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Pharmacist interventions

Kok Wai Kee, Cheryl Wai Teng Char, Anthony Yew Fei Yip
Introduction: Transition of care from hospital to primary care has been associated with increased medication errors. This review article aims to examine the existing evidence on interventions to reduce medication discrepancies or errors in primary or ambulatory care setting during care transition from hospital to primary care. Methods: We systematically reviewed the articles in primary or ambulatory care setting on patients with care transition that involved medication safety, discrepancy, or error as outcome assessment...
May 2018: Journal of Family Medicine and Primary Care
Hannah Dills, Kruti Shah, Barbara Messinger-Rapport, Kevin Bradford, Quratulain Syed
OBJECTIVES: Perform a systematic review to evaluate the outcome of deprescription compared with standard care. The focus was on chronic medical and mental health conditions managed in primary care. DESIGN: The databases searched include PubMed, Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science. Each study was assessed for bias with the Cochrane Collaboration tool. SETTINGS AND PARTICIPANTS: This review included outpatient, assisted living, nursing home, and acute care settings (if medications for chronic disease were deprescribed)...
August 11, 2018: Journal of the American Medical Directors Association
Anna Laven, Maira Anna Deters, Olaf Rose, Holger Schwender, Alexandra Smaranda, Isabell Waltering, Stephanie Laeer
Background Pharmacists who engage in Pharmaceutical Care need skills to optimise responsible medication use and increase medication adherence. Objectives We developed and evaluated a blended-learning programme for German community pharmacists that focused on conducting consultations in chronic diseases. Setting Community pharmacists in Germany. Method Interventional study with pre-post design. We combined e-learning with Objective Standardised Clinical Examinations (OSCEs) for emergency situations, initiation/implementation of medication therapy and detection of symptoms of four chronic diseases...
August 11, 2018: International Journal of Clinical Pharmacy
Lisa M Kalisch Ellett, Renly Lim, Nicole L Pratt, Mhairi Kerr, Emmae N Ramsay, Tammy V LeBlanc, John D Barratt, Elizabeth E Roughead
BACKGROUND: The Australian Government Department of Veterans' Affairs (DVA) Veterans' Medicines Advice and Therapeutics Education Services (Veterans' MATES) programme conducted two intervention (March 2009, follow-up intervention June 2012) both of which aimed to reduce hypnotic use among Australian veterans. We evaluated the effectiveness of the interventions, and estimated the associated health consequences. METHODS: Both interventions targeted veterans who had been dispensed hypnotics prior to the intervention...
August 9, 2018: BMC Health Services Research
Antionette Terblanche, Johanna Catharina Meyer, Brian Godman, Robert Stanley Summers
BACKGROUND AND AIMS: Under-reporting of adverse drug reactions (ADRs) by health care professionals (HCPs) is a worldwide problem. Spontaneous reporting in hospitals is scarce and several obstacles have been identified. Improved hospital-based reports could make important contributions to future care. Consequently, the objective of this study was to develop, implement and evaluate a structured pharmacist-driven pharmacovigilance (PV) system for in-patient ADR reporting in a leading public hospital in South Africa, for future use in South Africa and wider...
August 9, 2018: Hospital Practice (Minneapolis)
J Wuyts, J Maesschalck, I De Wulf, K Foubert, K Boussery, J De Lepeleire, V Foulon
BACKGROUND: Aged polymedicated patients are particularly vulnerable for drug-related problems. A medication review aims to optimize the medication use of patients and improve health outcomes. In this study, the effect of a pharmacist-led medication use review is investigated for polymedicated ambulatory older patients with the aim of implementing this pharmaceutical care intervention across Belgium. METHODS: This article describes the study protocol of the SIMENON study and reports the results of the feasibility study, which aimed to test and optimize this study protocol...
August 8, 2018: BMC Health Services Research
Trine Graabaek, Ulla Hedegaard, Mikkel B Christensen, Marianne H Clemmensen, Torben Knudsen, Lise Aagaard
RATIONALE, AIMS, AND OBJECTIVES: Medication-related problems are frequent and can lead to serious adverse events resulting in increased morbidity, mortality, and costs. Medication use in frail older patients is even more complex. The aim of this study was to investigate the effect of a pharmacist-led medicines management model among older patients at admission, during inpatient stay and at discharge on medication-related readmissions. METHOD: A randomized controlled trial conducted at the acute admission unit in a Danish hospital with acutely admitted medical patients, randomized to either a control group or one of two intervention groups...
August 7, 2018: Journal of Evaluation in Clinical Practice
Niteesh K Choudhry, Thomas Isaac, Julie C Lauffenburger, Chandrasekar Gopalakrishnan, Marianne Lee, Amy Vachon, Tanya L Iliadis, Whitney Hollands, Sandra Elman, Jacqueline M Kraft, Samrah Naseem, Scott Doheny, Jessica Lee, Julie Barberio, Lajja Patel, Nazleen F Khan, Joshua J Gagne, Cynthia A Jackevicius, Michael A Fischer, Daniel H Solomon, Thomas D Sequist
Importance: Approximately half of patients with chronic conditions are nonadherent to prescribed medications, and interventions have been only modestly effective. Objective: To evaluate the effect of a remotely delivered multicomponent behaviorally tailored intervention on adherence to medications for hyperlipidemia, hypertension, and diabetes. Design, Setting, and Participants: Two-arm pragmatic cluster randomized controlled trial at a multispecialty group practice including participants 18 to 85 years old with suboptimal hyperlipidemia, hypertension, or diabetes disease control, and who were nonadherent to prescribed medications for these conditions...
August 6, 2018: JAMA Internal Medicine
Tenielle Watkins, Sandra M Aguero, Michael Jaecks
Failure to appropriately document patient medical information, such as allergies, is an important cause of medication errors. Lack of allergy details in the electronic medical record (EMR) may prolong the pharmacist order verification process. A retrospective chart review was conducted in October 2017, to evaluate the impact of incomplete allergy details on time to antibiotic order resolution at the Einstein Medical Center Philadelphia. Details were present on 71% of orders. The difference in median time to order resolution, for orders with versus without details, was ⁻21 min (95% CI (confidence interval), ⁻39 to ⁻2...
August 3, 2018: Pharmacy (Basel, Switzerland)
Lindsay Dryden, Norman F Dewhurst
OBJECTIVE: To evaluate the clinical and cost implications generated by a newly integrated ED pharmacist in a Canadian urban, university-affiliated tertiary care hospital. METHODS: A pharmacist documented all interventions that took place over a 5-week period. Interventions were assessed by a review panel for clinical significance and probability of harm had the intervention not occurred. Direct medication cost and cost avoidance as a result of interventions were calculated...
August 6, 2018: International Journal of Pharmacy Practice
Lynn Maria Weekes, Suzanne Blogg, Sharene Jackson, Kerren Hosking
The cost and potential harms of medicines and other health technologies are issues of concern for governments and third party payers of health care. Various means have been demonstrated to promote appropriate evidence-based use of these technologies as a way to reduce waste and unintended variation. Since 1998, Australia has had a national organisation responsible for large scale programs to address safe, effective and cost effective use of health technologies. This article reviews 20 years of experience for NPS MedicineWise (NPS)...
2018: Journal of Pharmaceutical Policy and Practice
MarySue Beran, Stephen E Asche, Anna R Bergdall, Benjamin Crabtree, Beverly B Green, Sarah E Groen, Krissa J Klotzle, Ryan D Michels, Rachel A Nyboer, Patrick J O'Connor, Pamala A Pawloski, Daniel J Rehrauer, JoAnn M Sperl-Hillen, Nicole K Trower, Karen L Margolis
OBJECTIVES: The Hyperlink trial tested a 12-month intervention of home blood pressure (BP) telemonitoring with pharmacist case management in adults with uncontrolled hypertension. The intervention resulted in improved BP control compared with usual care at both 6 (72% vs. 45%; P < 0.001) and 12 months (71% vs. 53%; P = 0.005). We sought to investigate factors contributing to intervention success. DESIGN: Mixed-methods analysis of process of care data, patient focus groups, and pharmacist interviews...
August 1, 2018: Journal of the American Pharmacists Association: JAPhA
Juliana H Zschoche, Suzanne Nesbit, Umbreen Murtaza, Amanda Sowell, Julie M Waldfogel, Nicole Arwood, Jordan Rush, LeAnn McNamara, Meghan Swarthout, Todd Nesbit, Melinda Ortmann
PURPOSE: An interprofessional initiative to operationalize outpatient naloxone prescribing at a large academic medical center is described. SUMMARY: The initiative was carried out by a work group of clinical pharmacists and pharmacy administrators in collaboration with physicians and nursing staff leaders from multiple practice settings. An opioid overdose risk-assessment guide was developed on the basis of literature review and expert opinion. An institutional policy to guide identification of high-risk patient populations and facilitate naloxone prescribing and dispensing was developed and vetted by multiple expert committees...
August 3, 2018: American Journal of Health-system Pharmacy: AJHP
Masanori Ochi, Toshiro Kamoshida, Atsushi Ohkawara, Haruka Ohkawara, Nobushige Kakinoki, Shinji Hirai, Akinori Yanaka
AIM: To investigate the relationship between the onsets of multikinase inhibitor (MKI)-associated hand-foot skin reaction (HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib. METHODS: We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions...
July 28, 2018: World Journal of Gastroenterology: WJG
Kea Turner, Justin G Trogdon, Morris Weinberger, Angela M Stover, Stefanie Ferreri, Joel F Farley, Neepa Ray, Michael Patti, Chelsea Renfro, Christopher M Shea
BACKGROUND: Many state Medicaid programs are implementing pharmacist-led medication management programs to improve outcomes for high-risk beneficiaries. There are a limited number of studies examining implementation of these programs, making it difficult to assess why program outcomes might vary across organizations. To address this, we tested the applicability of the organizational theory of innovation implementation effectiveness to examine implementation of a community pharmacy Medicaid medication management program...
July 31, 2018: Implementation Science: IS
Junpei Komagamine, Kenichi Sugawara, Miho Kaminaga, Shinpei Tatsumi
INTRODUCTION: Given that polypharmacy and potentially inappropriate prescribing are common in elderly orthopaedic patients, pharmacist interventions to improve medication practices among this population are important. However, past studies have reported mixed results regarding the effectiveness of pharmacist-led interventions in inpatient elderly care. Furthermore, few randomised controlled trials have evaluated patient-relevant outcomes as a primary endpoint. Therefore, we will evaluate whether a pharmacist-led intervention could reduce readmission of hospitalised elderly orthopaedic patients with polypharmacy or potentially inappropriate prescribing...
July 30, 2018: BMJ Open
Ann M Taylor, Jennifer Bingham, Katherine Schussel, David Rhys Axon, Daniel J Dickman, Kevin Boesen, Rose Martin, Terri L Warholak
BACKGROUND: Pharmacist-delivered medication therapy management (MTM) services can improve patient outcomes, yet little is known about outpatient, interprofessional telepharmacy programs. OBJECTIVE: To evaluate an outpatient, interprofessional telehealth chronic care management (CCM) pilot program. METHODS: This 6-month program integrated family medicine providers, a university-based medication management telepharmacist, and an interprofessional care coordinator using telehealth solutions for CCM and pharmacy education services...
August 2018: Journal of Managed Care & Specialty Pharmacy
U Abubakar, S A Syed Sulaiman, A G Adesiyun
Background Audit of antibiotic prophylaxis is an important strategy used to identify areas where stewardship interventions are required. Objectives To evaluate compliance with surgical antibiotic prophylaxis in obstetrics and gynaecology surgeries and determine the Defined Daily Dose (DDD) of antibiotic. Settings Three public tertiary hospitals located in Northern Nigeria. Methods This prospective study included women who had obstetrics and gynaecology surgeries with no infection at the time of incision. Appropriateness of antibiotic prophylaxis was determined by a clinical pharmacist...
July 27, 2018: International Journal of Clinical Pharmacy
Nastassja Trausch, James A Green
Background Phone calls between pharmacists and prescribers play an important role in resolving potential errors and other issues. Despite their importance in patient care, and sometimes causing frustration for pharmacists, there is little research on these calls. Objective To quantify how long calls between pharmacists and prescribers are, how often phone calls occur, why calls are made, and who is called. Method An observational study was conducted with 130.5 h observed in 11 community pharmacies over 8 weeks in Dunedin, New Zealand, recording information about all incoming and outgoing calls...
July 26, 2018: International Journal of Clinical Pharmacy
Slaven Falamić, Marko Lucijanić, Maja Ortner Hadžiabdić, Srećko Marušić, Vesna Bačić Vrca
Background Community pharmacists can play an important role in optimizing warfarin treatment, which is very important in vulnerable patient groups such as the elderly patients in rural areas. Objective To evaluate the impact of a community pharmacist's interventions on the quality of anticoagulation in elderly rural patients receiving warfarin. Setting A community pharmacy in Donji Miholjac in Croatia's province of Slavonia. Method We conducted a prospective randomized trial. Eligible patients were recruited at the pharmacy and randomized into two groups...
July 26, 2018: International Journal of Clinical Pharmacy
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