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Hijazi MA, Shatila H, El-Lakany A, Al Rifai H, Aboul-Ela M, Naja F. Role of community pharmacists in weight management: results of a national study in Lebanon. BMC Health Serv Res 2020; 20:386. [PMID: 32381084 PMCID: PMC7204056 DOI: 10.1186/s12913-020-05258-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ideally situated within the community, pharmacists can be involved in a broad range of health promotion campaigns including prevention of obesity. Limited evidence is available regarding their involvement in weight management in Lebanon, a country with escalating prevalence rate of obesity. OBJECTIVE To examine the role of community pharmacists in weight management in Lebanon, specifically studying their beliefs, current practices, services, and knowledge. METHODS Using a stratified random sampling approach, a cross sectional national survey of community pharmacists was conducted (n = 341, response rate 89%). At the pharmacy, and through a face-to-face interview, pharmacists completed a multi-component questionnaire that addressed, in addition to socio-demographic and work characteristics, their beliefs, practices, knowledge in relation to weight management. Frequencies and proportions were used to describe the data. Simple and multiple linear regression analyses were used to examine the determinants of knowledge in the study population. RESULTS Over 80% of study participants agreed that they have an important role to play in weight management. However, 50% of pharmacists did not agree that weight loss products are well regulated and 81.1% thought that companies marketing weight loss products are making false promises. The majority of pharmacists always/often sold weight loss products (84.7%) and counseled their patients for diet (86.3%) and physical activity (91.7%). Despite taking weight and height measurements, 50% of pharmacists rarely/never calculated BMI. Among the pharmacists who reported side effects of weight loss products (46.5%), the majority (91.3%) did so to the pharmaceutical company. The knowledge of pharmacists was better for the use of weight loss products as opposed to their side effects and interactions. Significant predictors of knowledge were holding a Masters/ PhD degree in Pharmacy, graduating from a university inside Lebanon, obtaining weight management training within the academic degree, and receiving inquiries about weight management in the pharmacy more than once daily. CONCLUSIONS The results of the study provided important insights on the beliefs, practices and knowledge of community pharmacists in weight management in Lebanon. These findings could be used to inform the development of future evidence-based community pharmacists led weight management service provision nationally and internationally.
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Affiliation(s)
- Mohamad Ali Hijazi
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon, P.O. Box: 11 5020, Beirut, Lebanon
| | - Hibeh Shatila
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences American, University of Beirut, Beirut, Lebanon
| | - Abdalla El-Lakany
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon, P.O. Box: 11 5020, Beirut, Lebanon
| | - Hiba Al Rifai
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences American, University of Beirut, Beirut, Lebanon
| | - Maha Aboul-Ela
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon, P.O. Box: 11 5020, Beirut, Lebanon
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences American, University of Beirut, Beirut, Lebanon
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Lloyd KB, Thrower MR, Walters NB, Krueger KP, Stamm PL, Evans RL. Obesity: Implementation of a Weight Management Pharmaceutical Care Service. Ann Pharmacother 2016; 41:185-92. [PMID: 17284503 DOI: 10.1345/aph.1e466] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Obesity, a national epidemic, is one of the leading causes of preventable morbidity and mortality in the US. Pharmacists can play an integral role in weight management. Offering weight management services provides an opportunity to increase public awareness of pharmaceutical care and attract patients to pharmacy programs. Objective: To describe the implementation and evaluate outcomes of a weight management pharmaceutical care service in a stand alone pharmaceutical care center on a college campus. Methods: A retrospective review of data was conducted on 289 patient charts to evaluate the change in weight, body mass index (BMI), percent body fat, and weight-related health conditions in patients who participated in the Healthy Habits program. Results: The net change (change in values observed from first to last appointment) in weight was a loss of 1021.8 kg. The maximum weight change (change seen from the first appointment to the lowest value obtained during the program) was a loss of 1530.5 kg. These values correspond to a net mean weight loss of 3.6 kg per patient (10% of baseline weight) and a maximum mean weight loss per patient of 5.5 kg (15% of baseline weight). Eighty-three patients were able to decrease their BMI category and 76 patients had a decrease in risk status from baseline. Conclusions: The Auburn University Pharmaceutical Care Center's Healthy Habits program has been successful in helping patients decrease total body weight, BMI, and risk of weight-related complications. In addition, the program has increased the opportunity to identify other pharmaceutical care needs of patients and help establish the role of pharmacists in the management of obesity.
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A model to inform community pharmacy's collaboration in outpatient care. Res Social Adm Pharm 2016; 12:529-34. [DOI: 10.1016/j.sapharm.2015.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 11/23/2022]
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Elliott JP, Harrison C, Konopka C, Wood J, Marcotullio N, Lunney P, Skoner D, Gentile D. Pharmacist-led screening program for an inner-city pediatric population. J Am Pharm Assoc (2003) 2016; 55:413-8. [PMID: 26117001 DOI: 10.1331/japha.2015.14273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To identify the prevalence of asthma, obesity, hypertension, and environmental tobacco smoke (ETS) exposure among youth and provide recommendations for follow-up care. METHODS This cross-sectional study consisted of 12 health screenings for children between 5 and 17 years of age in various inner city, lower socioeconomic, and predominantly black communities throughout the city of Pittsburgh, PA. The screenings were conducted by pharmacists and student pharmacists from April 2010 to April 2012. Asthma, obesity, hypertension, and ETS screenings were offered at each event. RESULTS A total of 144 children (50% girls, 89% black, non-Hispanic) were enrolled. Sixteen percent of the study population had a previous diagnosis of asthma; 4% were poorly controlled, and 18% were identified as having potential, undiagnosed asthma. Fifty-three percent were at an unhealthy weight (0.7% underweight, 24.3% overweight, 28.5% obese), 24% had abnormal blood pressure (12.8% prehypertension, 8.5% stage 1 hypertension, 2.8% stage 2 hypertension), and 26% had ETS exposure equivalent to that of smokers (0.7% light smokers, 17.5% smokers, and 7.7% heavy smokers). Overall, 177 specific referrals were made. The incidence of hypertension (P <0.001) and the proportion of ETS equivalent to heavy smokers increased (P = 0.019) with increased weight classification. CONCLUSION Within this self-selected inner city, predominantly black pediatric population, there were high rates of positive screens for potential asthma, obesity, hypertension, and smoking. Additionally, the risk for high ETS exposure and hypertension increased with increasing weight. This study highlights the importance of pharmacists in disease screening and the need for alternative prevention and management strategies in disparate pediatric populations.
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Medication knowledge to be improved in participants in community universities in Taiwan: Outcome of a nationwide community university program. J Formos Med Assoc 2015; 114:1267-79. [DOI: 10.1016/j.jfma.2014.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 06/26/2014] [Accepted: 12/26/2014] [Indexed: 11/22/2022] Open
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Erickson SR, Workman P. Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics. J Am Pharm Assoc (2003) 2015; 54:618-24. [PMID: 25379982 DOI: 10.1331/japha.2014.14105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To document the availability of selected pharmacy services and out-of-pocket cost of medication throughout a diverse county in Michigan and to assess possible associations between availability of services and price of medication and characteristics of residents of the ZIP codes in which the pharmacies were located. DESIGN Cross-sectional telephone survey of pharmacies coupled with ZIP code-level census data. SETTING 503 pharmacies throughout the 63 ZIP codes of Wayne County, MI. MAIN OUTCOME MEASURES The out-of-pocket cost for a 30 days' supply of levothyroxine 50 mcg and brand-name atorvastatin (Lipitor-Pfizer) 20 mg, availability of discount generic drug programs, home delivery of medications, hours of pharmacy operation, and availability of pharmacy-based immunization services. Census data aggregated at the ZIP code level included race, annual household income, age, and number of residents per pharmacy. RESULTS The overall results per ZIP code showed that the average cost for levothyroxine was $10.01 ± $2.29 and $140.45 + $14.70 for Lipitor. Per ZIP code, the mean (± SD) percentages of pharmacies offering discount generic drug programs was 66.9% ± 15.0%; home delivery of medications was 44.5% ± 22.7%; and immunization for influenza was 46.7% ± 24.3% of pharmacies. The mean (± SD) hours of operation per pharmacy per ZIP code was 67.0 ± 25.2. ZIP codes with higher household income as well as higher percentage of residents being white had lower levothyroxine price, greater percentage of pharmacies offering discount generic drug programs, more hours of operation per week, and more pharmacy-based immunization services. The cost of Lipitor was not associated with any ZIP code characteristic. CONCLUSION Disparities in the cost of generic levothyroxine, the availability of services such as discount generic drug programs, hours of operation, and pharmacy-based immunization services are evident based on race and household income within this diverse metropolitan county.
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Nakamura CA, Soares L, Farias MR, Leite SN. Pharmaceutical services and health promotion: how far have we gone and how are we faring? Scientific output in pharmaceutical studies. BRAZ J PHARM SCI 2014. [DOI: 10.1590/s1984-82502014000400013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to investigate the scientific output on health promotion within the pharmaceutical field and its relation with the development of pharmaceutical services within health systems. A comprehensive review of published scientific articles from the Medline and Lilacs databases was carried out. The review comprised articles published until December 2011, and used combinations of the terms 'health promotion' or 'health education' and 'pharmacy', 'pharmacist' or 'pharmaceutical'. The articles were selected according to inclusion and exclusion criteria. A total of 170 full texts and 87 indexed abstracts were analyzed, evidencing that most described actions of health promotion in community pharmacies and other services. Following the Ottawa Charter, most of the studies dealt with new guidance of the service and the supply of pharmaceutical information and services. It was concluded that there is a lack of theoretical background on health promotion in the pharmaceutical field to sustain the professional education and practice required by the health system and the population.
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Elliott RA, Putman K, Davies J, Annemans L. A review of the methodological challenges in assessing the cost effectiveness of pharmacist interventions. PHARMACOECONOMICS 2014; 32:1185-1199. [PMID: 25145799 DOI: 10.1007/s40273-014-0197-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pharmacists' roles are shifting away from medicines supply and the provision of patient education involving acute medications towards consultation-type services for chronic medications. Determining the cost effectiveness of pharmacist interventions has been complicated by methodological challenges. A critique of 31 economic evaluations carried out alongside comparative studies of pharmacist interventions published between 2003 and 2013 (12 from the UK, six from the USA) found a range of disease-specific and cross-therapeutic interventions targeting both patients and prescribers in a range of settings evaluated through a variety of study designs. Only ten were full economic evaluations, five of which were based on randomized controlled trials (RCTs). The intervention was usually quite well described, but the comparator was not always clearly described, and some interventions are very context specific due to the variability in pharmacist services available in different countries and practice settings. Complex multidirectional aims of most pharmacist interventions have led to many process, intermediate and longer-term outcomes being included in any one study. Quality of resource use and cost data varied. Most incremental cost-effectiveness ratios (ICERs) were generated from process indicators such as errors and adherence, with only four studies reporting cost per quality-adjusted life-year (QALY). Very few studies examined the effect of uncertainty, and methods used were not very clear in some cases. The principal finding from our critique is that poor RCT study design or analysis precludes many studies from finding pharmacist interventions effective or cost effective. We conclude with a set of recommendations for future study design.
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Affiliation(s)
- Rachel A Elliott
- Division for Social Research in Medicines and Health, The School of Pharmacy, University of Nottingham, University Park, East Drive, Nottingham, NG7 2RD, UK,
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Devraj R, Gupchup GV. Knowledge of and barriers to health literacy in Illinois. J Am Pharm Assoc (2003) 2013; 52:e183-93. [PMID: 23229980 DOI: 10.1331/japha.2012.12011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine Illinois pharmacists' knowledge of and barriers to health literacy. DESIGN Cross-sectional descriptive study. SETTING Illinois, August to November 2009. PARTICIPANTS 701 Illinois pharmacists. INTERVENTION Mail survey. MAIN OUTCOME MEASURES Pharmacists' knowledge (percent correct), mean barrier factors, and percent agreement of barrier items. RESULTS Usable responses were obtained from 701 respondents out of 1,457 pharmacists receiving surveys (48.1%). Percent correct for knowledge items ranged from 31.5% to 95.4% with only 19% to 27% of respondents answering a majority of the items correctly. Pharmacists had poor knowledge (percent correct) about prevalence of low health literacy (31.5%), its relationship to years of schooling (46.9%) and its lack of relationship to reading comprehension (48.4%). Overall process and practice-related barrier domain items were the most important barriers. In particular, the most frequently cited barriers towards low health literacy interventions were lack of adequate time (90.4%), use of mail order (83.8%), and presence of convenient delivery mechanisms (82.8%), all process barriers. Majority of respondents (57.3%) agreed that lack of knowledge about health literacy and its consequences is a barrier. Significant differences existed for barrier factors by demographics. Multivariate analysis examining the relationship between knowledge and barriers after controlling for demographics revealed no significant differences. CONCLUSION Pharmacists have limited knowledge of health literacy. We suggest training programs designed to address poor knowledge, interpreter services, access to written information tailored for various reading grade levels, and minimizing functional barriers such as time constraints.
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Affiliation(s)
- Radhika Devraj
- School of Pharmacy, Southern Illinois University Edwardsville, IL 62026-2000, USA.
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How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives. Res Social Adm Pharm 2012; 10:272-84. [PMID: 23089293 DOI: 10.1016/j.sapharm.2012.05.006] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 05/10/2012] [Accepted: 05/10/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. OBJECTIVES To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. METHODS The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. RESULTS All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. CONCLUSIONS Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services.
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Awad A, Waheedi M. Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study. BMC Public Health 2012; 12:863. [PMID: 23057422 PMCID: PMC3491033 DOI: 10.1186/1471-2458-12-863] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 10/08/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Obesity is a growing health concern in Kuwait. Obesity has been identified as a key risk factor for many chronic diseases including hypertension, dyslipidemia and type 2 diabetes mellitus. It has been shown that community pharmacists' involvement is associated with successful weight management in developed countries. This study was conducted to investigate the role of community pharmacists in obesity counseling, and to identify the barriers to counseling in Kuwait. METHODS A descriptive cross-sectional study involved 220 community pharmacies that were selected via stratified and systematic random sampling. A pretested self-administered questionnaire collected information on frequency and comfort level with obesity counseling, and the perceived effectiveness of four aspects of obesity management (diet and exercise, prescribed antiobesity medications, diet foods, and nonprescription products and dietary supplements). Information on perceived confidence in achieving positive outcomes as a result of counseling and barriers to counseling was also collected. Descriptive and Spearman' r analysis were conducted using SPSS version 17. Responses with Likert scale rating 1(low score) to 5 (high score) and binary choices (yes/no) were presented as mean (SD) and (95% CI), respectively. RESULTS The response rate was 93.6%. The overall mean (SD) responses indicated that pharmacists counseled obese patients sometimes to most of the time, 3.67 (1.19) and were neutral to comfortable with counseling about aspects of obesity management, 3.77 (1.19). Respondents perceived obesity management aspects to be somewhat effective, 3.80 (1.05). Of the four aspects of obesity management, diet and exercise, and diet foods were the highest ranked in terms of frequency of counseling, comfort level and perceived effectiveness. Pharmacists were neutral to confident in achieving positive outcomes as a result of obesity counseling, 3.44 (1.09). Overall mean responses of counseling obese patients by pharmacists were positively correlated with their perceived comfort with counseling and perceived effectiveness of obesity management aspects. The most anticipated barriers to obesity counseling were lack of patient awareness about pharmacists' expertise in counseling 76.2% (95% CI: 69.7-81.7) and pharmacists' opinions that obese patients lack willpower and are non-adherent to weight reduction interventions 71.8% (95% CI: 65.1-77.8). CONCLUSIONS Strengths, weaknesses and barriers related to obesity counseling by pharmacists in Kuwait were identified, and suggestions were provided to strengthen that role.
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Affiliation(s)
- Abdelmoneim Awad
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Mohammad Waheedi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
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Abstract
Home health clinicians are uniquely qualified to fully evaluate patient falls risk and carry out clinical interventions to reduce risk. The objectives of this article are to give home health providers an update on the risk factors for falling, review the current guideline recommendations for prevention of falls, and provide a stepwise approach to evaluate patients and apply the clinical literature to decrease falls in older patients living at home. Many falls may be prevented with patient screening, assessment of risk, and modification of risk factors. Since the risk of falling is an interaction between three groupings of patient-specific factors, namely, environmental factors, diseases/disorders, and medication use, a multifactorial fall risk assessment can help identify the factors to consider modifying in an individual patient.
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Truong HA, Taylor CR, DiPietro NA. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2012; 76:12. [PMID: 22412211 PMCID: PMC3298394 DOI: 10.5688/ajpe76112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 08/20/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. METHODS The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. RESULTS Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. CONCLUSION The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.
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Affiliation(s)
- Hoai-An Truong
- School of Pharmacy, University of Maryland, 20 North Pine St., Baltimore, MD 21201, USA.
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Agomo CO. The role of community pharmacists in public health: a scoping review of the literature. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2011. [DOI: 10.1111/j.1759-8893.2011.00074.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
This article is the first of a three-part series intended to enhance clinical pharmacists' understanding of methods frequently used in epidemiologic research and their applications. The basic tenets of epidemiology and uses for data derived from epidemiologic studies are given, along with a high-level overview of the differences between experimental and observational study designs. The defining characteristics of each of the observational study designs (case report or case series, ecologic, cross-sectional, cohort, case-control, nested case-control, and case-cohort) and the resultant strengths and limitations of the study designs are presented. Applications for observational studies in pharmacoepidemiology (including the case-crossover and case-time-control study designs) are discussed. Finally, points to consider when evaluating data from observational studies are addressed.
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Affiliation(s)
- Natalie A DiPietro
- Department of Pharmacy Practice, Raabe College of Pharmacy, Ohio Northern University, Ada, Ohio 45810, USA
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Abstract
Falls are caused by many factors in older patients. Medications have been shown to be a risk factor for falls, and studies have shown that patients taking more than five total medications may have a two-fold increased risk of impaired balance. A more recent model suggests only medications with sedating and anticholinergic properties contribute significantly to physical impairment. The authors of this paper helped to develop a multidisciplinary clinic to evaluate the risk of falls in at-risk patients. We present the case of a woman on multiple medications that increased her risk of falling. Of note, this patient was taking a total of 14 prescription medications, seven of which were considered sedating. Based on a comprehensive medication evaluation, six specific changes were recommended to improve this patient's medication regimen and reduce her risk of falling.
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Kelsch MP, Werremeyer AB. Poster project to emphasize public health in the pharmacy curriculum. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2011; 75:2. [PMID: 21451754 PMCID: PMC3049661 DOI: 10.5688/ajpe7512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 10/11/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program. DESIGN Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference. ASSESSMENT Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills. CONCLUSION The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.
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Affiliation(s)
- Michael P Kelsch
- Department of Pharmacy Practice, North Dakota State University College of Pharmacy, Nursing and Allied Sciences, Fargo, ND 58108, USA.
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Deguire N, Fjortoft N, Duncan W, Coffman R, Young E, Bradberry JC, Lang WG. Report of the 2009-2010 standing committee on advocacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:S18. [PMID: 21436906 PMCID: PMC3058429 DOI: 10.5688/aj7410s18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Nancy Deguire
- Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
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Truong HA, Patterson BY. Professional and educational initiatives, supports, and opportunities for advanced training in public health. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:122. [PMID: 21088727 PMCID: PMC2972516 DOI: 10.5688/aj7407122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 04/19/2010] [Indexed: 05/30/2023]
Abstract
The United States is facing a public health workforce shortage and pharmacists have the opportunity and obligation to address this challenge in health care. There have been initiatives and supports from within and beyond the profession for the pharmacist's role in public health. This article identifies existing professional and educational initiatives for the pharmacist's expanded role in public health, as well as postgraduate and other advanced educational opportunities in public health. Recommendations also are provided on how to further engage pharmacists in public health activities to alleviate the public health workforce challenge.
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Affiliation(s)
- Hoai-An Truong
- University of Maryland School of Pharmacy, Baltimore, MD 21201, USA.
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Abstract
OBJECTIVES To assess the tobacco treatment practices of Montana pharmacists, evaluate pharmacist interest in addressing tobacco use, and identify perceived barriers to delivery of tobacco cessation services. DESIGN Descriptive, nonexperimental, cross-sectional study. SETTING Montana in February 2007. PARTICIPANTS 192 pharmacists attending an annual continuing professional education program. INTERVENTION Attendees at 11 meeting sites throughout the state completed the survey. MAIN OUTCOME MEASURES Pharmacists' use of the U.S. Clinical Practice Guideline 5 A's (ask, advise, assess, assist, and arrange) in regard to tobacco cessation services. RESULTS Of program attendees, 76% (192 of 253) completed the 35-item survey. More than one-half (58%) of respondents were men, and 90% were white. Respondents were licensed for a median of 22.5 years and dispensed a median of 1,000 prescriptions per week. The percent of pharmacists who treated one or more patients using the 5 A's in the preceding 30 days were as follows: asked about tobacco use, 39%; advised to quit smoking, 54%; assessed for readiness to quit smoking, 36%; assisted with quitting (i.e., cessation counseling), 46%; assisted with advice to use nonprescription cessation medication, 62%; assisted with advice to use prescription cessation medication, 54%; arranged for a follow-up appointment for additional counseling, 6%; and referred to a tobacco quit line, 23%. Most respondents (58%) reported that providing cessation services within routine practice was moderately or highly feasible. The most frequently cited barriers to providing cessation services included lack of time (52%), reimbursement (26%), and training (19%). CONCLUSION Few Montana pharmacists are routinely asking patients about tobacco use in a typical month. However, the majority of pharmacists reported that it would be feasible to provide more tobacco cessation activities within routine pharmacy practice. Addressing barriers related to workload, reimbursement, and training would likely increase the number of pharmacists who provide tobacco cessation services.
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Affiliation(s)
- Larry A Dent
- Skaggs School of Pharmacy, University of Montana, Missoula 59812, USA.
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Pilisuk T, Goad J, Backer H. Vaccination delivery by chain pharmacies in California: Results of a 2007 survey. J Am Pharm Assoc (2003) 2010; 50:134-9. [PMID: 20199953 DOI: 10.1331/japha.2010.09168] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To better understand the practice standards and scope of pharmacist-administered vaccination services at chain pharmacies in California. DESIGN Cross sectional. SETTING California in 2006-2007. PARTICIPANTS Eight state-level immunization coordinator corporate liaisons to chain pharmacies' immunization programs. INTERVENTION Key informant phone survey with follow-up written survey. MAIN OUTCOME MEASURES Policies, procedures, and vaccine usage. RESULTS All eight chains provided immunization services to adults; four chains also vaccinated adolescents. More than 1,000 California pharmacists employed at chain pharmacies have been trained to vaccinate; more than 500 locations participate with evening, weekend, and walk-in hours. Influenza and pneumococcal vaccines were the most common vaccines administered. Other vaccines were used less frequently. Respondents expressed interest in partnering with public health to improve record sharing, build awareness, receive vaccine news updates, and explore other activities. CONCLUSION Chain pharmacies in California have started to vaccinate adults and adolescents--two commonly undervaccinated age groups. To date, patients seeking vaccination at pharmacies are most likely to receive influenza and pneumococcal vaccines. Community locations and extended hours offer patients convenience, although out-of-pocket fees may be a barrier to some patients. Opportunities exist to build and strengthen partnerships among public health, the medical community, and pharmacists in order to vaccinate and protect patients not vaccinated in traditional settings.
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Affiliation(s)
- Tammy Pilisuk
- Division of Communicable Disease Control, California Department of Public Health, Immunization Branch, Richmond, USA
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Cerulli C, Cerulli J, Santos EJ, Lu N, He H, Kaukeinen K, White AM, Tu X. Does the health status of intimate partner violence victims warrant pharmacies as portals for public health promotion? J Am Pharm Assoc (2003) 2010; 50:200-6. [PMID: 20199963 PMCID: PMC4161009 DOI: 10.1331/japha.2010.09094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To explore whether the health status of intimate partner violence (IPV) victims warrants pharmacies to be portals for public health promotion. Specific objectives included (1) identifying prevalence of IPV including domestic violence (DV) and sexual assault (SA) in a community sample, (2) describing characteristics and correlates of DV/SA between participants who reported and did not report DV/SA, and (3) exploring whether DV/SA status is related to mental health medication use. DESIGN Cross sectional. SETTING Upstate New York during 2006. PARTICIPANTS English- and Spanish-speaking respondents younger than 65 years of age answering four questions to assess DV/SA. INTERVENTION Secondary analysis of a countywide random telephone survey, the 2006 Monroe County Adult Health Survey, which collects prevalence data on health behaviors and health status indicators. MAIN OUTCOME MEASURE To determine whether those reporting DV/SA are at increased odds for mental health medication use, controlling for other sociodemographic- and health-related variables. RESULTS The survey response rate was 30.3%, with 1,881 respondents meeting inclusion criteria. Those reporting DV/SA were almost twice as likely to use mental health medications. However, when controlling for other variables, only poor mental and physical health were significant in increasing the odds of mental health medication use. CONCLUSION The analyses reported here suggest that DV/SA victims in a community sample use mental health medications. When controlling for other variables, survey respondents reported worse physical and mental health. If pharmacies are suitable portals for DV/SA outreach, curricula would need to provide the knowledge and skills needed to take an active role in this public health promotion.
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Affiliation(s)
- Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
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Martin BA, Bruskiewitz RH, Chewning BA. Effect of a tobacco cessation continuing professional education program on pharmacists' confidence, skills, and practice-change behaviors. J Am Pharm Assoc (2003) 2010; 50:9-16. [PMID: 20097634 PMCID: PMC2863290 DOI: 10.1331/japha.2010.09034] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the impact of a tobacco cessation training program on pharmacists' confidence, skills, and practice-change behaviors. DESIGN Quasi-experimental study. SETTING Wisconsin during 2002-2003. PARTICIPANTS 25 community pharmacists. INTERVENTION A continuing education training program was developed and implemented using home and live training components consisting of the national tobacco cessation guidelines, including the 5A's counseling process. The home study component included lectures and readings in CD-ROM format. Consistent with self-efficacy theory, the live training was based on exercises that included modeling, rehearsal, and feedback to learners. MAIN OUTCOME MEASURES Knowledge assessment, pre- and post-surveys assessing confidence and skill levels, and service provision indicators. RESULTS Self-efficacy and perceived ability to counsel patients to quit using tobacco improved significantly after the combined program. No significant change in confidence or perceived skills occurred following home study alone, suggesting value in using a combination of teaching strategies (problem solving, modeling, rehearsal, and feedback). Of participants, 92% received a passing knowledge score and 75% attempted to implement a tobacco cessation service posttraining; more than 50% assisted patients up to 1 year post-training. A relationship between self-efficacy and service provision was found when practice settings were considered. CONCLUSION This program increased pharmacists' knowledge and self-efficacy to counsel patients on tobacco use. Further, the majority of pharmacy participants attempted to implement a tobacco cessation service.
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Affiliation(s)
- Beth A Martin
- Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Ave., Madison, WI 53705-2222, USA.
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Shah B, Rahim H, Yin H, Bhavsar J. Pharmacy students' attitudes toward a required public health course and developing a public health program. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2009; 73:134. [PMID: 19960091 PMCID: PMC2779649 DOI: 10.5688/aj7307134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 04/23/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To determine pharmacy students' attitudes towards a required public health course and developing a public health program. METHOD Two hundred ten first-year pharmacy students enrolled in a public health course at a large private pharmacy school were surveyed. A 24-item adjective rating scale and a 10-item scale were used to measure students' attitudes towards the course and developing a public health program. RESULTS Of 198 respondents, two-thirds found the course to be extremely or very appealing, of practical value, and only slightly demanding and difficult. The majority of the students indicated that establishing a public health program would be an opportunity to help the community and make a difference. Few students indicated that it would be a poor use of time or an example of busy work. CONCLUSION Pharmacy students had positive attitudes towards a required public health course and developing a public health program. Strategies to mold positive attitudes into actual behaviors of engaging in public health activities are needed.
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Westrick SC, Mount J, Watcharadamrongkun S. College/school of pharmacy affiliation and community pharmacies' involvement in public health activities. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2009; 73:123. [PMID: 19960082 PMCID: PMC2779635 DOI: 10.5688/aj7307123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 04/05/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To examine the relationship between pharmacy college/school affiliation and community pharmacies' involvement in immunization and emergency preparedness activities. METHODS Telephone interviews were completed with 1,704 community pharmacies randomly sampled from 17 states to determine the pharmacies' involvement in immunization promotion, vaccine distribution, in-house immunization delivery, and health emergency preparedness and response, affiliation with college/school of pharmacy, and selected pharmacy and public health-related characteristics. RESULTS Pharmacy college/school-affiliated community pharmacies were more likely than non-affiliated pharmacies to participate in immunization and emergency preparedness when controlling for pharmacy characteristics. College/school affiliation generally became nonsignificant, however, when public health-related characteristics were included in the analysis. CONCLUSIONS Affiliation with a college/school of pharmacy was related to community pharmacies' involvement in immunization and emergency preparedness.
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Community pharmacy involvement in vaccine distribution and administration. Vaccine 2009; 27:2858-63. [DOI: 10.1016/j.vaccine.2009.02.086] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 02/14/2009] [Accepted: 02/24/2009] [Indexed: 11/18/2022]
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Khanna R, Kavookjian J, Scott VG, Kamal KM, Miller LAN, Neal WA. Using the theory of reasoned action to determine physicians' intention to measure body mass index in children and adolescents. Res Social Adm Pharm 2009; 5:170-81. [PMID: 19524864 DOI: 10.1016/j.sapharm.2008.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 06/22/2008] [Accepted: 06/23/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Over the past few decades, childhood obesity has become a major public health issue in the United States. Numerous public and professional organizations recommend that physicians periodically screen for obesity in children and adolescents using the body mass index (BMI). However, studies have shown that physicians infrequently measure BMI in children and adolescents. OBJECTIVES The purpose of this study was to use the theory of reasoned action (TRA) to explain physicians' intentions to measure BMI in children and adolescents. The study objectives were to (1) determine if attitude and subjective norm predict physicians' intention to measure BMI in children and adolescents; (2) determine if family physicians and pediatricians differ in terms of theoretical factors; and (3) assess differences in behavioral beliefs, outcome evaluations, normative beliefs, and motivation to comply among physicians based on their level of intention to measure BMI. METHODS A cross-sectional mailed survey of 2590 physicians (family physicians and pediatricians) practicing in 4 states was conducted. A self-administered questionnaire was designed that included items related to the TRA constructs. The association between the theoretical constructs was examined using correlation and regression analyses. Student's t test was used to determine differences between family physicians and pediatricians on theoretical constructs and to compare the underlying beliefs of nonintenders with intenders. RESULTS The usable response rate was 22.8%. Less than half (44%) of the physicians strongly intended to measure BMI in children and adolescents. Together, the TRA constructs attitude and subjective norm explained up to 49.9% of the variance in intention. Pediatricians had a significantly (P<.01) higher intention to measure BMI as compared to family physicians. There were significant (P<.01) behavioral and normative belief differences between physicians who intend and those who do not intend to measure BMI. CONCLUSION The TRA is a useful model in identifying the factors that are associated with physicians' intentions to measure BMI.
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Affiliation(s)
- Rahul Khanna
- Department of Pharmaceutical Systems and Policy, West Virginia University, PO Box 9510, Morgantown, WV 26506-9510, USA.
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Worley MM, Hermansen-Kobulnicky CJ. Outcome and self-efficacy expectations for medication management of patients with diabetes: Influence of the pharmacist-patient relationship. J Am Pharm Assoc (2003) 2008; 48:621-31. [DOI: 10.1331/japha.2008.07090] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cerulli J, Malone M. Women's health promotion within a community advanced pharmacy practice experience. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2008; 72:25. [PMID: 18483593 PMCID: PMC2384200 DOI: 10.5688/aj720225] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2007] [Accepted: 10/15/2007] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To establish low-cost easily conducted health promotion interventions for advanced pharmacy practice experience (APPE) students in community pharmacy settings that would increase women's awareness about health issues using Food and Drug Administration (FDA) educational materials. METHODS Students distributed fact sheets on medication use, heart disease, and diabetes to women over 45 years of age at 6 community pharmacy APPE sites. Interventions completed were either personal medication records (PMR) to identify medication-related problems (MRP) or heart health screenings followed by completion of an anonymous patient satisfaction survey instrument. RESULTS Over 1500 fact sheets were distributed. Fifty-eight women (age 61 +/- 15 years) completed PMRs, which identified 57 MRPs in 42 patients. Twenty-four women indicated the screening was "useful/very useful" for increasing medication understanding. Sixty-three women completed heart health screenings. Thirty-one of the 40 who completed the survey instrument indicated the screening was "useful/very useful" for learning heart disease risk. CONCLUSIONS Community pharmacy APPE students interventions identified MRPs and patients at risk for heart disease. These health promotion interventions enhanced women's awareness of these topics while guiding students to achieve the desired curricular outcomes.
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Affiliation(s)
- Jennifer Cerulli
- Department of Pharmacy Practice, Albany College of Pharmacy, 106 New Scotland Ave., Albany, NY 12208, USA.
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Berdine HJ, O'Neil CK. Development and implementation of a pharmacist-managed university-based wellness center. J Am Pharm Assoc (2003) 2007; 47:390-7. [PMID: 17510036 DOI: 10.1331/japha.2007.06077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe the development and implementation of a pharmacist-managed wellness center based on campus within a school of pharmacy. SETTING Duquesne University Mylan School of Pharmacy, located in Pittsburgh, Pa. PRACTICE DESCRIPTION University-based employee wellness center, the Academic Research Center for Pharmacy Care, located within a school of pharmacy staffed by clinical practice faculty and student pharmacists. PRACTICE INNOVATION The campus-based wellness practice integrates public health activities into the pharmacy school curriculum and provides a model that can be adapted for other ambulatory and community practices. INTERVENTIONS Referral of clients to primary care providers following identification of risk for disease. MAIN OUTCOME MEASURES Number of screenings; number of clients identified with elevated cholesterol, blood glucose (BG), blood pressure, or weight and referred to primary care providers; and number of student pharmacists participating in wellness experiential rotations. RESULTS The center conducted more than 19,000 individual screenings on campus, in neighboring communities, and in the western Pennsylvania region from October 2002 through May 2006. During the period July 2005 through May 2006, 16% of those screened required referral for elevated blood pressure (>140/90 mm Hg), 23% required referral for elevated total cholesterol (> 200 mg/dL, the population covers ages 20 to over 70 years), 8% required referral for elevated BG (fasting BG > or =100 mg/dL or nonfasting BG > or =200mg/dL), 43% required referral for low bone density (T-score < or =-1), 21% required referral for abnormal skin findings ranging from dryness to suspicious markings, and 26% required referral for body mass index (> or =30 kg/m2). A total of 70 student pharmacists, divided among two full-time clinical practice faculty, have participated in the wellness clinical rotation since 2004. CONCLUSION Pharmacists can successfully direct public heath initiatives such as wellness and health promotion programs in an employee-based health center, in the community, and in community pharmacies. Pharmacists are able to identify primary preventive patients for referral to other health care providers.
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Affiliation(s)
- Hildegarde J Berdine
- Mylan School of Pharmacy, Duquesne University, Pittsburgh, Pittsburgh, PA 15282, USA.
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O'Donnell DC, Brown CM, Dastani HB. Barriers to counseling patients with obesity: a study of Texas community pharmacists. J Am Pharm Assoc (2003) 2006; 46:465-71. [PMID: 16913390 DOI: 10.1331/154434506778073565] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess barriers to the counseling of obese patients and identify pharmacists' characteristics associated with these barriers. DESIGN Cross-sectional mail survey. SETTING Texas. PARTICIPANTS 139 community pharmacists. INTERVENTION Self-administered questionnaire. MAIN OUTCOME MEASURES Respondents' perceived barriers to pharmacists' counseling of obese patients. RESULTS The top three barriers to counseling included lack of time (76.8%), lack of patient demand or expectations (55.8%), and lack of reimbursement/compensation (49.3%). Pharmacists indicated that they rarely to sometimes counseled obese patients and were somewhat comfortable with counseling about obesity management. They perceived obesity management strategies to be somewhat effective in weight loss, but were neutral regarding their confidence in achieving positive outcomes with counseling. Pharmacists who were more experienced were more likely to indicate that obesity is controllable without medications. Those who considered obesity controllable without medications were significantly more likely to view the various obesity management strategies as less effective, compared with those who did not share this belief. Pharmacists who viewed lack of privacy as a barrier were significantly less confident in achieving positive outcomes as a result of counseling. Creating awareness among patients about pharmacists' ability to counsel was perceived as most important in overcoming barriers. CONCLUSION Pharmacists identified several barriers to counseling of obese patients. Pharmacists' demographics and beliefs about obesity were significantly associated with their perceived barriers.
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Anderson AS, Goode JVR. Engaging students in wellness and disease prevention services. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2006; 70:40. [PMID: 17149419 PMCID: PMC1636924 DOI: 10.5688/aj700240] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Pharmacy education has traditionally focused on medications and treatment of disease. However, as an accessible health care professional, pharmacists can influence healthy behaviors in their patients. Encouraging/promoting healthier lifestyles in the United States is essential because the leading causes of mortality are tobacco use, poor nutrition, and inactivity. In order to prepare pharmacists for this role, student pharmacists must be taught how to implement and deliver wellness and prevention services. Community advanced pharmacy practice experiences (APPEs) occur at an ideal point in the curriculum to engage students in these activities. This article provides preceptors with guidance and tools for restructuring the community APPE at their sites to incorporate wellness and disease prevention activities.
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Malone M, Alger-Mayer SA, Anderson DA. The lifestyle challenge program: a multidisciplinary approach to weight management. Ann Pharmacother 2005; 39:2015-20. [PMID: 16288070 DOI: 10.1345/aph.1g287] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The increasing prevalence of overweight and obesity in the US has received widespread attention and is highlighted in recent government-issued health priorities. While there are many weight loss programs in different settings, few include pharmacist involvement in spite of pharmacists' recognized easy accessibility to the public. OBJECTIVE To provide insight into a successful, collaborative, multidisciplinary approach to weight management and to encourage pharmacists and other healthcare professionals to adopt a similar approach to patient management. METHODS Adult patients >18 years of age were recruited from an outpatient university-based setting to participate in a weight management program. The principles of the program included diet, exercise, and behavior modification. The program was conducted through weekly one-hour group sessions held over a 20-week period. Faculty involved in the program included an attending physician specializing in nutrition, a pharmacist, and a behavioral psychologist. All data are expressed as mean +/- SD unless otherwise specified. RESULTS Ninety participants (74 female, mean age 48 +/- 10 y) entered the program between April 2001 and April 2004. Participants had multiple obesity-related comorbid diseases. The weight of completers (n = 59) decreased from 100.9 +/- 20 kg at baseline to 97.3 +/- 19.5 kg at 10 weeks and 95.9 +/- 20 kg at 20 weeks. Thirty-nine patients completed both baseline and final assessments, which showed improvement in health-related quality of life, binge-eating behavior, and depressive symptoms (p < 0.05). CONCLUSIONS This program is a successful multidisciplinary model for the management of overweight and obese patients in an outpatient-based hospital setting.
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Affiliation(s)
- Margaret Malone
- Department of Pharmacy Practice, Albany College of Pharmacy, NY 12208, USA.
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Shane-McWhorter L, Oderda GM. Providing Diabetes Education and Care to Underserved Patients in a Collaborative Practice at a Utah Community Health Center. Pharmacotherapy 2005; 25:96-109. [PMID: 15767225 DOI: 10.1592/phco.25.1.96.55623] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Many underserved patients in Utah lack insurance coverage for health care and prescription drugs but are provided medical care in community health centers (CHCs). Before June 2000, comprehensive pharmacy services were not provided to these patients at a Utah CHC. As part of a Health Resources and Services Administration grant, a collaborative agreement between the University of Utah College of Pharmacy and Utah CHCs was established so that a faculty clinician who is a certified diabetes educator (CDE) could provide diabetes education and care to underserved patients. The College of Pharmacy faculty clinician (pharmacist CDE) collaborated with physicians and midlevel practitioners to provide diabetes education and care for 176 patients. In addition to initial diabetes education, the pharmacist CDE provided continuing disease management by providing information and feedback to patients and recommendations to providers. The pharmacist CDE conducted continuing chart reviews to track certain parameters, such as laboratory test results for hemoglobin A 1c (A1C) and lipid levels, and blood pressure. Patients were followed for 1-3 years. The same outcome data were also collected for 176 patients with diabetes mellitus in another CHC clinic to provide a comparison group. Total cholesterol, low-density lipoprotein cholesterol, A1C, and triglyceride levels declined significantly from baseline at both sites. However, more patients who were provided care by the pharmacist CDE reached the American Diabetes Association A1C target goal of below 7%.
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Affiliation(s)
- Laura Shane-McWhorter
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, USA
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Neuhauser MM, Wiley D, Simpson L, Garey KW. Involvement of Immunization-Certified Pharmacists with Immunization Activities. Ann Pharmacother 2004; 38:226-31. [PMID: 14742755 DOI: 10.1345/aph.1d257] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Immunization certification courses allow pharmacists to directly administer vaccines to their patients. However, the demographics and level of immunization involvement of immunization-certified pharmacists compared with those noncertified are unknown. OBJECTIVE To document the demographics, professional activities, and job satisfaction of immunization-certified pharmacists compared with pharmacists not certified for immunization. METHODS In a cross-sectional pilot study, immunization-certified pharmacists were compared with noncertified pharmacists via a postal-mailed questionnaire. The questionnaire consisted of demographic and practice site characteristics, involvement in immunization services, and a job satisfaction survey. RESULTS Response rates were 48% (n = 101) and 36% (n = 158) for immunization-certified and noncertified pharmacists, respectively. Significantly more certified pharmacists were involved in immunizations (99% vs 24%; p < 0.001). Desire to improve the health care of the public and personal satisfaction were important factors that encouraged pharmacists to become certified to administer vaccines. Seventy-four percent of immunization-certified pharmacists directly administered the vaccines, primarily influenza (96%), pneumococcal (77%), hepatitis (55%), and diphtheria, pertussis, tetanus (19%). Adequate training, time, support from management and staff, and liability coverage were important factors that allowed pharmacists to incorporate immunizations into their practice. No significant differences in job satisfaction were observed between immunization-certified and noncertified pharmacists. CONCLUSIONS Immunization-certified pharmacists are using their skills to administer vaccines to patients within their communities. Efforts to increase the number of these pharmacists throughout the US should be undertaken.
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Affiliation(s)
- Melinda M Neuhauser
- Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, TX 77030-3047, USA
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Kamal KM, Madhavan SS, Maine LL. Pharmacy and immunization services: pharmacists' participation and impact. J Am Pharm Assoc (2003) 2003; 43:470-82. [PMID: 12952311 DOI: 10.1331/154434503322226211] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To conduct a follow-up to the National Pharmacist Immunization Survey of 1998 to determine changes in pharmacist involvement in immunizations and obstacles to pharmacy-based immunization services and to assess the descriptive information about pharmacy-based immunization services provided. DESIGN Cross-sectional mail survey. SETTING United States. PARTICIPANTS A randomly selected national sample of 6,000 pharmacists. INTERVENTIONS None. MAIN OUTCOME MEASURES An updated version of the 1998 study questionnaire was used to collect data about pharmacists' current involvement in adult or childhood immunizations, perceived obstacles to such involvement, and characteristics of pharmacist-administered immunization services. RESULTS Four mailings in fall 2001 yielded a response rate of 21.2% (1,266 completed, usable surveys out of 5,958 deliverable surveys). Immunization activities that reportedly increased during this period, compared with results from the 1998 survey, include counseling about adult immunizations (increase from 11.9% to 14.7%), nurse-administered childhood immunizations (6.3% to 7.8%), nurse-administered adult immunizations (16.2% to 30.2%), pharmacist-administered childhood immunizations (0.9% to 1.3%), pharmacist-administered adult immunizations (2.2% to 6.8%), and immunization promotion (18.9% to 27.3%). Only counseling for childhood immunizations appears to have decreased slightly, from 13.4% to 8.9%. Willingness to provide all of the above immunization services also increased during the 1998-2001 period. In addition to flu shots and pneumococcal vaccines, pharmacists were administering vaccines for hepatitis A and B, Lyme disease, tetanus, and chicken pox, but flu shots accounted for the majority of immunizations being administered. CONCLUSION Pharmacist involvement in childhood and adult immunizations has increased significantly in the last few years. Pharmacists perceived obstacles to their involvement in immunizations as less problematic.
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Affiliation(s)
- Khalid M Kamal
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown 26506-9510, USA
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