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emergency department pharmacist

Christine D Jones, Amanda Anthony, Matthew D Klein, Courtney Shakowski, Holly K Smith, Amy Go, Katharine Perica, Hemali Patel, Jonathan Pell, Read Pierce
OBJECTIVES: To evaluate the feasibility and effect of a pharmacist-led transitions-of-care (TOC) pilot targeted to patients at high risk of readmission on process measures, hospital readmissions, and emergency department (ED) visits. SETTING: Academic medical center in Colorado. PRACTICE DESCRIPTION: Pharmacists enrolled patients identified as high risk for readmission in a TOC pilot from July 2014 to July 2015. The pilot included medication reconciliation, medication counseling, case management or social work evaluation, a postdischarge telephone call, and an expedited primary care follow-up appointment...
July 15, 2018: Journal of the American Pharmacists Association: JAPhA
Emily R Locke, Rachel M Thomas, Deborah M Woo, Ethan H K Nguyen, Bryson K Tamanaha, Valerie G Press, Gayle E Reiber, Peter J Kaboli, Vincent S Fan
BACKGROUND: Proper inhaler technique is important for effective drug delivery and symptom control in chronic obstructive pulmonary disease (COPD) and asthma, yet not all patients receive inhaler instructions. INTRODUCTION: Using a retrospective chart review of participants in a video telehealth inhaler training program, the study compared inhaler technique within and between monthly telehealth visits and reports associated with patient satisfaction. MATERIALS AND METHODS: Seventy-four (N = 74) rural patients prescribed ≥1 inhaler participated in three to four pharmacist telehealth inhaler training sessions using teach-to-goal (TTG) methodology...
July 17, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Teresa George Abraham, Charnicia Huggins, Gilda Diaz-Fuentes, John Roglieri
OBJECTIVE: Asthma is one of the major causes of hospital readmissions in the South Bronx. The goal of this study was to assess the impact of asthma education provided by registered pharmacists with asthma educator certification (AE-C), on medication adherence and hospitalizations/Emergency Department (ED) visits. METHODS: This was a retrospective chart review of patients seen in the pulmonary clinic from October 2014 to August 2015 for asthma education by AE-C pharmacists...
July 17, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Danielle McDonald, Rupal Mansukhani, Suzannah Kokotajlo, Frank Diaz, Christine Robinson
OBJECTIVE: This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department. METHODS: This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials...
May 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Christina Herbert, Holly Winkler
Introduction: The demand for mental health (MH) services has increased as more veterans seek MH care. At the South Texas Veterans Health Care System, Primary Care Mental Health Integration (PCMHI) was developed to manage patients with uncomplicated MH conditions, including depression, anxiety, or posttraumatic stress disorder (PTSD), within an interdisciplinary primary care (PC) team that includes clinical pharmacy specialists (CPSs). Pharmacists have improved outcomes and access to care for many chronic medical conditions, but limited data demonstrate the impact of MH pharmacists within PC...
May 2018: The mental health clinician
Julia Boyle, Cassandra Clement, Abril Atherton, Christopher Stock
Introduction: Opioid-related overdoses have risen despite extensive media coverage and apparent awareness of this public health crisis. Emergency department visits related to opioid use nearly tripled from 2004 to 2011. Patients with mental illness are more likely to be prescribed opioids and have higher rates of overdose. This retrospective chart review sought to determine if opioid represcribing occurred after patients were treated for a nonfatal opioid overdose (NFO) at a Veterans Affairs hospital...
November 2017: The mental health clinician
Sarah M Westberg, Angela Yarbrough, Eric D Weinhandl, Terrence J Adam, Amanda R Brummel, Shannon L Reidt, Brian T Sick, Wendy L St Peter
BACKGROUND: Improved understanding of how drug therapy problems (DTPs) contribute to rehospitalization is needed. OBJECTIVE: The primary objectives were to assess the association of DTP likelihood of harm (LoH) severity score, as measured by comprehensive medication management (CMM) pharmacist after hospital discharge, with 30-day risk of hospital readmission, observation visit, or emergency department visit, and to determine whether resolution of DTPs reduces 30-day risk...
June 1, 2018: Annals of Pharmacotherapy
Lawson Kloesel, Maria Carvalho, Fabiana Banov
There is a high incidence of household knife-related injuries requiring emergency department treatment in the U.S. The Pitch Ointment, a named formula developed by a compounding pharmacist, was used separately by two patients who suffered a knife injury in a finger and a foot. This formula combines Pinene (L-Alpha) 0.5% and Canada Balsam 5% in PracaSil-Plus, special ingredients with applications in scar and wound healing. The patients' level of satisfaction with the Pitch Ointment was very high since all 4 treatment satisfaction domains by the Treatment Satisfaction Questionnaire for Medication (effectiveness, side effects, convenience, global satisfaction) were rated over 85...
May 2018: International Journal of Pharmaceutical Compounding
Kirk Moberg
Substance misuse is a critical and costly public health problem in the United States. Data as of 2016 show 11,517 cases of opioid analgesic misuse, with the majority (6924 cases) related to hydrocodone misuse. Substance misuse impacts our society significantly with high costs related to healthcare, crime, and lost productivity. Opioid analgesic pain relievers are one of the most prescribed classes of medications and are among the most common drugs related to misuse. Increases in emergency department visits of over 200% have been associated with a dramatic surge in written prescriptions for opioid pain relievers...
May 2018: American Journal of Managed Care
Cristina Roman, Gail Edwards, Michael Dooley, Biswadev Mitra
PURPOSE: Results of a systematic literature review to identify roles for emergency medicine (EM) pharmacists beyond traditionally reported activities and to quantify the benefits of these roles in terms of patient outcomes are reported. SUMMARY: Emergency department (ED)-based clinical pharmacy is a rapidly growing practice area that has gained support in a number of countries globally, particularly over the last 5-10 years. A systematic literature search covering the period 1995-2016 was conducted to characterize emerging EM pharmacist roles and the impact on patient outcomes...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
Ashley Sproul, Carole Goodine, David Moore, Amy McLeod, Jacqueline Gordon, Jennifer Digby, George Stoica
Background: Medication reconciliation at transitions of care increases patient safety. Collection of an accurate best possible medication history (BPMH) on admission is a key step. National quality indicators are used as surrogate markers for BPMH quality, but no literature on their accuracy exists. Obtaining a high-quality BPMH is often labour- and resource-intensive. Pharmacy students are now being assigned to obtain BPMHs, as a cost-effective means to increase BPMH completion, despite limited information to support the quality of BPMHs obtained by students relative to other health care professionals...
March 2018: Canadian Journal of Hospital Pharmacy
Aline F Bonetti, Bruna Q Bagatim, Antonio M Mendes, Inajara Rotta, Renata C Reis, Maria Luiza D Fávero, Fernando Fernandez-Llimós, Roberto Pontarolo
OBJECTIVES: This study aimed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate, hospital readmissions, emergency department visits, and medication adherence at 30 days post discharge. METHODS: This randomized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital. The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge...
2018: Clinics
Mireille Gagnon-Roy, Benyahia Hami, Mélissa Généreux, Nathalie Veillette, Marie-Josée Sirois, Mary Egan, Véronique Provencher
OBJECTIVES: Older cognitively impaired adults present a higher risk of hospitalisation and mortality following a visit to the emergency department (ED). Better understanding of avoidable incidents is needed to prevent them and the associated ED presentations in community-dwelling adults. This study aimed to synthetise the actual knowledge concerning these incidents leading this population to ED presentation, as well as possible preventive measures to reduce them. DESIGN: A scoping review was performed according to the Arksey and O'Malley framework...
April 17, 2018: BMJ Open
Joshua S Jacoby, Heather M Draper, Lisa E Dumkow, Muhammad U Farooq, G Robert DeYoung, Kasey L Brandt
Background and Purpose: Decreased door-to-needle (DTN) time with tissue plasminogen activator (tPA) for acute ischemic stroke is associated with improved patient outcomes. Emergency medicine pharmacists (EMPs) can expedite the administration of tPA by assessing patients for contraindications, preparing, and administering tPA. The purpose of this study was to determine the impact of EMPs on DTN times and clinical outcomes in patients with acute ischemic stroke who receive tPA in the emergency department...
April 2018: Neurohospitalist
Sumaiah J Alarfaj, Daniel H Jarrell, Asad E Patanwala
BACKGROUND: Prothrombin complex concentrate (PCC) is used as an alternative to fresh frozen plasma (FFP) for emergency bleeding. The primary objective of this study was to compare the time from order to start of administration between 3-factor PCC (PCC3), 4-factor (PCC4), and FFP in the emergency department (ED). The secondary objective was to evaluate the effect of an ED pharmacist on time to administration of PCCs. METHODS: This was a single center three-arm retrospective cohort study...
March 24, 2018: American Journal of Emergency Medicine
Aude Motulsky, Daniala L Weir, Isabelle Couture, Claude Sicotte, Marie-Pierre Gagnon, David L Buckeridge, Robyn Tamblyn
Objective: (1) To describe the usage of medication data from the Health Information Exchange (HIE) at the health care system level in the province of Quebec; (2) To assess the accuracy of the medication list obtained from the HIE. Methods: A descriptive study was conducted utilizing usage data obtained from the Ministry of Health at the individual provider level from January 1 to December 31, 2015. Usage patterns by role, type of site, and tool used to access the HIE were investigated...
June 1, 2018: Journal of the American Medical Informatics Association: JAMIA
Nathan D Mah, Asha R Birmingham, Cierra N Treu, Ryan P Bodkin, Nadia I Awad, Nicole M Acquisto
PURPOSE: Review selected sexually transmitted infections (STIs) and treatment recommendations for pharmacists and providers practicing in the acute care setting. SUMMARY: In 2015, the Centers for Disease Control and Prevention (CDC) published an updated guideline on the treatment of STIs with an emphasis on prevention and new diagnostic strategies to combat the growing problem of STIs in the United States. Despite this guidance, the incidence of infection has continued to grow...
January 1, 2018: Journal of Pharmacy Practice
Mohammed K El-Habil
BACKGROUND: Acute poisoning is a major public health problem worldwide and a common cause of patient admissions to emergency departments and intensive care units. The aim of this study was to assess the acute poisoning cases admitted to three hospitals in the Gaza Strip and to assess the need for a poison control and drug information centre in the Gaza Strip. METHODS: All patients diagnosed with acute poisoning between 2010 and 2015 at the emergency departments of Al-Shifa Hospital, European Gaza Hospital, and Al-Nassr Paediatric Hospital in the Gaza Strip were included in this retrospective study...
February 21, 2018: Lancet
Jacob C Easaw, Susan McCall, Adrian Azim
Stable cancer patients diagnosed with a pulmonary embolus or deep vein thrombosis are commonly referred to the emergency department for management. This practice strains an already overburdened emergency department and is associated with long wait times and poor disease/injection education for patients. This pilot study sought to determine if stable cancer patients with newly diagnosed cancer-associated thrombosis could be effectively managed by community-based pharmacists who followed an evidence-based protocol to prescribe and initiate low-molecular weight heparin therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
Ann E Vandenberg, Katharina V Echt, Lawanda Kemp, Gerald McGwin, Molly M Perkins, Anna K Mirk
Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs)...
March 2018: Journal of the American Geriatrics Society
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