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Adam Ward Jill Hall Jay Mutch Lydia Cheung Matthew Ken Cor Theresa L. Charrois 《Journal of the American Pharmacists Association》2019,59(1):23-29.e1
Objectives
The primary objective of this study was to identify characteristics of pharmacists that contribute to their success.Design
A working definition of success in pharmacy practice was derived from a scoping literature review and is based on the premise that successful pharmacists practice to full scope within the context of their practice setting. Semistructured individual interviews were conducted with selected pharmacists. Potential candidates were nominated by leading pharmacists in the field with the use of our prespecified definition of success. Lists from the nominators were compared, and pharmacists who appeared on more than 1 list were invited to participate. The interview tool was developed with the use of previous research on success in health care professions.Setting and participants
Participants were 10 practicing pharmacists in a variety of locations (5 urban/5 rural) and practice settings (5 hospital/4 community/1 ambulatory care).Outcome measures
Themes related to successful pharmacists practicing to full scope.Results
Pharmacists meeting our definition of success were engaged in assessment and care planning, other expanded scope activities, and interpersonal activities and collaboration. The 10 interviewed pharmacists described motivation, critical thinking, emotional intelligence, core competencies, and work-life balance as significant contributors to their success.Conclusion
Several characteristics were identified as potentially related to success. These characteristics may be useful in pharmacists identifying areas for personal growth and development. 相似文献2.
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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4.
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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7.
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Sandra Zeater Shalom I. Benrimoj Fernando Fernandez-Llimos Victoria Garcia-Cardenas 《Journal of the American Pharmacists Association》2019,59(1):108-116.e1
Objectives
Limited studies have assessed the financial benefit of professional pharmacy services (PPSs) to the community pharmacy as a business. These studies are crucial in developing an insight into the long-term sustainability and broader implementation of services. We reviewed the literature to identify measures and indicators used to assess the financial performance of professional services in community pharmacy.Data sources
The literature search was undertaken in Pubmed and Scopus, and a gray literature search was performed in Google.com. References of the included papers were reviewed for other relevant studies.Study selection
Articles were reviewed against the following exclusion criteria: 1) literature reviews, 2) studies not reporting quantitative financial data from community pharmacy, 3) studies not assessing a PPS, 4) studies lacking a methodology for the measurement and assessment of financial outcomes, and 5) cost-effectiveness analysis, cost-utility analysis, or cost-benefit analysis studies.Data extraction
A piloted data extraction form was used. A selection of key data collected is as follows: 1) method of data collection and calculation, 2) currency, limitations for cost and revenue and method of data collection and method of calculation, 3) standardized currency value for the results reported, 4) professional services: number assessed, type of service, name of services, nature of services, implementation stage reported, financial result, the frequency of service, costs, sources of revenue, net total cost, net total revenue, break-even point, break-even price, net profit and loss.Results
The 21 studies included used different methodologies and indicators to financially assess PPSs. This has led to the development of a model for assessing PPSs composed of the key financial elements identified in this systematic review.Conclusion
From this review, we propose a model that provides a structured approach for pharmacists to manage the financial performance of services. 相似文献9.
Kenneth C. Hohmeier Sharon L.K. McDonough Leanne Justis Rein Andrea L. Brookhart Mara L. Gibson Mary F. Powers 《Journal of the American Pharmacists Association》2019,59(2):187-194
Objectives
To explore the current roles of the pharmacy technician in the provision of medication therapy management (MTM) and their relation to organizational behavior at “high-performing” community pharmacies within a nationwide supermarket chain.Design
Qualitative research study using methodologic triangulation with the use of semistructured interviews of key informants, direct observation at “high-performing” pharmacy sites, and respondent journals.Setting and participants
High-performing pharmacy sites within a large supermarket pharmacy chain in Tennessee. A high-performing site was defined as a pharmacy that has successfully implemented MTM into its pharmacy workflow.Main outcome measures
Themes related to pharmacy technician roles in the delivery of direct patient care services.Results
A total of 28 key informants were interviewed from May 2015 to May 2016. Key informants included 10 certified technicians, 5 noncertified technicians, and 13 pharmacists across 8 pharmacies in central and eastern Tennessee. Three themes were identified. At high-performing sites, pharmacy technicians were engaged in both clinical support activities as well as nonclinical support activities with the goal of improving clinical service implementation. Several barriers and facilitators were revealed.Conclusion
Within high-performing teams, expanded technician roles to support patient care service delivery were associated with successful clinical service implementation. Future studies should further explore these expanded technician duties, as well as the role of organizational culture, climate, and team dynamics, in the delivery of patient care and clinical services across a heterogeneous pharmacy setting. 相似文献10.
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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12.
Background
Pharmacists need to demonstrate knowledge of and have confidence in Food and Drug Administration (FDA) therapeutic equivalence (TE) standards to improve acceptance of generic medicines amongst patients and other healthcare professionals.Objective
To evaluate community pharmacists' understanding, interpretation and perceptions of the FDA TE standards to identify if further education is needed on this topic.Methods
An anonymous, 13-item survey was piloted and then distributed by e-mail to a random sample of 287 Indiana community pharmacists. The 5-min survey included demographic, knowledge-based, and perception-based questions on FDA TE criteria that participants were given one week to complete. Participants completed the survey using a Web-based survey tool (Qualtrics).Results
192 pharmacists completed the survey achieving a response rate of 66.9%. Only 7.3% of respondents correctly identified FDA bioequivalence criteria for approval of generic drug products. Two questions presented TE codes from the Orange Book and asked respondents to identify if a pair of drug products were therapeutically equivalent: 62.6% and 61.0% of respondents answered correctly. However, 89.4% of respondents correctly indicated that the Orange Book is the location of FDA TE evaluations. 74.9% of responding pharmacists indicated a positive perception of the rigor of FDA approval standards associated with generic medications and 66.0% believed that generic drug products made by different manufacturers are of similar quality.Conclusions
The results suggest that community pharmacists need additional education on the interpretation of TE codes and FDA bioequivalence criteria for approval of generic drug products. The safety and efficacy of generics are often questioned by patients and physicians. It is important for pharmacists to be knowledgeable of FDA TE standards as they are experts in medicines and need to be confident with the criteria to effectively convey them to patients and healthcare professionals. 相似文献13.
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Objectives
To discuss the current state of measuring value-added services in emerging value-based payment practice models and their impact on the pharmacy profession.Summary
Value-based care models require a focus on population health. In value-based care settings, providers are held accountable for risk that goes beyond the clinic encounter, and payment is tied to quality measures that reflect clinical and humanistic outcomes across the health care spectrum. This creates opportunities for pharmacist integration into value-based care settings through addressing gaps in care, optimizing medication use, and developing physician-pharmacist team-based care practice models.Conclusion
Scalable and sustainable pharmacist integration into value-based care settings should involve expansion of preventive care into the community. The need for measurement of the value added by pharmacy services is a priority. 相似文献16.
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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19.