bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of a Novel Proactive First Day Prescription Counseling Program on Adherence to Select Cardiovascular Medications
Authors: McConaha Jamie L. , Lynch Kevin 
Published: January 2018

Objective: To determine the impact of a proactive first day prescription counseling program on medication adherence to new cardiovascular maintenance medications
Design: Cross-sectional study
Setting: Regional chain community pharmacy in Pittsburgh, Pennsylvania; August 2009 through November 2010
Patients: Data was collected from all patients aged 18-89 presenting with a new or transferred prescription or change in dosage within the study dates at four study locations
Interventions: Patients presenting with a new or transferred prescription or change in dosage were identified to receive pharmacist or student pharmacist counseling. Data from the counseling session was tracked weekly to determine if the program increased adherence to statins, ACEIs and/or ARBs.
Main Outcome Measured: Adherence to statins, ACEIs and/or ARBs was determined by differences in proportion of days covered (PDC) at six months and medication persistence to therapy.
Results: Analysis was conducted using IDNA sm software. Results of the 6,916 prescriptions included in the study revealed that persistence rates for statins was 32.5% (intervention) and 34.2% (control) (p<0.001); ACEI/ARBs persistence was 37.3% (intervention) and 43.2% (control) (p<0.001). PDC was nonsignificant with respect to statins; 43.2% (intervention) and 45.1% (control); and 50.2% (intervention) and 57.1% (control) (p<0.001) for the ACEI/ARBs.
Conclusion: Results from this study showed no improvement in adherence of statins or ACEIs/ARBs with the D1TC program versus control pharmacies, although several important limitations were identified. It is clear that a variety of methods and programs are needed to consistently improve adherence to maintenance medications.

Type: Original Research
Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions
Authors: Root Rachel , Phelps Pamela , Brummel Amanda , Else Craig 
Published: January 2018

Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.
Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist's medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM) follow-up.
Adult patients with a predicted diagnosis-related group (DRG) of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85%) received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient) were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25%) receiving MTM follow-up, 26 (65%) completing a primary care visit after their first hospital discharge, and 23 (58%) receiving a home care visit.
Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

Type: Original Research
Promotion of ethical principles in provision of medication therapy management services
Authors: Kelling Sarah E. , Aultman Julie M. 
Published: January 2018

As 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 Paper
Assessment of Community Pharmacists Willingness and Barriers of Medication Therapy Management (MTM) focused on Pain Management and Mental Health
Authors: Keller Megan E. , Bright David R. , Sullivan Donald L. , Cornelius Doug C. 
Published: January 2018

Objectives: 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 Research
Improving the Tenure Committee's Review Efficiency with Embedded Dossier Functionality
Authors: Henriksen Brian , Kisor David F. 
Published: January 2018

Numerous manuscripts have been published addressing perceptions of the promotion and tenure process. Very little has been published on mechanism to improve the efficiency of dossier review or tools to assist the reviewer in understanding the comprehensive scope of the applicant’s experiences. An innovative dossier format was utilized to assess the hyperlinks and pop-up tool tips would enhance the reviewer efficiency when reviewing the applicant’s materials. Super scripted numbers at the end of the narrative’s sentences, in the same manner as a journal article, contained the embedded hyperlinks and pop-up tool tips. A majority of the reviewers found the embedded functionality in the dossier did enhance their efficiency in completing the review.

Type: Case Study
Enhancing Personal Health Record Adoption Through the Community Pharmacy Network: A Service Project
Authors: Veronin Michael 
Published: January 2018

Personal Health Records, or PHRs, are designed to be created, maintained and securely managed by patients themselves. PHRs can reduce medical errors and increase quality of care in the health care system through efficiency and improving accessibility of health information. Adoption of PHRs has been disappointingly low. In this paper a project is described—essentially a call for action—whereby the skills, expertise, and accessibility of the community pharmacist is utilized to address the problem of poor PHR adoption. The objective of this proposed project is to promote the expansion of PHR adoption directly at the consumer level by utilizing the existing infrastructure of community pharmacies. The ADDIE model can provide the framework for PHR adoption in community pharmacies. ADDIE is an acronym that stands for the 5 phases contained in the model: 1) Analysis, 2) Design, 3) Development, 4) Implementation, and 5) Evaluation. ADDIE is a versatile educational model used for creating instructional materials, and has found utility as a guidance model for managing projects of all types. By bringing together these concepts: the highly accessible infrastructure of community pharmacies with the educational resources to inform consumers on the proper use of PHRs, the quality of care for patients will be greatly enhanced.

Type: Idea Paper
Imaginary Worlds: The Status of Modeled Quality Adjusted Life Year Claims for New Oral Anticoagulants in Atrial Fibrillation Published Between January 2012 and February 2016
Authors: Langley Paul C , Rhee Taeho Greg 
Published: January 2018

The purpose of this commentary is to evaluate modeled quality adjusted life year claims (QALYs) for new oral anticoagulants (NOACs) published in the period from January 2012 to February 2016. The focus of this commentary is to assess whether or not the modeled claims meet the standards of normal science in supporting falsification and replication. A systematic and consensus review by the authors identified a total of 23 cost-utility NOACs evaluations along with four single technology appraisals undertaken by the National Institute for Health and Care Excellence (NICE) in the UK. Each study was evaluated in terms of four criteria: (i) did the study generate evaluable claims (ii) id the authors attempt to generate evaluable claims (iii) did the authors suggest how the claims might be evaluated and (iv) did the authors caution readers as to the implications of generating non-evaluable projections or claims for credibility in health system decision making? None of the 23 studies assessed or the four NICE single technology appraisals met any of the four assessment criteria. None of the studies presented projections or claims in a form suitable for empirical evaluation. None could support falsification or replication. They failed the standards associated with the scientific method. Failure to meet the standards of normal science meant that the studies, from a formulary assessment perspective, are not credible. The claims made were either impossible to verify, or if potentially verifiable, were not presented in a testable form. There was no basis for assessing whether the claims were right or even if they were wrong. This lack of scientific credibility is a major concern. In particular, the choice of a lifetime cost-utility framework for assessing the NOACs against warfarin and against each other effectively precludes any experimental assessment. If medical economics is to advance through the formulation and testing of hypotheses, then editors of journals should consider whether or not to set standards for the acceptance of publications to include the requirement for testable claims and the results of claims assessment. If this is not acceptable, then it should be made clear that published modeled claims and simulations are simply imaginary worlds or thought experiments. Editors cannot sit back and assume that at some time in the future non-testable projections will possibly be evaluated.
Conflict of Interest
None

Type: Commentary
Medication Reconciliation Limitations: Observation of the Medication Reconciliation Process in the Emergency Department by Two Immersion Pharmacy Students
Authors: Chong Christine , Haile Amanda 
Published: January 2018

Multiple medical records may exist for a particular individual based on the various health services he or she receives. Maintaining updated, accurate records remains the responsibility of both practitioners and patients. Medication reconciliation, defined as the process to accurately depict the patient’s current orders and medications, 2 seeks to avoid errors in duplicity, interactions and dosing errors. Medication histories at Moses Cone Hospital are currently recorded by pharmacy technicians who follow specific standards, for instance they cannot remove “house meds”, which are prescribed medications with an active prescription attached. Technicians instead mark these medications for removal, leaving reconciliation to the physician. The physicians in the emergency department are not required to complete a full reconciliation for patient's profiles as this is a task left for the admitting physician. This leads to the question whether the reconciliation process in the emergency department (ED) needs to be re-evaluated. Patients’ “After Visit Summary” reports were used to analyze patient profiles in determining medication reconciliation statuses (whether fully reconciled, partially reconciled, or unreconciled). 280 patients’ profiles were used. 243 records (86.79%) were found unreconciled, 18 (6.43%) were partially reconciled, and 19 (6.79%) were fully reconciled.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties

Type: Student Project
Pharmacy Students as Health Coaches
Authors: Trombetta Dominick P , Yanoski Heidi 
Published: January 2018

Chronic diseases are the main contributor to both health care costs and mortality in the United States, with medication non-adherence and lifestyle modifications being leading causes. To motivate patients with several co-morbidities, the longitudinal care class was used to educate on maintaining adherence to prescribed regimens. Twenty pharmacy students were trained in health coaching and motivational interviewing methods. Specifically, students were to provide patients with education sheets, apply the teach-back method, and motivate the patient to develop and reach SMART goals made with the pharmacy student over a course of one academic school year.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

Type: Note
Imaginary Worlds and the Institute for Clinical and Economic Review (ICER) Evidence Report: Targeted Immune Modulators for Rheumatoid Arthritis
Authors: Langley Paul C 
Published: January 2018

In April 2017, the Institute for Clinical and Economic Review (ICER) issued its evidence report on the value of targeted immune modulators (TIMs) in rheumatoid arthritis. The report made the case that for the TIMs to be accepted for formulary placement in the US, where notional willingness-to-pay thresholds are the ICER gateway criteria, manufacturers should be prepared to offer substantial unit price discounts. The purpose of this commentary is to make the case that the methodology underpinning the ICER claims for value assessment does not meet the required standards of normal science. None of the claims made for clinical and comparative cost-effectiveness are credible, evaluable and replicable. As such, formulary committees have no idea whether ICER recommendations are right or even if they are wrong. They are, in fact, immune to failure and should be rejected. Utilizing ICER claims generated by simulated projections, this review points out that it is entirely possible to justify the current WAC or net pricing structure of TIMS. The review concludes that if ICER is to contribute to the successful formulary placement of drugs and devices the methodology for pricing recommendation should be re-assessed. As it stands, questions must be raised regarding recommendations for, possibly unnecessary, price discounts. ICER needs to develop an assessment framework that focuses on developing claims for competing therapies that are robust, evaluable and replicable together with recommendations on how these claims are to be evaluated in a timeframe meaningful to health care decision makers.

Type: Commentary
Rush to Judgement: Imaginary Worlds and Cost-Outcomes Claims for PCSK9 Inhibitors
Authors: Langley Paul C 
Published: January 2018

Pricing by the manufacturers of the two PCSK9 inhibitors recently approved by the FDA, evolocumab and alirocumab, has led to an ongoing debate over the value of these interventions in clinical practice. In the US, the Institute for Clinical and Economic Review (ICER) has been in the forefront of those who have argued that, in the context of notional incremental willingness-to-pay thresholds, manufacturers should reduce drug prices substantially. This conclusion has been echoed in a number of other technology assessments, notably in assessments by the National Institute of Health and Care Excellence (NICE) in the UK. At the same time, other evaluations have reported favorably, arguing that at current US prices, the two products meet willingness-to-pay benchmarks. The purpose of this commentary is not to argue for or against current PCSK9 pricing policies but to point out that the case made for possible price adjustments rest upon technology assessments that fail to meet the standards of normal science. Modeled claims that are properly classified as pseudoscience. The claims made are non-evaluable. Formulary committees, rather than accepting these claims at face value, should step back and work with manufacturers to develop claims that are targeted, robust, evaluable and replicable in a timeframe where feedback on PCSK9 outcomes are meaningful to health system decision makers.

Type: Commentary
The Innovation Opportunity in Pharmacy Education Standards
Authors: Patel Ravi M 
Published: January 2018

The changing landscape of healthcare and recent formal Standards for innovation in pharmacy education presents a unique opportunity. To realize this opportunity, pharmacy should learn from the successes of other fields to make use of the rich environment for improvement in healthcare. The University of Pittsburgh School of Pharmacy presents one example of a Program that utilizes a curriculum, projects, and partners to realize innovation. Educators in pharmacy can make use of the opportunity for innovation by learning from successful examples and embracing the process’s challenges of iteration.

Type: Commentary
Online Tools to Improve Faculty Collaboration and Time Efficiency Inside and Outside the Classroom
Authors: Arif Sally A , Nizamuddin Huma 
Published: January 2018

The optimization of time is a valuable commodity to achieve scholarly and teaching goals. Embracing technology and the use of online tools can assist with focused communication and project collaboration with both students and faculty. An innovative approach to connecting virtually is more relevant today, as a majority of current pharmacy students are millennial-learners who are technologically proficient and more likely to adopt online tools. The aim of this commentary is to highlight the advantages of using such tools, while also stressing the considerations one should have when navigating the best fit to a faculty member’s needs.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.

Type: Commentary
Risk Factor Management with Guideline-Based Medications for Prevention of Recurrent Ischemic Stroke: A Retrospective Chart Review
Authors: Rose Jessica S. , Kyle Jeffrey A. , Skellley Jessica W. 
Published: January 2018

Background: Implementation of new practice guidelines for stroke prevention has decreased the number of patients experiencing recurrent stroke. Clinical trials show antihypertensives, high-intensity statins, and antithrombotics to be beneficial after stroke.
Objective: The objective of this study was to determine if recurrent stroke patients were discharged on guideline-based medications for secondary stroke prevention, and to identify potential errors in appropriate prescribing of medications.
Methods: A retrospective chart review was conducted at a community hospital and included patients 19 years and older diagnosed with their second, third, or fourth stroke (transient ischemic attack or cerebrovascular accident). Descriptive statistics were used to describe collected information. Collected data included relevant patient demographics, diagnosis, past medical history, medications, and readmission rates. The primary objective was the percentage of patients appropriately discharged on guideline-based secondary stroke prevention medications. Appropriate treatment was based upon the 2010 and 2014 American Heart Association/American Stroke Association Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack.
Results: A total of 124 charts were reviewed, 106 charts met the inclusion criteria. Guideline-based and appropriate medication-use was initiated in 9% and 4% of patients with noncardioembolic and cardioembolic stroke, respectively. Therapy deemed not guideline-based, but appropriate was initiated in 20% and 9% of patients with noncardioembolic and cardioembolic stroke, respectively. Errors in appropriate prescribing of secondary prevention medications were related to statins and antihypertensives.
Conclusion: Better adherence to preventative recurrent stroke measures is needed at the time of patient discharge.

Type: Student Project
Sistema de reconocimiento de voz para control de prototipo de silla de ruedas para niños con problemas en extremidades inferiores
Authors: Castro Arrieta Verónica Montserrat , González Bautista Teresa , Coello Galindo Luis Rodolfo 
Published: January 2018

El presente trabajo tiene como objetivo realizar un sistema de reconocimiento de voz, que permita ayudar a niños con daños en las extremidades inferiores en su desplazamiento; permitiendo ingresar palabras a través de un micrófono y que puedan ser comparadas en un banco de registros para mover una estructura mecánica que emula una silla de ruedas.
El sistema se controla por medio de una interfaz gráfica de usuario (GUI) en Matlab, el cual se encarga de realizar el proceso de reconocer el espectro de señal de entrada y ser procesada por medio de la técnica de Transformada Rápida de Fourier (FFT), la cual arroja el resultado en la comparación entre la señal de entrada y la que se encuentra en el banco de registro. Esta interfaz de usuario permite grabar, reproducir y comparar el espectro ingresado. Se aplica en un prototipo para verificar su funcionamiento y es controlado con una placa de prototipos Arduino Uno. Esta recibe los datos de Matlab a través de un módulo Bluetooth HC-06 y permite que exista una conectividad inalámbrica entre la computadora que es la que envía el resultado obtenido de la Transformada Rápida de Fourier al módulo Bluetooth y a la placa de prototipos y, que al ser comparados, realizan los movimientos de acuerdo a los datos enviados (“alto”, “seguir”, “reversa”, “derecha” e “izquierda”).