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Pharmacist interventions

Zeng Wang, Yunsong Peng, Xinjun Cai, Yingying Cao, Guonong Yang, Ping Huang
BACKGROUND/OBJECTIVES: Abdominal surgery significantly affects the structure and function of the gastrointestinal system of patients, total parenteral nutrition (TPN) is an important nutrition support method for postoperative patients. However, in the process of TPN practice, the excessive fat emulsion and compound amino-acid prescriptions ratio are often prescribed by doctors. To address the problem, we developed the computerized TPN prescription management system to promote the personalized provision of TPN...
October 17, 2018: European Journal of Clinical Nutrition
Louise S Deeks, Sam Kosari, Katja Boom, Gregory M Peterson, Aaron Maina, Ravi Sharma, Mark Naunton
Background : Asthma is principally managed in general practice. Appropriate prescribing and medication use are essential, so general practice pharmacists appear suitable to conduct asthma management consultations. This pilot study aimed to evaluate the asthma management role of a pharmacist in general practice. Methods : Analysis of an activity diary and stakeholder interviews were conducted to identify interventions in asthma management; determine whether asthma control changed following pharmacist input; and determine acceptability of asthma management review by a pharmacist in one general practice in Canberra, Australia...
October 15, 2018: Pharmacy (Basel, Switzerland)
Allison M Porter, Christopher M Bland, Henry N Young, David R Allen, Sabrina R Croft, R Ellen Gayheart, Parks W Miller, Rachel J Musgrove, Emilee M Robertson, Geneen M Gibson
Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to standard-of-care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased time-to-change in antimicrobial therapy (p=0.0081), increased change to optimal antimicrobial therapy (p=0.013) and decreased vancomycin use for coagulase negative staphylococci contaminants (p<0.01) with multiplex PCR implementation and pharmacist intervention...
October 15, 2018: Antimicrobial Agents and Chemotherapy
Steven P Dehmer, Michael V Maciosek, Nicole K Trower, Stephen E Asche, Anna R Bergdall, Rachel A Nyboer, Patrick J O'Connor, Pamela A Pawloski, JoAnn M Sperl-Hillen, Beverly B Green, Karen L Margolis
Background: Pharmacist-managed (team-based) care for hypertension with home blood pressure monitoring support interventions have been widely studied and shown to be effective in improving rates of hypertension control and lowering blood pressure; however, few studies have evaluated the economic considerations related to bringing these programs into usual practice. Objective: To analyze the economic outcomes of the Blood Pressure Telemonitoring and Pharmacist Management on Blood Pressure (Hyperlink) study, a cluster randomized controlled trial which used home blood pressure telemonitoring and pharmacist case management to achieve better blood pressure control in patients with uncontrolled hypertension...
October 2018: Journal of the American College of Clinical Pharmacy: JAACP
Priti S Flanagan, Andrea Barns
The scope of clinical pharmacy services available in outpatient settings, including home care, continues to expand. This review sought to identify the evidence to support pharmacist provision of clinical pharmacy services in a home care setting. Seventy-five reports were identified in the literature that provided evaluation and description of clinical pharmacy home visit services available around the world. Based on results from randomized controlled trials, pharmacist home visit interventions can improve patient medication adherence and knowledge, but have little impact on health care resource utilization...
2018: Integrated Pharmacy Research and Practice
Danielle M van der Laan, Petra J M Elders, Christel C L M Boons, Giel Nijpels, Liset van Dijk, Jacqueline G Hugtenburg
Introduction: Non-adherence to medication is a complex health care problem. In spite of substantial efforts, up till now little progress has been made to effectively tackle the problem with adherence-enhancing interventions. The aim of this study was to investigate the effectiveness of a patient-tailored, pharmacist-led and theory-driven intervention program aimed to enhance self-reported adherence to antihypertensive medication. Materials and Methods: A parallel-group randomized controlled trial in 20 community pharmacies with nine months follow-up was conducted...
2018: Frontiers in Pharmacology
Sohyun Jeong, Minhee Lee, Eunhee Ji
Purpose: Diabetes is a chronic lifelong condition, and adherence to medications and self-monitoring of blood glucose are challenging for diabetic patients. The dramatic increase in the prevalence of diabetes is largely due to the incidence of type 2 diabetes in low- and middle-income countries (LMIc) besides high-income countries (HIc). We aimed to evaluate whether pharmacist care (PC) service model in LMIc and HIc could improve clinical outcomes in diabetic patients by performing a meta-analysis...
2018: Therapeutics and Clinical Risk Management
C-Y Cheng, M-J Wu, C-C Lin, Y-C Hou, W-S Liou
BACKGROUND: The online percent coefficient of variation reporting system could monitor the variation of tacrolimus trough level (T0 ) and identify kidney transplant recipients (KTRs) with a higher percent coefficient of variation (%CV) instantly. Consequently, transplant doctors and pharmacists could take actions to improve drug variability. The purpose of this study was to determine the efficacy of the system for higher intrapatient variability of T0 in KTRs. METHODS: The T0 data were collected with KTRs routinely followed up at an outpatient clinic between June 2016 and November 2016...
October 2018: Transplantation Proceedings
M J Connolly, J B Broad, T Bish, X Zhang, D Bramley, N Kerse, K Bloomfield, M Boyd
INTRODUCTION: The complexity of care required by many older people living in long-term care (LTC) facilities poses challenges that can lead to potentially avoidable referrals to a hospital emergency department (ED). The Aged Residential Care Intervention Project (ARCHIP) ran an implementation study to evaluate a multidisciplinary team (MDT) intervention supporting LTC facility staff to decrease potentially avoidable ED presentations by residents. METHODS: ARCHIP (conducted in 21 facilities [1,296 beds] with previously noted high ED referral rates) comprised clinical coaching for LTC facility staff by a gerontology nurse specialist (GNS) and an MDT (facility senior nurse, resident's general practitioner, GNS, geriatrician, pharmacist) review of selected high-risk residents' care-plans...
November 2018: Maturitas
Gretchen Glaser, Sean C Dowdy, Abraham Peedicayil
Enhanced recovery protocols consist of a bundle of concepts including early feeding, opioid-sparing multimodal pain management, and euvolemia, with the overarching goal of hastening postoperative recovery. Enhanced recovery after surgery has been shown to reduce hospital length of stay, reduce costs, and decrease perioperative opioid requirements in benign and oncologic gynecologic surgery. Interventions without supporting evidence of benefit, such as the use of mechanical bowel preparation, routine use of nasogastric tubes and surgical drains, caloric restriction, routine use of intravenous opioid analgesics, and over-vigorous intravenous hydration should be discouraged to improve broader endpoints such as patient satisfaction and overall recovery...
October 2018: International Journal of Gynaecology and Obstetrics
Vicki Hunt, Dave Anderson, Richard Lowrie, Colette Montgomery Sardar, Susan Ballantyne, Graeme Bryson, John Kyle, Peter Hanlon
UK, home-based patients with COPD receive specialist care from respiratory physicians, nurses, and general practitioners (GPs), but increasing complexity of therapeutic options and a GP/Nurse workforce crisis suggests merit in testing the role of home visits by a clinical pharmacist. We conducted a non-randomised intervention study with a contemporaneous comparator group, in Glasgow (Scotland). A clinical pharmacist (working closely with a consultant respiratory physician) visited patients with COPD living at home, assessing respiratory and other co-morbid conditions, and medicines then, with patient approval, agreed treatment modifications with a consultant physician...
October 10, 2018: NPJ Primary Care Respiratory Medicine
C Grézard, J Rivard, P Robinson, G Leboucher, B Charpiat
INTRODUCTION: Potassium is used to treat or prevent hypokalemia and exhibits all the characteristics of an intravenous to oral therapy conversion program. Despite this, the intravenous route for potassium replacement seems frequently unjustified. OBJECTIVES: To determine the impact of a conversion program on the use of intravenous and oral galenic forms in a university tertiary care hospital. METHODS: Two promotion campaigns were conducted in 2006 and 2009...
October 6, 2018: Annales Pharmaceutiques Françaises
N Zoremba, M Coburn, G Schälte
Delirium is the most common form of cerebral dysfunction in intensive care patients and is a medical emergency that must be avoided or promptly diagnosed and treated. According to current knowledge the development of delirium seems to be caused by an interplay between increased vulnerability (predisposition) and simultaneous exposure to delirogenic factors. Since delirium is often overlooked in the clinical routine, a continuous screening for delirium should be performed. Due to the close connection between delirium, agitation and pain, sedation and analgesia must be evaluated at least every 8 h analogous to delirium screening...
October 8, 2018: Der Anaesthesist
Anny D Nguyen, Alice Lam, Iouri Banakh, Skip Lam, Tyron Crofts
BACKGROUND: The medication lists in pre-admission clinic (PAC) questionnaires completed by patients prior to surgery are often inaccurate, potentially leading to medication errors during hospitalization. Studies have shown pharmacists are more accurate when obtaining a medication history and transcribing prescription orders, thereby reducing errors. OBJECTIVE: To evaluate the impact of a PeRiopErative and Prescribing (PREP) pharmacist on postoperative medication management...
October 8, 2018: Journal of Pharmacy Practice
Gordon D Schiff, Elissa Klinger, Alejandra Salazar, Jeffrey Medoff, Mary G Amato, E John Orav, Shimon Shaykevich, Enrique V Seoane, Lake Walsh, Theresa E Fuller, Patricia C Dykes, David W Bates, Jennifer S Haas
BACKGROUND: Medication adverse events are important and common yet are often not identified by clinicians. We evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. METHODS: Cluster randomized trial with automated calls to eligible patients at 1 and 4 months after starting target drugs from intervention primary care clinics compared to propensity-matched patients from control clinics...
October 5, 2018: Journal of General Internal Medicine
Kea Turner, Morris Weinberger, Chelsea Renfro, Stefanie Ferreri, Troy Trygstad, Justin Trogdon, Christopher M Shea
BACKGROUND: Limited evidence exists on how to integrate community pharmacists into team-based care models, as the inclusion of community pharmacy services into alternative payment models is relatively new. To be successful in team-based care models, community pharmacies need to successfully build relationship with diverse stakeholders including providers, care managers, and patients. OBJECTIVES: The aims of this study are to: (1) identify the role of network ties to support implementation of a community pharmacy enhanced services network, (2) describe how these network ties are formed and maintained, and (3) compare the role of network ties among high- and low-performing community pharmacies participating in an enhanced services network...
September 27, 2018: Research in Social & Administrative Pharmacy: RSAP
Andrew Hale, Greg Merlo, Lisa Nissen, Ian Coombes, Nicholas Graves
BACKGROUND: Current evidence to support cost effectiveness of doctor- pharmacist collaborative prescribing is limited. Our aim was to evaluate inpatient prescribing of venous thromboembolism (VTE) prophylaxis by a pharmacist in an elective surgery pre-admission clinic against usual care, to measure any benefits in cost to the healthcare system and quality adjusted life years (QALYs) of patients. METHOD: A decision tree model was developed to assess cost effectiveness of pharmacist prescribing compared with usual care for VTE prophylaxis in high risk surgical patients...
October 1, 2018: BMC Health Services Research
Sheraz Ali, Oluwaseun Egunsola, Dalal Salem Al-Dossari, Ibrahim Abdulaziz Al-Zaagi
Background: Underreporting is a common problem with spontaneous adverse drug reaction (ADR) reporting. In this study, we aim to describe the reporting of ADRs in a tertiary hospital and determine the effect of incentives to healthcare professionals on ADR reporting. Methods: In this interventional study, a time series analysis was used to determine the effect of incentives on ADR reporting in a tertiary hospital between 2015 and 2016. The incentive strategy included public commendation of health care providers and nomination for a monthly award...
October 2018: Therapeutic Advances in Drug Safety
Mario Ciccotti, Anna Raguzzini, Tommaso Sciarra, Giovina Catasta, Paola Aiello, Cosimo Buccolieri, Raffaella Reggi, Maura Palmery, Florigio Lista, Ilaria Peluso
Veterans with disability represent a big burden worldwide and often require long-term rehabilitation. Unhealthy dietary and lifestyle habits, including smoke and alcohol abuse, are common in veterans. In the context of integrative medicine approaches, the "complementary and alternative medicine" has been suggested for the management of chronic diseases. However, the potential risk of interaction between herbal products, dietary supplements and drugs must be considered in veterans. The Mediterranean diet has been suggested as a natural, non-pharmacological nutraceutical for healthy ageing...
October 3, 2018: Current Pharmaceutical Design
Candace Bishop, Zeeshan Yacoob, Mary Jo Knobloch, Nasia Safdar
BACKGROUND: Antibiotic resistance is one of the world's most pressing public health problems, resulting in over 23,000 deaths per year. One of the main contributing factors to antimicrobial resistance is antibiotic misuse and overuse. Community pharmacists can play a role in reducing antibiotic resistance, since they are one of the most accessible healthcare professionals. OBJECTIVE: The purpose of this paper is to describe community pharmacy interventions and strategies to reduce antibiotic misuse and overuse and to discuss the implications for pharmacy training...
September 26, 2018: Research in Social & Administrative Pharmacy: RSAP
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