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Pharmacist intervention

Aaron Drovandi, Kelvin Robertson, Matthew Tucker, Niechole Robinson, Stephen Perks, Therése Kairuz
Clinical pharmacists provide beneficial services to adult patients, though their benefits for paediatric hospital patients are less defined. Five databases were searched using the MeSH terms 'clinical pharmacist', 'paediatric/paediatric', 'hospital', and 'intervention' for studies with paediatric patients conducted in hospital settings, and described pharmacist-initiated interventions, published between January 2000 and October 2017. The search strategy after full-text review identified 12 articles matching the eligibility criteria...
June 19, 2018: European Journal of Pediatrics
Evi Germeni, Julia Frost, Ruth Garside, Morwenna Rogers, Jose M Valderas, Nicky Britten
BACKGROUND: Reducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections. AIM: The authors sought to update a 2011 qualitative synthesis of GPs' experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists)...
June 18, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Amanda L Hurst, Jason Child, Sarah K Parker
We instituted a new antimicrobial stewardship approach that involves review of all antimicrobial agents and communication of interventions in person by a pharmacist-physician team termed handshake stewardship. The acceptance rate in this study was 86%, intervention rates were higher with a physician, and interventions on antibiotics not reviewed by other strategies were made frequently.
June 15, 2018: Journal of the Pediatric Infectious Diseases Society
Paul Dillon, Susan M Smith, Paul Gallagher, Gráinne Cousins
INTRODUCTION: Community pharmacy is an ideal setting to monitor medication adherence, however, barriers to pharmacist-led interventions exist. Preparing future pharmacists for enhanced roles may overcome such barriers. Our objective was to identify medication monitoring attitudes and contextual factors that influence adherence monitoring by pharmacy interns to inform educational activities on medication adherence. METHODS: An online factorial survey of all pharmacy interns (N = 123) in the Republic of Ireland, completing advanced community pharmacy experiential learning in May 2016 was undertaken to evaluate attitudes to medication monitoring and to identify respondent characteristics and contextual factors which influence adherence monitoring of older hypertensive adults during repeat dispensing...
June 13, 2018: International Journal of Pharmacy Practice
Natasha N Colvin, Cortney M Mospan, Jennifer A Buxton, John Davie Waggett, Chris Gillette
OBJECTIVES: To 1) identify barriers to medication adherence and 2) examine the relationship between the Indian Health Service (IHS) 3 prime questions and medication adherence in patients with diabetes, hypertension, or hyperlipidemia before and 6 months after intervention. METHODS: This quasi-experimental study evaluated the effectiveness of an adherence program at an independent community pharmacy. Patients who met inclusion criteria were telephoned monthly to answer questions related to their medications...
June 9, 2018: Journal of the American Pharmacists Association: JAPhA
Shih-Chieh Shao, Edward Chia-Cheng Lai, Kok Loon Owang, Hui-Yu Chen, Yuk-Ying Chan
Medication errors substantially threaten patient safety, and their prevention requires clinical vigilance. We present a case of taking the wrong drug due to a dispensing error by pharmacists involving medication packaging confusion, and we report how we prevent similar dispensing errors by thorough investigation and intervention. This case emphasizes the need for constant attention by hospital, medical industry, and regulatory authorities to avoid look-alike medication packaging in the interest of medication safety...
June 11, 2018: Journal of Patient Safety
Chayla Stanton-Robinson, Ali Azeez Al-Jumaili, Amy Jackson, Christine Catney, Stevie Veach, Matthew J Witry
OBJECTIVES: To 1) identify specific patient barriers and pharmacist interventions to medication adherence by means of the Drug Adherence Work-Up (DRAW) tool; and 2) measure patient adherence to antihypertensive and antidiabetic medications by calculating proportion of days covered (PDC) before and after pharmacist telephone adherence interview. DESIGN: This prospective quality-improvement study consisted of telephonic interviews and targeted interventions to increase medication adherence based on patient-specific barriers...
June 8, 2018: Journal of the American Pharmacists Association: JAPhA
Brittany Humphries, Stéphanie Collins, Laurence Guillaumie, Julie Lemieux, Anne Dionne, Louise Provencher, Jocelyne Moisan, Sophie Lauzier
Adjuvant endocrine therapy (AET) taken for a minimum of five years reduces the recurrence and mortality risks among women with hormone-sensitive breast cancer. However, adherence to AET is suboptimal. To guide the development of theory-based interventions to enhance AET adherence, we conducted a study to explore beliefs regarding early adherence to AET. This qualitative study was guided by the Theory of Planned Behavior (TPB). We conducted focus groups and individual interviews among women prescribed AET in the last two years ( n = 43)...
June 9, 2018: Pharmacy (Basel, Switzerland)
Katherine Corsi, Virginia Lemay, K Kelly Orr, Lisa Cohen
OBJECTIVES: The objective of this study was to quantify the financial impact of a pharmacist-driven pilot medication therapy management (MTM) program within a visiting nurse service (VNS) and identify types of medication-related problems affecting the home health care population. METHODS: Patients were contacted to schedule a home visit with the primary investigator. At the appointment, a comprehensive medication review (CMR) was completed, and data collected included primary reason for VNS care, comorbid diagnoses, number of prescription and nonprescription medications at time of visit, and type of pharmacist-identified medication therapy intervention(s)...
June 7, 2018: Journal of the American Pharmacists Association: JAPhA
Barry L Carter, Barcey Levy, Brian Gryzlak, Yinghui Xu, Elizabeth Chrischilles, Jeffrey Dawson, Mark Vander Weg, Alan Christensen, Paul James, Linnea Polgreen
BACKGROUND: The use of clinical pharmacists in primary care has improved the control of several chronic cardiovascular conditions. However, many private physician practices lack the resources to implement team-based care with pharmacists. The purpose of this study was to evaluate whether a centralized, remote, clinical pharmacy service could improve guideline adherence and secondary measures of cardiovascular risk in primary care offices in rural and small communities. METHODS AND RESULTS: This study was a prospective trial in 12 family medicine offices cluster randomized to either the intervention or usual care...
June 2018: Circulation. Cardiovascular Quality and Outcomes
Gloria Shalviri, Bahareh Yazdizadeh, Fariba Mirbaha, Kheirollah Gholami, Reza Majdzadeh
Adverse drug events (ADEs) may cause serious injuries including death. Spontaneous reporting of ADEs plays a great role in detection and prevention of them; however, underreporting always exists. Although several interventions have been utilized to solve this problem, they are mainly based on experience and the rationale for choosing them has no theoretical base. The vast variety of behavioural theories makes it difficult to choose appropriate theory. Theoretical domains framework (TDF) is suggested as a solution...
2018: Iranian Journal of Pharmaceutical Research: IJPR
E Kose, T An, A Kikkawa
In chronic kidney disease (CKD) patients, the ratio of warfarin enantiomers is changed and becomes unstable due to a reduction of cytochrome P450 (CYP) 2C9 activity of, which contributes to the development of hemorrhagic complications. The aim of this study was to investigate the influence of interventions by clinical pharmacists in addition to guidance by physicians on time in therapeutic range (TTR) control of warfarin therapy for CKD patients with non-valvular atrial fibrillation (NVAF). This retrospective cohort study included NVAF patients with CKD admitted and discharged from a cardiovascular internal medicine ward between March 2011 and July 2013 in Yokosuka Kyousai Hospital...
June 1, 2018: Die Pharmazie
Shamala Ayadurai, V Bruce Sunderland, Lisa Bg Tee, Siti Norlina Md Said, H Laetitia Hattingh
BACKGROUND: A review of pharmacist diabetes intervention studies revealed lack of structured process in providing diabetes care which consequently produced varied results from increased to minimal improvements. This study aimed to determine the effectiveness of a structured clinical guidelines tool, the Simpler™ tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c (glycated haemoglobin). Secondary outcomes were improved lipid profiles and blood pressure (BP)...
June 7, 2018: Journal of Diabetes
Béatrice Demoré, Gianpiero Tebano, Julien Gravoulet, Christophe Wilcke, Eric Ruspini, Jacques Birgé, Jean-Marc Boivin, Sandrine Hénard, Annick Dieterling, Lidiana Munerol, Julie Husson, Christian Rabaud, Céline Pulcini, Sophie Malblanc
Despite group A streptococci being an infrequent cause of pharyngitis in adult outpatients, sore throat remains a common indication for antibiotic prescription. This prospective multicentre non-randomised study describes a community pharmacy-based antimicrobial stewardship intervention consisting in the implementation of rapid antigen testing (RAT) for the management of adults with sore throat. Trained pharmacists triaged patients presenting with symptoms of pharyngitis using the modified Centor score. Those at risk for streptococcal infection were tested with RAT...
June 6, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Peter Lansberg, Andre Lee, Zhen-Vin Lee, Kannan Subramaniam, Sajita Setia
Poor adherence to statin therapy is linked to significantly increased risk of cardiovascular events and death. Unfortunately, adherence to statins is far from optimal. This is an alarming concern for patients prescribed potentially life-saving cholesterol-lowering medication, especially for those at high risk of cardiovascular events. Research on statin adherence has only recently garnered broader attention; hence, major reasons unique to adherence to statin therapy need to be identified as well as suggestions for countermeasures...
2018: Vascular Health and Risk Management
Gregory Sneed, Karl Kappeler, Travis Gilmore, Catherine Kuhn
OBJECTIVES: To describe the implementation of a medication therapy management (MTM) collaborative within a pediatric health system to ensure the safe use of medication. SETTING: Outpatient pharmacies and clinics within a pediatric health system in Central Ohio. PRACTICE DESCRIPTION: The outpatient pharmacies conducted the daily operations of a community pharmacy following a standard, 4-point workflow. The ambulatory clinical pharmacists served on interdisciplinary teams within outpatient clinics to ensure the appropriate use of medication...
June 2, 2018: Journal of the American Pharmacists Association: JAPhA
Chuo Yew Ting, Shahren Ahmad Zaidi Adruce, Mohamed Azmi Hassali, Hiram Ting, Chien Joo Lim, Rachel Sing-Kiat Ting, Abu Hassan Alshaari Abd Jabar, Nor Anizah Osman, Izzul Syazwan Shuib, Shing Chyi Loo, Sui Theng Sim, Su Ee Lim, Donald E Morisky
BACKGROUND: Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely "Know Your Medicine - Take if for Health" (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program...
June 5, 2018: Trials
Sarah Alton, Lisa Farndon
Chronic obstructive pulmonary disease (COPD) is a common long-term condition involving restricted airflow, which reduces quality of life. Treatments include lifestyle changes (smoking cessation), pulmonary rehabilitation and medication with inhaled therapies. However, medication adherence is often suboptimal, resulting in poor health outcomes. A pilot project assessed the impact of medicines management support from a community pharmacy team for people with COPD, delivered in their own homes. Individuals were given a medication review and an assessment of their inhaler technique and were followed up at 3 and 6 months...
June 2, 2018: British Journal of Community Nursing
Andrew Whitman, Kathlene DeGregory, Amy Morris, Supriya Mohile, Erika Ramsdale
PURPOSE: The aims of this study were to compare the application of three geriatric medication screening tools to the Beers Criteria alone for potentially inappropriate medication quantification and to determine feasibility of a pharmacist-led polypharmacy assessment in a geriatric oncology clinic. METHODS: Adult patients with cancer aged 65 and older underwent a comprehensive geriatric assessment. A polypharmacy assessment was completed by a pharmacist and included a review of all drug therapies...
June 4, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Marie E Murray, Jamie C Barner, Nathan D Pope, Mark D Comfort
OBJECTIVE: To determine how implementing a systematic medication therapy management (MTM) process impacted MTM completion rates. METHODS: This process improvement pilot included 4 grocery store-based community pharmacy sites. Site staff were trained on a systematic process to integrate OutcomesMTM opportunities into pharmacy workflow. Technicians prepared MTM paperwork, including a standardized comprehensive medication review (CMR) worksheet, which pharmacists used to deliver the service at the counsel window...
January 1, 2018: Journal of Pharmacy Practice
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