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Rubin D, Lo DF, Jammula S, Carroll N, Vasudevan M. Optimizing treatment outcomes: integrating antihypertensive drug concentration measurement, personalized feedback, and psychosocial factors in resistant hypertension. J Hypertens 2024; 42:1105-1106. [PMID: 38690909 DOI: 10.1097/hjh.0000000000003691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- David Rubin
- Rowan-Virtua School of Osteopathic Medicine, Stratford
- School of Arts and Sciences, Rutgers University, New Brunswick
- Future Forward Research Institute 501(c)3, Toms River
| | - David F Lo
- Rowan-Virtua School of Osteopathic Medicine, Stratford
- School of Arts and Sciences, Rutgers University, New Brunswick
- Future Forward Research Institute 501(c)3, Toms River
| | - Sriharsha Jammula
- Department of Internal Medicine, Virtua Our Lady of Lourdes Hospital, Camden
| | - Nathan Carroll
- Department of Psychiatry, Jersey Shore University Medical Center, Neptune Township
| | - Mahesh Vasudevan
- Department of Psychiatry, Rowan-Virtua School of Osteopathic Medicine, Mount Laurel, New Jersey, USA
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Li Y, Liu G, Liu C, Wang X, Chu Y, Li X, Yang W, Shen Y, Wu F, Zhang W. Effects of Pharmacist Intervention on Community Control of Hypertension: A Randomized Controlled Trial in Zunyi, China. GLOBAL HEALTH, SCIENCE AND PRACTICE 2021; 9:890-904. [PMID: 34933984 PMCID: PMC8691874 DOI: 10.9745/ghsp-d-20-00505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/15/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We aimed to test the effects of pharmacist intervention on the community control of hypertension through a comparative randomized controlled trial. METHODS We recruited adult hypertensive patients with comorbidity or confusion with medication (n=636) from 2 community health centers in Zunyi, China. They were randomly and equally divided into 2 groups. Both groups received the usual care and participated in the community systematic management program of hypertension. Participants in the intervention group were given interventions from pharmacists, including a monthly review of medications, patient education, and medication adjustment advice to medical doctors over 6 months. Participants' blood pressure was assessed at baseline, 3 months, and 6 months. Participants' knowledge and medication adherence were measured using a questionnaire before and after the trial. RESULTS Compared to the control group (n=298), a significantly higher percentage of participants in the intervention group (n=290) had their blood pressure under control 3 months (46.9% vs. 38.3%, P=.034) and 6 months (60.7% vs. 40.9%, P<.001) after the interventions. Difference-in-differences analyses showed that the pharmacist intervention resulted in an increase in knowledge scores by 12.55 points (P<.001), a decrease in systolic blood pressure by 6.65 mmHg (P=.001), and a decrease in diastolic blood pressure by 7.26 mmHg (P<.001) compared to the controls after adjustment for variations in potential confounding factors. The odds of participants passing the hypertension knowledge tests in the intervention group was 4.45 times those in the control group (P<.001). Similarly, it was found that the intervention group had higher odds of not needing any medication adjustments (adjusted odds ratio [AOR]=2.75, P<.001) and having their blood pressure under control (AOR=2.18, P=.002) compared to the control group. CONCLUSION It is evident that pharmacist intervention has significant short-term effects on improving the knowledge and medication adherence of hypertensive patients, as well as timely medication adjustments from medical doctors, resulting in lowered blood pressure and an increased control rate. Further studies should explore the long-term sustainability of the effects of community pharmacist intervention.
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Affiliation(s)
- Ying Li
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, People's Republic of China
| | - Guoqin Liu
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China.
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne VIC 3086, Australia.
| | - Xianhong Wang
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Yalin Chu
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Xiaoqin Li
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Wenhao Yang
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Yewei Shen
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Fang Wu
- School of Management, Zunyi Medical University, Zunyi, People's Republic of China
| | - Wenzhi Zhang
- Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi, People's Republic of China
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Establishment of a Framework to Support Multi-Faceted Initiatives for Pharmacy-Practice Transformation: Lessons Learned. PHARMACY 2021; 9:pharmacy9030153. [PMID: 34564560 PMCID: PMC8482234 DOI: 10.3390/pharmacy9030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022] Open
Abstract
We describe the first two years of a multifaceted, five-year program to support sustainable pharmacist-provided health services in Alaska. In 2018, the Alaska Pharmacists Association funded the Sustainable Education and Training Model under Pharmacist as Providers (SETMuPP) to train and support pharmacists to navigate the insurance medical billing process for nondispensing healthcare services. The SETMuPP employed a three-pillar implementation approach: (1) training and practice support infrastructure, (2) PharmD curriculum augmentation, and (3) advocacy and legislative support. The first two years have demonstrated the effectiveness of triad partnerships between professional associations, state policy makers, and academic centers to catalyze meaningful practice transformation.
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Lagisetty P, Smith A, Antoku D, Winter S, Smith M, Jannausch M, Mi Choe H, Bohnert ASB, Heisler M. A physician-pharmacist collaborative care model to prevent opioid misuse. Am J Health Syst Pharm 2021; 77:771-780. [PMID: 32315401 DOI: 10.1093/ajhp/zxaa060] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Clinical pharmacists in primary care clinics can potentially help manage chronic pain and opioid prescriptions by providing services similar to those provided within their scope of practice to patients with diabetes and hypertension. We evaluated the feasibility and acceptability of a pharmacist-physician collaborative care model for patients with chronic pain. METHODS The program consisted of an in-person pharmacist consultation and optional follow-up visits over 4 months in 2 primary care practices. Eligible patients had chronic pain and a long-term prescription for opioids or buprenorphine or were referred by their primary care physician (PCP). Pharmacist recommendations were communicated to PCPs via the electronic medical record (EMR) and direct communication. Mixed-methods evaluation included baseline and follow-up surveys with patients, EMR review of opioid-related clinical encounters, and provider interviews. RESULTS Between January and October 2018, 47 of the 182 eligible patients enrolled, with 46 completing all follow-up; 43 patients (91%) had received opioids over the past 6 months. The pharmacist recommended adding or switching to a nonopioid pain medication for 30 patients, switching to buprenorphine for pain and complex persistent opioid dependence for 20 patients, and tapering opioids for 3 patients. All physicians found the intervention acceptable but wanted more guidance on prescribing buprenorphine for pain. Most patients found the intervention helpful, but some reported a lack of physician follow-up on recommended changes. CONCLUSION The study demonstrated that comanagement of patients with chronic pain is feasible and acceptable. Policy changes to increase pharmacists' authority to prescribe may increase physician willingness and confidence to carry out opioid tapers and prescribe buprenorphine for pain.
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Affiliation(s)
- Pooja Lagisetty
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, and Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Alex Smith
- University of Michigan College of Pharmacy, Ann Arbor, MI
| | - Derek Antoku
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Suzanne Winter
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Michael Smith
- University of Michigan College of Pharmacy, Ann Arbor, MI
| | - Mary Jannausch
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI
| | - Hae Mi Choe
- University of Michigan College of Pharmacy, Ann Arbor, MI
| | - Amy S B Bohnert
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, and Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Michele Heisler
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, and Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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Mu X, Yin C, He X, Li H, Gong Y, Wei W, Zhang Y, Tang F. Correlation Between Patients' Medication Adherence and Their Psychological Contract with Hospital Pharmacists. Patient Prefer Adherence 2020; 14:1605-1613. [PMID: 32943852 PMCID: PMC7478916 DOI: 10.2147/ppa.s264026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the correlation between patients' medication adherence and their psychological contract with hospital pharmacists under the background of the pharmacist-patient relationship, providing a reference for improving the pharmacist-patient relationship and the patients' medication adherence based on the patients' psychological contract with the hospital pharmacists. MATERIALS AND METHODS Some of the patients who received medication dispensing service at the outpatient pharmacies at the First Affiliated Hospital of Zunyi Medical University and the Second Affiliated Hospital of Zunyi Medical University were included and investigated as follows: 320 patients were included through the convenient sampling method for psychological contract and medication adherence questionnaire survey with the self-designed scales for patients' psychological contract with the hospital pharmacists and their medication adherence. SPSS 17.0 was used for reliability and validity testing, correlation analysis, and multiple linear regression analysis. RESULTS The average score of the psychological contract was 3.80±0.59. The average score of the patients' medication adherence was 2.93±0.70. The patients' psychological contract with the pharmacists and its dimensions (the responsibility of competence, the responsibility of service, and the responsibility of humanistic care) were positively correlated with medication adherence (P<0.05). The results of the multiple linear regression analysis showed that the effect of patients' psychological contract with the pharmacists on medication adherence was statistically significant (P<0.05). CONCLUSION Outpatients' psychological contract with the pharmacists is positively correlated with their medication adherence. Maintaining the patients' psychological contract with the pharmacists may be an effective way to improve medication adherence.
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Affiliation(s)
- Xingrui Mu
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Chengchen Yin
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Xing He
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Hongfang Li
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Yuansha Gong
- School of Nursing, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Weipeng Wei
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Yan Zhang
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
| | - Fushan Tang
- Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of China
- The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi563006, People’s Republic of China
- Correspondence: Fushan Tang School of Pharmacy, Zunyi Medical University, Zunyi563006, People’s Republic of ChinaTel +86 851 2864 2337Fax +86 851 2864 2334 Email
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Dixon DL, Salgado TM, Caldas LM, Van Tassell BW, Sisson EM. The 2017 American College of Cardiology/American Heart Association hypertension guideline and opportunities for community pharmacists. J Am Pharm Assoc (2003) 2018; 58:382-386. [DOI: 10.1016/j.japh.2018.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/20/2018] [Accepted: 04/15/2018] [Indexed: 01/22/2023]
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