Timothy P. Stratton

ASHP guidelines: Minimum standard for pharmacies in hospitals

The following minimum standard guidelines are intended to serve as a basic guide for the provision of pharmacy services in hospitals. These guidelines outline a minimum level of services that most hospital pharmacy departments should consistently provide. The reader is strongly encouraged to review the American Society of Health-System Pharmacy (ASHP) guidance documents referenced throughout these guidelines for more detailed descriptions. Certain elements of these guidelines may be applicable to other health care settings or may be useful in evaluating the scope and quality of pharmacy services.

Point-of-care screenings at the University of Minnesota: Mechanism for civic engagement

OBJECTIVES To describe Wellness Initiative of the Northland (WIN) screening events; present participant results from those events; discuss the benefits of pharmacist-conducted, community-based point-of-care (POC) testing to medically underserved patients and to the profession of pharmacy; and describe logistical considerations in launching disease screening services. SETTING Pharmacist-led community health fairs in a variety of settings, including shopping malls, churches, community pharmacies, senior residence facilities, critical-access hospitals, and clinics. PRACTICE DESCRIPTION Disease screenings for economically disadvantaged residents of northeastern Minnesota and northwest Wisconsin, held between 2005 and 2012, through WIN. PRACTICE INNOVATION Mobile POC screenings for dyslipidemia, diabetes, hypertension, and osteoporosis. MAIN OUTCOME MEASURE Percentage of screenings with out-of-range readings. RESULTS Since 2005, WIN screenings have served more than 2,000 individuals, providing 4,152 POC screenings. Out-of-range readings were obtained for 40.3% of fingerstick cholesterol tests, 24.8% of fingerstick blood glucose tests, 24.3% of blood pressure tests, and 38.7% of quantitative ultrasound heel bone density readings. CONCLUSION Community-conducted POC testing functions both as an important public health service and a mechanism by which pharmacists and student pharmacists can become involved in civic engagement.

Patient care services in rural Minnesota community pharmacies

OBJECTIVE To compare the availability of medication therapy management (MTM) services, point-of-care (POC) testing, and disease management resources between rural and urban Minnesota community pharmacies. DESIGN Cross-sectional study. SETTING Minnesota in 2006. PARTICIPANTS Owners and operational managers of 564 Minnesota community pharmacies. INTERVENTION Mail survey containing structured, quantitative questions. Resulting data were separated to evaluate urban and rural area community pharmacies. MAIN OUTCOME MEASURES Staffing trends, MTM services, and patient care services of urban compared with rural community pharmacies in Minnesota. RESULTS Urban and rural pharmacies reported allocating nearly the same percent of a typical day to filling and dispensing prescriptions (approximately 70%). A higher percent of rural community pharmacies offered patient care services in 5 of 15 categories, including drug information services (55.7% vs. 45.6%), provision of durable medical equipment (43.4% vs. 32.6%), dyslipidemia management (7.8% vs. 3.8%), hypertension management (14.6%% vs. 7.3%), and MTM (29.4% vs. 18.7%). CONCLUSION Although the time allocated to dispensing medication was approximately 70% for both urban and rural pharmacies, a significantly higher proportion of rural pharmacies reported providing MTM and other direct patient care services. This may be a result of geographic isolation and greater use of pharmacists as providers of first-contact care in these areas.

Developing a mobile pharmacist-conducted wellness clinic for rural montana communities

OBJECTIVE To describe pharmacist-conducted disease screening services in remote communities. SETTING Frontier, rural, and nonrural counties throughout western Montana. PRACTICE DESCRIPTION Using federal telehealth funds, a motor home was converted into a mobile office and equipped with a satellite transmitting/receiving dish to provide wireless Internet access. The pharmacist uses an ultrasound unit to test heel bone density, a spirometer to test lung function, and appropriate analyzers to measure A1C and serum lipid levels. Screening clinics are held in conjunction with county health departments, tribal health authorities, community pharmacies, county agricultural extension agents, and Federally Qualified Health Centers. Employee wellness clinics are also conducted. Student pharmacists assist with screenings. PRACTICE INNOVATION Mobile pharmacist-conducted disease screening clinics in remote communities. MAIN OUTCOME MEASURES Number of communities served, number of patients screened, percentage of test results out-of-range/patients referred to their primary health care providers for follow-up, number of student pharmacists participating, and total revenues generated. RESULTS During the first 2 years of the project, IPHARM pharmacists traveled approximately 14,000 miles, conducted 72 clinics in 17 counties and performed 5,100 screening tests for more than 3,100 people. Approximately 36% of all screening test results were outside of expected range. More than 80 student pharmacists, most of whom were on clinical rotations, participated in the clinics and 11 community pharmacists have been trained to conduct screenings. In excess of dollar 70,000 was generated by the project in operating revenue and donations. At the conclusion of IPHARMs first year of operations, the motor home was taken out of service because of the cost of gasoline, difficulties of winter travel with such a large vehicle, and the realization that virtually all host organizations were able to provide space in which the screening clinics could be conducted. CONCLUSION Pharmacists and student pharmacists are capable of providing disease screening services in remote frontier and rural communities. Obtaining sufficient payment for these services in rural communities to cover costs remains a challenge.

ASHP Statement on Telepharmacy

ASHP believes appropriately trained and equipped pharmacists can use telepharmacy to remotely oversee pharmacy operations and provide distributive, clinical, analytical, and managerial services. ASHP advocates that telepharmacy be applied to suitable functions of pharmacy operations and patient care

Comparison of consumer-oriented books on medications

Consumers increasingly want to be informed about the processes involved in their own health care. Health professionals may be called upon to recommend appropriate consumer-oriented sources of information. To assist the health professional in making a rational recommendation, 15 currently available consumer-oriented books on prescription medications were compared with respect to readability, number of drugs covered, completeness of drug monograph information, price, and other factors. Mean readability scores, reported as a reading grade level, ranged from 9.2 to 14.3. The number of drugs covered by these books ranged from 135 to 1,200. Monograph completeness scores were assigned by determining the percentage of information from a standard references drug monograph covered in each book. The lowest percentage completeness score was 21.4%, while the highest was 76.7%. Prices for the books ranged from

Have you ever thought about a career in small and rural hospitals

2.50 to

Ethical dimensions of the prescription opioid abuse crisis

19.95. Regardless of the relative priorities placed on these factors, a consumer or health professional may use the objective and descriptive assessments of this study to make an informed decision when choosing among consumer-oriented sources of medication information.

Continuum of Care for Inmates Taking Psychiatric Medications While Incarcerated in Minnesota County Jails

Not much appears in the published literature describing pharmacy practice in small and rural hospitals.[1][1]–[4][2] Pharmacy practice in such settings can prove professionally satisfying, and living in a rural area can prove personally rewarding. The terms small hospital and rural hospital often

Open letter to administrators of rural hospitals

The number of deaths by drug overdose in the United States tripled between 1999 and 2014 and reached a historic peak in 2015.[1][1] Opioids were involved in nearly two thirds of these deaths despite few rigorous examinations of the benefits of opioid treatment for pain lasting greater than 3 months