INNOVATIONS in pharmacy (Iip - E-Journal)
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Impact of Pharmacists and Student Pharmacists in Educating and Screening Low-Income Women for Cardiovascular Disease
Get PDFObjectives: To evaluate the effectiveness of an educational intervention on knowledge of cardiovascular disease (CVD) and to increase awareness of risk factors among female patients of a community health center with an on-site 340B pharmacy.
Methods: The program consisted of a 10-minute educational intervention and brief pre-test, post-test, and participant satisfaction survey. Adult female patients at the clinic for any provider visit or prescription fill were eligible to participate. Participants met individually with a student pharmacist or faculty member and verbally completed the pre-test. The participant received education regarding CVD, risk factors, and symptoms of myocardial infarction and were screened for hypertension and/or hyperlipidemia. The post-test was then verbally administered. Participants answered the satisfaction survey privately. Based on individual needs, educational materials and information on available pharmacy clinical services were provided. The university IRB deemed the study exempt.
Results:Eighty-four individuals received educational materials and/or a screening test. Of those, 30 women (mean age 46.9 years) completed the educational intervention. Thirteen (43%) reported smoking; 22 (73%) identified themselves as overweight. Fourteen (47%) indicated a preexisting diagnosis of hypertension. Correct responses for 6 of 8 knowledge-based questions were statistically significantly improved from pre-test to post-test (p
Conclusion: CVD is the leading cause of death in U.S. women. Data from this program indicate that through screening and education, pharmacists and student pharmacists can impact female patients' knowledge of CVD risk factors. Continued efforts in this area may help to reduce the public health burden of CVD.
Type: Student Projec
Antidepressant Use Amongst College Students: Findings of a Phenomenological Study
Get PDFBackground: Depression among college students is an escalating problem and could have serious consequences such as suicide. There has been an increase in use of antidepressants on college campuses in United States. However, an in depth understanding of this phenomenon from the college student's perspective is lacking in the literature.
Objective: This study examined college students' experiences and treatment decision making during their depression treatment.
Methods: A longitudinal, phenomenological research methodology was completed. The participants were nine students who were taking antidepressants for diagnosis of depression. Recruitment was done via brochures placed at University bulletin boards, and a mental health clinic. Three audio taped, unstructured interviews were conducted with each participant over four months. The central question asked was: What has the experience of treating depression been for you? Analysis of text was done using Van Manen's lifeworld existentials of lived body, lived time, lived relation and lived space as the organizing framework.
Results: Thirteen themes were identified within the four lifeworlds. The results showed that lived relation with providers was important for college students' decision to both initiate and continue antidepressant use. Students' role was defined in conjunction with provider's role by them as wanting to be a 'player' in their treatment decisions and needing to be 'acknowledged' as such by their providers.
Conclusions: Overall, the underlying essential theme of ‘autonomy’ was portrayed by the students’ experiential accounts of their depression treatment and treatment decision making.
Type: Original Researc
Commentary for Medication Adherence of Patient Assistance Program Recipients: A Pilot Study
Get PDFType: Commentar
Don't Leave Without Them: Dispensing asthma medications to pediatric patients upon discharge is associated with decreased hospital readmissions
Get PDFPurpose: Asthma exacerbations are a leading cause of hospital and emergency department admissions at pediatric institutions. The objective of this study was to determine if patients who obtain discharge medications from a pediatric institution's outpatient pharmacy after an admission for asthma have a lower thirty-day readmission rate than those who do not obtain discharge medications from the outpatient pharmacy.
Methods: This multi-phase retrospective study included an initial chart review, an intervention period, and a second chart review of the intervention period. The chart reviews included patients ages two years and older with a discharge diagnosis of asthma or wheezing. During the intervention phase, pharmacists promoted use of the outpatient pharmacy by patients admitted for these conditions using multiple methods. In each chart review, the patients readmitted for asthma or wheezing within thirty days were classified as either outpatient pharmacy users (OPP users) or non-OPP users. Differences in readmission rates between OPP users and non-OPP users, as well as differences in overall OPP utilization, were analyzed before and during the intervention phase using a Chi-square test.
Results: The initial chart review found no significant difference in thirty day readmission rates between OPP users and non-OPP users (6.2% and 7.5%, respectively; x2 = 1.15; p = 0.274). The number of OPP users increased significantly from the first chart review to the second (11.8% and 45.9%, respectively; x2 = 929.04, p < 0.001). The second chart review revealed that OPP users had a significantly lower readmission rate than non-OPP users during the intervention phase (2.3% and 10.9%, respectively; x2 = 52.5; p < 0.001).
Conclusion: Obtaining discharge medications from the OPP was associated with a lower thirty-day readmission rate in children with asthma. Promoting use of the OPP for transitional care should continue to be part of future efforts to decrease hospital readmissions.
Type: Original Researc
Development and Implementation of a Novel Lifestyle Medicine Advanced Pharmacy Practice Experience Elective
Get PDFObjective: To develop and implement an Advanced Pharmacy Practice Experience (APPE) to increase student's awareness and use of lifestyle modifications in chronic disease prevention and management.
Design: A five-week APPE was developed that utilized a wide variety of activities, including direct patient care, patient education, case studies, journal clubs and reflective assessment and writing to explore various lifestyle modifications and their relation to chronic disease prevention and management.
Conclusion: The novel lifestyle medicine APPE provides students a unique opportunity to advance their knowledge in therapeutic lifestyle changes and expand their understanding of the pharmacist's role in chronic disease prevention and management.
Type: Idea Pape
Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services
Get PDFThe purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementation, and (6) marketing plan evaluation.
The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS). Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.
Type: Original Researc
Remember Your MEDS: Medication Education Delivers Success
Get PDFBackground: Medication adherence is one of the largest barriers to better patient outcomes today. As pharmacists and student pharmacists expand their roles with community outreach projects, they have the potential to make a huge impact on improving adherence.
Objective: To improve medication adherence through patient counseling and constructive resources, and to determine patient preferences of adherence tools.
Methods: Student pharmacists partnered with a 340B pharmacy to promote the importance of medication adherence. Patients were counseled in an initial 10 minute session, and then given the opportunity to receive one or more of the following adherence tools: a pill box, timer, reminder refrigerator magnets, calendar stickers, refill reminder phone calls and/or text message reminders. A pre-survey was conducted to establish the patients' baseline medication adherence using the validated ©Morisky Medication Adherence Scale (©MMAS-8). After three months, students conducted the post-survey via the ©MMAS-8 by calling the patients and asking them questions about the helpfulness of the adherence tools as well as the effectiveness of the initial counseling visit.
Results: Sixty five patients with hypertension enrolled in the study, and 51 patients completed both the pre- and post-surveys. Patients improved from a 6.02 (SD +/- 1.62) average pre-score to a 6.83 (SD +/-1.25) average post score (p < 0.001). Pill boxes, text message reminders, and calendar stickers were respectively ranked as the top 3 most helpful tools studied. The refrigerator magnets were also considered helpful by most patients who used them. The timers were ranked the least helpful, mostly due to difficulty of use.
Conclusion: Student pharmacists can have a positive impact on medication adherence through simple counseling and offering effective adherence tools.
Type: Student Projec
Evaluation of Patient Assistance Program Eligibility and Availability for Top 200 Brand Name and Generic Drugs in the United States
Get PDFOne strategy to encourage uninsured and underinsured patients' compliance with medication regimen is to refer them to pharmaceutical industry-sponsored patient assistance programs (PAPs). In order to receive the requested medications, patients should be qualified based on the program eligibility requirements. The purpose of this study was to examine PAP eligibility criteria for the most commonly dispensed prescriptions in the United States. We identified 136 unique chemical entities in the Top 200 drug list and 111 (82%) of these pharmaceutical products were offered by PAPs. Among the available medications, 69 (62%) were brand name; 29 (26%) were generic, and 13 (12%) had both brand name/generic forms. In terms of the availability of types of drugs (brand name vs. generic) provided by PAPs, differences in PAP eligibility requirements were found for citizenship (p < 0.001), permanent residency (p < 0.001), and prescription drug coverage (p< 0.001), but not for income limits (p= 0.051). Overall, PAPs could help low-income patients to obtain necessary medications; however, U.S. citizenship/permanent residency and restriction on prescription coverage are more likely to be required for brand name drugs rather than for generics. PAPs also provide some options for the underinsured and those with private insurance or Medicare Part D plan that offers inadequate prescription coverage.
Type: Original Researc
Patient-perceived value of Medication Therapy Management (MTM) services: a series of focus groups
Get PDFObjective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services.
Design: Focus groups.
Setting: Fairview Pharmacy Services, Minneapolis, MN.
Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i) patients who paid out-of-pocket to receive MTM services; (ii) insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii) patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services.
Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers.
Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient's belief that MTM services are not needed.
Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.
Type: Original Researc