共查询到20条相似文献，搜索用时 15 毫秒
1.
Haesuk Park Ayoade Adeyemi Wei Wang Teresa E. Roane 《Journal of the American Pharmacists Association》2017,57(1):62-66.e2
Objectives
To determine the impact of a telephone call reminder program provided by a campus-based medication therapy management call center on medication adherence in Medicare Advantage Part D (MAPD) beneficiaries with hypertension.Methods
The reminder call services were offered to eligible MAPD beneficiaries, and they included a live interactive conversation with patients to assess the use of their medications. This study used a quasi-experimental design for comparing the change in medication adherence between the intervention and matched control groups. Adherence, defined by proportion of days covered (PDC), was measured using incurred medication claims 6 months before and after the adherence program was implemented. A difference-in-differences approach with propensity score matching was used.Results
After propensity score matching, paired samples included 563 patients in each of the intervention and control groups. The mean PDC (standard deviation) increased significantly during postintervention period by 17.3% (33.6; P <0.001) and 13.8% (32.3; P <0.001) for the intervention and the control groups, respectively; the greater difference-in-differences increase of 3.5% (36.3) in the intervention group over the control group was statistically significant (P = 0.022). A generalized estimating equation model adjusting for covariates further confirmed that the reminder call group had a significant increase in pre-post PDC (P = 0.021), as compared with the control group.Conclusions
Antihypertensive medication adherence increased in both reminder call and control groups, but the increase was significantly higher in the intervention group. A telephonic outreach program was effective in improving antihypertensive medication adherence in MAPD beneficiaries. 相似文献2.
3.
4.
5.
6.
7.
William R. Doucette Julia J. Rippe Caroline A. Gaither David H. Kreling David A. Mott Jon C. Schommer 《Journal of the American Pharmacists Association》2017,57(1):72-76.e1
Objectives
To describe services provided by community pharmacies and to identify factors associated with services being provided in community pharmacies.Design
Cross-sectional national mail survey.Setting and participants
Pharmacists actively practicing in community pharmacies (independent, chain, mass merchandisers, and supermarkets).Outcome measures
Frequency and type of pharmacy services available in a community pharmacy, including medication therapy management, immunization, adjusting medication therapy, medication reconciliation, disease state management, health screening or coaching, complex nonsterile compounding, and point-of-care testing.Results
With a 48.4% response rate, the survey showed that community pharmacies offered on average 3 of the 8 services studied. Pharmacy chains and supermarket pharmacies reported providing significantly more services than did mass merchandise pharmacies. The number of pharmacy services provided was positively associated with involvement in an interprofessional care team, innovativeness, and perceived workload. The number of pharmacy services was negatively correlated with having 3.5 or more pharmacy technicians on duty.Conclusion
Pharmacy chains and supermarkets are providing the most pharmacy services among community pharmacy settings. The number of services provided was associated with innovativeness, technician staffing, and perceived workload. Also, involvement with an interprofessional care team supported greater service delivery. Community pharmacies vary in their provision of services beyond dispensing. 相似文献8.
9.
Reina Haque Jiaxiao Shi Joanie Chung Xiaoqing Xu Chantal Avila Christopher Campbell Syed A. Ahmed Lei Chen Joanne E. Schottinger 《Journal of the American Pharmacists Association》2017,57(3):303-310.e2
Objective
Our objective was to examine the association between adherence to tyrosine kinase inhibitors (TKIs) and molecular monitoring and the risk of disease progression or mortality among patients with chronic phase chronic myeloid leukemia (CML).Design
We assembled a retrospective cohort of patients with CML (chronic phase, no prior cancer history, and confirmed to be Philadelphia chromosome positive) using data from electronic health records and chart reviews. Medication possession ratio (MPR) was used to measure drug adherence.Setting
A large, community-based, integrated health plan in Southern California.Participants
The cohort consisted of 245 adult patients (≥18 years old) with Philadelphia positive chronic phase CML diagnosed from 2001 to 2012 and followed through 2013.Main outcome measures
In survival analyses, we examined the association of TKI adherence (MPR) and polymerase chain reaction (PCR) monitoring test frequency with the composite clinical outcome, progression to accelerated phase disease–blast crisis or mortality (progression-free survival). The cohort was followed for a maximum of 13 years (median 4.6 years).Results
Over 90% of the cohort initiated TKI therapy within 3 months of diagnosis, and the mean MPR was 88% (SD 18%). Virtually all patients (96%) started on imatinib. The rates of progression to accelerated phase–blast crisis and mortality were lower in patients with greater TKI adherence (20.4/1000 person-years) versus lower adherence (27.0/1000 person-years). Patients who underwent PCR monitoring had a significantly reduced risk of progression or mortality, which was seen in patients with high and low TKI adherence status from both the groups (hazard ratio [HR] 0.07 [95% CI 0.03-0.19 if MPR >90%] and HR 0.70 [95% CI 0.02-0.21 if MPR<90%]).Conclusion
Our results suggest that close clinical monitoring, which includes PCR monitoring in patients with high and low TKI drug adherence, is associated with a lower risk of progression or mortality. 相似文献10.
11.
12.
13.
14.
Madhavi Gavini Eve S. Faber Andrea Birnbaum Richard Sadovsky 《Journal of the American Pharmacists Association》2017,57(2):188-192.e1
Objectives
Primarily to determine how many of our adult patients receive significant assistance from another individual with medication management. Secondarily, to determine if the number of prescribed medications can be predictors of whether the patient receives significant assistance with medication management.Design
Cross-sectional survey study.Setting
A level 3 patient-centered medical home family practice clinic in an inner city university hospital in Brooklyn, New York.Participants
Patients 40 years of age and older coming for a regular clinic visit to see the primary care physician.Intervention
Administering the survey to the patients was the intervention.Main outcome measures
The number of patients who receive significant assistance with any phase of medication management was the main outcome measure.Results
Out of 143 patients surveyed, 61 patients (42.7%) received assistance with 1 or more phases of medication management; 38.5% (n = 55) of patients received help with phase 1 (ensuring that patients have medications at home). Of those 55 patients, 28 (50.9%) received help from family members, 22 (40%) received help from pharmacies, and 5 (9.1%) received help from home health aides or visiting nurses. Thirteen patients (9%) received help with phase 2 (arranging medications to help take them properly); 11 (84.6%) of them received help from family members. Twenty-three patients (16.1%) received help with phase 3 (reminding patients to take medications or handing them to the patient); 17 (73.9%) out of 23 received help from family members. There was a statistically significant trend (Mann-Whitney 2-sided test: P <0.001) showing a direct relationship between the number of medications and the need for assistance with 1 or more phases of medication management.Conclusion
Many adult patients receive help with 1 or more phases of medication management. Family members are the major source of assistance with medication management. Pharmacies also play an important role in making certain that patients have medications at home. Patients with a higher number of medications are more likely to receive assistance from others. 相似文献15.
16.
17.
Terri L. Warholak Mira Patel Meagen Rosenthal Donna West-Strum Earl B. Ettienne Gail Nunlee-Bland David Nau Ana L. Hincapie 《Journal of the American Pharmacists Association》2017,57(3):311-317
Objectives
To identify patients’ understanding of what constitutes a “quality pharmacy” and to obtain their feedback regarding the development and use of the pharmacy star rating model, a pharmacy-specific aggregate performance score based on the Centers for Medicare and Medicaid Services’ Medicare Star Rating.Design
Prospective cross-sectional study.Setting and participants
Focus groups were conducted in Arizona, California, Mississippi, Maryland, and the District of Columbia, and one-on-one interviews were conducted in Indiana. Eligible patients were required to routinely use a community pharmacy.Main outcome measures
Consumer insights on their experiences with their pharmacies and their input on the pharmacy star rating model were attained. Key themes from the focus groups and interviews were obtained through the use of qualitative data analyses.Results
Forty-nine subjects from 5 states and DC participated in 6 focus groups and 4 one-on-one interviews. Eighty-eight percent of participants reported currently taking at least 1 medication, and 87% reported having at least 1 health condition. The 7 themes identified during qualitative analysis included patient care, relational factors for choosing a pharmacy, physical factors for choosing a pharmacy, factors related to use of the pharmacy star rating model, reliability of the pharmacy star rating model, trust in pharmacists, and measures of pharmacy quality. Most participants agreed that the ratings would be useful and could aid in selecting a pharmacy, especially if they were moving to a new place or if they were dissatisfied with their current pharmacy.Conclusion
Pharmacy quality measures are new to patients. Therefore, training and education will need to be provided to patients, as pharmacies begin to offer additional clinical services, such as medication therapy management and diabetes education. The use of the pharmacy star rating model was dependent on the participants’ situation when choosing a pharmacy. 相似文献18.
19.