Jean-Venable R. Goode

collaborations to facilitate success of community pharmacy practice-based research networks

OBJECTIVE To describe the nature of the collaborations between academia and practitioners in two community pharmacy practice-based research networks (PBRNs). SETTING Community pharmacy practice sites owned by two pharmacy chain corporations that have cooperated with two pharmacy schools for up to 10 years in research efforts. PRACTICE DESCRIPTION A PBRN is a group of community pharmacy practice sites that are affiliated with an academic institution(s) that investigate questions related to community practice. PRACTICE INNOVATION A model of collaboration between academia and community pharmacy practice to enhance PBRNs. Collaborators in academia include practice and science faculty. Collaborators in community pharmacy practice include practitioners and practice-site decision makers. MAIN OUTCOME MEASURES The role of each collaborator in the PBRN, suggestions for developing and maintaining collaborations among PBRN members, strategies to identify collaborators and to expand a PBRN, and the value to each collaborator of participating in a PBRN. RESULTS Academically based pharmacy faculty members connect with practice sites and listen to the needs of practitioners in an effort to design research that will solve practice problems. Practitioners and practice-site decision makers need to understand the role of research in solving projects, propose problems to be addressed and methods to address them, and become committed to completing the research. Building partnerships among collaborators is an important step in developing and maintaining the pharmacy-based PBRN. For faculty members, the value is connecting with community practice, helping to solve problems, and sharing results with the pharmacy community. For practitioners, the value of collaboration centers on improving practice and expanding their professional role. CONCLUSION The involvement of community pharmacy sites with PBRNs has the potential to be a driving force in practice innovation, improving patient care and professional satisfaction.

Home Blood Glucose Monitoring

OBJECTIVE: To provide a review of self-monitoring blood glucose including home blood glucose meters and patient education. DATA SOURCES: A MEDLINE search (January 1966–January 1998) was conducted to identify original and review articles. Search terms included self-monitoring blood glucose and blood glucose monitoring. Owners manuals and package inserts were reviewed to determine specific characteristics for each glucose meter. DATA EXTRACTION: All current original and review articles about self-monitoring blood glucose and home blood glucose meters were included if they contained information about benefits of self-monitoring blood glucose, technology and performance of blood glucose meters, quality control, selection characteristics of blood glucose meters, and patient education. DATA SYNTHESIS: Self-monitoring of blood glucose has become an increasingly vital component of the care of the diabetic patient. Many glucose monitors are available with various features that may be confusing to pharmacists. Pharmacists need to be able to aid patients in the selection of an appropriate glucose meter and provide the education necessary for proper use and follow-up. Patient education is a key component in optimizing the potential benefits of self-monitoring. CONCLUSIONS: Self-monitoring of blood glucose, if used properly, can have a positive effect by increasing patient involvement in overall diabetes care. Pharmacists are accessible and can teach patients necessary skills that will enhance their ability to self-manage blood glucose.

Development and implementation of a pharmacist-delivered Medicare annual wellness visit at a family practice office

OBJECTIVE To describe the development and implementation of a pharmacist-delivered Medicare Annual Wellness Visit (MWV). SETTING Physician-owned, private family practice office. PRACTICE INNOVATION Pharmacist-delivered MWV. MAIN OUTCOME MEASURES Patient visits and practice income. RESULTS Because of time constraints in the practice, physicians, nurse practitioners, and a physician assistant had been unable to offer MWVs, a new service available to Medicare beneficiaries under the Affordable Care Act. A pharmacist who was previously providing patient care services 1 day/week at a fixed hourly rate was able to add an additional 1 day/week for provision of MWVs. These visits involve updating medical and medication histories; measuring weight, mass, and blood pressure; assessing cognitive and physical function; and screening the patient and recommending preventive services. From September 2012 to February 2013, 174 patients participated in the pharmacist-delivered MWV. Pharmacist visits were billed using codes G0438 and G0439, and the practice realized a positive net income for the MWVs. CONCLUSION Pharmacist-delivered MWVs are financially viable and allow for greater pharmacist participation on the primary care team.

Implementation of a comprehensive pretravel health program in a supermarket chain pharmacy

OBJECTIVE To describe the procedures for implementing a comprehensive pretravel health program in a supermarket chain pharmacy. SETTING Central Virginia (Richmond, Fredericksburg, Williamsburg, and Roanoke) between 2000 and 2008. PRACTICE DESCRIPTION Ukrops is a local supermarket chain with 29 stores, 20 of which have pharmacies. Ukrops Pharmacy offers enhanced patient care services, including medication therapy management, wellness services, diabetes education and management, smoking cessation, and immunizations. PRACTICE INNOVATION Comprehensive pretravel health program. MAIN OUTCOME MEASURES Number of patients participating in the pretravel health program and number of vaccinations administered by pharmacists. RESULTS An average of 1,000 patients per year participate in the pretravel health program, and approximately 1,900 vaccines are administered each year. CONCLUSION A comprehensive pretravel program is a successful service in a supermarket chain pharmacy. It provides another option for travelers seeking pretravel health care.

Keeping Up-to-Date on Immunizations: A Framework and Review for Pharmacists

OBJECTIVE To provide a framework for keeping current in the immunizations field; an update on changes in adult and pediatric vaccine delivery since 2003; and an update on new immunization guidelines, new approved vaccines, and changes in uses for current vaccines. DATA SOURCES Published guidelines identified from the Centers for Disease Control National Immunization Program Web site. In addition, published articles were identified through Medline (January 2003-November 2005) using specific vaccine names as search terms. Additional sources were identified from the bibliographies of retrieved articles. STUDY SELECTION By the authors. DATA EXTRACTION By the authors. DATA SYNTHESIS To implement the immunization services now permitted under law in 44 states, many pharmacists receive initial training through the American Pharmacists Association Pharmacy-Based Immunization Delivery CERTIFICATE PROGRAM. To remain up-to-date in this field, pharmacists can apply the process described in this article, which includes regular monitoring of the Web site and publications of the Centers for Disease Control and Prevention and participation in one or more listservs. Specific information is presented on new vaccines marketed in the United States since 2003 along with updates on standards for adult and adolescent immunizations and changes in guidelines during this time frame. CONCLUSION As increasingly committed health professionals in the immunizations field, pharmacists are responsible for keeping updated on the constantly changing recommendations for vaccines and related products. By incorporating the recent information presented in this article and applying the process described for tracking changes in this field, pharmacists can fulfill their emerging vaccine-related roles on the health care team.

Pharmacy Practice in Virginia in 2011

Background: Opportunities for pharmacy practice reform exist at state and national levels. The Virginia Commonwealth University (VCU) School of Pharmacy created a working group to assess these opportunities with a mission to advance pharmacy practice in Virginia. Objectives: To assess the perceptions of chronic and acute care pharmacy practice and confidence in providing patient care and medication therapy management (MTM) activities and characterize current work activities of pharmacists in Virginia. Methods: A cross-sectional, online survey was used. VCU School of Pharmacy pharmacist preceptors, students, and faculty members were eligible. The questionnaire contained items that assessed perceptions of chronic and acute care pharmacy practice and confidence in patient care and MTM activities. Demographic and practice site characteristics were also collected. Results: A total of 974 preceptors, 515 students, and 78 faculty members were invited to participate, and 335 preceptors, 155 students, and 41 faculty members had usable responses, yielding response rates of 34%, 30%, and 53%, respectively, Preceptors, students, and faculty members favorably viewed direct patient care roles in the chronic and acute care settings. Pharmacists were very confident or confident in performing many patient care and MTM activities. They were least confident in considering genetic characteristics when adjusting medications and creating business plans for new services. Many pharmacists in chronic and acute care settings provided some type of patient care service, but few were regularly providing services. Inadequate time, staffing, and reimbursement, and lack of perceived value from patients and providers were most frequently cited as barriers to service provision. Conclusions: VCU preceptors, students, and faculty members overwhelmingly believe that pharmacists should provide direct patient care and MTM activities. To transform pharmacy practice, it will be important to define the pharmacists role, responsibilities, and expected outcomes and to consider time, staffing, and compensation as well as to engage patients and providers.

The relationship between medication-related problems and behavioural health condition among patients served by a health care for the homeless centre

Objectives  To evaluate the association between behavioural health conditions and the presence of a medication‐related problem (MRP) and the association between the type of MRP and the presence of a dual diagnosis.

A Prescription for Prescribing: Ensuring Continued Pharmacist Preparedness:

The scope of practice for pharmacists in the United States increasingly includes elements of prescribing under collaborative practice agreements and statewide protocols. However, as a result of continued health care access concerns, we believe that pharmacists will be called on to serve as independent prescribers in the future. For this anticipated practice expansion to become a successful reality, the assurance of pharmacist preparedness and continuous professional development through profession-wide standards will be imperative.

Homeless patients’ perceptions about using cell phones to manage medications and attend appointments

The objectives of this study were to (1) describe homeless persons’ access and use of cell phones and their perceptions about using cell phone alerts to help manage medications and attend health care appointments and (2) identify demographic characteristics, medication use and appointment history and perceptions associated with interest in receiving cell phone alerts to manage medications and appointments.

Public attitudes and beliefs about Virginia community pharmacists dispensing and administering naloxone

OBJECTIVES To determine awareness concerning naloxone and perceived severity of opioid overdose, to identify attitudes and beliefs concerning naloxone, and to assess perceived benefits and barriers related to naloxone dispensed and administered by community pharmacists. METHODS The project was conducted in 3 phases. Phase 1 consisted of survey development and pretesting to identify unclear questions. The survey used principles of the health belief model, focusing on perceived severity of opioid overdose, perceived barriers and benefits to community pharmacists dispensing and administering naloxone, naloxone awareness, sources of health information, and attitudes and beliefs about naloxone. Question types were 5-point Likert response scale with several multiple choice and dichotomous questions. In phase 2, the paper-based survey was distributed to adults in the Richmond area from December 2016 to June 2017. Phase 3 consisted of data analysis using descriptive statistics. RESULTS One hundred twenty-nine individuals with a mean age of 35.4 years (56.7% male and 44.4% white) completed the survey. Opioid overdose was identified as a serious problem in the Richmond area and the United States by 71.9% and 81.3% of respondents, respectively. Among respondents, 39.5% had heard of naloxone before the survey. Most respondents were comfortable with a community pharmacist dispensing and administering naloxone (66.4% and 64.0%, respectively). Of the 31 respondents who were not comfortable with pharmacists dispensing or administering naloxone, 18 respondents identified promoting drug abuse and misuse and 12 respondents identified promoting reckless behavior as a perceived barrier. CONCLUSIONS While most survey respondents were not aware of naloxone before completing the survey, the majority were in favor of community pharmacists in Virginia dispensing and administering naloxone. The most commonly identified concern is that pharmacists dispensing naloxone would promote drug abuse and misuse, which should be addressed with patient education.