Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 5 Articles
Two clinical pharmacy faculty members from a college of pharmacy provide comprehensive\nmedication management in a rural family medicine clinic. The data was assessed for patients with\ndiabetes managed by the pharmacists from 1 January 2017 through to 31 December 2019 to determine\nthe serviceâ??s impact on patient outcomes. The primary outcome of this study is the change in the\ngoal attainment rates of the three clinical goals of hemoglobin A1c, blood pressure, and appropriate\nstatin therapy after pharmacist intervention. A total of 207 patients were included. At baseline,\nthe patients had an average of 1.13 of the three goals met, improving to an average of 2.02 goals\nmet after pharmacist intervention (p < 0.001). At baseline, 4.8% of the patients had met all three\nclinical goals, improving to 30.9% after pharmacist intervention (p < 0.001). There were significant\nimprovements for the individual goal attainment rates of hemoglobin A1c (24.15% vs. 51.21%,\np < 0.001), blood pressure (42.51% vs. 85.51%, p < 0.001), and appropriate statin therapy (45.89% vs.\n65.70%, p < 0.001). This data adds to the evidence supporting the integration of clinical pharmacists\ninto primary care clinics to improve patient outcomes related to diabetes....
Challenges with primary care access and overextended providers present opportunities for\npharmacists as patient care extenders for chronic disease management. The primary objective was to\nalign primary care pharmacist services with organizational priorities and improve patient clinical\noutcomes. The secondary objective was to develop a technological strategy for service evaluation.\nAn interdisciplinary workgroup developed primary care pharmacist services focused on improving\nperformance measures and supporting the care team in alignment with ongoing population health\ninitiatives. Pharmacist collaborative practice agreements (CPAs) were developed and implemented.\nAn electronic dashboard was developed to capture service outcome measures. Blood pressure control\nto <140/90 mmHg was achieved in 74.15% of patients who engaged with primary care pharmacists\nversus 41.53% of eligible patients electing to follow usual care pathways. Appropriate statin use\nwas higher in patients engaged with primary care pharmacists than in eligible patients electing\nto follow usual care pathways both for diabetes and ischemic vascular disease (12.4% and 2.2%\nhigher, respectively). Seventeen of 54 possible process and outcome measures were identified and\nincorporated into an electronic dashboard. Primary care pharmacist services improve hypertension\ncontrol and statin use. Service outcomes can be measured with discrete data from the electronic\nhealth record (EHR), and should align with organizational priorities....
Purpose: To identify the prevalence of potentially inappropriate drug prescription in a\nsample of nursing home residents in France, combining explicit criteria and implicit approach and\nto involve pharmacists in the multi-professional process of therapeutic optimization. Methods:\nA cross-sectional, observational, multicenter study was conducted during a five-month period in a\nsample of French nursing homes. Information on drug prescription, diseases, and socio-demographic\ncharacteristics of nursing home residents was collected. For each prescription, identification of\npotentially inappropriate drug prescription was done, based on explicit and implicit criteria. Results:\nNursing home residents were administered an average of 8.1 (SD 3.2, range 0â??20) drugs per day.\nNearly 87% (n = 237) of the residents had polypharmacy with five or more drugs prescribed per day.\nAmong the 274 nursing home residents recruited from five nursing homes, 212 (77.4%) had at least\none potentially inappropriate drug prescription. According to the Laroche list, 84 residents (30.7%)\nhad at least one drug with an unfavorable benefitâ??harm balance. An overdosing was found for 20.1%\n(n = 55) of the residents. Nearly 30% (n = 82) of the residents had a drug prescribed without valid\nmedical indication. Conclusions: This study shows that potentially inappropriate drug prescriptions\nare highly prevalent among nursing home residents, nevertheless pharmacists can take part in drug\nutilization review in collaboration with the nursing home staff....
Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of\nCanadians, that is diffcult to manage. With their broad accessibility and expertise on drugs,\nprimary care pharmacists can help patients optimize their pain management. Methods: The objective\nof this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain\nintervention on pain and quality of life in patients with chronic non-cancer pain. A three-month\nnaturalistic prospective study was conducted in primary care settings (five community pharmacies\nand one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study\nparticipants. The primary care, pharmacist-driven chronic pain intervention consisted of patient\nassessments, medication reviews, care plan recommendations, and patient education. In order to\nevaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were\nevaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement\nin pain and quality of life were found, however, these improvements were not statistically significant\nat follow up (month 3). Conclusions: This study provides the foundational research required\nto better understand the impact of Ontario pharmacistsâ?? extended role in pain management in\nnon-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has\nillustrated the importance of modifying and customizing care plans in patients with chronic pain.\nA larger sample size with tailored outcome measures may be necessary to better highlight significant\nimprovements in pain and quality of life in patients with chronic non-cancer pain using a primary\ncare, pharmacist-driven intervention....
(1) Objective: To determine the change in prevalence of clinical pharmacists as clinician\neducators within family medicine residency programs (FMRPs) in North America and to describe\ntheir clinical, educational and administrative scope over time. (2) Methods: A systematic review of\nthe literature was performed starting with an electronic search of PubMed and Embase for articles\npublished between January 1980 and December 2019. Studies were included if they surveyed clinical\npharmacists regarding their clinical, educational, or other roles in FMRPs in the United States or\nCanada. The primary outcome was the change in prevalence of clinical pharmacists in North\nAmerica. Secondary outcomes included: demographic information of clinical pharmacists, change\nin the prevalence in Canada and United States, and descriptions of clinical services, educational\nroles, and other activities of clinical pharmacists within FMRPs. (3) Results: Of the 65 articles\nidentified, six articles met the inclusion criteria. The prevalence of clinical pharmacists as clinician\neducators in FMRPs in North America has grown from 24% to 53% in the United States (U.S.)\nand from 14% to 47% in Canada over the study period. The clinical and educational roles are similar\nincluding: the direct patient care, clinical education, and interprofessional education and practice.\n(4) Conclusion: The prevalence of clinical pharmacists in FMRPs is growing across North America.\nClinical pharmacists are highly educated and trained to support these clinician educator positions.\nWhile educational roles are consistent, clinical pharmacistsâ?? patient care roles are unique to their\nclinical site and growing....
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