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Ambulatory care pharmacy

Gennaro A Paolella, Andrew D Boyd, Scott M Wirth, Sandra Cuellar, Neeta K Venepalli, Stephanie Y Crawford
Interprofessional care is exhibited in outpatient oncology practices where practitioners from a myriad of specialties (e.g., oncology, nursing, pharmacy, health informatics and others) work collectively with patients to enhance therapeutic outcomes and minimize adverse effects. Historically, most ambulatory-based anticancer medication therapies have been administrated in infusion clinics or physician offices. Oral anticancer medications (OAMs) have become increasingly prevalent and preferred by patients for use in residential or other non-clinic settings...
March 8, 2018: Pharmacy (Basel, Switzerland)
Maria Chiara Corti, Francesco Avossa, Elena Schievano, Pietro Gallina, Eliana Ferroni, Natalia Alba, Matilde Dotto, Cristina Basso, Silvia Tiozzo Netti, Ugo Fedeli, Domenico Mantoan
BACKGROUND: The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local Health Trusts (LHTs) is based on a capitation system adjusted only for age, gender and area of residence. We applied a risk-adjustment system (Johns Hopkins Adjusted Clinical Groups System, ACG® System) in order to explain health care costs using routinely collected administrative data in the Veneto Region (North-eastern Italy)...
March 4, 2018: European Journal of Internal Medicine
Stacie J Lampkin, Brooke Gildon, Sandra Benavides, Kelly Walls, Leslie Briars
Pediatric clinical pharmacists are an integral part of the health care team. By practicing in an ambulatory care clinic, they can reduce the risk of medication errors, improve health outcomes, and enhance patient care. Unfortunately, because of limited data, misconceptions surrounding the role of pharmacists, and reimbursement challenges, there may be difficulty in establishing or expanding pediatric clinical pharmacy services to an ambulatory care setting. The purpose of this paper is to provide an overview of considerations for establishing or expanding pharmacy services in a pediatric ambulatory care clinic...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Guillaume Hébert, Etienne Minvielle, Mario Di Palma, François Lemare
PURPOSES: Analyze the relationship and expectations of cancer patients towards the community pharmacist in a pharmaceutical care coordination project. METHODS: In November 2014, a questionnaire was distributed to ambulatory patients of a university hospital specialized in oncology. Thirteen questions explored the consumption habits and the usage of the pharmacy (typology of consumers, use of goods and benefits consumed), and collected their expectations for pharmaceutical benefits in the context of the management of their cancer...
February 24, 2018: Bulletin du Cancer
Yvonne Pfeiffer, Stephan S Gut, David L B Schwappach
PURPOSE: To increase medication safety in oncology, checking procedures are increasingly applied by nurses, physicians, and pharmacists. However, little is known about the number, types, and consistency of implemented checks. The aim of the study was to assess the number and types of different checking procedures that are performed along the lifecycle of a chemotherapy prescription across three hospitals, different care settings, administration routes, and professional groups. METHODS: A scheme to evaluate checking procedures and a mapping approach to illustrate the checks along the phases of the medication process were developed...
February 26, 2018: Journal of Oncology Practice
Brooke L Gildon, Barnabas John, Michelle Condren, Shellie Keast, Roxanne Maglunog, Jeremy L Johnson, Christopher Robertson
OBJECTIVES: To use a pharmacist-managed short-acting beta agonist (SABA) service (1) to determine the patient's rationale for SABA refill requests, (2) to assess adherence to current controller therapy and current level of disease control, and (3) to characterize the pharmacist's recommendations made in response to a patient's SABA refill request. SETTING: An academic-based general pediatric clinic. PRACTICE DESCRIPTION: SABA overuse is a marker of increased morbidity and mortality in children with asthma...
February 3, 2018: Journal of the American Pharmacists Association: JAPhA
Matthew H Rim, Karen C Thomas, Brittanie Hatch, Michael Kelly, Linda S Tyler
PURPOSE: The development and implementation of a centralized, comprehensive, refill authorization (CCRA) program within an academic health system are described. SUMMARY: In order to improve continuity of care for our medically complicated patients, ambulatory pharmacy services developed and implemented a highly coordinated CCRA program for multiple community clinics within the system. To implement the CCRA program, we centralized the refill-request intake process to the Pharmacy Ambulatory Clinical Care Center (PAC3)...
February 1, 2018: American Journal of Health-system Pharmacy: AJHP
Seina Lee, Lin Xie, Yuexi Wang, Neel Vaidya, Onur Baser
AIMS: Examine the comorbidity and economic burden among moderate-to-severe psoriasis (PsO) and/or psoriatic arthritis (PsA) patients in the US Department of Defense (DoD) population. MATERIALS AND METHODS: This retrospective cohort claims analysis was conducted using DoD data from November 2010 to October 2015. Adult patients with ≥2 diagnoses of PsO and/or PsA (cases) were identified, and the first diagnosis date from November 2011 to October 2014 was defined as the index date...
January 23, 2018: Journal of Medical Economics
Melanie Yee Lee Siaw, Jing Heng Toh, Joyce Yu-Chia Lee
Background Qualitative evidence on patients' perceptions of pharmacist-managed diabetes services (PMDSs) is limited. Objective To explore patients' perceptions of PMDSs Setting Patients being cared for in the outpatient settings in Singapore. Methods This focus group included patients who were diagnosed with type 2 diabetes, spoke either English or Mandarin, attended PMDSs for at least 6 months in the ambulatory care or community settings, and were at least 21 years of age. Patients with cognitive impairments or mobility issues were excluded...
January 20, 2018: International Journal of Clinical Pharmacy
Yuze Yang, Stacy Ward-Charlerie, Ajit A Dhavle, Michael T Rupp, James Green
BACKGROUND: The prescriber's directions to the patient (Sig) are one of the most quality-sensitive components of a prescription order. Owing to their free-text format, the Sig data that are transmitted in electronic prescriptions (e-prescriptions) have the potential to produce interpretation challenges at receiving pharmacies that may threaten patient safety and also negatively affect medication labeling and patient counseling. Ensuring that all data transmitted in the e-prescription are complete and unambiguous is essential for minimizing disruptions in workflow at prescribers' offices and receiving pharmacies and optimizing the safety and effectiveness of patient care...
January 18, 2018: Journal of Managed Care & Specialty Pharmacy
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
Bianca Au, Deonne Dersch-Mills, Sunita Ghosh, Jennifer Jupp, Carole Chambers, Frances Cusano, Melanie Danilak
Purpose To describe the practice settings and prescribing practices of oncology pharmacists with additional prescribing authorization. Methods A descriptive, cross-sectional survey of all oncology pharmacists in Alberta was conducted using a web-based questionnaire over four weeks between March and April 2016. Pharmacists were identified from the Cancer Services Pharmacy Directory and leadership staff in Alberta Health Services. Descriptive statistics were used to describe the practice setting, prescribing practices, motivators to apply for additional prescribing authorization, and the facilitators and barriers of prescribing...
January 1, 2018: Journal of Oncology Pharmacy Practice
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
Ashley N Walus, Donna M M Woloschuk
Background: Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. Objectives: The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations...
November 2017: Canadian Journal of Hospital Pharmacy
Joseph Vande Griend, Danielle R Fixen, Cy W Fixen, Jason Zupec, Joseph J Saseen
BACKGROUND: Postgraduate year 2 ambulatory care pharmacy residents (PGY2 residents) may be able to improve healthcare quality by providing clinical pharmacy services provided to self-insured employer health plan patients. The objectives of this study are to describe this care delivery in a family medicine clinic, and to identify patients most likely to benefit from the service. METHODS: From October 1, 2014 till June 30, 2015, comprehensive medication review was completed by PGY2 residents for patients insured by CU Anthem at the University of Colorado Westminster Family Medicine...
February 2018: Journal of Pharmacy Practice
Kari Vavra, Matthew Paluzzi, Margaret de Voest, Sarah Raguckas, Martha Slot
BACKGROUND AND PURPOSE: Student pharmacists are well equipped to complete transitions of care (TOC) activities. This communication describes the implementation of a student-operated TOC pilot service at a community hospital and explores the clinical and educational findings of such a service. EDUCATIONAL ACTIVITY AND SETTING: Patients admitted to the hospital were included in the service if they had a primary care provider from an affiliated ambulatory care office...
January 2018: Currents in Pharmacy Teaching & Learning
Julienne K Kirk, Rebecca Edwards, Andrew Brewer, Cathey Miller, Bryan Bray, James B Groce
BACKGROUND AND PURPOSE: To describe the design of an ongoing anticoagulation certificate program and annual renewal update for pharmacists. EDUCATIONAL ACTIVITY AND SETTING: Components of the anticoagulation certificate program include home study, pre- and posttest, live sessions, case discussions with evaluation and presentation, an implementation plan, and survey information (program evaluation and use in practice). Clinical reasoning skills were assessed through case work-up and evaluation prior to live presentation...
July 2017: Currents in Pharmacy Teaching & Learning
Christina H Sherrill
BACKGROUND AND PURPOSE: Pharmacists can make a great impact on the management of chronic kidney disease (CKD), which is a highly prevalent and costly disorder. This article describes the implementation and impact of a CKD elective course for second-year pharmacy students, which aimed to expose students to CKD and enhance their ability to care for these patients. EDUCATIONAL ACTIVITY AND SETTING: Topics associated with CKD were covered in a fifteen-week, three credit hour course...
March 2017: Currents in Pharmacy Teaching & Learning
Rebecca Toor, Kathryn Samai, Ryan Wargo
BACKGROUND AND PURPOSE: To determine the student impression of utilizing a debate style journal club as an alternative approach for preceptors to teach medical literature evaluation skills to pharmacy students undergoing Advance Pharmacy Practice Experiences (APPE) in both acute care and ambulatory care. EDUCATIONAL ACTIVITY AND SETTING: Students were asked to debate on a controversial topic or two drugs with similar indications. Each side had to research supporting evidence based medicine and use literature appraisal skills to incorporate the information logically into an oral debate style format...
May 2017: Currents in Pharmacy Teaching & Learning
Tatum Mead, Stephanie Schauner
BACKGROUND AND PURPOSE: An abundance of literature supports the benefits of electronic medical records (EMR) for improving overall healthcare quality. Identifying preventative care opportunities, reducing medical and medication related errors and incorporating clinical practice guidelines are just a few attributes of EMR implementation. The goals of this study were to engage experiential pharmacy students in the assessment of medication related documentation discrepancies in a newly implemented EMR system and to provide exposure to various aspects of conducting research...
May 2017: Currents in Pharmacy Teaching & Learning
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