INNOVATIONS in pharmacy (Iip - E-Journal)
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Individualized Dosing of Children's Liquid Medications in the Community Pharmacy Setting: A Survey of Parents and Guardians
Get PDFObjectives: 1) To determine parents' and/or guardians' interest in having pharmacists provide children's liquid medications in a pre-measured, individualized dosing device 2) To assess parents' and/or guardians' perception of dosing liquid medications for a child.
Design: Observational survey
Setting: Regional chain pharmacy in North Carolina
Participants: > 18 years old, parent/guardian of a childchain, responsible for administering child's liquid medication
Intervention: 14 item questionnaire
Main Outcome Measure: Interest in pharmacists providing children's liquid medications in pre-measured, individualized dosing devices
Results: 250 questionnaires were mailed; 42 were marked "return to sender" (16.8%), 22 were returned completed (10.6%), and 20 of the 22 met inclusion criteria (9.6%). 95% of study participants reported being interested in having pharmacists provide children's liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is "not at all difficult" to understand the amount of dose a child is to receive, while 55% reported it is "not at all difficult" to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child's medication.
Conclusion: Community pharmacists should explore providing children's liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide.
Type: Original Researc
A Description of Medication Decision-Making, Dispensing, and Utilization for Hypertensive Patients in Nishtar Hospital Multan, Pakistan
Get PDFHypertension is a worldwide health problem affecting developed and developing countries, and Pakistan is no exception. Nishtar Hospital Multan is categorized as one of the biggest hospitals in South Asia. The objective for this study was to describe medication decision-making, dispensing, and utilization for patients diagnosed with hypertension at this patient care facility. The study was conducted by 5 trained pharmacists working in collaboration with prescribers who met with study participants when they visited the hospital. All interview questions were asked in Urdu during the hospital visit. Data were summarized using descriptive statistics. A total of 301 patients who visited the hospital agreed to participate in the study. The findings showed that prescribers spend little time with patients and rarely follow guidelines for decision-making. Regarding the dispensing of medications for the treatment of hypertension, none of the dispensing was completed by a pharmacist and none of the patients received counseling about medications at the time of dispensing. Most patients reportedly do not take their medication as prescribed. Regarding outcomes, 20% of the patients had pre-hypertension, 47% stage 1 hypertension, and 33% stage 2 hypertension. Great improvements are possible in the treatment of hypertension at the hospital we studied through application of standard treatment guidelines, patient education, and adjustments to work system processes so that alignment of provider's skills with opportunities in improving the patient care process can be achieved.
Type: Case Stud
Transitions in Care: Medication Reconciliation in the Community Pharmacy Setting After Discharge
Get PDFObjective: To assess the feasibility of a workflow process in which pharmacists in an independent community pharmacy group conduct medication reconciliation for patients undergoing transitions in care.
Methods: Three workflow changes were made to improve the medication reconciliation process in a group of three independent community pharmacies. Analysis of the process included workflow steps performed by pharmacy staff, pharmacist barriers encountered during the medication reconciliation process, number of medication discrepancies identified, and pharmacist comfort level while performing each medication reconciliation service.
Key Findings: Sixty patient medication reconciliation services met the inclusion criteria for the study. Pharmacists were involved in all steps associated with the medication reconciliation workflow, and were the sole performer in four of the steps: verifying discharge medications with the pharmacy medication profile, resolving discrepancies, contacting the prescriber, and providing patient counseling. Pharmacists were least involved in entering medications into the pharmacy management system, performing that workflow step 13% of the time. The most common barriers were the absence of a discharge medication list (24%) and patient notpresent during consultation (11%). A total of 231 medication discrepancies were identified, with an average of 3.85 medication discrepancies per discharge. Pharmacists' comfort level performing medication reconciliation improved through the 13 weeks of the study.
Conclusions: These findings suggest that medication reconciliation for patients discharged from hospitals and long term care facilities can be successfully performed in an independent community pharmacy setting. Because many medication discrepancies were identified during this transition of care, it is highly valuable for community pharmacists to perform medication reconciliation services.
Type: Original Researc
The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System
Get PDFType: Commentar
Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management
Get PDFThe current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.
Type: Original Researc
Community Pharmacists' Awareness of Intimate Partner Violence: An Exploratory Study
Get PDFBackground: Intimate partner violence (IPV) is a serious public health problem, impacting more than 12 million people in the United States each year. The only know effective health care intervention is routine screening for IPV exposure; however, this intervention has been poorly adopted. Expansion of screening efforts to the community pharmacy setting provides an opportunity to have a substantial impact on the health and well-being of pharmacy patients. However, little is known about pharmacists' knowledge, attitudes, and behaviors related to IPV.
Objective: The objective of this study was to conduct an exploratory investigation of community pharmacists' current level of knowledge, attitudes, behaviors, and intentions related to IPV and to IPV screening.
Methods: A cross-sectional study using an online questionnaire was conducted. Surveys were distributed via email. Descriptive analyses of survey responses were conducted.
Results: A total of 144 community pharmacists completed the survey. Results indicated most (67.4%) had no IPV education/training. Participants were significantly more willing to conduct screening with targeted patients compared to all patients. (X2=129.62; df=36; p<0.0001). There was strong agreement with interest in and willingness to participate in continuing education.
Conclusions: Most respondents indicated relatively low levels of IPV knowledge and training and very little current IPV screening activity. Continuing education on IPV should be considered for pharmacists to increase knowledge and awareness of IPV.
Type: Original Researc
Design and Evaluation of Health Literacy Instructional Video for Pharmacy Students
Get PDFObjectives: 1) To describe the development of a health literacy video tailored for pharmacy students. 2) To compare the use of a health literacy video as an instructional method to a previously used health literacy instructional strategy by using both and: a) assessing pharmacy students' perceptions of their ability to communicate with low health literacy patients and b) assessing pharmacy students' perceptions of their overall understanding of the role of health literacy in a pharmacy setting.
Case Study: A novel pharmacy health literacy instructional video was created providing patient-pharmacist scenarios involving low literacy patients. A previously used role-play activity was performed in a required "Health Promotion and Literacy" course followed by the viewing of the newly designed health literacy instructional video. Two separate paper-based survey instruments were developed and administered to individually assess both active learning strategies and for comparison of the strategies. Statistically significant differences were noted on all five survey questions with the instructional video rating higher than the role play activity in the overall enhancement of students' understanding of health literacy.
Conclusions: A pharmacy health literacy instructional video was well received by students. It significantly improved students' perception of their ability to communicate with low health literacy patients in a pharmacy setting and their overall understanding of health literacy.
Type: Case Stud
Landscape of Medication Management in the Minnesota Patient-Centered Medical Home (PCMH)
Get PDFPurpose: To describe the landscape of medication management within the patient-centered medical homes (PCMH) in the state of Minnesota.
Methods: An electronic survey of care coordinators within PCMHs certified with the Department of Health in state of Minnesota was conducted. The survey and follow up were distributed by the Minnesota Department of Health. At the time the survey was distributed, there were 161 certified PCMHs in the state.
Results: The final analysis included 21 respondents. Size, setting, and time as a certified PCMH varied between practices. PCMHs reported a higher percentage of patients enrolled at lower complexity tiers (35.0 percent at tier I and 40.4 percent enrolled at tier II), with PCMHs with clinical pharmacist services reporting slightly increased frequency of higher complexity patients. The composition of the care team varied from clinic to clinic, but all clinics were multidisciplinary with a mean of 5.8 different provider types listed for each clinic. Physicians were the most common providers of medication management across all settings, and one respondent reported that medication management services are not formally provided in his/her clinic. The presence or absence of a clinical pharmacist did not significantly influence care coordination time dedicated to medication-related activities. Respondents residing in a clinic with clinical pharmacist services reported a high level of satisfaction with pharmacist-provided services.
Conclusion: The implementation of the PCMH model in many of the participating clinics was relatively recent and there remains much to be learned regarding the landscape of comprehensive medication management in the PCMH. The reported distribution of patients in complexity tiers suggests that clinics may use different strategies to determine resource allocation. Although the presence of a clinical pharmacist did not influence care coordination time dedicated, care coordinators valued services provided by clinical pharmacists.
Type: Original Researc
Cultivation and Implementation of Community-Engaged Pharmacy Services in a Free Clinic to Enhance Care for the Medically Underserved
Get PDFPartnerships between community free clinics and academic medical centers improve patient outcomes and enhance learning opportunities for students. A community-academic partnership between the Maliheh Free Clinic and the University of Utah College of Pharmacy was formed to fulfill a community need for pharmacy services, to promote interdisciplinary patient care, and to provide an experiential opportunity for students. The Maliheh Free Clinic based in Salt Lake City, Utah provides free primary health care to uninsured individuals who live 150% below federal poverty guidelines. Three pharmacy services were developed and implemented. These include: 1) clinic chart reviews which involve written recommendations following a comprehensive assessment of the patient's chart examining his or her disease states and the appropriateness of his or her medications; 2) medication reconciliations and discussion of pharmacy-related recommendations with patients during Diabetes Day, an inclusive interdisciplinary patient appointment that addresses important aspects of diabetes care; and 3) an insulin dose adjustment service through a collaborative practice agreement with the clinic to monitor a patient's blood glucose levels and adjust his or her medications accordingly on a weekly basis.
Type: Student Projec
Lessons Learned from the Implementation of Two Transitions of Care Programs
Get PDFType: Clinical Experienc