Implementation of a pharmacy-based immunization program in a supermarket chain

OBJECTIVE: To describe procedures for implementing a pharmacy-based immunization program in a supermarket chain. SETTING: Supermarket chain pharmacy. PRACTICE DESCRIPTION: Ukrop's is a local supermarket chain with 27 stores in the greater area of Richmond, Fredericksburg, and Williamsburg, Virginia, 19 of which have pharmacies. Ukrop's offers enhanced patient care services including immunizations, diabetes, asthma, hypertension, hyperlipidemia monitoring, and smoking cessation. All pharmacies offer adult immunizations and host periodic diabetes, hypertension, and hyperlipidemia screening events. PRACTICE INNOVATION: Adult immunization program. INTERVENTIONS: Each pharmacy offered influenza and pneumococcal vaccinations on a walk-up basis during pharmacy hours and during clinics held at least 3 days per week. Immunizations were also offered periodically at off-site locations. Distribution of letters and chart stickers to patients' physicians, and even partnership with a physician to establish the immunization protocol, helped increase awareness of the pharmacy immunization services. This service involved a core group of immunizing pharmacists who developed a policies and procedures manual, distributed the vaccine, and handled additional staffing requirements. MAIN OUTCOME MEASURES: Number of adult influenza and pneumococcal vaccinations administered by pharmacists. RESULTS: Between September and December 1998, Ukrop's pharmacists administered 5,137 influenza vaccinations and 613 pneumococcal vaccinations. Between September 1999 and January 2000, Ukrop's pharmacists administered 18,000 influenza vaccinations and 1,200 pneumococcal vaccinations. CONCLUSION: In addition to immunizing thousands of people in its first year, the program served as a successful marketing tool to increase awareness of enhanced pharmacy services in the community and among local physicians. Administration of vaccines increased pharmacists involvement with and enthusiasm for enhanced patient care services and generated a revenue stream for the pharmacies.     

Obligations of Investigators in Clinical Research a Pharmacist's Perspective

Abstract

The Department of Pharmacy Practice at the University of Illinois at Chicago, College of Pharmacy currently employs 40 fulltime clinical pharmacists who have minimal drug distribution responsibilities and provide pharmacy services to a specific patient care team and are involved with the education of pharmacy and medical students. In addition, these clinical pharmacists have collaborated in the clinical research activities of the medical and surgical staffs at the University of Illinois, Since many of these pharmacists have gain recognition as primary and co-investigators by various study sponsors, the Department of Pharmacy Practice has developed a program to inform each clinical pharmacist of his/her responsibilities as a clinical investigator. The following document summarizes the Department's policies and procedures.     

Primary care provider perceptions of an integrated community pharmacy hypertension management program

BackgroundTrained community pharmacists provided hypertension (HTN) management services in collaboration with a patient-centered medical home (PCMH).ObjectiveTo explore primary care provider (PCP) perceptions of a HTN management program in which patients at the PCMH with elevated blood pressure could choose to receive follow-up care with a trained community pharmacist at a chain community pharmacy.MethodsWe conducted informal interviews with 8 PCPs with a range of level of involvement with the collaborative HTN management program to inform the development of a 13-question online survey that was distributed to PCPs at 10 participating Michigan Medicine PCMH clinics. The primary outcome was the percent of PCPs who reported that the program improved their patient’s blood pressure. Secondary outcomes included awareness of the program, alternative follow-up strategies, PCP satisfaction, and barriers to using the program.ResultsA total of 39 PCPs (30.0%) responded to the survey. More than one-half (n = 21 of 39, 53.9%) of respondents reported that at least 1 of their patients had seen a trained community pharmacist for HTN management services. Almost all of these PCPs (n = 19 of 21, 90.5%) reported being satisfied with the program, and 80.9% (n = 17 of 21) agreed that it helped patients improve their blood pressure control. The most common barriers identified were patients preferring to follow up directly with their PCP (n = 18 of 39, 46.2%), PCPs being more comfortable with patients having a visit with an embedded ambulatory care pharmacist (n = 16 of 39, 41.0%), and a lack of written materials to share with patients about the program (n = 15 of 39, 38.5%).ConclusionPCPs who used the integrated community pharmacy HTN management program were satisfied with the program and thought that it resulted in improved blood pressure control. PCPs may benefit from written information to share with their patients as well as education to increase their awareness of the program and its beneficial effect on patient blood pressure.     

Diabetes Ten City Challenge: Final economic and clinical results

ObjectiveTo assess the economic and clinical outcomes for the Diabetes Ten City Challenge (DTCC), a multisite community pharmacy health management program for patients with diabetes.DesignQuasiexperimental observational analysis, pre–post comparison.SettingEmployers at 10 distinct geographic sites contracting with pharmacy providers in the community setting.Participants573 patients with diabetes who had baseline and year 1 medical and pharmacy claims and two or more documented visits with pharmacists.InterventionsCommunity-based pharmacists provided patient self-management care services via scheduled consultations within a collaborative care management model.Main outcome measuresChanges in health care costs for employers and beneficiaries and key clinical measures.ResultsAverage total health care costs per patient per year were reduced by $1,079 (7.2%) compared with projected costs. Statistically significant improvements were observed for key clinical measures, including a mean glycosylated hemoglobin decrease from 7.5% to 7.1% (P = 0.002), a mean low-density lipoprotein cholesterol decrease from 98 to 94 mg/dL (P < 0.001), and a mean systolic blood pressure decrease from 133 to 130 mm Hg (P < 0.001) over a mean of 14.8 months of participation in the program. Between the initial visit and the end of the evaluation period, influenza vaccination rate increased from 32% to 65%, eye examination rate increased from 57% to 81%, and foot examination rate increased from 34% to 74%.ConclusionDTCC successfully implemented an employer-funded, collaborative health management program using community-based pharmacist coaching, evidenced-based diabetes care guidelines, and self-management strategies. Positive clinical and economic outcomes were identified for 573 patients who participated in the program for at least 1 year, compared with baseline data.