bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients' Knowledge of and Practices Relating to the Disposal of Used Insulin Needles
Authors: Musselman Kerri T. , Sicat Brigitte L. , Thomas Michelle Herbert , Harpe Spencer E.
Published: January 2018

Objective: To determine (1) how patients currently dispose of used insulin needles, (2) whether patients were educated about disposal of their used insulin needles, and (3) who educated patients about the disposal of their used insulin needles.

Methods: A self-administered questionnaire was designed for this study. The survey assessed patient knowledge about disposal of used insulin needles and the patient-reported source and location of education about disposal techniques. The questionnaire was administered to a convenience sample of patients from four locations in Richmond, Virginia. Any patient who used insulin, was at least 18 years old, and was willing to complete the survey was eligible for inclusion.

Results: Fifty responses were received with 40% indicating that education had been received on the disposal of used needles. From that 40%, nurses were identified as the source of education 60% of the time and pharmacists 25% of the time. Approximately 50% of the respondents reported disposing of used needles directly in the trash when at home. While away from home, 22% reported placing used needles in the trash, and 38% took them home for disposal.

Conclusion: Patients are not consistently educated regarding the proper disposal of used needles. Health care practitioners should play a larger role in educating patients about the potential risks of inappropriate needle disposal and appropriate disposal methods. Future research is still needed to understand fully the magnitude of the problems associated with inappropriate needle disposal by patients.

Type: Original Research
Is Mail Service Pharmacy Cost Beneficial to Plan Sponsors?
Authors: Vulakh Larisa , Wertheimer Albert I.
Published: January 2018

The objective of this study was to describe and compare prescription drug costs charged to a plan sponsor for the top 50 maintenance medications provided through retail and mail service procurement channels. Data were obtained for covered beneficiaries of a health plan sponsored by an employer with just over 3,000 covered employees The analytics team at the PBM administering the plan sponsor's prescription drug benefit provided de-identified claims information for the top 50 maintenance prescription drugs delivered through either mail service or retail procurement methods for this employer over a one year period (7/1/2008 to 6/30/2009). Based on these data, (1) dollar amount difference (mail service minus retail), and (2) percentage difference between mail and retail costs (as a percentage of the lower net cost per day) were computed. The findings revealed that 76 percent of the medication products studied were associated with a lower net cost per day to the plan sponsor through mail service procurement and 24 percent were associated with lower net cost through retail procurement.

 

Type: Original Research
Drug Shortages in the US - Causes, Impact, and Strategies
Authors: Gu Anna , Wertheimer Albert I. , Brown Bernard , Shaya Fadia T.
Published: January 2018

Type: Idea Paper
Unit-of-Use Versus Traditional Bulk Packaging
Authors: So Tiffany , Wertheimer Albert
Published: January 2018

Background: The choice between unit-of-use versus traditional bulk packaging in the US has long been a continuous debate for drug manufacturers and pharmacies in order to have the most efficient and safest practices. Understanding the benefits of using unit-of-use packaging over bulk packaging by US drug manufacturers in terms of workflow efficiency, economical costs and medication safety in the pharmacy is sometimes challenging.

Methods: A time-saving study comparing the time saved using unit-of-use packaging versus bulk packaging, was examined. Prices between unit-of-use versus bulk packages were compared by using the Red Book: Pharmacy's Fundamental Reference. Other articles were reviewed on the topics of counterfeiting, safe labeling, and implementation of unit-of-use packaging. Lastly, a cost-saving study was reviewed showing how medication adherence, due to improved packaging, could be cost-effective for patients.

Results: When examining time, costs, medication adherence, and counterfeiting arguments, unit-of-use packaging proved to be beneficial for patients in all these terms.

 

Type: Student Project
Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals
Authors: Wallack Madeline Carpinelli , Sorensen Todd
Published: January 2018

Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs) for all drugs except those designated as "orphan." Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs.

Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals' current cost.

Results: The 18 CAHs' purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital) had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings.

Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

 

Type: Original Research
Evaluation of Patient Assistance Program Eligibility and Availability for Top 200 Brand Name and Generic Drugs in the United States
Authors: Chu Chin-Fun , Lal Lincy S , Felder Tisha M , Rosenau Pauline
Published: January 2018

One 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 Research
Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer's Criteria
Authors: Rumore Martha M. , Vaidean Georgeta
Published: January 2018

Medication review is an essential component of comprehensive falls assessment. A medication review by pharmacists can assist to identify and notify prescribers of medications that require adjustment or discontinuation. Beers Criteria and the Medication Assessment Index (MAI) are explicit and implicit inappropriate prescribing (IP) tools, respectively. While the Beers Criteria has been applied to falls prevention, the MAI has not. Developing alternative falls prevention tools has been spurned by both the desire to overcome limitations of the Beers Criteria, coupled with the need for implicit criteria which includes consideration for patient äóñspecific clinical judgement. A literature search and review of the Beers Criteria and MAI tools revealed advantages and disadvantages of each. Using combined explicit/implicit falls assessment criteria using both the Beers Criteria and MAI as a framework, a falls specific inappropriate prescribing (FASPIP) tool for use in elderly hospitalized patients was developed. Validation of the FASPIP in the clinical setting is needed.

 

Type: Review
The use of the health belief model to assess predictors of intent to receive the novel (2009) H1N1 influenza vaccine
Authors: Coe Antoinette B. , Gatewood Sharon B.S. , Moczygemba Leticia R. , Goode Jean-Venable "Kelly" R.
Published: January 2018

Objectives: 1) Assess participants' perceptions of severity, risk, and susceptibility to the novel H1N1 influenza virus and/or vaccine, vaccine benefits and barriers, and cues to action and 2) Identify predictors of participants' intention to receive the novel H1N1 vaccine.

Design: Cross-sectional, descriptive study

Setting: Local grocery store chain and university in the central Virginia area

Participants: Convenience sample of adult college students and grocery store patrons

Intervention: Participants filled out an anonymous, self-administered questionnaire based upon the Health Belief Model.

Main Outcome Measures: Participants' predictors of intention to receive the novel H1N1 vaccine

Results: A total of 664 participants completed a questionnaire. The majority of participants were aged 25-64 years old (66.9%). The majority were female (69.1%), Caucasian (73.7%), and felt at risk for getting sick from the virus (70.3%). Most disagreed that they would die from the virus (68.0%). Participants received novel H1N1 vaccine recommendations from their physicians (28.2%), pharmacists (20.7%), and nurses (16.1%). The majority intended to receive the H1N1 vaccine (58.1%). Participants were significantly more likely to intend to receive the H1N1 vaccine if they had lower scores on the perceived vaccine barriers domain (OR= 0.57, CI: 0.35-0.93). Physicians' recommendations (OR=0.26, CI: 0.11-0.62) and 2008 seasonal flu vaccination (OR=0.45, CI: 0.24-0.83) were significant predictors of intention to receive the H1N1 vaccine.

Conclusions: Most participants felt at risk for getting the novel H1N1 virus and intended to receive the novel H1N1 vaccine. Educating patients about vaccine benefits and increasing healthcare professionals' vaccine recommendations may increase vaccination rates in future pandemics.

 

Type: Original Research
Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program
Authors: Lenz Thomas L. , Gillespie Nicole D. , Faulkner Michele A. , Skrabal Maryann Z. , Skradski Jessica J. , Qi Yongyue , Larson Jessica C.
Published: January 2018

Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.

 

Type: Original Research
Design and Evaluation of Health Literacy Instructional Video for Pharmacy Students
Authors: Butler Lakesha M , Devraj Radhika , Santanello Catherine
Published: January 2018

Objectives: 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 Study
Psychometric Assessment of the PPDG: Utilizing Cronbach's Alpha as a Means of Reliability
Authors: Marr-Lyon Lisa R , Gupchup Gireesh V , Anderson Joe R
Published: January 2018

Introduction: Since the development of the 10 item Purdue Pharmacist Directive Guidance (PPDG) Scale several studies of the psychometric properties of the PPDG have been conducted. Although Cronbach's alpha was calculated as a means of internal consistency reliability, a demonstration of the mean centering of the individual items from the instrument were not explored.

Objectives: This study focused on investigating the mean stabilization of items within the PPDG as they pertain to Cronbach's reliability coefficient calculation.

Methods: Using item analysis procedures in SPSS, the mean stability of items within the general factor of directive guidance and subscales of instruction and feedback and goal setting were examined for the PPDG.

Results: Mean stability scores for entire PPDG scale and the subscales of instruction and feedback and goal setting were strong. Also, corrected item-total correlations and Cronbach's alphas following item deletion were good for the overall PPDG scale and the subscales.

Conclusions: The results provide evidence to enhance understanding of the psychometric stability of the PPDG scale and its subscales.

 

Type: Original Research
Affordable Care Act: A review and discussion of its impact on healthcare today, and a primer for pharmacists
Authors: Lui Leo Lai Ho , Wertheimer Albert
Published: January 2018

In the midst of countless healthcare debates, the Patient Protection and Affordable Care Act is written into legislation as a possible solution to the United States's rising healthcare costs. Individualized into nine titles, the act sought to provide additional coverage to millions of Americans while cutting down healthcare costs through numerous provisions effective into 2020. While the act has been challenged publicly and privately by the states, many healthcare professionals today, let alone the average American, are unaware and uneducated of what comprises the act, as well as the impact in which it has on the future of healthcare in the United States. With an increasing role of patient care placed upon pharmacists today, an understanding of the PPACA allows us to provide extensive answers to questions in which our patients may have.

 

Type: Student Project
The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System
Authors: Simard Tim
Published: January 2018

Type: Commentary
Social Media and Unprofessional Pharmacist Conduct: A Cross-Sectional Survey of Boards of Pharmacy
Authors: Skelley Jessica , Hughes Peter , Elmore Lindsey
Published: January 2018

Purpose: To determine how often boards of pharmacy (BOPs) receive complaints related to licensee's online behavior, and what types online behaviors may prompt an investigation of a licensee.

Methods: A survey (consisting of questions related to BOP's management of complaints against licensee online behavior and 10 case vignettes) was adapted from a previous survey of United States medical boards. Vignettes encompassed themes such as patient confidentiality, derogatory language, alcohol use, false or misleading product claims, and others. Following institutional review board approval, survey materials were distributed via email by the National Association of Boards of Pharmacy to 63 domestic and international boards of pharmacy. Completed surveys were analyzed using descriptive statistics. The proportion of respondents who indicated that the vignette would "very likely" or "likely" result in an investigation was used to determine consensus. Proportions of >75%, 50%-75% and <50% were classified as high, moderate and low consensus, respectively.

Results: Fourteen completed surveys (22.2%) were received. Sixty percent of respondents stated that their board has been involved in managing a complaint regarding the online behavior of a licensee, and that disciplinary actions including revocation or suspension of license, letter of reprimand, and monetary fines have been enacted. While 79% of responding BOPs have a policy regarding Internet usage, 36% are unsure whether the policies are sufficient to cover online professionalism. One vignette, where a pharmacist made misleading claims regarding a compounded product, achieved high consensus for likelihood to prompt an investigation. Moderate consensus was achieved for a breach of patient confidentiality, inappropriate alcohol use, and misrepresentation of professional credentials.

Conclusion: Boards of pharmacy are widely varied in what types of online behaviors may prompt an investigation. Additional dialogue is needed among pharmacy leaders to determine best practices.

 

Type: Original Research
Project ImPACT: Hypertension Outcomes of a Pharmacist-Provided Hypertension Service
Authors: Nemerovski Carrie Wentz , Young Maria , Mariani Nicholas , Bugdalski-Stutrud Carol , Moser Lynette R.
Published: January 2018

Objective: To evaluate the impact of pharmacists, working collaboratively with patients, on blood pressure control, lifestyle goal setting, adherence to antihypertensive therapy, patient knowledge and satisfaction, and modification of cardiovascular risk factors.

Methods: Self-declared hypertensive patients met with the pharmacist for blood pressure monitoring, lifestyle goal setting, and education about medications and disease state on four occasions over a 6-month period.

Practice innovation: A community pharmacy partnered with an employer wellness plan to provide education and monitoring for patients with hypertension based on home blood pressure readings obtained using monitors that wirelessly transmit information to the pharmacist.

Main outcome measure(s): Percentage of patients at blood pressure goal, mean blood pressure, percentage of patients with lifestyle goals, medication adherence, patient knowledge and satisfaction, and modification of cardiovascular risk factors.

Results: Patients not at their goal blood pressure at baseline had a significant decrease in blood pressure and a significant increase in achievement of their blood pressure goals. Across the population, no significant changes were seen in the primary outcome, lifestyle goals, medication adherence or modification of cardiovascular risk factors. Patient knowledge increased from baseline and satisfaction with the service was high.

Conclusion: Blood pressure control improved in patients not at their treatment goal. All patients increased their knowledge about hypertension and reported high satisfaction with the pharmacy service. Pharmacy services should be offered to patients who are more likely to reap a benefit. Home blood pressure readings are useful to inform clinical decision making and supplement patient consultation within the pharmacy setting.

 

Type: Original Research
Student Self-Ratings of Skill Acquisition from a Clinical Controversy Debate in a Third Year Pharmaceutical Care Lab
Authors: McNamara Anusha , Janke Kristin , Conway Jeannine , Schweiss Sarah
Published: January 2018

Objectives: To evaluate student perspectives of a clinical controversy debate activity designed to improve their skills to effectively approach and communicate complex therapeutic dilemmas.

Design: A clinical controversy debate activity was implemented in the fall semester of the third year pharmaceutical care laboratory curriculum. Topics were chosen based on controversies encountered in practice. Students were assigned to groups of 5-6 and subdivided to the pro or con of the topic. Each debate lasted 25 minutes. Students completed a self-assessment asking them to rate eight skills (e.g. selecting appropriate references, analysis of literature, defending and predicting arguments, composing and delivering the presentation, and persuading the audience) before and after the debate as: novice, developing, skilled, facilitating/leading, or educating. Results were analyzed descriptively and the pre-post ratings were compared using a Wilcoxon Signed Rank Test.

Results: 140 (84.8%) students responded to the self-assessment survey. The skill that students rated most highly prior to the debate was selecting appropriate resources and primary literature, with only 7.1% rating themselves as novice. After completing the debate, the skill rated with the greatest improvement was predicting opposing arguments with 47.1% rating as developing and 40% rating as skilled. All eight skills had statistically significant improvements pre- and post- assignment (p < 0.001).

Implications: Preparing arguments for and against treatment options is an important clinical skill, used regularly by pharmacists. A clinical controversy debate activity resulted in reports of improvement on eight measures of evidence based medicine-related skills.

 

Type: Case Study
Leadership: Three Key Employee-Centered Elements With Case Studies
Authors: Summerfield Marc
Published: January 2018

Type: Book Review
A Description of Medication Decision-Making, Dispensing, and Utilization for Hypertensive Patients in Nishtar Hospital Multan, Pakistan
Authors: Saeed Hafiz Muhammad Khawar , Nasar Naveera , Batool Sonia , Ghauri Rabia , Rauf Aquula
Published: January 2018

Hypertension 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 Study
The impact of a community pharmacist conducted comprehensive medication review (CMR) on 30-day re-admission rates and increased patient satisfaction scores: A pilot study
Authors: Snodgrass Brittany , Babcock Charles K. , Teichman Anne
Published: January 2018

Objective: To determine the impact of pharmacist conducted Comprehensive Medication Review (CMR) follow-up within seven days after discharge on (1) readmission rates, (2) detection of drug related problems, (3) and changes in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

Design: Rates of re-admission for pneumonia, congestive heart failure (CHF), or myocardial infarction (MI), within 30 days of discharge are compared between patients receiving a CMR from the pharmacist to a historical control group not receiving the service. The CMR documentation is reviewed to classify any detected drug related problems. Overall HCAHPS scores for the hospital are compared for the three months prior to instituting this service and the three months during the service.

Setting: Patients were discharged from a 101-bed acute care hospital located in rural West Virginia. The community pharmacist worked with the hospital to contact patients after discharge to demonstrate a partnership between inpatient and outpatient care.

Patients: Patients were included if they had a discharge diagnosis of pneumonia, congestive heart failure (CHF), or myocardial infarction (MI), and were returning to self-care or family-care. If discharged between 10/12/2012 and 12/11/2012 they were included in the historical control group. If discharged between 12/12/2012 and 2/12/2012 they were offered the CMR service and included in the intervention group.

Intervention: Patients received a telephone call two to seven days following discharge from a pharmacist who conducted the Comprehensive Medication Review (CMR)

Results: Patients who participated in a CMR via the telephone had decreased 30-day readmission rates compared to the historical control group (16% v 33%). Overall 22 significant drug therapy problems were identified among patients. HCAHPS scores for the questions "Did you receive communication regarding your medications" increased during the study time period (65% vs 72%).

Conclusion: The mixed results of available data from previous studies on pharmacist inclusion in the discharge process focuses heavily on counseling before the patient is discharged. Results of this study show community pharmacist partnership in discharge follow-up can also assist in decreasing readmissions, detecting drug related problems, and increasing patient satisfaction.

 

Type: Original Research
Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services
Authors: Kauffman Yardlee , Barkowitz Elana , Cerussi Nicole , Pringle Jan , McGivney Melissa
Published: January 2018

Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available.

Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services.

Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted.

Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s) and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory.

Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists.

Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for pharmacists and pharmacies interested in providing advanced care to patients with HIV.

 

Type: Original Research
The Development of a Community-Based, Pharmacist-Provided Falls Prevention MTM Intervention for Older Adults: Relationship Building, Methods, and Rationale
Authors: Mott David A. , Martin Beth , Breslow Robert , Michaels Barb , Kirchner Jeff , Mahoney Jane , Margolis Amanda
Published: January 2018

The objectives of this article are to discuss the process of community engagement experienced to plan and implement a pilot study of a pharmacist-provided MTM intervention focused on reducing the use of medications associated with falling, and to present the research methods that emerged from the community engagement process to evaluate the feasibility, acceptance, and preliminary impact of the intervention. Key lessons learned from the community engagement process also are presented and discussed. The relationship building and planning process took twelve months. The RE-AIM framework broadly guided the planning process since an overarching goal for the community partners was developing a program that could be implemented and sustained in the future. The planning phase focused on identifying research questions that were of most interest to the community partners, the population to study, the capacity of partners to perform activities, and process evaluation. Much of the planning phase was accomplished with face-to-face meetings. After all study processes, study materials, and data collection tools were developed, a focus group of older adults who represented the likely targets of the MTM intervention provided feedback related to the concept and process of the intervention. Nine key lessons were identified from the community engagement process. One key to successful community engagement is partners taking the time to educate each other about experiences, processes, and successes and failures. Additionally, partners must actively listen to each other to better understand barriers and facilitators that likely will impact the planning and implementation processes. Successful community engagement will be important to develop both formative and summative evaluation processes that will help to produce valid evidence about the effectiveness of pharmacists in modifying drug therapy and preventing falls as well as to promote the adoption and implementation of the intervention in other communities.

 

Type: Original Research
Case Study: Developing, Implementing, and Evaluating a One-Day Leadership Conference to Foster Women's Leadership in Healthcare
Authors: Fierke Kerry K. , Kading Margarette L.
Published: January 2018

Despite women increasingly entering the healthcare field, they still face barriers to advancing in leadership ranks within healthcare. To address the need for leadership development among women in healthcare, the Center for Leading Healthcare Change (CLHC) at the University of Minnesota College of Pharmacy piloted a one-day conference in November 2012 entitled "Women Impacting Healthcare: Decide to Make a Difference." This conference utilized an interactive agenda: each speaker's presentation was followed by hands-on leadership activities during which attendees developed their own personal leadership visions. Specific leadership activities were designed to build upon one another and help design a leadership pathway. All activities were consistent as they included personal reflection and interaction with others. Attendees were asked to complete two evaluations, one immediately at the conclusion of the conference, and another two-weeks post. The conference committee achieved the goal of delivering the conference objectives. As the Women Impacting Healthcare committee continues to look for ways to develop leaders in healthcare, the focus of future conferences will also evolve to include the needs of women currently in leadership roles, as well as ways women can grow into leadership roles.

 

Type: Case Study
Introducing Pharmacogenetics and Personalized Medicine via a Weblog
Authors: Bova Kaitlin , Bova Sara , Hill Kevin , Dixon Mark , Ivankovich Diana , Kisor David F.
Published: January 2018

Objectives: To evaluate a weblog (blog)-based course introducing pharmacogenetics (PGt) and personalized medicine (PM) relative to freshmen pharmacy students' knowledge base.

Methods: Incoming freshmen pharmacy students were invited by email to enroll in a one semester-hour, elective, on-line blog-based course entitled "Personal Genome Evaluation". The course was offered during the students' first semester in college. A topic list related to PGt and PM was developed by a group of faculty with topics being presented via the blog once or twice weekly through week 14 of the 15 week semester. A pre-course and post-course survey was sent to the students to compare their knowledge base relative to general information, drug response related to PGt, and PM.

Results: Fifty-one freshmen pharmacy students enrolled in the course and completed the pre-course survey and 49 of the 51 students completed the post-course survey. There was an increase in the students' general, PGt and PM knowledge base as evidenced by a statistically significant higher number of correct responses for 17 of 21 questions on the post-course survey as compared to the pre-course survey. Notably, following the course, students had an increased knowledge base relative to "genetic privacy", drug dosing based on metabolizer phenotype, and the breadth of PM, among other specific points.

Conclusions: The study indicated that introducing PGt and PM via a blog format was feasible, increasing the students' knowledge of these emerging areas. The blog format is easily transferable and can be adopted by colleges/schools to introduce PGt and PM.

 

Type: Case Study
Immunization Tour: Preparing for Mass Immunization through Pharmacy and Nursing Interprofessional Student-led Service-learning
Authors: Moon Jean , Pfeiffer Jeanne , Adwan Jehad , Rudie Maria , Uden Don
Published: January 2018

Pharmacy and nursing students piloted a collaborative student initiative to administer mass influenza immunizations to a large university campus. Through the support of the School of Nursing, College of Pharmacy, and University Health Service this project later turned into a unique service-learning interprofessional one credit elective course promoting public health philosophy and principles, emergency preparedness strategies, clinical skills, and interprofessional team competencies centered around influenza immunizations. Including lessons learned, this article will describe the evolution of this innovative student-led project.

 

Type: Case Study
Leadership: Three Key Employee-Centered Elements With Case Studies
Authors: Summerfield Marc
Published: January 2018

Type: Book
Evaluating the Impact of Drug Dispensing Systems on the Safety and Efficiency in a Singapore Outpatient Pharmacy
Authors: Sheng Peter Ong Yong , Li Chen Li , Ai Wong Jane , Gunawan Yeyen , Jiang Goh Wei , Chai Tan Mui , Boon Lee Soo
Published: January 2018

Purpose: Automation of pharmacy workflow can reduce medication errors as well as improve efficiency of the medication picking, packing and labeling process. Since September 2012, two drug dispensing systems (DDS) began operations in the Singapore General Hospital Specialist Outpatient Clinic Pharmacy. This study sought to evaluate the impact of the DDS on safety and efficiency in the pharmacy.

Methods: The primary outcome was the rate of prevented dispensing incidents contributed by DDS or manual picking of medications defined as the number of prevented dispensing incidents per 1000 medications picked. The secondary outcome was the productivity of each full time equivalent (FTE) when assigned to either the DDS or manual picking stations. Data pertaining to the primary and secondary outcomes between January and December 2013 were collected and analyzed. The rate of prevented dispensing incidents was expressed in median (interquartile range) and compared using Mann-Whitney U test. Other continuous variables were expressed in mean ± standard deviation and compared using independent samples t-test.

Results: An average of 59494 medications was picked every month in the pharmacy. DDS accounted for 21.1 percent while manual picking accounted for 78.9 percent of all the medications picked. The median rate of prevented dispensing incidents per month committed by manual picking (2.73) was significantly higher than the DDS (0.00). DDS had greater productivity with each FTE in the DDS having an average of 6175 picks per month which was significantly higher than each FTE in the manual picking stations which had an average of 4867 picks per month.

Conclusion: Installation of DDS in an outpatient pharmacy improved safety of the pharmacy workflow by automating the medication picking, packing and labeling process and minimizing human errors. Efficiency of the medication picking, packing and labeling process was also improved by the DDS as there were continuous efforts to boost their productivity as well as being more reliable and better able to handle fluctuations in patient load.

 

Type: Original Research
Evaluation of a Model Comparative Drug Price Resource in Fostering Prescriber - Patient Engagement, Lowering Consumer Costs and Improving Adherence
Authors: Hams Marcia , Wilkinson Wells
Published: January 2018

Type: Original Research
Health Information Exchange to Support a Prescription Drug Monitoring Program
Authors: Cochran Gary L. , Klepser Donald G. , Morien Marsha , Lander Lina
Published: January 2018

Objective: To describe barriers to the utilization of a query based Health Information Exchange (HIE) that supports a statewide Prescription Drug Monitoring Program (PDMP).

Methods: Emergency room (ER) prescribers were surveyed bi-weekly and at the end of a four-month study to estimate HIE/PDMP utilization and identify barriers to utilization.

Results: Self-reported utilization from seventeen providers in three emergency rooms was very low. Providers estimated that prescription history was rarely available when queried. Problem lists and laboratory reports were estimated to be available 60% of the time.

Discussion: Barriers to HIE utilization for PDMP purposes included prescribers not finding the information they queried and lack of integration into clinical workflow. Low perceived need for PDMP and prescriber preparedness to manage abusers may also have reduced utilization.

Recommendation: Financial and human resources must be available for training and integration of a HIE based PDMP into the ER's clinical workflow. Minimizing information gaps is also necessary to increase utilization.

 

Type: Case Study
Pharmacovigilance Programme of India
Authors: Kumar Duvvuru Ashok , Reddenna Languluri , Basha Shaik Ayub
Published: January 2018

Pharmacovigilance is defined as "the pharmacological science relating to the detection, assessment, understanding and prevention of adverse effects, principally long term and short term adverse effects of medicines." It is an important and integral part of clinical research. India is the world's second most populated country with over one billion potential drug consumers. Although, India is participating in the Uppsala monitoring center program, its contribution to that database is relatively small. This problem is essentially due to the absence of a robust ADR monitoring system and also the lack of awareness of reporting concepts among Indian health care professionals. The specific aims of pharmacovigilance are to advance patient care and safety in relation to the use of medicines and all medical and paramedical interventions, contribute to the assessment of benefit, harm, effectiveness, and risk of medicines, promising their safe, rational, and more effective use, promote indulgent, education, and clinical training in pharmacovigilance and its effective communication to the public. Pharmacovigilance methods must also be capable to designate which patients are at risk of developing an adverse drug reaction. A suitably working pharmacovigilance system is important if medicines are to be used prudently. It will be advantageous for healthcare professionals, regulatory authorities, pharmaceutical companies and consumers to monitor medicines for risk.

 

Type: Commentary
A Profile of Retirement Age Pharmacists in Illinois
Authors: Quiñones-Boex Ana C. , Turgeon Alyson
Published: January 2018

Introduction: This manuscript describes the unexpected results from a routine state survey of pharmacist workforce patterns. It describes the background characteristics, practice activities, working conditions, compensation, and fringe benefits among registered Illinois pharmacists of typical retirement age (≥ 65 years old) still active in practice.

Methods: A 4-page self-administered questionnaire was mailed to a random sample of 500 registered pharmacists residing in Illinois in early 2013. A reminder postcard was mailed to the whole sample at two weeks from the initial correspondence. Data collection concluded three months after the initial mailing.

Results: Response rate was 44.8%. Half of all respondents reported to be active in practice (n =119, 54.1%); most of these pharmacists reported working part-time (n= 92, 41.8%). Further inspection revealed that all respondents were age 65 or older. The average respondent could be characterized as a married, Caucasian male of typical retirement age. Respondents wanted significantly less time spent in medication dispensing (63.4%) and more time providing patient care services (27.5%). As expected, most work-related characteristics were significantly different between part-time and full-time respondents with one exception: there were no major differences in hourly wages observed.

Conclusion: Based on data from this survey, there is a substantial number of retirement age pharmacists in Illinois who continue to practice past the age of 65. A better understanding of pharmacist retirement trends is of importance to the profession as it has potential implications for pharmacy employers, educational institutions, and other stakeholders.

 

Type: Original Research
A Night-shift Pharmacy Introductory Pharmacy Practice Experience
Authors: Mospan Geoffrey
Published: January 2018

Type: Commentary
Patient Assessment Skills Pertinent to Practicing Pharmacists
Authors: Wilson Jennifer A. , Waghel Rashi C. , Salem Danny
Published: January 2018

Objectives: To describe pharmacists’ opinions regarding which patient assessment skills are necessary to understand and/or perform to provide optimal patient care in pharmacy practice.

Methods: An online questionnaire was distributed to pharmacists licensed in North Carolina (n=14,167), as identified by the Board of Pharmacy. The 80 patient assessment items in the questionnaire were derived from a course text book and faculty experience. Participants indicated whether they “need to understand and be able to perform”, “need to understand only”, or “not need to understand or be able to perform” each item in their current practice setting. Descriptive statistics were used to describe background demographics and perceived need for each item. Post-hoc chi-square analyses were performed to determine differences in need based on practice setting and Pharm.D. degree completion.

Results: Of 1036 responses received, 770 were used in data analysis; incomplete questionnaires and non-practicing pharmacist responses were excluded. Fifty-nine percent of respondents held a Pharm.D. degree. Participants identified their practice site(s) as inpatient (29%), outpatient (16%), community/retail (50%), long term care (5%), and other (8%). The top five patient assessment items respondents identified as important to understand and perform included automatic blood pressure measurement (63%), point of care testing (57%), manual blood pressure measurement (53%), heart rate measurement (52%), and peak flow meter use (47%). Post-hoc analyses showed a significant difference among those with a Pharm.D. versus those without for the response “need to understand and be able to perform” for 20 patient assessment items; a significant difference was also noted among practice settings for 29 items.

Conclusions: The top items pharmacists identified they need to both understand and perform could be applied in various practice settings. The study results may guide which patient assessment items should be included in pharmacy education and training.

 

Type: Original Research
Lesson Learned in the Growth and Maturation Stages of a Community Pharmacy Practice-Based Research Network: Experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet)
Authors: Kozak Mary Ann , Gernant Stephanie A. , Hemmeger Heather M. , Snyder Margie E.
Published: January 2018

Community pharmacy practice-based research networks (CP PBRNs) are a relatively new arena for pharmacists. While some lessons may be gleaned from primary care PBRNs, the experiences of CP PBRNs have much to offer the profession in terms of organization and practice. In 2012, we reported on our early experiences developing the Medication Safety Research Network of Indiana (RxSafeNet) after establishing the Network in 2010. Over the past 3 years, our CP PBRN of approximately 180 members has managed further growth by revisiting policies and procedures, maintaining CP PBRN member relationships, and preparing for financial sustainability. We look forward to furthering our CP PBRN projects in the coming years and collaborating with other CP PBRNs to enhance medication safety in Indiana and beyond.

 

Type: Original Research