en días desde la intervención en la respuesta a los valores sub-óptimos de laboratorio y el tiempo en alcanzar los objetivos de hemoglobina A1c (A1c) presión arterial sistólica (SBP) y lipoproteínas de baja densidad (LDL). RESULTADOS: Se incluyó en el análisis de este estudio a un total de 113 pacientes, 54 en el grupo PMDC y 59 en el UMC. La mediana de tiempo (días) desde la intervención para valores de A1c >7% fue de 8 y 9 días en los grupos PMDC y UMC, respectivamente (p > 0,05). En los pacientes con A1c basal>8%, la mediana de tiempo para alcanzar una A1c<7% fue de 259 días vs. 403 días en los grupos PMDC y UMC, respectivamente (p < 0,05). El tiempo medio hasta el objetivo de SBP fue de 124 días en el grupo PMDC y 532 en el UMC (p < 0,05). La mediana de tiempo para el objetivo de LDL fue de 412 días en el grupo PMDC vs. 506 días en el UMC (p < 0,05). CONCLUSIONES: Las tasas de inercia clínica, definidos como el tiempo desde la intervención de valores clínicos sub-óptimos, no difirieron significativamente entre los pacientes incluidos en un PMDC comparados con pacientes en UMC en relación a A1c, SBP y LDL. Sin embargo, la participación en un PMDC estuvo asociado con alcanzar el objetivo de niveles de A1c, SBP y LDL más rápido, comparado con el UMC (AU)


Asunto(s)
Humanos , Masculino , Femenino , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Servicios Farmacéuticos/organización & administración , Estudios Retrospectivos , Estudios de Cohortes , Presión Arterial , Lipoproteínas LDL , Atención a la Salud/métodos , Atención a la Salud/organización & administración , Atención a la Salud/normas
12.
J Am Pharm Assoc (2003) ; 51(6): 727-33, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22068194

RESUMEN

OBJECTIVES: To assess the interest of American Pharmacy Services Corporation (APSC) independent community pharmacists in participating in a community pharmacy research network (CPRN) and to identify perceived barriers to participation in a CPRN. DESIGN: Descriptive, exploratory, nonexperimental study. SETTING: University of Kentucky and APSC during 2009-10. PARTICIPANTS: 65 APSC independent community pharmacists in Kentucky. INTERVENTION: Single-mode survey. MAIN OUTCOME MEASURE: Independent community pharmacists' willingness to participate in community-based research and perceived barriers to participation. RESULTS: A total of 65 independent community pharmacists from 191 pharmacies returned the survey. The majority of independent community pharmacists were "interested" or "very interested" (83.8%) in participating in a CPRN. Respondents were willing to participate for a mean (±SD) of 6.5 ± 5.8 hours per week. However, they reported only being able participate in a CPRN for 5.2 ± 4.1 hours per week, with time being the greatest limitation to participation. An overwhelming percentage of respondents (92.1%) were interested in learning more about opportunities to participate in a CPRN in the future. CONCLUSION: CPRNs are an emerging interest in community pharmacy practice. A CPRN is an opportunity for independent community pharmacies to collaborate and use resources as a group to conduct research to solve issues in the community pharmacy setting.


Asunto(s)
Servicios Comunitarios de Farmacia/organización & administración , Investigación Participativa Basada en la Comunidad/organización & administración , Farmacéuticos/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , Conducta Cooperativa , Recolección de Datos , Femenino , Investigación sobre Servicios de Salud/organización & administración , Humanos , Kentucky , Masculino , Persona de Mediana Edad
13.
J Am Geriatr Soc ; 57(8): 1487-91, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19573220

RESUMEN

The Geriatric Pharmacy elective course at the University of Kentucky College of Pharmacy uses a simulated medication adherence project to increase awareness of adherence concerns facing older adults who take multiple medications. This study evaluated the effect of this project. Students enrolled in this 3-credit hour course in 2002 to 2007 participated in the 10-day project followed by a live classroom discussion and a reflective assignment. Evaluations of the project were administered to the students on Blackboard. Two hundred thirty-seven health professional students (99% pharmacy) participated in the course project. Open-ended comments in the evaluations and reflective assignments were retrospectively analyzed using a qualitative research method known as thematic analysis. The majority (83%) of comments were positive. Students indicated the greatest learning experiences in the categories of empathy and adherence. This simulated medication adherence project is one tool that may be used to increase students' awareness of the difficulties with medication adherence that their patients may encounter.


Asunto(s)
Educación en Farmacia/métodos , Geriatría/educación , Cooperación del Paciente , Simulación de Paciente , Polifarmacia , Evaluación Educacional , Femenino , Humanos , Kentucky , Masculino , Estudios Retrospectivos
14.
J Am Pharm Assoc (2003) ; 48(6): 722-30, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19019800

RESUMEN

OBJECTIVE: To describe outcomes attained by the DiabetesCARE component of the PharmacistCARE program, which is an innovative pharmacy practice model implemented within a self-insured employer. DESIGN: Descriptive nonexperimental study. SETTING: University of Kentucky (UK), from March 2003 through December 2006. PATIENTS: 236 patients with diabetes (95% with type 2 diabetes). INTERVENTION: Three clinical pharmacists provided UK Health Plan (UKHP) members with diabetes with comprehensive disease state and medication therapy management. MAIN OUTCOME MEASURES: Clinical outcomes included glycosylated hemoglobin (A1C), fasting lipid panels, blood pressure, weight, vaccination rates, and aspirin use. Humanistic outcomes included the mental and physical components of the 12-Item Short-Form Health Survey (SF-12) and patient satisfaction with health services related to their diabetes care. Screening parameters included the proportion of patients meeting Healthcare Effectiveness Data and Information Set expectations for patients with diabetes. Productivity and health resource use were also assessed based on patient responses to survey questions. RESULTS: After 1 year of enrollment, patients in the DiabetesCARE program achieved improved clinical outcomes compared with baseline, as evidenced by statistically significant reductions in A1C, low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Statistically significant increases were seen in high-density lipoprotein cholesterol and the proportion of patients obtaining influenza vaccine, yearly screenings for lipid level assessment, screenings for kidney disease, and eye examinations. The mental component score of the SF-12 was significantly increased. Patients were highly satisfied with the DiabetesCARE service, and satisfaction with their overall diabetes care within UKHP was significantly enhanced. Based on the patient provided survey data analyzed here, productivity and health resource use were unchanged; however, additional analyses using UKHP claims data are ongoing. CONCLUSION: The DiabetesCARE program is a unique pharmacist-provided service delivered in a freestanding pharmacist clinic that enhances health outcomes for adult members with diabetes in a self-insured employer group.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Administración del Tratamiento Farmacológico/organización & administración , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , Adulto , Anciano , Atención Ambulatoria/organización & administración , Complicaciones de la Diabetes/prevención & control , Manejo de la Enfermedad , Femenino , Hemoglobina Glucada/metabolismo , Encuestas Epidemiológicas , Humanos , Kentucky , Lípidos/sangre , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Resultado del Tratamiento
15.
J Am Pharm Assoc (2003) ; 48(6): 731-6, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19019801

RESUMEN

OBJECTIVES: To evaluate the efficacy of pharmacist recommendations to health care providers, as part of PharmacistCARE, a single-center, pharmacist-run, diabetes medication therapy management (MTM) service. If the recommendation was accepted, a secondary objective was to measure the length of time for acceptance. DESIGN: Prospective assessment. SETTING: University of Kentucky (UK), from March 2003 through December 2006. PATIENTS: 172 adult patients with diabetes enrolled in the UK Health Plan who participated in the DiabetesCARE program. INTERVENTION: Pharmacists provided medication therapy-related recommendations to health care providers. MAIN OUTCOME MEASURES: Acceptance of pharmacist recommendations by health care providers, length of time to acceptance, and cost savings attained with formulary recommendations. RESULTS: A total of 692 recommendations were sent to health care providers; 425 (61.4%) were accepted. A total of 578 clinical recommendations were related to drug therapy problems; 348 (60.2%) were accepted by health care providers. Median time to acceptance for clinical recommendations was 13.5 days (0-229). Formulary recommendations accounted for 114 (16%) of the total recommendations, 77 (67.5%) were accepted, and median time to acceptance was 47.2 days (0-172). Average monthly cost savings per accepted formulary recommendation was $13.59 for the health plan and $13.85 for the patient. CONCLUSION: A similar percentage of health care provider acceptance (61.4%) was seen compared with previous studies of pharmacists' interventions in different practice settings. To our knowledge, this is the first study to evaluate time to acceptance of pharmacist recommendations to health care providers, including the resolutions made through collaborative drug therapy management. Lastly, the current study reinforces the assertion that pharmacists can positively affect cost savings for both the patient and health plan, through formulary management.


Asunto(s)
Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Administración del Tratamiento Farmacológico/organización & administración , Farmacéuticos/organización & administración , Anciano , Atención Ambulatoria/economía , Atención Ambulatoria/organización & administración , Actitud del Personal de Salud , Ahorro de Costo , Diabetes Mellitus Tipo 1/economía , Diabetes Mellitus Tipo 2/economía , Femenino , Formularios Farmacéuticos como Asunto , Humanos , Seguro de Salud/economía , Kentucky , Masculino , Persona de Mediana Edad , Servicios Farmacéuticos/economía , Servicios Farmacéuticos/organización & administración , Médicos/psicología , Rol Profesional , Estudios Prospectivos , Factores de Tiempo
16.
J Am Pharm Assoc (2003) ; 48(6): 793-802, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19019810

RESUMEN

OBJECTIVE: To describe the PharmacistCARE program, an innovative pharmacy practice model implemented within a self-insured employer and to describe lessons learned by the authors in implementing and maintaining the program. SETTING: University of Kentucky (UK), March 2003 to present. PRACTICE DESCRIPTION: A free-standing pharmacist clinic located within an ambulatory care facility owned by UK HealthCare. PRACTICE INNOVATION: PharmacistCARE, a pharmacist-provided patient care service for UK Health Plan members that includes comprehensive disease and medication therapy management. MAIN OUTCOME MEASURES: Various lessons learned by the authors during development, implementation, and maintenance of the program. RESULTS: The program has been recognized by the university as a positive contribution to health plan service enhancement and cost savings and has documented enhanced patient care outcomes. CONCLUSION: The PharmacistCARE program is a unique pharmacist-provided service delivered in a free-standing pharmacist clinic that enhances health outcomes for adult members in a self-insured employer group.


Asunto(s)
Atención Ambulatoria/organización & administración , Atención al Paciente/métodos , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , Atención Ambulatoria/economía , Ahorro de Costo , Manejo de la Enfermedad , Humanos , Kentucky , Administración del Tratamiento Farmacológico/organización & administración , Evaluación de Resultado en la Atención de Salud , Atención al Paciente/economía , Atención al Paciente/normas , Servicios Farmacéuticos/economía , Servicios Farmacéuticos/normas , Farmacéuticos/economía , Calidad de la Atención de Salud
17.
J Am Pharm Assoc (2003) ; 47(1): 86-92, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17338480

RESUMEN

OBJECTIVE: To describe the Raising Energy and Awareness in Campus Health (REACH) program, an innovative pharmacy practice model implemented within a self-insured employer. SETTING: University of Kentucky, Lexington. PRACTICE DESCRIPTION: A self-funded university-based health plan. PRACTICE INNOVATION/INTERVENTIONS: As part of a university-wide effort to control rising health care costs for 24,000 employees and dependents, four novel pharmacist services encompassed in the REACH program were provided: Co-Pay Counseling; Good Medicines; OutREACH; and Disease Management and Health Promotion. MAIN OUTCOME MEASURES: University health plan expenditures and health plan member out-of-pocket expenses for prescription medications. RESULTS: The REACH services were provided by 3.5 full-time equivalent pharmacists. Pharmacists evaluated health plan members' medications and conditions in an effort to identify more cost-effective treatment regimens in the Co-Pay Counseling program; provided confidential medication regimen review in the Good Medicines effort; provided informational programs at worksites within the university in the Out-REACH service; and worked with plan members and their health providers to prevent and/or minimize the impact of diseases such as diabetes and dyslipidemias. The overall university program and medication coinsurance strategy saved an estimated 1.6 million dollars in 2003-04. CONCLUSION: This unique package of employee benefits and services enabled the University of Kentucky to slow the growth of health care expenditures. Pharmacists were an important element in this effort.


Asunto(s)
Control de Costos/organización & administración , Prescripciones de Medicamentos/economía , Seguro de Servicios Farmacéuticos/economía , Consejo , Honorarios Farmacéuticos , Humanos , Práctica Profesional , Facultades de Farmacia/organización & administración , Servicios de Salud para Estudiantes/organización & administración
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