INNOVATIONS in pharmacy (Iip - E-Journal)
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Assessment of Community Pharmacists Willingness and Barriers of Medication Therapy Management (MTM) focused on Pain Management and Mental Health
Get PDFObjectives: To determine the willingness and barriers of community pharmacists to provide pain management and depression MTM services.
Methods: An anonymous, self-administered survey was distributed electronically to 350 licensed pharmacists in a supermarket pharmacy chain. The survey consisted of a 40 question, Likert-type scale, where strongly disagree was assigned a value of one and strongly agree a value of seven. Constructs measured included: MTM interest, comfort with MTM, confidence with appropriate medication use and adjustment, educational needs, training required, time constraints, and work-related factors. Demographic data was also collected.
Results: A total of 186 (53%) community pharmacists completed the survey. These pharmacists worked in an environment where MTM was currently being provided. Ninety percent of respondents averaged 0-5 MTM sessions per 4 week period. Pharmacists agreed that patients would benefit from MTM focused on pain (median 6 IR[5-7]) and/or depression (median 6 IR[5-7]) and agreed pharmacists can have positive interventions in these situations (pain: median 6 IR[5-7]; depression: median 6 IR[5-7]). Pharmacists surveyed were interested in continuing education and live presentation as preferred methods to improve knowledge of pain management and depression.
Conclusion: Pharmacists are interested in and believe patients would benefit from MTM specifically for pain management and depression. Barriers to MTM focused on pain and depression were pharmacist training and workflow issues with the MTM process.
Type: Original Researc
Recognizing and Disseminating Innovations in Scholarly Teaching and Learning to Support Curricular Change
Get PDFType: Invitatio
Needle free injection technology - An overview
Get PDFNeedle free injection technology was developed to reduce the number of needle stick accidents and associated problems. A comprehensive literature review was completed regarding needle free injection technology and its applications, advantages over needle injections, their components and types such as powder injection, liquid injection, depot or projectile injection. This review describes needle free injection technology involving the generation of force by using compressed gas upon actuation in order to deliver a drug at very high speed through a nozzle. This review also describes injection methods that use a spring load jet injector, battery powdered jet injector, and gas powdered jet injector. An overview of marketed products, recent trends and other needleless drug delivery systems is given. Needle free injection technology is growing and has the potential to make the administration of medicine more efficient, safe and convenient.
Type: Commentar
Evaluation of a Model Comparative Drug Price Resource in Fostering Prescriber - Patient Engagement, Lowering Consumer Costs and Improving Adherence
Get PDFType: Original Researc
Promotion of ethical principles in provision of medication therapy management services
Get PDFAs pharmacists move toward more patient-centered care through medication therapy management (MTM), important issues and conflicts may arise within the therapeutic relationship, requiring pharmacists to use ethical knowledge and skills toward conflict-resolution. The purpose of this paper is to explore practical strategies that pharmacists and other champions of MTM may utilize to support the ethical principles of autonomy, veracity, nonmaleficence, beneficence, and justice, along with an ethic of care during the provision of MTM services. With a deeper understanding of ethical principles and the Code of Ethics for Pharmacists, pharmacists may be more prepared to make difficult ethical decisions, and ultimately, guide better patient care.
Type: Idea Pape
Integrating Components of Medication Therapy Management Services into Community Pharmacy Workflow
Get PDFObjective: The objective of this study was to develop and evaluate a process for integrating components of medication therapy management services into a community pharmacy workflow. Secondary objectives were to evaluate outcomes as well as patient and pharmacist satisfaction with this change.
Methods: This prospective, 3-month observational study took place in a small, independent community pharmacy. This intervention included a redesigned work system that included a seated private desk area and focus on the pharmacist, rather than the technician, being the first contact when patients entered the pharmacy. Pharmacists participated in a focus group before and after the implementation of the new workflow to better understand the delivery of the intervention and assess satisfaction. Process outcomes included time spent with the patient, the number of medication-related problems identified and recommendations made, the type of disease education provided, type and number of immunizations administered, and health monitoring tests performed. Patient satisfaction surveys were distributed after completing the intervention during the third month of the study.
Results: A total of 56 patients were enrolled in this study resulting in 82 encounters. Forty medication-related problems, including experiencing an adverse drug reaction and ineffective therapy, were identified with recommendations made to patients or prescribers. Disease education, such as goals of therapy, was provided 46 times. Health monitoring tests, such as blood pressure, were performed 16 times and eight immunizations were administered. The revised workflow incorporating components of MTM services was successful in that 39% of encounters were less than two minutes and 49% of encounters were between two and five minutes in length. Only 12% of encounters were greater than five minutes. Overall, patients were very satisfied with the intervention. Pharmacists responded positively, but expressed concern that the changes to the work system prevented them from overseeing technician functions.
Conclusion: Pharmacists in community practice are able to provide components of medication therapy management services during a brief, face-to-face interaction with patients. Overall, patients and pharmacists were satisfied with the changes to the pharmacy work system and that additional work system changes are needed to further expand the role of the community pharmacist and facilitate patient-pharmacist interactions.
Type: Original Researc
Incorporating a Continuing Professional Development Process into Residency Training
Get PDFContinuing Professional development (CPD) has been defined as a "self-directed, ongoing, systematic and outcomes-focused approach to learning and professional development." CPD is an important process that can be used to achieve a habit of lifelong learning and competence in the profession. The CPD process includes 5 steps - reflect, plan, act, evaluate and document. It has been postulated that introducing CPD early in a pharmacist's career encourages the development of life-long learning habits. Pharmacy residents are an ideal cohort to implement CPD into their program, since their accrediting body, the American Society of Health System Pharmacists (ASHP) already encourages the use of deliberate goal identification and evaluation throughout the resident's training. We describe here the process of integrating a continuing professional development (CPD) model into a residency teaching certificate program, subsequent lessons learned and recommendations for the future.
Type: Idea Pape
Assessing Pharmacists' Attitudes and Barriers Involved with Immunizations
Get PDFPharmacists are considered the most accessible health care professional. Immunizations create an opportunity for the profession to grow and develop toward direct patient care. Between 1995 and 2004 programs involving immunizations led to a national initiative to train pharmacists that became a significant leap toward pharmacist's involvement in direct patient care. Although immunizations can be considered a catalyst to change the pharmacist's role, little was known about pharmacist's attitudes and the barriers involved with immunizing. Few studies have assessed barriers, attitudes, and practice issues experienced by immunizing pharmacists. The objective of this study was to determine pharmacists' attitudes toward immunizations and more specifically to assess possible barriers involved with this practice. Five hundred pharmacists were randomly selected for inclusion in the study from the State of Ohio Board of Pharmacy Database, of which 137 (27.4%) completed the survey. A 37- item questionnaire was administered via an e-mail invitation to take an online survey using Qualtrics software with a Likert-type scale, where 1 = strongly disagree and 7 = strongly agree. Several topics were assessed regarding immunizations including time constraints, workflow constraints, adequacy of training, technician support, worksite conditions and space, immunization processes, reimbursement issues, safety issues, documentation issues, and the future direction of immunizations. Demographics included gender, age, degree, number of years practicing, practice site, and number of years immunizing. Seventy-three percent of pharmacists believed that immunizing could lead to prescription filling errors (mean=4.45, SD=1.79). Pharmacists strongly agreed that having more technicians on staff would make providing immunizations easier (mean=5.80, SD=1.39) and that they play a vital role in keeping the process running smoothly (mean=6.08, SD=1.16). Also, pharmacists strongly agreed that they would feel more comfortable providing immunizations with another pharmacist on duty (mean=5.77, SD=1.39). Currently, less than ten percent of patients complete the immunization paperwork in advance; pharmacists strongly agreed that having patients complete the paperwork ahead of time would make the process more efficient (mean=5.76, SD=1.20). Pharmacists agreed that they feel adequately trained on their pharmacy's emergency protocol if patients were to have an adverse reaction to an immunization (mean=5.17, SD=1.60) although, seventy-three percent are only comfortable immunizing patients sixteen years and older. Most pharmacists agreed that they felt comfortable allowing interns to give immunizations under supervision (mean=5.23, SD=1.79). Pharmacists agreed that they should be able to provide the measles (mean=5.04, SD=2.07) and Tdap (mean=5.31, SD=2.00) vaccinations. Finally, most pharmacists agreed that the best way to compensate immunizing pharmacists was through a performance-based bonus. Pharmacist's attitudes toward immunizations are generally positive, however, more technician help and overlap of pharmacists would greatly benefit the immunization process.
Type: Student Projec
Experience and Outcomes of a Pharmaceutical Care Leadership Residency Program
Get PDFThe University of Minnesota College of Pharmacy's Ambulatory Care Residency Program has graduated 22 residents from its Leadership Emphasis program from 1999 to 2014. The Leadership Emphasis program is unique in its design, providing a set of experiences over two years focused on developing leadership skills in practice development, establishing personal influence, advocacy in the profession, and teaching. The program's design has focused on bringing value to three distinct audiences: pharmacists enrolled in the program, the local pharmacy practice community, and the College of Pharmacy. This paper explores the program's contributions in each of these areas.
Program graduates from 1999-2009 were interviewed and cited the independent, yet mentored, activities of the program as instrumental to their professional and personal development. The program has provided significant value to the College of Pharmacy, primarily in the form of instructional support, service to faculty practice sites and development of new practice sites for APPEs. Teaching and precepting hours offset the salary of the residents, resulting in financial benefits for the College. In the second year of the program, residents pursue development of new practice sites, 15 of which have been sustained to provide at least a half-time pharmacist position, having a direct impact on pharmacy practice development in the region.
The program provides a win-win-win situation for all the stakeholders involved. Schools and colleges of pharmacy are encouraged to consider whether a similar program may assist in achieving its own goals in practitioner development, teaching and learning, and community engagement.
Type: Clinical Experienc