bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of drug-related problems in self-medication in Danish community pharmacies
Authors: Frøkjær Bente , Bolvig Tina , Griese Nina , Herborg Hanne , Rossing Charlotte 
Published: January 2018

Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this.
Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine) identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems.
Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies.
Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC) medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs) were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner.
Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended effects and, to a lesser extent, inappropriate self-medication.

Type: Original Research
Patient-perceived value of Medication Therapy Management (MTM) services: a series of focus groups
Authors: Schultz Heidi , Westberg Sarah M. , Oliveira Djenane Ramalho de , Brummel Amanda 
Published: January 2018

Objective: 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 Research
Perspectives from the Hmong Population on Type 2 Diabetes
Authors: Xiong Phoua , Westberg Sarah M. 
Published: January 2018

The primary goal of the study was to determine perceptions the Hmong population has about Type 2 diabetes. Specific information to be gathered from the Hmong participants were: reactions after being diagnosed with Type 2 diabetes, knowledge and beliefs about medications, and how pharmacists can help them with their diabetes care. Learning the beliefs of this population related to Type 2 diabetes will help identify methods to improve diabetes care and education for Hmong patients. A focus group was conducted with Hmong participants with Type 2 diabetes to explore their perceptions and experiences with diabetes. There were 9 participants in the focus group which lasted approximately 90 minutes. The major themes were a misunderstanding of diabetes and its treatment, a reluctance to adhere to medications, a reluctance to change cultural diet, and the need for clear education from pharmacists. Participant recommendations for pharmacists were to improve their diabetes care by educating them about the condition, medication, and available treatments.

Type: Original Research
Developing a Professionalism Plan
Authors: Grice Gloria R , Monson Kacie , Pitlick Jamie , Chereson Rasma , Duncan Wendy , Geslani Gemma , Kilgore Kimberly , Patel Puja B. , Pautler Heather 
Published: January 2018

Professionalism is a way of being which underlies all the responsibilities of a pharmacist and associated general and professional abilities. The Student Affairs Committee was charged with developing a college-wide professionalism plan to meet the Accreditation Council for Pharmacy Education (ACPE) Standards 15.1 and 23. This plan was developed concurrently with a new curriculum. The plan was developed systematically with the following goals: 1) create a definition of professionalism, 2) determine outcomes of the plan, 3) identify existing components which should be continued and new components to be added, 4) ensure existing and new components are linked to outcomes and 5) develop a continuous assessment process for the plan. The proposed plan consists of curricular, co-curricular and extra-curricular activities designed to help students gain experience in three professionalism pillars: Competence, Connection and Character, as defined by Brown et al in "Taxonomy of Professionalism". While knowledge and skills will be enhanced, the focus of development will be on student virtues, values and attitudesäóîthat what they do defines who they are. The goal is to help students develop as people and professionals who value the high ideals expected of a pharmacist.

Type: Idea Paper
Landscape of Medication Management in the Minnesota Patient-Centered Medical Home (PCMH)
Authors: Wallace Margaret L , Moon Jean , Lounsbery Jody L , Uden Donald L 
Published: January 2018

Purpose: 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 Research
Attitudes of Iraqi society towards the role of community pharmacists
Authors: Ibrahim Inas R. , Al Tukmagi Haydar F. , Wayyes Abdulrasoul 
Published: January 2018

Objectives: The main aims of this study were to assess society's use of community pharmacies; evaluate attitudes towards the role of the community pharmacist; and describe required pharmacist characteristics and future services.
Study design: A cross-sectional survey with a stratified sampling technique.
Methods: A self-administered, validated, questionnaire was distributed to 500 consumers in attendance at 50 community pharmacies in Baghdad, Iraq. Data were gathered from January to April 2012. Mann-Whitney and Kruskal-Wallis tests were performed to test for statistical differences among the study variables. Further analysis through the Chi-square test and logistic regression was completed to assess the predictors of society's attitudes.
Results: Twenty-six percent of respondents visited their community pharmacies at least once per week and an additional 65% reported visiting their pharmacy at least once per month. Fifty-five percent of respondents listed the community pharmacist as the first person they would contact in case of any drug-related problem. However, the pharmacist's role was under-appreciated by the majority of respondents (79.8%). These attitudes varied significantly with regard to the demographic characteristics of respondents. Logistic regression analysis showed that gender and age were the influential predictors of favourable versus non-favourable attitudes towards the role of pharmacist.
Conclusions: The use of community pharmacies in Iraq was characterized by frequent visits to purchase medicines. Selection of the pharmacy primarily depended on its location. Overall, an under-appreciation of the professional performance of pharmacists was predominant. Raising public awareness towards the important role of community pharmacists in providing public health is warranted.

Type: Original Research
Student Scientific Inquiry in the Core Doctor of Pharmacy Curriculum: Critical Issues in Designing and Implementing a Student Research Program
Authors: Vaidean Georgeta D. , Vansai Sandeep S. , Moore Ronnie J. , Feldman Stuart 
Published: January 2018

While student-driven research has been credited with many learning benefits, few schools of pharmacy require such activities. Professional organizations repeatedly urge for incorporating research content in schools' curricula, yet no guiding principles or recommendations currently exist to guide such implementation efforts. This paper provides an overview of the critical issues, guiding principles, benefits and challenges encountered in designing and implementing a required, research program in the Pharm.D. curriculum. Several critical issues are reviewed: goals, unitary focus and expectations, structure and deliverables, time and curricular integration, monitoring and institutional oversight, outcomes measurement, resources, students and faculty response, and dissemination. These general critical issues are then discussed as implemented in the student research program at Touro College of Pharmacy-New York. Different schools can address these core issues, based on their academic milieu. This paper invites an inter-institutional dialogue for the pursuit of successful incorporation of student scientific inquiry in the core curriculum.

Type: Idea Paper
Acceptance Rates for Pharmacist-Initiated Interventions in Long-Term Care Facilities
Authors: Carson Gina L. , Crosby Kimberly , Huxall Garrett R. , Brahm Nancy C. 
Published: January 2018

Objectives: Describe individualized medication interventions, categorize intervention types, and report acceptance rates by prescribers following a pilot medication intervention program in which a pharmacist rounded with the patient care team in long-term care facilities in addition to their traditional medication regimen review (MRR) process.
Design: Prospective Chart review
Setting: Two primary long-term care (LTC) facilities
Participants: Fifty randomly selected patient charts. Inclusion criteria were adult patients (18 years old or older) residing in one of the LTC facilities receiving consultant pharmacist services. Patient charts not meeting inclusion criteria were excluded from the review.
Interventions: Recommendations made according to the needs of each patient and categorically reported.
Main Outcome Measures: Intervention acceptance rates by prescribers and aggregate reporting for type of medication interventions.
Results: For 50 patient charts (68% female, 32% male) 66 interventions were reported. The average patient age was 81.5 years. Approximately 45% of the interventions pertained to drug utilization concerns, and 21% involved pain management. Additional categories included treatment of eye and skin conditions and pharmacotherapy for mental health. A 'nonpharmacotherapy' designation was given to individual interventions not fitting into a larger category. New medications and regimen changes were the most common medication therapy outcomes (42% and 32%, respectively). Overall 92% of all pharmacist interventions were either fully or partially accepted by the prescriber where partial acceptance was defined as implementation of the recommendation with an adjustment. Interventions related to drug utilization or pain management each approached a 93% acceptance rate.
Conclusions: The consultant pharmacist provided personalized recommendations following extensive chart review and patient assessment. Our chart review suggests that high prescriber acceptance rates along with medication therapy optimization may produce similar benefits in other LTC facilities.

Type: Original Research
On house calls, healthcare, and hope: one student's perspective
Authors: Shelquist Ryan , Greene Elisa 
Published: January 2018

Healthcare providers spend years studying pathophysiology and therapeutics, often neglecting to consider the whole picture of influences on a person's health. House calls are a beneficial tool in that they provide the opportunity for trainees to experience these concepts firsthand, often opening student eyes to suffering, poverty, and unexpectedly, hope. Exposure to this broader perspective may empower health care providers to see beyond the limitations of disease and medication, into deeper issues that affect patient health.

Type: Idea Paper
Examining the Impact of a Pharmacists Postpartum Counseling Service; Evidence from a University Hospital
Authors: Schatz Kristina , Chapman Jennifer , Chang Jongwha 
Published: January 2018

Purpose: To describe a pharmacist's counseling service pertaining to methods of contraception on the postpartum unit of a university hospital and to evaluate the number of postpartum patients who desire information on contraception with the demographics of age, public or private insurance, and whether the patient was English or Spanish-speaking.
Methods: Retrospective cohort data analysis of postpartum women who received the option of counseling by a pharmacist or pharmacy intern at a university hospital over a year and 7 month period. There were 2,048 cases included for this study. The total number of patients who wanted information as well as pharmacist preparation time and counseling time were also noted.
Results: Patients who were interested in a hormonal contraception method were 3 times more likely to desire counseling compared with patients who declined information (p<0.05). Also, patients who wanted an implantable form of contraception were 8 times more likely to desire information compared with patients who declined counseling (p<0.05). Patients in the age range of 18-25, 26-30, and 31-45 years were less likely (56%, 64%, & 65%) to want counseling compared with the age range of 12-17 years (all p<0.05). Lastly, patients who spoke Spanish were 3 times more likely to have been counseled compared with non-Spanish speaking patients. The number of postpartum patients counseled on different contraception methods was 1,546 versus 699 patients who declined counseling. Total pharmacist preparation time totaled 160.95 hours, while total patient counseling time totaled 204.55 hours.
Conclusion: Overall, postpartum women who chose to be counseled by a pharmacist were considering either a hormonal or implantable method of contraception, were younger than the age of 17 and were Spanish speaking. The average amount of pharmacist preparation time spent was 4.3 minutes per patient and actual counseling time on average was 5.5 minutes per patient.

Type: Original Research
International Variations In Essential Medication Lists
Authors: Tejani Ali H. , Wertheimer Albert 
Published: January 2018

Every nation in the world has established a National Medication Formulary to account for all the medications present in the country. Many countries follow the Essential Medication List provided by the World Health organization (WHO) when making their own National Medication Formulary. Our study looked at variations in the National Formularies when compared to the Essential Medication Lists. Different relationships such as missing and extra medications lists were formulated and the statistics analyzed. It was noted that on average most of the countries studied were lacking 47% of medications, and had 30% additional medications on their national formulary. Further studies need to be conducted as Essential Medications may be lacking, or harmful medications may be present in a country's formulary leading to severe health problems.

Type: Commentary
Pharmacist Perspectives on Medication Costs and Affordability: A Pilot Study
Authors: Shinde Shraddha , Shah Bupendra 
Published: January 2018

Background- Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability.
Objective- To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication.
Method- A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pharmacists were also asked to opine on how to improve affordability of medications and their perceived barriers for such communication with the patients. Questions were formulated to differentiate pharmacists' perceptions and behaviors in regards to dealing with patients with (PWI) and without insurance (PWOI). Data was analyzed using SPSS version 17.0.
Result- A total of twenty-six pharmacists out of 54 approached participated in the study. Majority of the pharmacists reported the cost of medication to be extremely/very burdensome for PWOI (73%) than PWI (23%). In contrast, more pharmacists reported initiating a discussion very often/always about affordability with PWI (35%) than PWOI (20%). Discussions about price of medications were more common than discussions about affordability and ways to reduce medication burden. On an average, 33% of the pharmacists suggested generics as a way to improve affordability of the medications for PWI and PWOI.
Conclusion- Patient-pharmacist communication on affordability and ways to reduce cost burden occurs very infrequently. Understanding the perspectives on patient-pharmacist communication on medication cost may help in developing effective strategies and may help reduce cost-related medication non-adherence.

Type: Student Project
Integrating Components of Medication Therapy Management Services into Community Pharmacy Workflow
Authors: Lester Corey A. , Helmke Jennifer L. , Kaefer Tana N. , Moczygemba Leticia R. , Goode Jean-Venable R. 
Published: January 2018

Objective: The objective of this study was to develop and evaluate a process for integrating components of medication therapy management services into a community pharmacy workflow. Secondary objectives were to evaluate outcomes as well as patient and pharmacist satisfaction with this change.
Methods: This prospective, 3-month observational study took place in a small, independent community pharmacy. This intervention included a redesigned work system that included a seated private desk area and focus on the pharmacist, rather than the technician, being the first contact when patients entered the pharmacy. Pharmacists participated in a focus group before and after the implementation of the new workflow to better understand the delivery of the intervention and assess satisfaction. Process outcomes included time spent with the patient, the number of medication-related problems identified and recommendations made, the type of disease education provided, type and number of immunizations administered, and health monitoring tests performed. Patient satisfaction surveys were distributed after completing the intervention during the third month of the study.
Results: A total of 56 patients were enrolled in this study resulting in 82 encounters. Forty medication-related problems, including experiencing an adverse drug reaction and ineffective therapy, were identified with recommendations made to patients or prescribers. Disease education, such as goals of therapy, was provided 46 times. Health monitoring tests, such as blood pressure, were performed 16 times and eight immunizations were administered. The revised workflow incorporating components of MTM services was successful in that 39% of encounters were less than two minutes and 49% of encounters were between two and five minutes in length. Only 12% of encounters were greater than five minutes. Overall, patients were very satisfied with the intervention. Pharmacists responded positively, but expressed concern that the changes to the work system prevented them from overseeing technician functions.
Conclusion: Pharmacists in community practice are able to provide components of medication therapy management services during a brief, face-to-face interaction with patients. Overall, patients and pharmacists were satisfied with the changes to the pharmacy work system and that additional work system changes are needed to further expand the role of the community pharmacist and facilitate patient-pharmacist interactions.

Type: Original Research