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[PMID]:29441932
[Au] Autor:Okuyan B; Sancar M; Ay P; Demirkan K; Apikoglu-Rabus S; Vehbi Izzettin F
[Ti] Título:Translation and psychometric evaluation of the Turkish version of the pharmacy students' perceptions of preparedness to provide pharmaceutical care scale.
[So] Source:Pharmazie;71(10):613-616, 2016 Oct 01.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The aim of the study is to conduct the psychometric evaluation of the Turkish version of the Pharmacy Students' Perceptions of Preparedness to Provide Pharmaceutical Care (PREP) scale. The present study was conducted at three faculties of pharmacy among fifth-year students during a three-month period in 2015. After the translation process, the Turkish version was developed. Psychometric evaluation consisted of the calculation of inter-rater and test-retest reliability and factor analysis. The mean age of 184 students (71.2% of female) was 23.74±1.07. The mean score of the Pharmacy Students' PREP scale was 4.54±1.00 and the Cronbach's alpha was 0.971. Inter-rater and test-retest reliability and factor analysis were also in concordance with the literature. In the present study, the Turkish version of Pharmacy Students' Perceptions of Preparedness to Provide Pharmaceutical Care Scale has been determined to be a reliable and validated tool to assess students' perceptions of preparedness to provide pharmaceutical care.
[Mh] Termos MeSH primário: Educação em Farmácia
Assistência Farmacêutica/normas
Estudantes de Farmácia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Psicometria
Reprodutibilidade dos Testes
Traduções
Turquia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6716


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[PMID]:29233273
[Au] Autor:Karwaki TE; Hazlet TK
[Ad] Endereço:University of Washington, School of Pharmacy, Box 357630, Seattle, WA 98195-7630, United States. Electronic address: tkarwaki@uw.edu.
[Ti] Título:A qualitative analysis of student-written law and ethics cases: A snapshot of PY2 student experience.
[So] Source:Curr Pharm Teach Learn;9(3):369-375, 2017 May.
[Is] ISSN:1877-1300
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: This study was designed to better understand pharmacy students' experiences and recognition of legal and ethical tensions existing in pharmacy practice as demonstrated in student-written law and ethics cases. METHODS: A qualitative analysis of 132 student-written cases representing the team efforts of 1053 students over a 12-year time period was conducted. Student-written cases were coded and analyzed thematically. RESULTS: Our results demonstrate the types of ethical and legal issues our students have experienced in pharmacy practice during the first five quarters of their professional education. Our data highlight three themes: 1) ethical dilemmas presented when the law is misapplied; 2) ethical dilemmas presented when an institutional policy or law was viewed as insufficient; and 3) ethical dilemmas presented as provider distress. The third theme was further subdivided into five subthemes. CONCLUSION: The themes that emerged from this study represent some of the ethical dilemmas that second professional year students have encountered and how these dilemmas may intersect with legal boundaries. Educators can use cases demonstrating these themes to reinforce law and ethics education in the curriculum, thus helping prepare students for pharmacy practice. This article recommends how and when to use case examples.
[Mh] Termos MeSH primário: Educação em Farmácia
Assistência Farmacêutica/ética
Assistência Farmacêutica/legislação & jurisprudência
Estudantes de Farmácia
[Mh] Termos MeSH secundário: Confidencialidade/ética
Confidencialidade/legislação & jurisprudência
Emprego/ética
Seres Humanos
Erros de Medicação/ética
Política Organizacional
Aceitação pelo Paciente de Cuidados de Saúde
Preferência do Paciente/legislação & jurisprudência
Papel Profissional
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:29172982
[Au] Autor:Rubinstein E
[Ad] Endereço:1 EB Rubinstein Associates.
[Ti] Título:Letter--A Challenge to the Pharmacy Profession to Raise Its Voice on Health Care Reform.
[So] Source:J Manag Care Spec Pharm;23(12):1277, 2017 Dec.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:DISCLOSURES: Rubinstein provides consulting services to the pharmaceutical industry, health plans, employers, and specialty pharmacies and is a member of the editorial advisory board of Specialty Pharmacy News. He was a participant on the Amgen Biosimilar Report Advisory Board and reports consulting fees from Amgen.
[Mh] Termos MeSH primário: Reforma dos Serviços de Saúde/legislação & jurisprudência
Legislação Farmacêutica
Assistência Farmacêutica/legislação & jurisprudência
[Mh] Termos MeSH secundário: Seres Humanos
Patient Protection and Affordable Care Act/legislação & jurisprudência
Assistência Farmacêutica/organização & administração
Farmácia/organização & administração
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.12.1277


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[PMID]:29172981
[Au] Autor:Peterson J; Budlong H; Affeldt T; Skiermont K; Kyllo G; Heaton A
[Ad] Endereço:1 Fairview Pharmacy Services, Minneapolis, Minnesota.
[Ti] Título:Biosimilar Products in the Modern U.S. Health Care and Regulatory Landscape.
[So] Source:J Manag Care Spec Pharm;23(12):1255-1259, 2017 Dec.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Biosimilars have the potential to greatly reduce medication costs in the United States. As of July 1, 2017, 5 biosimilars have been approved by the FDA, but only 2 are available for purchase. This commentary outlines the efforts of an integrated health system to ensure biosimilar accessibility and discusses the current challenges and future implications. We highlight the implementation of a health plan policy and how a health system's formulary committee can encourage use while considering provider perceptions and operational challenges. In addition, we provide our perspective on potential implications for pricing, site of care, and pharmacy dispensing practices based on our experience with regulatory hurdles and market trends. Overall, we believe biosimilars are a good thing for the health care system, but their expected benefit may not be realized for years to come. DISCLOSURES: No outside funding supported this work. Affeldt reports advisory board membership with Janssen, and Skiermont reports membership with Amgen and McKesson. The other authors have nothing to disclose. Peterson and Budlong contributed the study concept and design and wrote the manuscript. Affeldt, Skiermont, Kyllo, and Heaton reviewed and revised the manuscript.
[Mh] Termos MeSH primário: Medicamentos Biossimilares/administração & dosagem
Prestação Integrada de Cuidados de Saúde/organização & administração
Aprovação de Drogas
[Mh] Termos MeSH secundário: Medicamentos Biossimilares/economia
Prestação Integrada de Cuidados de Saúde/economia
Custos de Medicamentos
Formulários Farmacêuticos como Assunto
Acesso aos Serviços de Saúde
Seres Humanos
Assistência Farmacêutica/organização & administração
Comitê de Farmácia e Terapêutica
Estados Unidos
United States Food and Drug Administration
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biosimilar Pharmaceuticals)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.12.1255


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[PMID]:28449205
[Au] Autor:Siaw MYL; Ko Y; Malone DC; Tsou KYK; Lew YJ; Foo D; Tan E; Chan SC; Chia A; Sinaram SS; Goh KC; Lee JY
[Ad] Endereço:Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
[Ti] Título:Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial.
[So] Source:J Clin Pharm Ther;42(4):475-482, 2017 Aug.
[Is] ISSN:1365-2710
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:WHAT IS KNOWN AND OBJECTIVE: With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes may be managed effectively within a multidisciplinary collaborative care model; however, evidence on its effectiveness in Asian patients is lacking. Therefore, the primary objective was to evaluate the clinical outcomes of multidisciplinary collaborative care vs physician-centred care in diabetes. The secondary objectives were to evaluate humanistic and economic outcomes among the two types of care. METHODS: This 6-month prospective, open-label, parallel-arm, randomized, controlled study was conducted at four outpatient healthcare institutions. High-risk patients aged ≥21 years with uncontrolled type 2 diabetes, polypharmacy and comorbidities were included. Patients with type 1 diabetes or those who were unable to communicate independently were excluded. The control arm received usual care with referrals to nurses and dietitians as needed. The intervention arm (multidisciplinary collaborative care) was followed up with pharmacists regularly, in addition to receiving the usual care. The primary outcomes included HbA1c, systolic blood pressure, low-density lipoprotein and triglycerides. The secondary outcomes included scores from the Problem Areas in Diabetes (PAID) and the Diabetes Treatment Satisfaction Questionnaires (DTSQ), and diabetes-related health service utilization rates and costs. RESULTS AND DISCUSSION: Of 411 eligible patients, 214 and 197 patients were randomized into the intervention and control arms, respectively. At 6 months, 141 patients in the intervention arm (65.9%) and 189 patients in the control arm (95.9%) completed the study. Mean HbA1c reduced from 8.6%±1.5% at baseline to 8.1%±1.3% at 6 months in the intervention arm (P=.04), with up to mean HbA1c improvement of 0.8% in patients with greater levels of uncontrolled glycemia. Whereas the mean HbA1c in the control arm remained unchanged (8.5%±1.4%) throughout the 6-month period. Improvements in PAID and DTSQ scores, reduction in physician workload and an average cost savings of US$91.01 per patient were observed in the intervention arm over 6 months. WHAT IS NEW AND CONCLUSIONS: The positive clinical, humanistic and economic outcomes highlighted the value of multidisciplinary collaborative care for Asian diabetic patients, thereby supporting the effectiveness of this approach in managing chronic diseases.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/terapia
Equipe de Assistência ao Paciente/organização & administração
Assistência Farmacêutica/organização & administração
Farmacêuticos/organização & administração
[Mh] Termos MeSH secundário: Idoso
Glicemia
Pressão Sanguínea
Comportamento Cooperativo
Feminino
Seres Humanos
Comunicação Interdisciplinar
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Médicos/organização & administração
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1111/jcpt.12536


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[PMID]:29281577
[Au] Autor:Woodcock J; Dohm J
[Ad] Endereço:From the Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD.
[Ti] Título:Toward Better-Quality Compounded Drugs - An Update from the FDA.
[So] Source:N Engl J Med;377(26):2509-2512, 2017 12 28.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Composição de Medicamentos/normas
Contaminação de Medicamentos/legislação & jurisprudência
Legislação de Medicamentos
United States Food and Drug Administration
[Mh] Termos MeSH secundário: Contaminação de Medicamentos/prevenção & controle
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Regulamentação Governamental
Seres Humanos
Meningite Fúngica/epidemiologia
Meningite Fúngica/etiologia
Assistência Farmacêutica
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1712905


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[PMID]:28448784
[Au] Autor:Abughosh S; Wang X; Serna O; Esse T; Mann A; Masilamani S; Holstad MM; Essien EJ; Fleming M
[Ad] Endereço:1 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas.
[Ti] Título:A Motivational Interviewing Intervention by Pharmacy Students to Improve Medication Adherence.
[So] Source:J Manag Care Spec Pharm;23(5):549-560, 2017 May.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diabetes mellitus (DM) patients with comorbid hypertension (HTN) are at a higher risk of developing microvascular and macrovascular DM complications. Through guideline-driven recommendations, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are highly recommended for these patients. Unfortunately, medication adherence to these products, though crucial to achieving therapeutic benefit, is frequently suboptimal. Motivational interviewing (MI) is a patient-centered collaborative communication style that is used to strengthen internal motivation for change that may prove effective in enhancing adherence. OBJECTIVE: To examine the effect of an MI telephone intervention conducted by pharmacy students in improving adherence to ACEIs/ARBs among Medicare Advantage Plan (MAP) patients with both DM and HTN. METHODS: A prospective study was conducted among patients enrolled in a Texas MAP. Medical claims data were used to identify patients with DM and HTN, and pharmacy claims were observed to recognize those who filled either an ACEI or an ARB during June 2014. Patients with a 6-month proportion of days covered (PDC) < 0.80 in the previous 6 months were determined nonadherent, and 75% of those were randomly selected to serve as potential subjects for the intervention, while 25% were randomly selected to serve as potential subjects for the control group. The intervention was a telephone call by a pharmacy student on rotation at the health plan, and 5 monthly follow-up calls. Before implementing calls, participating students attended a 3-day MI training course, where their proficiency for MI skills was evaluated. Refill data during the 6-month postintervention were evaluated to examine the intervention effect measured on 3 outcomes: PDC; PDC ≥ 0.80 versus < 0.80; and discontinuation versus continuation. Multivariate linear and logistic regression models were constructed to adjust for any imbalances in baseline characteristics, including age, gender, number of other medications, regimen complexity, health low-income subsidy status, prescriber specialty, comorbidities, 6-month previous hospitalization, baseline 6-month PDC, and Centers for Medicare & Medicaid Services risk score. RESULTS: A total of 11 students participated in the intervention implementation. Patients receiving calls were randomly selected from those potential subjects for the intervention arm until a target of 250 was reached; 500 controls were randomly selected from the potential subjects for the control arm. The final cohort included in multivariate models consisted of 743 patients. Patients completing the initial call and at least 2 follow-ups were less likely to discontinue (OR = 0.29; 95% CI = 0.15-0.54; P < 0.001) and more likely to be adherent in the linear regression model (ß = 0.0604, P < 0.001) and the logistic regression model (OR = 1.53; 95% CI = 1.02-2.28; P = 0.009). Other factors significantly associated with better adherence included higher baseline PDC and number of medications. Depression status was significantly associated with lower adherence. CONCLUSIONS: Patients receiving 2 or more calls had significantly better adherence and less discontinuation during the 6 months following initial calls compared with those who did not receive calls. This finding indicates that an MI-based telephone intervention by pharmacy students may be a promising intervention to improve adherence. Future research should examine the sustainability of the intervention effect for longer time periods and its influence on associated clinical outcomes. DISCLOSURES: This project was supported by the Pharmaceutical Research and Manufacturers of America Foundation (PhRMA). The content is solely the responsibility of the authors and does not necessarily represent the official views of PhRMA. The funding agency was not involved in research design, analysis, or reporting results. Funding was obtained by Abughosh. Holstad provided a consultation regarding the MI guide and provided the MI training. Study concept and design were contributed by Abughosh and Fleming, along with Serna, Esse, and Holstad. Serna, Esse, Mann, Holstad, and Masilamani collected the data, and data interpretation was performed by Abughosh, Wong, and Esse. The manuscript was written by Abughosh, Wong, and Esse and revised by Masilamani and Holstad, along with the other authors.
[Mh] Termos MeSH primário: Adesão à Medicação
Entrevista Motivacional/métodos
Assistência Farmacêutica/organização & administração
Estudantes de Farmácia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antagonistas de Receptores de Angiotensina/administração & dosagem
Inibidores da Enzima Conversora de Angiotensina/administração & dosagem
Diabetes Mellitus/tratamento farmacológico
Feminino
Seres Humanos
Hipertensão/tratamento farmacológico
Modelos Lineares
Modelos Logísticos
Masculino
Meia-Idade
Estudos Prospectivos
Telefone
Texas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.5.549


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[PMID]:28448783
[Au] Autor:Caffiero N; Delate T; Ehizuelen MD; Vogel K
[Ad] Endereço:1 Pharmacy Department, Kaiser Permanente Colorado, Aurora.
[Ti] Título:Effectiveness of a Clinical Pharmacist Medication Therapy Management Program in Discontinuation of Drugs to Avoid in the Elderly.
[So] Source:J Manag Care Spec Pharm;23(5):525-531, 2017 May.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite evidence of fall risk associated with some drugs to avoid in the elderly (DAEs), many aged patients continue to receive them. OBJECTIVE: To assess the effectiveness of a clinical pharmacist medication therapy management program (MTM) on discontinuation of prescribed DAEs. METHODS: This was a retrospective cohort study conducted at an integrated health care delivery system. Kaiser Permanente Colorado beneficiaries aged ≥65 years who were MTM-eligible and targeted for a DAE dispensing between 01/01/2015 and 09/30/2015 were included in the observation group. Medicare beneficiaries who were not eligible for MTM but had a targeted DAE dispensing during the same time period were included in the control group. The percentage of patients with another DAE dispensing of the same specified medication (no matter the strength) during the 100 days following index DAE dispensing was assessed. Univariate and multivariable logistic regression analyses were conducted. RESULTS: A total of 9,059 Medicare beneficiaries were included, with 226 beneficiaries in the MTM group and 8,833 beneficiaries in the non-MTM group. Beneficiaries were primarily female and white and had a high burden of chronic disease. The percentages of patients with another dispensing of the specified DAE were 7.1% (95% CI = 3.7%-10.4%) for the MTM beneficiaries and 35.3% (95% CI 34.2%-36.2%) for the non-MTM beneficiaries (P < 0.001). The OR for the MTM group to have received another dispensing of the specified DAE was 0.12 (95% CI = 0.08-0.22) with adjustment for potential confounders. CONCLUSIONS: A clinical pharmacist-provided MTM intervention was associated with decreased DAE dispensing in Medicare beneficiaries. Future studies should evaluate means to further decrease DAE use in the aged. DISCLOSURES: This study was funded by the Kaiser Permanente Colorado Pharmacy Department. The funder had no role in the study design, collection, analysis and interpretation of data, writing of the report, or the decision to submit the manuscript for publication. Delate has received grant funding from Janssen Pharmaceutical Companies of Johnson & Johnson outside of this study. The authors report no other disclosures. Delate supervised the study and had complete access to the data and takes responsibility for the data integrity. Study concept and design were contributed by Caffiero, Delate, Ehizuelen, and Vogel. Delate collected the data, assisted by the other authors, and analysis and interpretation of the data were provided by Ehizuelen and Vogel, along with Caffiero and Delate. The manuscript was written by Caffiero and Delate, with assistance from Ehizuelen and Vogel, and revised by all the authors. Preliminary findings from this study were presented at the Mountain States Conference for Pharmacy Residents, Fellows, and Preceptors on May 13, 2016, in Salt Lake City, Utah.
[Mh] Termos MeSH primário: Prescrição Inadequada/prevenção & controle
Conduta do Tratamento Medicamentoso
Assistência Farmacêutica/organização & administração
Farmacêuticos/organização & administração
[Mh] Termos MeSH secundário: Acidentes por Quedas/prevenção & controle
Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Colorado
Prestação Integrada de Cuidados de Saúde/organização & administração
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Medicare
Lista de Medicamentos Potencialmente Inapropriados
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.5.525


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[PMID]:28448780
[Au] Autor:Joseph T; Hale GM; Eltaki SM; Prados Y; Jones R; Seamon MJ; Moreau C; Gernant SA
[Ad] Endereço:1 Department of Pharmacy Practice, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, Florida.
[Ti] Título:Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.
[So] Source:J Manag Care Spec Pharm;23(5):541-548, 2017 May.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care. Pharmacist-provided care has been shown to reduce drug expenditures, hospital readmissions, length of stay, and emergency department visits. Although pharmacists have become key team members of interdisciplinary teams within traditional care settings, their role has often been overlooked in the primary care-based ACO. In 2015, Nova Southeastern University College of Pharmacy founded the Accountable Care Organization Research Network, Services, and Education (ACORN SEED), a team of pharmacy practice faculty dedicated to using innovative approaches to patient care, while providing unique learning experiences for pharmacy students by partnering with ACOs in the South Florida region. Five opportunities are presented for pharmacists to improve medication use specifically in primary care-based ACOs: medication therapy management, annual wellness visits, chronic disease state management, chronic care management, and transitions of care. OBSERVATIONS: Several challenges and barriers that prevent the full integration of pharmacists into primary care-based ACOs include lack of awareness of pharmacist roles in primary care; complex laws and regulations surrounding clinical protocols, such as collaborative practice agreements; provider status that allows compensation for pharmacist services; and limited access to medical records. By understanding and maximizing the role of pharmacists, several opportunities exist to better manage the medication-use process in value-based care settings. IMPLICATIONS/RECOMMENDATIONS: As more organizations realize benefits and overcome barriers to the integration of pharmacists into patient care, programs involve pharmacists will become an increasingly common approach to improve outcomes and reduce the total cost of care and will improve the financial viability of primary care-based ACOs. DISCLOSURES: No outside funding supported this research. The authors report no conflicts of interest related to this manuscript. Study concept and design were contributed by Joseph, Hale, and Eltaki, with assistance from the other authors. Prados and Jones took the lead in data collection and data interpretation and analysis, with assistance from the other authors. The manuscript was written primarily by Joseph and Hale, along with the other authors, and revised primarily by Seamon and Gernant, along with the other authors.
[Mh] Termos MeSH primário: Organizações de Assistência Responsáveis/organização & administração
Assistência Farmacêutica/organização & administração
Farmacêuticos/organização & administração
Atenção Primária à Saúde/organização & administração
[Mh] Termos MeSH secundário: Organizações de Assistência Responsáveis/economia
Assistência à Saúde/economia
Assistência à Saúde/organização & administração
Seres Humanos
Conduta do Tratamento Medicamentoso
Assistência ao Paciente/economia
Assistência ao Paciente/normas
Equipe de Assistência ao Paciente/economia
Equipe de Assistência ao Paciente/organização & administração
Assistência Farmacêutica/economia
Farmacêuticos/economia
Atenção Primária à Saúde/economia
Papel Profissional
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.5.541


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[PMID]:28448779
[Au] Autor:Korcegez EI; Sancar M; Demirkan K
[Ad] Endereço:1 Department of Clinical Pharmacy, Near East University Faculty of Pharmacy, Nicosia, Northern Cyprus.
[Ti] Título:Effect of a Pharmacist-Led Program on Improving Outcomes in Patients with Type 2 Diabetes Mellitus from Northern Cyprus: A Randomized Controlled Trial.
[So] Source:J Manag Care Spec Pharm;23(5):573-582, 2017 May.
[Is] ISSN:2376-1032
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The management of type 2 diabetes mellitus is complex, requiring continuous medical care by health care professionals and considerable self-care efforts by patients. Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes. Pharmacist-led care is a new health care concept in Northern Cyprus. OBJECTIVE: To evaluate the effect of a pharmacist-led care program on glycemic control, determined by hemoglobin A1c (A1c), and secondarily on blood pressure, lipid profile, body mass index (BMI), waist circumference, medication adherence, and self-care activities, for patients with type 2 diabetes over a 12-month period. METHODS: This was a prospective, randomized controlled study conducted in a public hospital's outpatient diabetes clinic, with 152 patients who had been diagnosed with type 2 diabetes. Of these, 75 patients were in the intervention group, and 77 patients were in the usual care group. The intervention group participated in a pharmacist-led care program with a clinical pharmacist who provided 5 face-to-face educational sessions over a period of 12 months. The main outcome measure was change in A1c, and secondary outcome measures were changes in fasting blood glucose, systolic and diastolic blood pressure, lipid values (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and serum levels of triglycerides [TGs]), BMI, waist circumference, self-reported medication adherence (Morisky-Green test), and self-care activities. Changes in outcome measures from baseline to the end of the study were assessed using the Mann-Whitney U-test and Wilcoxon test. RESULTS: At the end of the 12-month study period, the intervention patients showed a greater reduction in A1c values than the usual care patients (-0.74% vs. -0.04%; P < 0.001). Both groups showed significant reductions in fasting blood glucose levels between baseline and the end of 12 months; the difference between the groups was statistically nonsignificant (P = 0.410). When comparing the intervention and usual care groups, there was a significant decrease in systolic (P = 0.01) and diastolic blood pressure (P = 0.04) at the end of the trial. No significant differences were found between the groups in LDL-C, HDL-C, or TG values; however, total cholesterol levels did decrease significantly (P = 0.063, 0.331, 0.896, and 0.04, respectively). Significant reductions occurred in BMI (P < 0.001) and waist circumference (P < 0.001), and improvements were observed in self-reported medication adherence and self-care activities in the intervention group. CONCLUSIONS: A clinical pharmacist-led care program in a public hospital's outpatient diabetes clinic was associated with significant improvements in reducing A1c and other secondary outcomes in a 12-month randomized controlled study. DISCLOSURES: This study was conducted as a PhD thesis by Korcegez under the supervision of Sancar for the clinical pharmacy program at Near East University, Health Sciences Institute, Northern Cyprus, and received no external funding. The authors have no potential conflicts of interest to report. Study concept and design were contributed by Korcegez, with assistance from Sancar and Demirkan. Korcegez took the lead in data collection, and data interpretation was performed by Korcegez, along with Sancar and Korcegez. The manuscript was written and revised by Korcegez, along with Sancar, and with assistance from Demirkan.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/terapia
Hemoglobina A Glicada/metabolismo
Assistência Farmacêutica/organização & administração
Farmacêuticos/organização & administração
[Mh] Termos MeSH secundário: Idoso
Glicemia
Pressão Sanguínea
Chipre
Feminino
Seres Humanos
Masculino
Adesão à Medicação
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Pacientes Ambulatoriais
Papel Profissional
Estudos Prospectivos
Autocuidado
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.18553/jmcp.2017.23.5.573



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