bluuebunny/crossref_metadata_2025_split huggingface dataset:
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
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
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
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
Pharmacokinetic Analysis of Meropenem and Piperacillin in Critically-Ill Patients Requiring Continuous Ven-Venous Hemodiafiltration
Authors: Ferlas Brandon , Nelson Kristina , Junghare Milind , Boeser Kimberly 
Published: January 2018

Background: Literature has demonstrated proper antibiotic selection and prompt initiation of antibiotics are associated with lower morbidity and mortality. Septic patients have altered pharmacokinetics and often require continuous renal replacement therapy which contributes to altered drug clearance and metabolism. The current study evaluates the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.
Purpose: This observational, prospective, single-center, nonrandomized study evaluated the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.
Methods: Plasma drug concentrations were determined via high-performance liquid chromatography using three post-dose blood samples after steady-state antimicrobial agent administration.
Results: Meropenem peak drug concentrations ranged from 35.9 to 61 mcg/mL, while trough concentrations ranged from 3.9 to 16.7 mcg/mL. Piperacillin peak drug concentrations ranged from 240 to 331.8 mcg/mL, while trough concentrations ranged from 152.7 to 194.9 mcg/mL. Both drugs examined displayed peak concentrations relatively consistent with those expected from the literature, but observed trough concentrations for meropenem and piperacillin were uniformly high.
Conclusions: Intravenous doses of meropenem and piperacillin result in peak drug concentrations similar to those previously reported and trough concentrations significantly greater than those in the literature. While concentrations above an organism’s MIC are desirable given the time-dependent nature of these beta-lactam antibiotics, decreased renal clearance of patients maintained on CVVHDF therapy while receiving higher doses of antimicrobials creates a situation in which drug accumulation and toxicity may occur. Given the complex nature of ICU patient care, increased pharmacovigilance and therapeutic drug monitoring are necessary in this unique population.

Type: Original Research
Development and Implementation of Charitable Pharmacy Services within a Federally-Qualified Health Center (FQHC)
Authors: Mospan Cortney M. , Alexander Katelyn M. 
Published: January 2018

Underserved patient populations often have limited access to health care services, especially medications, leading to lower quality care due to their transitional status and lack of access. To ensure access to medications for underserved patients in the Johnson City, Tennessee area, the Colleges of Nursing and Pharmacy at ETSU developed a charitable pharmacy to serve those of greatest need in hopes of improving quality of care. By establishing a community pharmacy within a FQHC, clinical community pharmacists were able to establish enhanced community pharmacy services as a part of the health-care team. This manuscript describes the development, implementation, and benefits of the community pharmacy integration within a FQHC

Type: Clinical Experience