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Harjit K. Singh Gerard A. Kennedy Ieva Stupans 《Research in social & administrative pharmacy》2019,15(3):244-251
Background
Pharmacy health coaching is a nascent topic offering promise on several fronts. There is considerable benefit to discerning the contributions thus far and future directions of pharmacy health coaching and research of the topic.Objective
The objective of this review was to synthesize the available empirical evidence regarding pharmacy health coaching and to define it.Methods
This systematic review followed the PRISMA guidelines. CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS) were searched (2000–2017) to identify sources related to pharmacy health coaching. Included articles were reviewed for their definition and outcomes of health coaching as well as recurring terms/themes pertaining to health coaching.Results
Ten papers met the eligibility criteria. The results of each empirical study as well as the definitions were used to identify the key outcomes associated with pharmacy health coaching and were then cross tabulated. The most commonly occurring outcome of health coaching was an improvement in a health outcome of a target population. An improvement in medication management/adherence and the relationship between health professionals was equally evident. Lastly, an improved attitude towards drug therapy was referred to more often than the cost-effectiveness of health coaching.Conclusions
The evaluations enabled the formulation of a grounded definition of health coaching. 相似文献3.
Peter Doshi Jan Sieluk Anna Hung 《Journal of the American Pharmacists Association》2019,59(2):195-201
Objectives
To evaluate the degree to which health care professionals and patients receive consistent messages regarding the possible harms of statins.Design
Cross-sectional study of prescribing information (PI), patient package inserts (PPIs), and pharmacy leaflets for 8 statins approved by the U.S. Food and Drug Adminstration.Setting
Not applicable.Participants
Not applicable.Main Outcome Measures
All passages describing 7 adverse events (diarrhea, arthralgia, dyspepsia, confusion, memory loss, rhabdomyolysis, and kidney failure) were extracted from PIs, PPIs, and pharmacy leaflets. For each type of information source and adverse event (drug-harm pair), 2 reviewers independently judged passages as indicating either a confirmed, unconfirmed, or mixed causal relationship between statin and adverse event (drug-harm pair). Disagreements were resolved through consensus, and the consistency between information sources was calculated.Results
PI and PPI consistently conveyed the relationship between a given statin and given adverse event (either both “confirmed” or both “unconfirmed”) in 12 of 17 evaluable drug-harm pairs. PPIs and pharmacy leaflets were consistent in 10 of 10 evaluable drug-harm pairs. PIs indicated a confirmed, causal relationship in 15 drug-harm pairs that were not mentioned in pharmacy leaflets. Likewise, PPIs indicated a confirmed, causal relationship in 7 drug-harm pairs that were not listed in pharmacy leaflets.Conclusion
Despite the widespread use of statins, we discovered considerable ambiguity in language used to describe the evidence concerning their possible harms and variable consistency between PIs, PPIs, and pharmacy leaflets. Further study is needed to understand the reason why pharmacy leaflets did not list, in 15 cases, adverse events that PIs indicated were causally related to the statin. 相似文献4.
Christian Díaz de León-Castañeda Jéssica Gutiérrez-Godínez Juventino III Colado-Velázquez Cairo Toledano-Jaimes 《Research in social & administrative pharmacy》2019,15(3):321-329
Background
In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services.Objectives
To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision.Methods
A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti.Results
Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision.Conclusions
The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision. 相似文献5.
Chelsea Phillips Renfro Benjamin Y. Urick Mohamad A. Mansour Stefanie P. Ferreri 《Journal of the American Pharmacists Association》2019,59(2):275-279
Objective
To assess the correlation between pharmacy characteristics and a broad set of performance measures used to support a community pharmacy network.Methods
Baseline characteristics regarding demographics, services provided, technology, and staffing were collected via a 68-item survey for 123 pharmacies participating in the North Carolina community pharmacy enhanced services network. Performance metric data were collected, and scores were calculated for each pharmacy. Outcome measures for this study comprised of 4 adherence measures, a risk-adjusted hospitalization measure, a risk-adjusted emergency department visit measure, a total cost of medical care measure, and a composite pharmacy performance measure. Generalized estimating equations (GEE) were used to create multivariable statistical models measuring the correlation between pharmacy characteristics and performance measures.Results
After inclusion criteria were applied, 115 pharmacies remained in the analysis. These pharmacies were primarily single and multiple independent pharmacies, at 36.5% and 59.1%, respectively. Five characteristics were significantly associated with 3 measures, and none were associated with 4 or more. Having pharmacists in non dispensing roles was positively associated with total score, diabetes adherence, and chronic medication adherence. Home visits were positively associated with hypertension adherence, ED visit rate, and total score. Offering a smoking cessation program was positively associated with chronic medication, hypertension, and statin adherence. Offering free home delivery was positively associated with diabetes adherence but negatively associated with total medical spending and ED visit rate. Using dispensing automation was negatively associated with adherence to chronic medications, renin-angiotensin system antagonists, and statins.Conclusion
No pharmacy characteristics were associated with a majority of performance measures chosen. Additional research is needed to identify structural variables that can be used as minimum participation criteria for high-performing pharmacy networks. 相似文献6.
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7.
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8.
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9.
Background
Self-care advice and management of minor ailments have long been provided in community pharmacies across England. However, formal pharmacy minor ailment service provision is geographically variable and has yet to gain recognition and political support as a valued sustainable service for nationwide adoption and commissioning.Objective
To investigate the sustainability potential of pharmacy minor ailment services from the perspective of community pharmacy stakeholders within the North East of England.Methods
A mixed methods approach was adopted to survey and interview stakeholders from the North East of England who commission; provide; and/or represent groups influencing the design, delivery and investment in community pharmacy clinical and public health services. The 40-item Programme Sustainability Assessment Tool, a validated instrument to assess a public health programme's capacity for sustainability across eight domains, was administered to fifty-three stakeholders, identified from a pharmacy minor ailments showcase event. The same stakeholders were invited for a semi-structured interview to explore issues further. Interviews were audio-recorded, transcribed verbatim, and underwent framework analysis.Results
Forty-two (79.2% response rate) stakeholders representing commissioning, provider and influencing (e.g. Local Professional Network) organisations completed the assessment tool. Pharmacy minor ailment services were rated as unsustainable across the majority of the domains. Elements within the domain ‘Partnerships’ demonstrated potential for sustainability. Stakeholder interviews provided detailed explanation for the low scoring sustainability domains, highlighting the multifaceted challenges threatening these services.Conclusion
The Programme Sustainability Assessment Tool allowed stakeholders to evaluate the potential of pharmacy minor ailment services in England. Follow-up interviews highlighted that initial design and implementation of services was poorly conceived and lacked evidence, thereby impeding the services' sustainability. There are many challenges facing a widespread provision of pharmacy ailment services, but it is clear the profession needs to be clear on the service objectives to secure future interest and investment. 相似文献10.
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Matthew Lengel Catherine H. Kuhn Marcia Worley Allison M. Wehr James W. McAuley 《Journal of the American Pharmacists Association》2018,58(2):179-185.e2
Objectives
To assess the impact of technician involvement on the completion of medication therapy management (MTM) services in a community pharmacy setting and to describe pharmacists' and technicians' perceptions of technician involvement in MTM-related tasks and their satisfaction with the technician's role in MTM.Design
Prospective observational study.Setting and participants
In the fall of 2015, pharmacists and selected technicians from 32 grocery store–based community pharmacies were trained to use technicians within MTM services.Main outcome measures
Completed MTM claims were evaluated at all pharmacies for 3 months before training and 3 months after training. An electronic survey, developed with the use of competencies taught in the training and relevant published literature, was distributed via e-mail to trained employees 3 months after training.Results
The total number of completed MTM claims at the 32 pharmacy sites was higher during the posttraining time period (2687 claims) versus the pretraining period (1735 claims). Of the 182 trained participants, 112 (61.5%) completed the survey. Overall, perceived technician involvement was lower than expected. However, identifying MTM opportunities was the most commonly reported technician MTM task, with 62.5% of technicians and 47.2% of pharmacists reporting technician involvement. Nearly one-half of technicians (42.5%) and pharmacists (44.0%) agreed or strongly agreed they were satisfied with the technician's role in MTM services, and 40.0% of technicians agreed that they were more satisfied with their work in the pharmacy after involvement in MTM.Conclusion
Three months after initial training of technicians in MTM, participation of technicians was lower than expected. However, the technicians involved most often reported identifying MTM opportunities for pharmacists, which may be a focus for future technician trainings. In addition, technician involvement in MTM services may increase satisfaction with many aspects of work for actively involved technicians. 相似文献13.
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Amy Shaver Melissa Morano Jill Pogodzinski Stacy Fredrick David Essi Erin Slazak 《Journal of the American Pharmacists Association》2019,59(2):202-209
Objectives
The primary objective of this study was to evaluate the impact of a transitions-of-care (TOC) program on both all-cause and related 30-day hospital readmission. The secondary objective was to evaluate which patient-specific factors, if any, are predictive of 30-day hospital readmissions.Design, setting, and participants
A TOC program in an outpatient pharmacy, driven primarily by student pharmacists, provided telephone-based counseling to recently discharged patients. The calls were conducted within 2 to 7 days after discharge and focused on medication counseling and reconciliation, as well as promotion of a physician follow-up visit. The goal of this program was to decrease hospital readmissions among patients discharged with a cardiovascular-related diagnosis. Patient-specific information was recorded in a spreadsheet, including discharge diagnosis, and readmission diagnosis for those who returned to an inpatient facility within 30 days. This study was a retrospective chart review. Data were manually extracted from the program’s data spreadsheet and the institution’s electronic medical record for patients referred to the TOC program from June through November 2017. Patients discharged to hospice, prison, or a long-term care facility were excluded from analysis. Researchers collected information on patient demographics, diagnoses, and readmissions. Data analyses were performed with the use of SAS 9.4.Outcome measures
The primary outcome measure was 30-day all-cause readmission, and the secondary measure was 30-day related readmission.Results
A total of 1219 encounters were examined. Compared with those patients without TOC participation, those who used the TOC program had a 67% decreased odds of all-cause 30-day readmission (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.22–0.48; P < 0.0001) and a 62% decreased odds of a related readmission (OR 0.38, 95% CI 0.18–0.82; P = 0.008).Conclusion
Community pharmacists and Advanced Pharmacy Practice Experience–level student pharmacists have the potential to make a significant impact on reducing hospital readmission rates. 相似文献15.
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Mai H. Duong Rebekah J. Moles Betty Chaar Timothy F. Chen 《Research in social & administrative pharmacy》2019,15(3):260-266
Background
Persistent medicine shortages have highlighted that global access to essential medicines remain problematic. Existing supply chain vulnerabilities impact health systems and risk consumer safety.Objectives
This study aimed to examine how different key stakeholders’ roles facilitate access to essential medicines.Methods
In depth interviews were conducted with 47 participants across seven stakeholder groups globally. Stakeholders included government, academics, consumer groups, non-profit organizations, hospital healthcare providers, manufacturers, and wholesaler/distributors. An inductive approach to data analysis was undertaken. A pragmatic Grounded Theory “approach” was adopted, using tools such as open, axial, and selective coding. Thematic content analysis was applied to the comprehensive theory of collaboration to provide a contextual management framework to interpret themes. Results were displayed in Ishikawa fishbone diagrams for decision making and the logistics process.Results
Findings showed that logistics management and therapeutic decision making were managed separately by stakeholders. Interestingly, hospital pharmacists had overlapping roles in patient care decisions and supply chain logistics, highlighting their importance as supply chain managers. Furthermore, despite the significant role that wholesalers/distributors had in managing supply disruptions and shortages, they were not involved in the decision-making process and did not participate in therapeutic selection committees. Additionally, sometimes stakeholders’ intended control mechanisms contributed to increasing the complexity of the supply chain.Conclusion
There is a need for improved and innovative stakeholder engagement. Expanding the role of pharmacy to include hospital formulary pharmacists and including wholesaler/distributors in therapeutic selection committee decisions could improve these collaborations, may help to align the selection and procurement of medicines processes. 相似文献18.
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Stuart J. Beatty Sarah M. Westberg Anita Sharma 《Journal of the American Pharmacists Association》2019,59(2):217-221.e2