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Ashley N. Hannings Lori J. Duke Linda D. Logan Bradford L. Upchurch Jodi C. Kearney Andrew Darley Lindsey H. Welch Kay L. Brooks Michelle B. McElhannon 《Journal of the American Pharmacists Association》2019,59(2):228-231.e1
Objective
To assess patients’ perceptions of student pharmacist–run mobile influenza immunization clinics, including satisfaction, comfort, comparison to other experiences, and the views of pharmacists as immunizers.Methods
A 7-item survey was designed to assess patient satisfaction with receiving influenza vaccinations from student pharmacists, to compare the experience with vaccines received in nonpharmacy settings, and to determine the impact of the experience on patients’ views of pharmacist-administered vaccines. The anonymous survey was provided to patients in the postvaccination monitoring area for campus and non–campus mobile clinics from September through October of 2017.Results
Student pharmacists administered 1303 immunizations to patients at 27 campus or community-based mobile clinics. Of 928 patients (71.2% response rate) completing the survey, 90.9% had previously received at least 2 prior influenza vaccinations. More than 98% of patients were very satisfied or satisfied with the student pharmacist–run mobile flu clinic. Similarly, more than 98% of patients were very comfortable or comfortable receiving immunizations from a student pharmacist, and 99.9% of patients rated the experience as either better or similar to previous vaccinations received in nonpharmacy settings. Although 53.4% already used pharmacists as an immunization resource, an additional 38.5% reported they were more comfortable with pharmacists providing vaccinations as a result of the experience. Only 8.1% of patients reported that they would rather receive vaccinations from a physician or nurse. Reasons cited for choosing the mobile clinic for vaccination included convenience (92.2%), cost (35.8%), and positive past experience (28.9%).Conclusion
Patients were very satisfied with influenza vaccinations provided by student pharmacists in mobile clinics. The experience appeared to positively affect participants’ views of pharmacists as vaccine providers. Proper training, education, and skill development of student pharmacists are essential for ensuring patient safety and for obtaining and maintaining the trust of the patient and health care community. 相似文献3.
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Andrew W. Roberts Delesha M. Carpenter Austin Smith Kevin A. Look 《Research in social & administrative pharmacy》2019,15(2):222-225
Background
Expanding access to naloxone is crucial for mitigating the public health epidemic of opioid overdose deaths in America. Pharmacists now have greater independent authority to dispense naloxone to the public due to a wave of enhanced pharmacy naloxone access laws. It is unknown to what extent pharmacists are required to receive specialized training to serve in this capacity.Objectives
The goal of this study was to review naloxone training mandates from states with enhanced pharmacy naloxone access laws.Methods
Structured internet searches were completed using publicly available legislative, regulatory, and administrative records to identify the type of enhanced pharmacy naloxone access law and the presence and characteristics of a pharmacist naloxone training mandate in each state.Results
As of November 22, 2017, all 50 states have implemented an enhanced pharmacy naloxone access law. Only 19 states mandated targeted naloxone education before pharmacists engaged in independent naloxone dispensing/prescribing activities.Conclusions
A lack of standardized naloxone training requirements for naloxone-dispensing pharmacists may affect the rate of adoption of enhanced pharmacy naloxone dispensing practices at community pharmacies and suboptimal education of patients at risk of opioid overdose. Ensuring pharmacists' preparedness to serve as naloxone providers is necessary to meaningfully prevent opioid overdose deaths in their communities. 相似文献5.
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Objectives
To describe barriers faced by community pharmacists and recommend strategies to demonstrate the value of community-based pharmacy services.Data sources
Not applicable.Summary
Progress toward the Triple Aim and value-based programs increases opportunities for pharmacists to provide value within the health care system. However, community pharmacists continue to face many barriers to showing their value. A lack of provider status prevents independent billing for services and perpetuates an inability to provide care. Traditional documentation tools focus on dispensing and restrict bidirectional communication and interoperability with other electronic medical records. Finally, a lack of robust quality improvement and research infrastructure limits pharmacists’ ability to contribute to evidence demonstrating their value.Conclusion
Barriers to demonstrating the value of pharmacist-provided services can be overcome through ongoing efforts for pharmacist provider status, use of the Pharmacist eCare Plan, and greater quality improvement and research infrastructure in community pharmacies. 相似文献8.
Kenneth C. Hohmeier Nancy Borja-Hart Maureen Cooper James Kirby Cindy Fisher 《Journal of the American Pharmacists Association》2017,57(1):82-85
Objective
To determine pharmacist career paths and resident perceptions after completion of a PGY1 community pharmacy residency with a national supermarket pharmacy chain.Methods
Cross-sectional nationwide survey.Results
Overall, 65% (n = 24) of residents who responded accepted a position with Kroger immediately after graduation. When asked about the degree of value the residency had on obtaining the resident’s ideal position, 29 (76%) reported that it was “very valuable” and the remaining 9 (24%) reported that it was “somewhat valuable.” Positions that these pharmacists held immediately after residency completion were: clinical pharmacist (clinical coordinators, patient care specialists, or patient care managers; 54%), staff pharmacist (21%), split/mixed (mixed clinical and staffing components; 21%), and pharmacy manager (4%).Conclusion
Residency trained pharmacists were retained by the pharmacy chain where they practiced, and the majority of those pharmacists held split or full-time clinical pharmacist roles within the chain supermarket pharmacy. 相似文献9.
Kyle R. Frazier Kimberly C. McKeirnan Sorosh Kherghehpoush Lisa J. Woodard 《Journal of the American Pharmacists Association》2019,59(2):210-216
Objective
To understand rural patient opinions regarding their willingness to participate in pharmacist-provided chronic condition management.Design
Qualitative semi-structured key informant interview using The Concept of Access as a theoretical framework.Setting
Three community pharmacies serving patients in rural Washington State from November 2016 to November 2017.Participants
Current patients from 3 rural independent community pharmacies.Main Outcome Measures
Qualitative analysis of patient attitudes, acceptance, perceptions, and preferences regarding pharmacist-provided chronic condition management services in a community pharmacy.Results
Eighteen key informant interviews were conducted between November 2016 and November 2017. Five themes were identified: trust between the pharmacist, patient, and physician is key; patients already value pharmacists’ knowledge about chronic condition medications; participants identified the pharmacist as the first point of contact with regard to understanding appropriate use of medications to treat medical conditions; implementing clinical services in the community pharmacy setting may reduce the need for doctors’ visits and improve timely patient care; and creating designated clinical space, appointment options, and efficient service may increase patient accommodation.Conclusion
Management of chronic conditions continues to be one of the largest health care expenditures in the United States. One promising method of addressing this public health concern is through sustainable clinical pharmacy services. The themes identified in this study provide insight into factors that community pharmacists might consider as medical provider status continues to gain momentum and the use of clinical pharmacy services becomes more prominent. 相似文献10.
Jason H. Lam Serinna Singh Grace M. Kuo 《Journal of the American Pharmacists Association》2019,59(1):30-34
Objectives
To compare the completeness of immunization records for 6 vaccines between a community pharmacy database, a regional immunization information system (IIS), and a health system’s electronic health record (EHR).Methods
In a community pharmacy immunization program, 2 pharmacists and a community pharmacy resident performed a needs assessment for 6 vaccines (tetanus–diphtheria–acellular pertussis vaccine for adults or diphtheria–tetanus–acellular pertussis vaccine for children and adolescents, zoster vaccine live, 13-valent pneumococcal conjugate vaccine, 23-valent pneumococcal polysaccharide vaccine, hepatitis B vaccine series, and human papillomavirus vaccine) for more than 2400 patients from August 2016 to March 2017. This was a retrospective study to review immunization records for 243 patients. Inclusion criteria included patients from the community pharmacy immunization program who also had at least 1 medication prescribed by an academic health system provider. Immunization records for 6 vaccines were collected from the community pharmacy database, the regional IIS, and the EHR.Results
A total of 186 of 243 patients (77%) had additional immunization records in the regional IIS or EHR that were not found in the community pharmacy database. Among those 186 patients, 108 (58%) had additional immunization records for 2 or more unique vaccines. In total, 378 additional immunization records were identified for the 6 vaccines. For all 6 vaccines, the regional IIS and EHR possessed more complete immunization records than the community pharmacy database (P < 0.05 for HPV and P < 0.001 for the remaining 5 vaccines).Conclusion
Our study showed that immunization records were more complete in a regional IIS and health system EHR compared with a community pharmacy database. If all 3 sources were used by the pharmacist during the needs assessment, the community pharmacy team would have made fewer vaccine recommendations, which would have reduced the potential for duplicate or inappropriate vaccines. 相似文献11.
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Objectives
Gaps in vaccination coverage leave populations vulnerable to illnesses. Since the 1990s, there has been a growing movement to improve vaccination access by giving pharmacists the authority to administer vaccines according to state laws. Understanding the variation of pharmacist vaccination laws over time is critical to understanding the effect of improving access to vaccination services.Methods
We identified relevant statutes and regulations with the use of Westlaw legal databases. A 4-stage coding process identified 220 legal variables of pharmacist vaccination authority. Each jurisdiction’s laws were coded against these 220 legal variables. The resulting legal dataset was then evaluated to determine whether jurisdictions expanded or restricted pharmacist vaccination authorities over time.Results
From 1971 to 2016, jurisdictions made 627 changes to statutes and regulations relating to pharmacist vaccination authority. There were 85 expansions, 3 restrictions, and 22 regulatory clarifications. Eight changes were deemed to be unclear, and 479 changes did not substantively alter the scope of pharmacist vaccination authority.Conclusion
Collectively, the laws in 50 states and DC paint a clear picture: the scope of pharmacists’ vaccination authority is expanding. Jurisdictions are allowing pharmacists to administer more vaccines to younger patients with less direct prescriber oversight. This clear expansion of pharmacist vaccination authority stands in contrast to the reservations expressed by some physician groups for pharmacists as vaccination providers. However, laws in some states still do not permit pharmacists to vaccinate according to the Advisory Committee on Immunization Practices recommendations. 相似文献15.
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Joshua L. Akers Geoffrey Meer Jeffrey Kintner Anna Shields Laurel Dillon-Sumner Jennifer L. Bacci 《Journal of the American Pharmacists Association》2019,59(2):243-251
Objectives
To describe one independent pharmacy group’s experience delivering and being reimbursed for in-home medication coaching, or home visits, to high-risk and high-complexity community-dwelling patients.Setting
A nondispensing clinical division of an independent community pharmacy in Seattle, Washington.Practice innovation
A community pharmacist–led in-home medication coaching program delivered through partnerships with 3 community-based organizations for referrals and payment over a 4.5-year period. Community-based partners included a state comprehensive care management program, a local health system’s cardiology clinic, and the local Area Agency on Aging.Evaluation
A retrospective analysis of patient demographics, drug therapy problems, interventions, and pharmacy and technician time was conducted with the use of the pharmacy’s internal patient care documentation and billing systems from January 1, 2012, to June 31, 2016.Results
A total of 462 home visits (142 initial, 320 follow-up) were conducted with 142 patients. Patients averaged 13 disease states (range 3–31) and 16 medications (range 1–44) at their initial visit. Pharmacists identified an average of 11 drug therapy problems per patient (range 1–36) and performed an average of 13 interventions per patient (range 1–48). The most common drug therapy problem identified was nonadherence, and the most common intervention performed was education. The median pharmacist time in the home was 1.5 hours (range 0.67–2.75) for an initial visit and 1 hour (range 0.08–2.25) for a follow-up visit.Conclusion
Home visits can be successfully implemented by community pharmacists to provide care to high-risk and high-complexity community-dwelling patients. Our experience may inform other community pharmacy organizations looking to develop similar home visit services. 相似文献20.
Lorinda Anderson Laura M. Borgelt Paige Clark Gina Moore 《Journal of the American Pharmacists Association》2018,58(1):113-116