bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacists' social authority to transform community pharmacy practice
Authors: McPherson Timothy , Fontane Patrick 
Published: January 2018

Leaders in the profession of pharmacy have articulated a vision of pharmacists as providers of patient-centered care (PCC) services and the Doctor of Pharmacy was established as the required practice degree to achieve this vision. Pharmacist-provided PCC services have been shown to reduce medication costs and improve patient compliance with therapies. While community pharmacists are capable of, and are ideally placed for, providing PCC services, in fact they devote most of their time to prescription dispensing rather than direct patient care. As professionals, community pharmacists are charged with protecting society by providing expert services to help consumers manage risks associated with drug therapies. Historically pharmacists fulfilled this responsibility by accurately dispensing prescription medications, verifying doses, and allergy checking. This limited view of pharmacy practice is insufficient in light of the modern view of pharmacists as providers of PCC. The consumers' view of community pharmacy as a profession represents a barrier to transforming the basis of community pharmacy from product distribution to providing PCC services. Community pharmacists are conferred with social authority to dictate the manner in which their professional services are provided. Pharmacists can therefore facilitate the transition to PCC as the primary function of community pharmacy by exercising their social authority to engage consumers in their roles in the new patient-pharmacist relationship. Each pharmacist must decide to provide PCC services. Suggestions for initiating PCC services in community pharmacy are offered.

Type: Idea Paper
Providing Health Care Service-learning Experiences for IPPE Credit
Authors: Bartelme Kassandra M. , Ticcioni Andrew J. , Janke Kristin K. 
Published: January 2018

Service-learning (SL) provides an opportunity for students to learn personal and professional skills while providing a useful service to the community. Many pharmacy education programs use SL within their curriculum because of the benefits to the community, the faculty, the learning institution and the student(s). While SL has been used in schools/colleges of pharmacy for many years, SL that also fulfills IPPE requirements is newer. This paper seeks to promote the use of combined SL/IPPE experiences. It provides an example where students volunteered at federally qualified health centers and also reviews the ACPE Standards related to SL. Schools/colleges of pharmacy are encouraged to design mechanisms for students to participate in combined SL/IPPE experiences as part of their IPPE requirements.

Type: Idea Paper
Patient And phaRmacit Telephonic Encounters (PARTE) in an Underserved Rural Population with Asthma: Methods and Rationale
Authors: Young Henry N. , Havican S. Nadra , Chewning Betty A. , Sorkness Christine A. , Ruppel Xin , Griesbach Sara 
Published: January 2018

Purpose: Methods used to deliver and test a pharmacy-based asthma care telephonic service for an underserved, rural patient population are described.
Summary: In a randomized controlled trial (RCT), the Patient And phaRmacist Telephonic Encounters (PARTE) project is assessing the feasibility, acceptability, and preliminary impact of providing pharmacy-based asthma care service telephonically. The target audience is a low income patient population across a large geographic area served by a federally qualified community health center. Ninety-eight participants have been randomized to either standard care or the intervention group who received consultation and direct feedback from pharmacists via telephone regarding their asthma self-management and medication use. Pharmacists used a counseling framework that incorporates the Indian Health Services 3 Prime Questions and the RIM Technique (Recognition, Identification, and Management) for managing medication use problems. Pharmacists encouraged patients to be active partners in the decision-making process to identify and address the underlying cause of medication use problems. Uniquely, this trial collected process and summative data using qualitative and quantitative approaches. Pharmacists' training, the fidelity and quality of pharmacists' service delivery, and short term patient outcomes are being evaluated. This evaluation will improve our ability to address research challenges and intervention barriers, refine staff training, explore patient perspectives, and evaluate measures' power to provide preliminary patient outcome findings.
Conclusion: A mixed method evaluation of a structured pharmacist intervention has the potential to offer insights regarding staff training, service fidelity and short term outcomes using quantitative and qualitative data in an RCT. Results will provide evidence regarding the feasibility and quality of carrying out the study and service delivery from the multiple perspectives of participants, clinicians, and researchers.

Type: Original Research
Pharmacist-Driven Management of Chemotherapy Induced Nausea and Vomiting in Hospitalized Adult Oncology Patients. A Retrospective Comparative Study
Authors: Elshaboury Ramy , Green Kathleen 
Published: January 2018

Chemotherapy-induced nausea and vomiting (CINV) is a major adverse event associated with cancer treatments. There are clinical practice guidelines that assist practitioners in managing CINV. Many cancer centers develop protocols for physicians and pharmacists to guide prophylaxis and breakthrough treatments of CINV based on published guidelines. The purpose of this study was to evaluate the outcome differences between pharmacist and physician -driven management of CINV in adult hospitalized cancer patients in a large academic medical center. This is a single center retrospective chart review study. The primary outcome of the study was the number of breakthrough antiemetic doses needed throughout the hospitalization. A total of 106 adult patients receiving inpatient chemotherapy were reviewed for CINV management. Fifty-five patients (52%) were managed according to the pharmacist-driven protocol, and fifty-one patients (48%) were managed by the physician. There was no difference between the two groups in the primary outcome. Patients in the pharmacist-managed group needed 6.4 breakthrough antiemetic doses; whereas, patients in the physician managed group needed 5.9 doses throughout the hospital stay (P-value = 0.7). No difference was seen when results were adjusted for length of hospitalization. There was a difference in adherence to the institution CINV guidelines favoring the pharmacist-driven approach (85% versus 33%, P < 0.0001). In conclusion, pharmacist-run protocol for CINV management was as effective as the standard of care. Protocols that are based on practice guidelines may offer the advantage of care standardization and potential cost savings.

Type: Student Project
Development and Implementation of a Novel Lifestyle Medicine Advanced Pharmacy Practice Experience Elective
Authors: Gillespie Nicole D. , Lenz Thomas L. 
Published: January 2018

Objective: To develop and implement an Advanced Pharmacy Practice Experience (APPE) to increase student's awareness and use of lifestyle modifications in chronic disease prevention and management.
Design: A five-week APPE was developed that utilized a wide variety of activities, including direct patient care, patient education, case studies, journal clubs and reflective assessment and writing to explore various lifestyle modifications and their relation to chronic disease prevention and management.
Conclusion: The novel lifestyle medicine APPE provides students a unique opportunity to advance their knowledge in therapeutic lifestyle changes and expand their understanding of the pharmacist's role in chronic disease prevention and management.

Type: Idea Paper
Remember Your MEDS: Medication Education Delivers Success
Authors: Rife Kelsey M. , Ginty Sarah E. , Hohner Elizabeth M. , Stamper Heather R. , Sobota Kristen F. , Bright David R. 
Published: January 2018

Background: Medication adherence is one of the largest barriers to better patient outcomes today. As pharmacists and student pharmacists expand their roles with community outreach projects, they have the potential to make a huge impact on improving adherence.
Objective: To improve medication adherence through patient counseling and constructive resources, and to determine patient preferences of adherence tools.
Methods: Student pharmacists partnered with a 340B pharmacy to promote the importance of medication adherence. Patients were counseled in an initial 10 minute session, and then given the opportunity to receive one or more of the following adherence tools: a pill box, timer, reminder refrigerator magnets, calendar stickers, refill reminder phone calls and/or text message reminders. A pre-survey was conducted to establish the patients' baseline medication adherence using the validated ©Morisky Medication Adherence Scale (©MMAS-8). After three months, students conducted the post-survey via the ©MMAS-8 by calling the patients and asking them questions about the helpfulness of the adherence tools as well as the effectiveness of the initial counseling visit.
Results: Sixty five patients with hypertension enrolled in the study, and 51 patients completed both the pre- and post-surveys. Patients improved from a 6.02 (SD +/- 1.62) average pre-score to a 6.83 (SD +/-1.25) average post score (p < 0.001). Pill boxes, text message reminders, and calendar stickers were respectively ranked as the top 3 most helpful tools studied. The refrigerator magnets were also considered helpful by most patients who used them. The timers were ranked the least helpful, mostly due to difficulty of use.
Conclusion: Student pharmacists can have a positive impact on medication adherence through simple counseling and offering effective adherence tools.

Type: Student Project
Impact of Pharmacists and Student Pharmacists in Educating and Screening Low-Income Women for Cardiovascular Disease
Authors: DiPietro Natalie A. , Sobota Kristen Finley , Giannamore Martin R. 
Published: January 2018

Objectives: To evaluate the effectiveness of an educational intervention on knowledge of cardiovascular disease (CVD) and to increase awareness of risk factors among female patients of a community health center with an on-site 340B pharmacy.
Methods: The program consisted of a 10-minute educational intervention and brief pre-test, post-test, and participant satisfaction survey. Adult female patients at the clinic for any provider visit or prescription fill were eligible to participate. Participants met individually with a student pharmacist or faculty member and verbally completed the pre-test. The participant received education regarding CVD, risk factors, and symptoms of myocardial infarction and were screened for hypertension and/or hyperlipidemia. The post-test was then verbally administered. Participants answered the satisfaction survey privately. Based on individual needs, educational materials and information on available pharmacy clinical services were provided. The university IRB deemed the study exempt.
Results:Eighty-four individuals received educational materials and/or a screening test. Of those, 30 women (mean age 46.9 years) completed the educational intervention. Thirteen (43%) reported smoking; 22 (73%) identified themselves as overweight. Fourteen (47%) indicated a preexisting diagnosis of hypertension. Correct responses for 6 of 8 knowledge-based questions were statistically significantly improved from pre-test to post-test (p
Conclusion: CVD is the leading cause of death in U.S. women. Data from this program indicate that through screening and education, pharmacists and student pharmacists can impact female patients' knowledge of CVD risk factors. Continued efforts in this area may help to reduce the public health burden of CVD.

Type: Student Project
Don't Leave Without Them: Dispensing asthma medications to pediatric patients upon discharge is associated with decreased hospital readmissions
Authors: Hiteshew Kelly J. , Franz Thaddeus , Lamberjack Kristen , Chen Aleda M.H. 
Published: January 2018

Purpose: Asthma exacerbations are a leading cause of hospital and emergency department admissions at pediatric institutions. The objective of this study was to determine if patients who obtain discharge medications from a pediatric institution's outpatient pharmacy after an admission for asthma have a lower thirty-day readmission rate than those who do not obtain discharge medications from the outpatient pharmacy.
Methods: This multi-phase retrospective study included an initial chart review, an intervention period, and a second chart review of the intervention period. The chart reviews included patients ages two years and older with a discharge diagnosis of asthma or wheezing. During the intervention phase, pharmacists promoted use of the outpatient pharmacy by patients admitted for these conditions using multiple methods. In each chart review, the patients readmitted for asthma or wheezing within thirty days were classified as either outpatient pharmacy users (OPP users) or non-OPP users. Differences in readmission rates between OPP users and non-OPP users, as well as differences in overall OPP utilization, were analyzed before and during the intervention phase using a Chi-square test.
Results: The initial chart review found no significant difference in thirty day readmission rates between OPP users and non-OPP users (6.2% and 7.5%, respectively; x2 = 1.15; p = 0.274). The number of OPP users increased significantly from the first chart review to the second (11.8% and 45.9%, respectively; x2 = 929.04, p < 0.001). The second chart review revealed that OPP users had a significantly lower readmission rate than non-OPP users during the intervention phase (2.3% and 10.9%, respectively; x2 = 52.5; p < 0.001).
Conclusion: Obtaining discharge medications from the OPP was associated with a lower thirty-day readmission rate in children with asthma. Promoting use of the OPP for transitional care should continue to be part of future efforts to decrease hospital readmissions.

Type: Original Research
Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) Team
Authors: Watkins Sarah C. , Winchester Bruce R. , Brahm Nancy C. , Washington Nicole B. 
Published: January 2018

Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI) community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers.
Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed.
Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI), haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable.
Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.

Type: Student Project
Consumer Reports - Best Buy Drugs' Outreach Project in Minnesota
Authors: Schommer Jon C. , Worley Marcia M. , Schondelmeyer Stephen 
Published: January 2018

The objectives for this study were to apply four different approaches for disseminating Consumer Reports Best Buy Drugs (CR-BBD) information about effectiveness, safety, and cost to patients for therapeutic classes of medications that they were using and then (1) evaluate the usefulness of the information to participants and (2) document resultant information seeking. For the three approaches that utilized face-to-face contact (Approaches 2 through 4), we also compared them in terms of (1) number of medications reviewed per person, (2) availability of CR-BBD information per person, (3) changes that could be made for each person, and (4) potential/likely cost savings (per person per month). Finally, we described the availability of CR-BBD information for each participant categorized by the 19 therapeutic classes of medications for which there were Best Buy Drugs reports. Data were collected via self-administered surveys, in-person interviews, and telephone interviews. The results showed that almost all of the participants in the information sessions held for this study had at least one medication for which Best Buy Drug information was available with significant savings potential to be gained by using the recommended Best Buy Drug. Potential cost savings through the use of recommended Best Buy Drugs was $89.47 per person per month averaged over all participants (n = 172) and was $157.20 per person per month for those with savings over zero dollars (n = 98). Thirty-two percent of respondents to our evaluation survey reportedly sought more information from a physician and 30 percent sought more information from a pharmacist. We concluded that provision of information about effectiveness, safety, and cost to patients has the potential for achieving significant cost savings. Recommendations regarding (1) the timing of provision, (2) targeting of recipients and (3) traversing impediments are given.

Type: Original Research
Cultivation and Implementation of Community-Engaged Pharmacy Services in a Free Clinic to Enhance Care for the Medically Underserved
Authors: Tran Emmeline , Jennings Brandon T. 
Published: January 2018

Partnerships between community free clinics and academic medical centers improve patient outcomes and enhance learning opportunities for students. A community-academic partnership between the Maliheh Free Clinic and the University of Utah College of Pharmacy was formed to fulfill a community need for pharmacy services, to promote interdisciplinary patient care, and to provide an experiential opportunity for students. The Maliheh Free Clinic based in Salt Lake City, Utah provides free primary health care to uninsured individuals who live 150% below federal poverty guidelines. Three pharmacy services were developed and implemented. These include: 1) clinic chart reviews which involve written recommendations following a comprehensive assessment of the patient's chart examining his or her disease states and the appropriateness of his or her medications; 2) medication reconciliations and discussion of pharmacy-related recommendations with patients during Diabetes Day, an inclusive interdisciplinary patient appointment that addresses important aspects of diabetes care; and 3) an insulin dose adjustment service through a collaborative practice agreement with the clinic to monitor a patient's blood glucose levels and adjust his or her medications accordingly on a weekly basis.

Type: Student Project
Developing a Respiratory Depression Scorecard for Capnography Monitoring
Authors: Felhofer Katie 
Published: January 2018

Pulse oximetry is the most common way to measure a patient's respiratory status in the hospital setting; however, capnography monitoring is a more accurate and sensitive technique which can more comprehensively measure respiratory function. Due to the limited number of capnography monitoring equipment at the University of Minnesota Medical Center-Fairview (UMMC-Fairview), we analyzed which patients should preferentially be chosen for capnography monitoring over pulse oximetry based on risk of respiratory depression. We conducted a retrospective chart review of all serious opioid-induced over-sedation events that occurred at UMMCFairview between January 1, 2008 and June 30, 2012. Thirteen risk factors were identified which predispose patients to respiratory depression. The average patient demonstrated 3.75 risk factors. The most commonly occurring risk factor was the concomitant use of multiple opioids or an opioid and a CNS-active sedative, followed by an ASA score äŠ« 3. Based on this data, we developed a scorecard for choosing patients at the most risk of developing respiratory depression; these patients are the best candidates for capnography. Although further studies are necessary to corroborate this research, at this time giving extra consideration to patients demonstrating the previously stated risk factors is prudent when assessing those patients most in need of capnography.

Type: Student Project
The Role of Clinical Pharmacists in Modifying Cardiovascular Disease Risk Factors
Authors: Bagwell Autumn , Skelley Jessica W. , Saad Lana , Woolley Thomas , Dugan DeeAnn 
Published: January 2018

Objective: Assess the effect of intensive clinical and educational interventions aimed at reducing risk factors for Cardiovascular Disease (CVD), implemented by clinical pharmacists, on modifying risk factors in targeted patients at high risk for CVD.
Design: Patients with at least two risk factors for CHD were identified at two clinics by conducting a pre-intervention survey and were monitored over a period of 6 months with follow up conversations conducted every 4 weeks by phone and at subsequent physician visits. A post-intervention survey was conducted at the end of the study period to detect modified risk factors.
Setting: The Jefferson County Public Health Department (JCHD)
Participants: We followed a total of 47 patients over 6 months. The average age at baseline was 51 years old and 80% of the participants were female. The baseline average number of modifiable cardiovascular disease risk factors was 3.7.
Measurements: We assessed total number of CVD risk factors, smoking behavior, blood pressure, LDL, A1C, weight, and level of physical activity (major modifiable risk factors by the American Heart Association).
Results: Over a 6 month follow-up of 47 patients, statistically significant reductions occurred in total number of CVD risk factors, systolic and diastolic blood pressures, and A1C. Reductions also occurred in LDL level, weight, and changes in smoking behavior and physical activity were identified.
Conclusions: Results showed that increased patient counseling on adherence and lifestyle changes along with increased disease state monitoring and medication adjustment led by a clinical pharmacist can decrease risk factors in patients with multiple risk factors for cardiovascular disease.

Type: Student Project