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https://www.readbyqxmd.com/read/29036296/unintended-adverse-consequences-of-a-clinical-decision-support-system-two-cases
#1
Erin G Stone
Many institutions have implemented clinical decision support systems (CDSSs). While CDSS research papers have focused on benefits of these systems, there is a smaller body of literature showing that CDSSs may also produce unintended adverse consequences (UACs). Detailed here are 2 cases of UACs resulting from a CDSS. Both of these cases were related to external systems that fed data into the CDSS. In the first case, lack of knowledge of data categorization in an external pharmacy system produced a UAC; in the second case, the change of a clinical laboratory instrument produced the UAC...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28973087/association-of-prior-authorization-and-out-of-pocket-costs-with-patient-access-to-pcsk9-inhibitor-therapy
#2
Ann Marie Navar, Benjamin Taylor, Hillary Mulder, Eugene Fievitz, Keri L Monda, Anna Fievitz, Juan F Maya, J Antonio G López, Eric D Peterson
Importance: Although PCSK9 inhibitors (PCSK9i) were approved in 2015, their high cost has led to strict prior authorization practices and high copays, and use of PSCK9i in clinical practice has been low. Objective: To evaluate patient access to PCSK9i among those prescribed therapy. Design, Setting, and Participants: Using pharmacy transaction data, we evaluated 45 029 patients who were newly prescribed PCSK9i in the United States between August 1, 2015, and July 31, 2016...
September 27, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28970411/medication-safety-experiential-learning-for-pharmacy-students-and-staff-in-a-hospital-setting
#3
Linda V Graudins, Michael J Dooley
Medication Safety has been an established pharmacy specialty in Australian hospitals since the early 2000s and is now one of the ten Australian hospital accreditation standards. Although advances have occurred, medication-related patient harm has not been eradicated. Victorian undergraduate pharmacy programs include some aspects of medication safety, however clinical pharmacy experience, along with interpersonal and project management skills, are required to prepare pharmacists to be confident medication safety practitioners...
November 17, 2016: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28967301/meeting-abstracts-academy-of-managed-care-pharmacy-nexus-2017
#4
(no author information available yet)
The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice through publication in AMCP's Journal of Managed Care & Specialty Pharmacy (JMCP). Abstracts that have been reviewed are published in the JMCP Meeting Abstracts supplement. Poster presentations for AMCP Nexus 2017 are scheduled for Wednesday, October 18, from 12:00 pm to 2:45 pm. For each poster, at least 1 author is available during the poster presentations to discuss findings...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28947411/information-about-medications-in-the-district-of-bamako-mali
#5
M Koné, T Diallo, A Dénou, B F Coulibaly, B Dackouo, B Coulibaly, B Y Koumaré, A Maiga
The aim of our study was to investigate the quality of information about pharmaceutical products in Mali. The study surveyed 98 prescribers, 60 pharmacists, and the package inserts of a basket of 30 generic medicines, compared to those of the corresponding proprietary versions. We made a rational choice of 98 doctors from various specialties and levels of the health system and randomly selected 60 of the 215 pharmacies in the district of Bamako (Mali). A rational sampling of generic medicines provided us with a basket of 30 drug notices for the antimalarial, antibiotic, antalgic, antipyretic, and anti-inflammatory agents used most in the Republic of Mali...
August 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28944727/changing-the-way-we-pay-for-health-care-is-value-the-new-plastic
#6
Robert P Navarro
Navarro is a clinical professor in the College of Pharmacy at the University of Florida, Gainesville, and is an assistant editor with the Journal of Managed Care and Specialty Pharmacy. Navarro reports consulting fees from Analysis Group, Amgen, Novartis, and Allergan.
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944726/paying-for-cures-how-can-we-afford-it-managed-care-pharmacy-stakeholder-perceptions-of-policy-options-to-address-affordability-of-prescription-drugs
#7
Kai Yeung, Kangho Suh, Anirban Basu, Louis P Garrison, Aasthaa Bansal, Josh J Carlson
BACKGROUND: High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28941554/an-evaluation-of-dental-antibiotic-prescribing-practices-in-the-united-states
#8
Michael J Durkin, Kevin Hsueh, Ya Haddy Sallah, Qianxi Feng, S Reza Jafarzadeh, Kiraat D Munshi, Peter B Lockhart, Martin H Thornhill, Rochelle R Henderson, Victoria J Fraser
BACKGROUND: Antibiotic prescribing practices among general dentists and dental specialists in the United States remains poorly understood. The purpose of this study was to compare prescribing practices across dental specialties, evaluate the duration of antibiotics dentists prescribed, and determine variation in antibiotic selection among dentists. METHODS: The authors performed a retrospective cross-sectional analysis of dental care provider specialties linked to deidentified antibiotic claims data from a large pharmacy benefits manager during the 2015 calendar year...
September 16, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28887345/design-and-implementation-of-population-based-specialty-care-programs
#9
Sheila R Botts, Michael T Gee, Christopher C Chang, Iris Young, Logan Saito, Alfred E Lyman
PURPOSE: The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted. SUMMARY: The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28854074/implementation-of-a-new-clinic-based-pharmacist-managed-pcsk9-inhibitor-consultation-service
#10
Adenike Atanda, Nancy L Shapiro, JoAnn Stubbings, Vicki Groo
BACKGROUND: The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors alirocumab and evolocumab were approved by the FDA in 2015. In anticipation of provider interest and a potential increase in referrals to the on-site specialty pharmacy, we created a pharmacist-managed consultation service. PROGRAM DESCRIPTION: The development of a clinic-based pharmacist-managed consultation service for the management of the PCSK9 inhibitor agents alirocumab and evolocumab is described...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28830867/creation-of-a-certification-requirement-for-pharmacists-in-direct-patient-care-roles
#11
David R Hager, Katherine J Hartkopf, Sara M Koth, Steven S Rough
PURPOSE: Steps taken by a large health system to require certification for all pharmacists in direct patient care roles are detailed. SUMMARY: Major supply chain changes and rising payer expectations are reshaping pharmacy practice, resulting in expanded responsibilities for pharmacists and a heightened need for certification in specialized practice areas. In response, the pharmacy leadership team at UW Health, the integrated health system of the University of Wisconsin-Madison, used an iterative process and a "rolling" FAQ format to develop and implement a certification requirement...
August 22, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28800770/knowledge-of-pharmacy-students-about-doping-and-the-need-for-doping-education-a-questionnaire-survey
#12
Keita Shibata, Koichi Ichikawa, Naomi Kurata
BACKGROUND: Anti-doping activities are carried out on a global scale. Based on these activities, the specialty of "sports pharmacist," which entails a deeper comprehension of doping, use of supplements, and appropriate drug use for athletes, was established in 2009 in Japan. It is difficult to say whether the education on doping is adequate for pharmacy students who will be eligible to become sports pharmacists. It is also unclear how well these students understand doping. Therefore, the aim of this study was to investigate pharmacy students' current knowledge of appropriate drug use, doping and use of supplements, and to explore the need for further education on these topics...
August 11, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28737994/impact-of-a-patient-support-program-on-patient-adherence-to-adalimumab-and-direct-medical-costs-in-crohn-s-disease-ulcerative-colitis-rheumatoid-arthritis-psoriasis-psoriatic-arthritis-and-ankylosing-spondylitis
#13
David T Rubin, Manish Mittal, Matthew Davis, Scott Johnson, Jingdong Chao, Martha Skup
BACKGROUND: AbbVie provides a free-to-patient patient support program (PSP) to assist adalimumab-treated patients with medication costs, nurse support, injection training, pen disposal, and medication reminders. The impact of these services on patient adherence to adalimumab and direct medical costs associated with autoimmune disease has not been assessed. OBJECTIVE: To quantify the relationship between participation in a PSP and outcomes (adalimumab adherence, persistence, and direct medical costs) in patients initiating adalimumab treatment...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#14
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28725859/is-telehealth-right-for-your-practice-and-your-patients-with-asthma
#15
Wendy Brown, Tara Schmitz, David M Scott, Daniel Friesner
INTRODUCTION: Telehealth services are becoming increasingly used to provide care to patients living in rural areas. Little is known about the patient satisfaction with the provision of these services. METHODS: A prospective cohort pilot study was developed to evaluate the use of telehealth for the delivery of asthma education services in the rural, medically underserved community of Oakes, North Dakota. A certified asthma educator used real-time, audio-visual telehealth technology to meet with patients the local community pharmacy...
March 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28697049/wide-variation-and-overprescription-of-opioids-after-elective-surgery
#16
MULTICENTER STUDY
Cornelius A Thiels, Stephanie S Anderson, Daniel S Ubl, Kristine T Hanson, Whitney J Bergquist, Richard J Gray, Halena M Gazelka, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: We aimed to identify opioid prescribing practices across surgical specialties and institutions. BACKGROUND: In an effort to minimize the contribution of prescription narcotics to the nationwide opioid epidemic, reductions in postoperative opioid prescribing have been proposed. It has been suggested that a maximum of 7 days, or 200 mg oral morphine equivalents (OME), should be prescribed at discharge in opioid-naïve patients. METHODS: Adults undergoing 25 common elective procedures from 2013 to 2015 were identified from American College of Surgeons National Surgical Quality Improvement Program data from 3 academic centers in Minnesota, Arizona, and Florida...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28665904/evaluating-a-collaborative-approach-to-improve-prior-authorization-efficiency-in-the-treatment-of-hepatitis-c-virus
#17
Emily E Dunn, Kathryn Vranek, Lauren M Hynicka, Janet Gripshover, Darryn Potosky, T Joseph Mattingly
OBJECTIVE: A team-based approach to obtaining prior authorization approval was implemented utilizing a specialty pharmacy, a clinic-based pharmacy technician specialist, and a registered nurse to work with providers to obtain approval for medications for hepatitis C virus (HCV) infection. The objective of this study was to evaluate the time to approval for prescribed treatment of HCV infection. METHODS: A retrospective observational study was conducted including patients treated for HCV infection by clinic providers who received at least 1 oral direct-acting antiviral HCV medication...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28639465/an-innovative-approach-to-addressing-the-hiv-care-continuum-implementation-of-a-clinical-pharmacy-resident-in-a-veterans-affairs-hiv-specialty-clinic
#18
Autumn Bagwell, M Shawn McFarland, Todd Hulgan
PURPOSE: Engagement of patients in the HIV care continuum and adherence to antiretroviral therapy (ART) continue to limit successful viral suppression. Innovative practices to improve this continuum and ameliorate potential physician shortages are needed. The objective of this evaluation was to determine the clinical benefits of incorporating pharmacy resident involvement on a multidisciplinary team in caring for patients with HIV. METHODS: A single-center pre-post cohort pilot evaluation was conducted at the Tennessee Valley Healthcare Systems VA Medical Center...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28629454/impact-of-pharmacy-channel-on-adherence-to-oral-oncolytics
#19
Michael Stokes, Carolina Reyes, Yu Xia, Veronica Alas, Hans-Peter Goertz, Luke Boulanger
BACKGROUND: Oral chemotherapy is increasingly prescribed to treat cancer. Despite its benefits, concerns have been raised regarding adherence to therapy. The study objective was to compare and measure adherence, persistence, and abandonment in patients filling prescriptions in traditional retail (TR) versus specialty pharmacy (SP) channels. METHODS: Using a retrospective cohort design, we selected newly treated patients aged ≥18 years with a prescription for erlotinib, capecitabine, or imatinib during 2007-2011 from a Medco population of both United States commercial and Medicare health plans...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28629300/dynamic-interplay-of-pharmacy-learners-during-a-solid-organ-transplantation-learning-experience
#20
Jonathan H Sin, Hanlin Li, Nicholas Jandovitz, Madeline King, Demetra S Tsapepas
Institutions with established clinical pharmacy services have the ability to offer focused patient care learning experiences, often led by a clinical specialist, for pharmacy residents and pharmacy students. Since all parties are continually involved in professional development and lifelong learning, the aforementioned groups can all be considered "pharmacy learners." By utilizing the dynamic interplay and collaboration between pharmacy learners through direct and nondirect patient care activities, experiential and educational opportunities may be improved and enhanced for each learner...
January 1, 2017: Journal of Pharmacy Practice
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