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Nardolillo JA, Rosario N, Cheng V, Lobkovich AM. Initiating Primary Care Services when the World Is Paused: Lessons for Pharmacists in the Post-COVID-19 Era. J Pharm Pract 2023; 36:1052-1055. [PMID: 35440223 PMCID: PMC9024150 DOI: 10.1177/08971900221087934] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic impacted primary care and required pharmacists to adapt when implementing primary care services. Many lessons learned through this process are applicable in the post-pandemic era. First, primary care pharmacists must prepare for an ever-changing role and communicate with stakeholders to align with shifting institutional priorities. Additionally, designing a workflow given limited staffing and in-person communication require flexibility for scheduling and referral processes. Proactive outreach and communication via virtual platforms may be used to build trust in place of in-office interactions with providers. Lastly, fostering relationships with patients is essential to the success of the service and often requires creation of patient-centered goals to account for personal barriers. Many pandemic obstacles are transient; however, telehealth, virtual communication, and the subsequent lessons learned in adaptability, creativity, and flexibility when building a clinic practice are everlasting.
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Affiliation(s)
- Joseph A. Nardolillo
- Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Detroit, MI, USA
| | | | - Vivian Cheng
- University of Washington Medicine Valley Family Medicine Clinic, Renton, WA
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2
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Azhar A, Wasif Gillani S, Jiaan N, Menon V, Abdi S, Rathore HA. Patient satisfaction with inpatient pharmacy services at tertiary care setting—a meta-analysis of recent literature. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2022. [DOI: 10.1093/jphsr/rmac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objectives
This study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals.
Methods
Studies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as ‘patient satisfaction’/‘inpatient pharmacist’/‘pharmacist hospital services’/‘clinical pharmacist roles’. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well.
Key findings
A total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist’s inpatient counselling (I2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P < 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P < 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48).
Conclusion
This meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often.
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Affiliation(s)
- Anam Azhar
- College of Pharmacy, Gulf Medical University , Ajman , UAE
| | - Syed Wasif Gillani
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University , Ajman , UAE
| | - Nada Jiaan
- College of Pharmacy, Gulf Medical University , Ajman , UAE
| | - Vineetha Menon
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University , Ajman , UAE
| | - Semira Abdi
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University , Ajman , UAE
- Dubai Pharmacy College , Dubai , UAE
| | - Hassaan A Rathore
- College of Pharmacy, QU Health, Qatar University , Doha 2713 , Qatar
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3
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Han A, Nguyen NY, Hung N, Kamalay S. Efficacy of a Bariatric Surgery Clinic-Based Pharmacist. Obes Surg 2022; 32:2618-2624. [PMID: 35349045 PMCID: PMC9273558 DOI: 10.1007/s11695-022-06022-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022]
Abstract
Purpose To evaluate the impact of a bariatric clinic-based pharmacist on inpatient length of stay, medication errors, and patient experience. Materials and Methods This was a retrospective cohort study comparing patients who received a pre-operative pharmacist consultation to historical cases without pre-operative pharmacist consultation prior to admission for bariatric surgery. A patient experience survey was administered post-operatively to the intervention group. The primary outcome was hospital length of stay (LOS). Secondary outcomes included corrected medication errors on reconciliation, pharmacist interventions, adverse drug event (ADE) prevention, and patient satisfaction. Results With 68 patients in the intervention group and 67 patients in the control group, the majority were female (76%) and received either laparoscopic Roux-en-Y gastric bypass (53%) or sleeve gastrectomy (47%). The median LOS in the intervention group was 55.5 h, which did not significantly differ from the median 57.9 h in the control group (p = 0.56). The clinic-based pharmacist made an average of 13 interventions per patient. Surveys were distributed to 73 patients with a 60% response rate. High overall satisfaction with the pre-operative pharmacist consultation was reported by 97% of patients. Conclusion Although hospital LOS did not significantly differ between groups, pre-operative pharmacist consultation prevented potential ADEs, and provided strong patient satisfaction. Having pharmacists as part of a multidisciplinary approach to bariatric surgery patient care can prevent medication-related adverse events and improve patient satisfaction. Graphic Abstract ![]()
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Affiliation(s)
- Althea Han
- Department of Pharmaceutical Sciences, University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA. .,Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 513 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Nicole Yvonne Nguyen
- Department of Pharmaceutical Sciences, University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA.,Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 513 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Nancy Hung
- Department of Pharmaceutical Sciences, University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA.,Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 513 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Salem Kamalay
- Department of Pharmaceutical Sciences, University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA.,Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 513 Parnassus Ave, San Francisco, CA, 94143, USA
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Shin J, Moczygemba LR, Barner JC, Garza A, Linedecker-Smith S, Srinivasa M. Patient experience with clinical pharmacist services in Travis County Federally Qualified Health Centers. Pharm Pract (Granada) 2020; 18:1751. [PMID: 32377276 PMCID: PMC7194041 DOI: 10.18549/pharmpract.2020.2.1751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 04/13/2020] [Indexed: 11/14/2022] Open
Abstract
Background Positive patient experiences with care have been linked to improved health outcomes. Patient experience surveys can provide feedback about the level of patient-centered care provided by clinical pharmacists and information about how to improve services. Objectives Study objectives are: 1) To describe patient experience with clinical pharmacist services in a federally qualified health center (FQHC). 2) To determine if demographic or health-related factors were associated with patient experience. Methods This cross-sectional survey included adult patients who were English or Spanish speaking, and completed a clinical pharmacist visit in March or April 2018. Patient experience was evaluated, on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), with 10 items using four domains: pharmacist-patient interaction information provision, support for self-care, and involvement in decision making. In addition, one item was used to rate the overall experience. Demographic and health-related variables were also collected. Eligible patients completed the survey after their clinical pharmacist visit. Descriptive and inferential statistics, as well as Cronbach's alpha for scale reliability, were employed. Results Respondents (N=99) were 55.4 (SD=12.1) years and 53.1% were women. Overall, patients rated their experiences very high with the 10-item scale score of 4.8 (SD=0.4) out of 5 points and the overall experience rating of 4.9 (SD=0.4) out of 5 points. With the exception of race, there were no differences between patient experience and demographic and health-related variables. African Americans had significantly (p=0.0466) higher patient experience scores compared to Hispanics. Conclusions Patients receiving care in a FQHC highly rated their experience with clinical pharmacists. This indicates that clinical pharmacists provided a high level of patient-centered care to a diverse group.
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Affiliation(s)
- Jennifer Shin
- PharmD. Clinical Pharmacist Specialist. Memorial Hermann-Texas Medical Center. Houston, TX (United States).
| | - Leticia R Moczygemba
- PharmD, PhD. Associate Professor. Health Outcomes Division, College of Pharmacy, University of Texas. Austin, TX (United States).
| | - Jamie C Barner
- PhD. Professor and Division Head. Health Outcomes Division, College of Pharmacy, University of Texas. Austin, TX (United States).
| | - Aida Garza
- PharmD, CDE, BCACP. Associate Pharmacy Director, Pharmacy Residency Program Director. CommUnityCare Health Centers. Austin, TX (United States).
| | - Sara Linedecker-Smith
- PharmD, BCACP. Clinical Pharmacist. CommUnityCare Health Centers. Austin, TX (United States).
| | - Maaya Srinivasa
- PharmD, BCACP, CDE. Clinical Pharmacist. CommUnityCare Health Centers. Austin, TX (United States).
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5
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Araújo DC, Santos JS, Barros IM, Cavaco AM, Mesquita AR, Lyra DP. Communication skills in Brazilian pharmaceutical education: a documentary analysis. Pharm Pract (Granada) 2019; 17:1395. [PMID: 31015878 PMCID: PMC6463414 DOI: 10.18549/pharmpract.2019.1.1395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/24/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: To characterize the inclusion of the teaching of communication skills in the
curriculum of Pharmacy Schools of Federal Institutions of Higher
Education. Methods: An exploratory study of documental analysis of curriculum of Pharmacy Schools
was carried out. A convenience sample was selected from undergraduate
pharmacy courses of Federal Institutions of Higher Education (IFES). The
variables collected were related to the identification of the course, its
nature (elective or mandatory), workload, semester, and program content. Results: Among the 49 undergraduate pharmacy courses of IFES, 35 (71.4%) had
their curriculum available online. The teaching of communication in health
was identified in 26 (74.3%) curriculum. In this study, three courses
(7.2%) specifically aimed at teaching communication skills, while 39
(92.9%) had content related to this subject. Most courses (22;
52.4%) belonged to the field of Social, Behavioral, and
Administrative Sciences. As for the course period, there was a concentration
in the third (19%) and fourth (28.6%) years. The main content
present in the curriculum was related to the principles and techniques of
health communication (42.8%). Conclusions: Data obtained enabled the identification of gaps in the curricula of
undergraduate courses in pharmacy concerning the inclusion of the teaching
of communication skills. These results can be used to reflect the current
models adopted in Brazil for the teaching of this skills, especially after
the recent publication of the new curricular guidelines for undergraduate
pharmacy courses.
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Affiliation(s)
- Dyego C Araújo
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe. São Cristóvão, SE (Brazil).
| | - Janiely S Santos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe. São Cristóvão, SE (Brazil).
| | - Izadora M Barros
- Laboratory of Studies in Pharmaceutical Care, Federal University of Sergipe. Lagarto, SE (Brazil).
| | - Afonso M Cavaco
- Reseach Institute for Medicines (iMed.ULisboa), Department of Social Poharmacy, Faculty of Pharmacy, University of Lisboa. Lisbon (Portugal).
| | - Alessandra R Mesquita
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe. São Cristóvão, SE (Brazil).
| | - Divaldo P Lyra
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe. São Cristóvão, SE (Brazil).
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Hefti E, Remington M, Lavallee C. Hospital consumer assessment of healthcare providers and systems scores relating to pain following the incorporation of clinical pharmacists into patient education prior to joint replacement surgery. Pharm Pract (Granada) 2017; 15:1071. [PMID: 29317922 PMCID: PMC5741999 DOI: 10.18549/pharmpract.2017.04.1071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/15/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Pharmacist involvement has been shown to improve various aspects of patient care. Patients undergoing knee and hip replacement surgery generally experience post-operative pain and discomfort. Pain control can impact patient satisfaction, as reported by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Objective: The current pilot study aims to measure the potential impact that incorporating pharmacists into preoperative patient education programs has on the response to select HCAHPS questions. Methods: Patient responses to two select HCAHPS questions related to pain were recorded for a year prior to pharmacist involvement in a comprehensive preoperative patient education program (2012) and a year after pharmacists became actively involved (2013). Results: In all reporting surgical patients, there was a modest 3.68% improvement in mean scores reflecting patient’s feelings that hospital staff did “everything they could” to attend to their pain (mean2012=3.66, SD=0.63 versus mean2013=3.80, SD=0.43, p=0.018, Mann-Whitney U test). There was a non-significant 2.98% improvement in scores reflecting the level that pain was “well controlled” (mean2012=3.54, SD=0.651 versus mean2013=3.65, SD=0.554, p=0.069, Mann-Whitney U test) in surgical patients. Conclusion: The results suggest comprehensive pharmacist involvement in patient education prior to joint replacement surgery may impact HCAHPS scores related to pain control. While the observed potential improvements were modest, the current results justify larger, multi-institution prospective studies to better elucidate the impact pharmacists can have on pain management in patients undergoing joint replacement.
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Affiliation(s)
- Erik Hefti
- Department of Pharmaceutical Services, Sisters of Charity Hospital, St. Joseph Campus. Cheektowaga, NY (United States).
| | - Michael Remington
- Department of Pharmaceutical Services, Sisters of Charity Hospital, St. Joseph Campus. Cheektowaga, NY (United States).
| | - Charles Lavallee
- Department of Pharmaceutical Services, Sisters of Charity Hospital, Main Street Campus. Buffalo, NY (United States).
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7
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Hall JJ, Katz SJ, Cor MK. Patient Satisfaction with Pharmacist-Led Collaborative Follow-Up Care in an Ambulatory Rheumatology Clinic. Musculoskeletal Care 2017; 15:186-195. [PMID: 27686752 DOI: 10.1002/msc.1160] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Patient satisfaction is known to increase with pharmacist intervention in general outpatient clinics and with nurse-led care in rheumatology clinics. The aim of the present study was to describe and compare patient satisfaction with two different types of care: a pharmacist physician collaborative model and a traditional physician model in a rheumatology clinic setting. METHODS A cross-sectional survey of inflammatory arthritis patients seen during a follow-up visit in Edmonton, Alberta, Canada, was conducted over a ten-week period. Patient satisfaction was measured using a modified version of the validated Leeds Satisfaction Questionnaire, which uses a five-point Likert scale to measure six dimensions of satisfaction, and compared between the collaborative care and traditional physician models. RESULTS A total of 62 patients completed the questionnaire (21 collaborative care and 41 traditional physician model). The average age of respondents was 52 years and the majority were female. The mean score for satisfaction across the six dimensions was 4.56 in the collaborative care group and 4.30 in the traditional physician group (p = 0.02). Patient satisfaction in the collaborative care group was consistently higher across all dimensions. No difference was noted between participants seen for the first time compared with those seen two or more times by the pharmacist. CONCLUSIONS A collaborative care model can exceed the already high expectations for care of patients with inflammatory arthritis. Our findings support the role of pharmacists using a collaborative care approach to care for patients in rheumatology clinics.
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Affiliation(s)
- Jill J Hall
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Steven J Katz
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - M Ken Cor
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
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8
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Kirk JK, Edwards R, Brewer A, Miller C, Bray B, Groce JB. Overview of a pharmacist anticoagulation certificate program. CURRENTS IN PHARMACY TEACHING & LEARNING 2017; 9:707-712. [PMID: 29233446 DOI: 10.1016/j.cptl.2017.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 03/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND PURPOSE To describe the design of an ongoing anticoagulation certificate program and annual renewal update for pharmacists. EDUCATIONAL ACTIVITY AND SETTING Components of the anticoagulation certificate program include home study, pre- and posttest, live sessions, case discussions with evaluation and presentation, an implementation plan, and survey information (program evaluation and use in practice). Clinical reasoning skills were assessed through case work-up and evaluation prior to live presentation. An annual renewal program requires pharmacists to complete home study and case evaluations. FINDINGS A total of 361 pharmacists completed the anticoagulation certificate program between 2002 and 2015. Most (62%) practiced in ambulatory care and 38% in inpatient care settings (8% in both). In the past four years, 71% were working in or starting anticoagulation clinics in ambulatory and inpatient settings. In their evaluations of the program, an average of 90% of participants agreed or strongly agreed the lecture material was relevant and objectives were met. SUMMARY Pharmacists are able to apply knowledge and skills in management of anticoagulation. This structured practice-based continuing education program was intended to enhance pharmacy practice and has achieved that goal. The certificate program in anticoagulation was relevant to pharmacists who attended the program.
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Affiliation(s)
- Julienne K Kirk
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157-1084, United States; Northwest Area Health Education Center, Wake Forest School of Medicine, Winston-Salem, NC, United States.
| | - Rebecca Edwards
- W.G. "Bill" Hefner Veterans Administration Medical Center, Winston-Salem, NC 27103, United States.
| | - Andrew Brewer
- Northwest Area Health Education Center, Wake Forest School of Medicine, Winston-Salem, NC, United States.
| | - Cathey Miller
- Medication Management, Greensboro, NC 27401, United States.
| | - Bryan Bray
- Medication Management, Greensboro, NC 27401, United States.
| | - James B Groce
- Campbell University College of Pharmacy Health Sciences, Buies Creek North Carolina, Cone Health, Greensboro NC 27401, United States.
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Truong H, Kroehl ME, Lewis C, Pettigrew R, Bennett M, Saseen JJ, Trinkley KE. Clinical pharmacists in primary care: Provider satisfaction and perceived impact on quality of care provided. SAGE Open Med 2017. [PMID: 28638617 PMCID: PMC5472232 DOI: 10.1177/2050312117713911] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate primary care provider satisfaction and perceived impact of clinical pharmacy services on the disease state management in primary care. METHODS A cross-sectional survey with 24 items and 4 domains was distributed anonymously to pharmacy residency program directors across the United States who were requested to forward the survey to their primary care provider colleagues. Primary care providers were asked to complete the survey. RESULTS A total of 144 primary care providers responded to the survey, with 130 reporting a clinical pharmacist within their primary care practice and 114 completing the entire survey. Primary care providers report pharmacists positively impact quality of care (mean = 5.5 on Likert scale of 1-6; standard deviation = 0.72), high satisfaction with pharmacy services provided (5.5; standard deviation = 0.79), and no increase in workload as a result of clinical pharmacists (5.5; standard deviation = 0.77). Primary care providers would recommend clinical pharmacists to other primary care practices (5.7; standard deviation = 0.59). Primary care providers perceived specific types of pharmacy services to have the greatest impact on patient care: medication therapy management (38.6%), disease-focused management (29.82%), and medication reconciliation (11.4%). Primary care providers indicated the most valuable disease-focused pharmacy services as diabetes (58.78%), hypertension (9.65%), and pain (11.4%). CONCLUSION Primary care providers report high satisfaction with and perceived benefit of clinical pharmacy services in primary care and viewed medication therapy management and disease-focused management of diabetes, hypertension, and pain as the most valuable clinical pharmacy services. These results can be used to inform development or expansion of clinical pharmacy services in primary care.
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Affiliation(s)
- Havan Truong
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA
| | - Miranda E Kroehl
- Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Carmen Lewis
- School of Medicine, University of Colorado, Aurora, CO, USA
| | | | | | - Joseph J Saseen
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA.,School of Medicine, University of Colorado, Aurora, CO, USA
| | - Katy E Trinkley
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA.,School of Medicine, University of Colorado, Aurora, CO, USA
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Moon J, Kolar C, Brummel A, Ekstrand M, Holtan H, Rehrauer D. Development and Validation of a Patient Satisfaction Survey for Comprehensive Medication Management. J Manag Care Spec Pharm 2016; 22:81-6. [PMID: 27015055 PMCID: PMC10397990 DOI: 10.18553/jmcp.2016.22.1.81] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Comprehensive medication management (CMM) services are a relatively new standard for clinical practice. A patient satisfaction tool for pharmacists providing comparable pharmacy services is essential for measuring quality and sustainability. OBJECTIVE To develop a psychometrically valid questionnaire for measuring patient satisfaction for CMM services. METHODS A patient satisfaction survey tool was developed through a multiphase development process. Validation studies were conducted across 2 urban ambulatory care health system settings providing CMM services. The survey consisted of 10 items related to 3 domains: medication-related needs, pharmacist-patient engagement, and overall satisfaction. Using a 4-point scale, the surveys were mailed, collected, and analyzed for descriptive statistics, internal consistency, and factorial composition. RESULTS Total surveys returned for analysis numbered 195, with an overall survey response rate of 19.2%. Factor analysis and item analysis identified 1 factor of pharmacists' patient care services. The factor was named "patient satisfaction." CONCLUSIONS The instrument that was developed provided 1 factor of CMM services. This brief patient satisfaction tool appears to be reliable and valid and may serve other CMM providers to assess 1 measure of quality assurance upon further evaluation.
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Affiliation(s)
- Jean Moon
- 1 Assistant Professor, Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - Claire Kolar
- 2 Graduate Student, University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - Amanda Brummel
- 3 Director, Clinical Ambulatory Pharmacy Services, Fairview Health Services, Minneapolis, Minnesota
| | - Molly Ekstrand
- 4 Medication Management Program Manager, Park Nicollet Health Services, St. Louis Park, Minnesota
| | - Haley Holtan
- 5 Ambulatory Pharmacist Manager, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Dan Rehrauer
- 6 Senior Clinical Pharmacy Program Manager, HealthPartners, Bloomington, Minnesota
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Burnett AE, Mahan CE, Vazquez SR, Oertel LB, Garcia DA, Ansell J. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis 2016; 41:206-32. [PMID: 26780747 PMCID: PMC4715848 DOI: 10.1007/s11239-015-1310-7] [Citation(s) in RCA: 222] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity and mortality, and an incidence that is expected to double in the next forty years. The advent of direct oral anticoagulants (DOACs) has catalyzed significant changes in the therapeutic landscape of VTE treatment. As such, it is imperative that clinicians become familiar with and appropriately implement new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance for VTE treatment with the DOACs. When possible, guidance statements are supported by existing published evidence and guidelines. In instances where evidence or guidelines are lacking, guidance statements represent the consensus opinion of all authors of this manuscript and are endorsed by the Board of Directors of the Anticoagulation Forum. The authors of this manuscript first developed a list of pivotal practical questions related to real-world clinical scenarios involving the use of DOACs for VTE treatment. We then performed a PubMed search for topics and key words including, but not limited to, apixaban, antidote, bridging, cancer, care transitions, dabigatran, direct oral anticoagulant, deep vein thrombosis, edoxaban, interactions, measurement, perioperative, pregnancy, pulmonary embolism, reversal, rivaroxaban, switching, \thrombophilia, venous thromboembolism, and warfarin to answer these questions. Non- English publications and publications > 10 years old were excluded. In an effort to provide practical information about the use of DOACs for VTE treatment, answers to each question are provided in the form of guidance statements, with the intent of high utility and applicability for frontline clinicians across a multitude of care settings.
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Affiliation(s)
- Allison E Burnett
- University of New Mexico Hospital Inpatient Antithrombosis Service, University of New Mexico College of Pharmacy, 2211 Lomas Blvd. NE, Albuquerque, NM, 87106, USA.
| | - Charles E Mahan
- Presbyterian Healthcare Services, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Sara R Vazquez
- University of Utah Health Care Thrombosis Center, Salt Lake City, UT, USA
| | - Lynn B Oertel
- Anticoagulation Management Service, Massachusetts General Hospital, Boston, MA, USA
| | - David A Garcia
- Division of Hematology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jack Ansell
- Hofstra North Shore/LIJ School of Medicine, Hempstead, NY, USA
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Abstract
Background: Asthma complicates 4% to 8% of pregnancies. The impact of clinical pharmacists providing asthma management and education to obstetric patients is unknown. Objective: Evaluate the impact of and patient satisfaction with clinical pharmacy services on asthma in pregnancy. Methods: This prospective quasi-experimental study enrolled 30 pregnant patients with asthma and assessed perceived asthma understanding, control, and inhaler technique before and after a clinical pharmacist visit and education. The primary outcome was change in pre- and postsurvey scores. Items were rated on a 5-point Likert-type scale; higher scores represented higher perceived knowledge or satisfaction. Secondary outcomes included inhaler technique scores, asthma control, correlating patient-specific factors with the primary outcome, and level of patient satisfaction with clinical pharmacy services. Results: Perceived knowledge of asthma in pregnancy median score (maximum score 50) significantly increased with clinical pharmacy education (37.5 pre vs 49 post, P = .001). Prior to clinical pharmacy services, patients highly rated their perceived knowledge of asthma in pregnancy with median scores on 7 of 10 items between 4 and 5. Despite this, significant changes were observed on 9 items. The proportion of patients with controlled asthma significantly increased after the pharmacist visit (33.3% vs 90%, P < .001). Satisfaction with clinical pharmacy services was overwhelmingly positive with average scores on all items 4.5 to 5. Inhaler technique scores significantly increased from baseline to follow-up (4 vs 7, P = .001). Conclusions: Pharmacists significantly improved patient perceived knowledge about asthma, asthma control, and inhaler technique. Patients were overwhelmingly satisfied with the care provided by the pharmacist.
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Dannemiller R, Ward T, Fanikos J. Regulatory Impact on Thrombosis Treatment, Prevention, and Anticoagulant Use. Hematol Oncol Clin North Am 2016; 30:1115-35. [PMID: 27637311 DOI: 10.1016/j.hoc.2016.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Thromboembolism afflicts millions of patients annually in the United States and is associated with a significant cost burden. Oral anticoagulants provide clinicians with options for management of these diseases and their use continues to grow. Accordingly, regulatory, legislative, and nonprofit organizations have set performance standards with the goal of improving patient outcomes, ensuring patient safety, and reducing costs. Recent efforts in quality improvement have introduced changes surrounding regulatory requirements, surveillance, litigation, and oversight that clinicians should be familiar with. This article summarizes key updates related to the management of anticoagulant therapy as it relates to thrombosis prevention and treatment.
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Affiliation(s)
- Robert Dannemiller
- Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Tucker Ward
- Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - John Fanikos
- Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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14
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Forinash AB, Chamness D, Yancey A, Mathews K, Miller C, Thompson J, Myles T. Physician Satisfaction With Clinical Pharmacist Services in an Obstetrics and Gynecology Teaching Clinic. J Pharm Technol 2016. [DOI: 10.1177/8755122516658767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To evaluate physician satisfaction with clinical pharmacy services in an obstetrics teaching clinic. Study Design: A 35-question survey was created to evaluate demographics and provider satisfaction with clinical pharmacy services using 5-point Likert scale and open response questions. Surveys were administered to all clinic attendings, maternal fetal medicine fellows, and OB/Gyn residents in June 2014 via Survey Monkey. Results: Thirty-one physicians (83.8%) completed the survey. The first set of questions utilized a 5-point Likert-type scale ranging from “poor” (1) to “excellent” (5) and evaluated respondents’ impressions of the clinical pharmacists’ clinical knowledge and professional behavior. The median score was 5 (“excellent”) on all items in the survey, and many demonstrated an average response of 4.81 to 4.9 or higher, demonstrating that almost all respondents chose “excellent.” The next set of questions assessed the clinical pharmacist’s role with the clinic’s multidisciplinary team and asked respondents to answer questions based on a 5-point Likert-type scale ranging from “strongly disagree” (1) to “strongly agree” (5). The majority of responses to questions in this section were between 4.19 and 4.84. Reasons for referring patients to the clinical pharmacist were smoking cessation, asthma management, psych medication use/issues, adherence/polypharmacy, medication reconciliation, counseling on medication safety in pregnancy, insulin/heparin administration, and substance abuse. Conclusions: Overall, the survey identified a positive response and high level of physician satisfaction with clinical pharmacy services. Clinical pharmacy has the capacity to enhance pregnancy care and should be more routinely integrated into the prenatal care team.
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Affiliation(s)
- Alicia B. Forinash
- St Louis College of Pharmacy, St Louis, MO, USA
- SSM Health St. Mary’s, MO, USA
| | | | - Abigail Yancey
- St Louis College of Pharmacy, St Louis, MO, USA
- SSM Health St. Mary’s, MO, USA
| | - Katherine Mathews
- SSM Health St. Mary’s, MO, USA
- Saint Louis University, Saint Louis, MO, USA
| | | | | | - Thomas Myles
- SSM Health St. Mary’s, MO, USA
- Saint Louis University, Saint Louis, MO, USA
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15
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Covvey JR, Grant J, Mullen AB. Development of an obstetrics triage tool for clinical pharmacists. J Clin Pharm Ther 2015; 40:539-544. [PMID: 26111223 DOI: 10.1111/jcpt.12301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/18/2015] [Indexed: 12/31/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES Obstetrics services are a high-throughput and high-risk environment poised for pharmacist involvement, but determining how to ideally allocate services is difficult. There is recent interest in the development of tools for service prioritization, but none are specifically targeted to obstetrics. Therefore, the aim of this study was (i) to conduct a practice audit surveying the demographics of patients attending obstetrics wards at a high-capacity maternity hospital; and (ii) to evaluate a triage tool developed to prioritize pharmacy services. METHODS A retrospective case review of women discharged after birth admissions was undertaken at a hospital in National Health Service (NHS) Scotland during June 2014. Demographic and admission data were collected, as well as pharmacist interventions and missed opportunities in patient care on post-natal wards. A pharmacy triage tool was developed and retrospectively applied to each case to ascertain a risk category that would trigger and target pharmacist review. Interventions/opportunities were classified as either clinical (medication related) or administrative (potential for error development). RESULTS AND DISCUSSION One hundred and seventy-five cases were reviewed with a median age of 29 years old. Eighty-six patients (49·1%) were retrospectively classified with elevated risk using the triage tool. A total of 117 charts (66·9%) were identified with missed opportunities for pharmacist intervention, which was significantly greater among patients classified as higher risk (75·6 vs. 58·4%, P = 0·017). Compared to low-risk patients, patients with a higher-risk classification had lower rates of administrative missed opportunities (55·4 vs. 80·8%, P = 0·015), but numerically higher rates of clinical (26·2 vs. 9·6%, p=NS) and mixed clinical/administrative (18·5 vs. 9·6%, p=NS) missed opportunities, although this failed to reach statistical significance. WHAT IS NEW AND CONCLUSION Evaluation of a triage tool for obstetric services demonstrated potential for prioritizing higher-risk patients for pharmacist review and addressing opportunities for clinical improvements.
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Affiliation(s)
- J R Covvey
- Division of Clinical, Social and Administrative Sciences, Duquesne University Mylan School of Pharmacy, Pittsburgh, PA, USA
| | - J Grant
- Obstetrics and Gynaecology, Women and Children's Services, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - A B Mullen
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
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Kern KA, Kalus JS, Bush C, Chen D, Szandzik EG, Haque NZ. Variations in pharmacy-based transition-of-care activities in the United States: A national survey. Am J Health Syst Pharm 2014; 71:648-56. [DOI: 10.2146/ajhp130510] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - James S. Kalus
- Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI
| | - Colleen Bush
- Market Research, American Society of Health-System Pharmacists, Bethesda, MD
| | - David Chen
- Pharmacy Practice Sections and Section of Pharmacy Practice Managers, American Society of Health-System Pharmacists, Bethesda, MD
| | - Edward G. Szandzik
- Department of Pharmacy Services, Department of Pharmacy Services, Henry Ford Hospital
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