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Health-Related Quality of Life Impact in Employees Participating in a Pharmacist-Run Risk Reduction Program  [PDF]
Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Maryann Z. Skrabal, PharmD,Michele A. Faulkner, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Health related quality of life (HRQOL) and self-perceived well-being have been shown to be associated with lower healthcare utilization and costs in people with chronic diseases. A pharmacist-run employee health program started in 2008 sought to improve HRQOL through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participant’s self-reported general health rating significantly improved compared with their baseline rating (p < 0.001). Participants also reported a significantly lower number of days within a month when they did not feel physically and/or mentally well at baseline vs. one-year, respectively (10.3 days vs. 6.0 days, p < 0.01). Pharmacists can positively impact self-reported HRQOL when working in an employee health setting.
Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program  [PDF]
Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Michele A. Faulkner, PharmD,Maryann Z. Skrabal, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.
A pharmacist-led intervention for increasing the uptake of Home Medicines Review (HMR) among residents of retirement villages (PHARMER): protocol for a cluster randomised controlled trial
Cik Lee, Johnson George, Rohan A Elliott, Kay Stewart
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-292
Abstract: This is a multicentre prospective cluster randomised controlled trial. Ten retirement villages in Victoria, Australia will be recruited for this trial. Retirement villages will be selected in consultation with the Residents of Retirement Villages Victoria Inc. (RRVV), based on geographical locations (e.g. northeast or southwest), size and other factors. Residents from selected villages will be recruited with the help of RRVV Resident Liaison Officers using a range of strategies. Randomisation will be by geographical location to minimise contamination. Participating villages and residents will be allocated to either Pharmacist Intervention Group (PIG) or Usual Care Group (UCG). Each group will include five retirement villages and will have at least 77 residents in total. The intervention (PHARMER) comprises educating residents regarding HMR, and using a risk assessment checklist by residents to notify their General Practitioners of their medication risk. Uptake of HMR and medication adherence will be assessed in both PIG and UCG at three and six months using telephone interviews and questionnaires.This study is the first to develop and test an intervention to improve the uptake of HMR among Australian residents in retirement villages, with a view to decreasing medication risk. A multi-faceted interventional approach will be used as suggested by stakeholders. The trial is expected to be complete by late 2011 and results will be available in 2012.Australian New Zealand Clinical Trials Registry (ACTRN12611000109909)Retirement villages offer accommodation for older people who wish to live independently or with limited assistance within a supportive community. There are approximately 1,756 retirement villages in Australia, which accommodate approximately 80,000 residents [1,2]. The number of residents in retirement villages is projected to increase to 300,000 by 2051 [2].The majority of residents living in retirement villages are at risk of medication misadventure. In our
Impact of pharmacist interventions on patients' adherence to antidepressants and patient-reported outcomes: a systematic review
Al-Jumah KA,Qureshi NA
Patient Preference and Adherence , 2012,
Abstract: Khalaf Ali Al-Jumah1, Naseem Akhtar Qureshi21Specialist Pharmacist, Al-Amal Mental Health Complex, Riyadh, 2General Administration for Medical Research and Mental Health and Social Services, Ministry of Health, Riyadh, Kingdom of Saudi ArabiaBackground: Pharmacist intervention in improving patient adherence to antidepressants is coupled with better outcomes.Aims: The aim of this investigation was to systematically examine the published literature to explore different types of pharmacist interventions used for enhancing patient adherence to antidepressant medications. Three specific questions guided the review: what is the impact of pharmacist interventions on adherence to antidepressant medication? What is the impact of pharmacist interventions on patient-reported outcomes and patient satisfactions? What are the types of interventions used by pharmacists to enhance patients' adherence to antidepressants? Search strategies: A systematic review of the literature was conducted during August–November 2010 using PubMed, BIOSIS Previews Web of Science, ScienceDirect, the Cochrane Library, PsycINFO , IngentaConnect , Cambridge Journals Online, and Medscape databases. Key text words and medical subject headings included pharmacist intervention, medication intervention, depression, medication adherence, health-related quality of life, patient-reported outcomes, and antidepressants.Results: A total of 119 peer-reviewed papers were retrieved; 94 were excluded on the basis of abstract review and 13 after full-text analysis, resulting in twelve studies suitable for inclusion and intensive review. The most common intervention strategy that pharmacists utilized was a combination of patient education and drug monitoring. A cumulative patient adherence improvement in this review ranged from 15% to 27% attributed to utilization of different interventions and different combinations of interventions together with patient satisfaction with the treatment when depression improved.Conclusion: This review suggests that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. This may be a basis for more studies examining the effectiveness of innovative interventions by pharmacists to enhance patient adherence to antidepressant medications.Keywords: pharmacist interventions, adherence to medication, depression, antidepressants, systematic review
Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic
Lim,Phei Ching; Lim,Kelvin;
Pharmacy Practice (Internet) , 2010, DOI: 10.4321/S1886-36552010000400008
Abstract: patient adherence to prescribed medication regimens is important in diabetes care to prevent or delay microvascular and macrovascular complications such as retinopathy, nephropathy and myocardial infarction. in penang hospital, malaysia, pharmacists collaborate with physicians in diabetes care through a pharmacist-managed diabetes medication therapy adherence clinic (dmtac) in the endocrine clinic, in operation since 2006. objective: to evaluate the effectiveness of the pharmacist-managed dmtac program in improving glycaemic control, lipid parameters and patients′ medication adherence. method: a retrospective study among patients enrolled in the dmtac program was conducted between september 2007 and december 2008. data was included from patients with a glycosylated haemoglobin (hba1c) >8% and who had completed eight visits with the pharmacists. medical records and dmtac forms that provided patients′ demographics, medication regimens, adherence and laboratory parameters as well as pharmacists′ interventions were reviewed. hba1c, fasting blood glucose (fbg), low-density lipoprotein cholesterol (ldl), triglycerides (tg) and high-density lipoprotein cholesterol (hdl) were evaluated. documented data of patients′ adherence to medication regimen [modified morisky medication adherence score (mmmas); high adherence if score >8, medium adherence if score 6 to <8 and low adherence if score <6] was also evaluated. results: a total of 43 patients (53.5% females; 46.5% malays, 44.2% chinese and 9.3% indians) were included in the analysis. a mean reduction in hba1c of 1.73% (p<0.001), mean reduction in fbg of 2.65mmol/l (p=0.01) and mean reduction in ldl cholesterol of 0.38mmol/l (p=0.007) were achieved. the difference in tg and hdl cholesterol were not significant. patients′ adherence to medication regimens improved significantly with an increase in the mean mmmas score from 7.00 to 10.84 (p<0.001) after completion of the dmtac program. conclusion: the pharmacist-managed dmtac pr
ASSESSMENT OF PHARMACIST MEDIATED PATIENT COUNSELING ON MEDICATION ADHERENCE IN HYPERTENSION PATEINTS OF SOUTH INDIAN CITY
Biradar SS,Kapatae Rajashekhar,Reddy Srinivas,Raju SA
International Research Journal of Pharmacy , 2012,
Abstract: Non adherence to antihypertensive medication is a major problem among patients with hypertension, and has been identified as one of the main causes of failure to achieve adequate control of blood pressure (BP). In turn, patients with hypertension who have elevated BP as a result of their poor adherence to medication remain at risk for serious morbidity and mortality. Hence this study was undertaken with an objective to measure the adherence of Antihypertensives therapy (AT) in hypertension patients. A Pharmacist mediated patient counseling was carried out with pretested questionnaires on a convenience sample of 123 patients with antihypertensive therapy at the government general Hospital, Gulbarga Karnataka. Morisky scale to measure adherence to medications, in all questionnaires were shown were highly significant with values P<0.001, P<0.05, P<0.001, P<0.001 respectively. This showed the pharmacist educational intervention has improved the adherence in hypertensive patients.
ASSESSMENT OF MEDICATION ADHERENCE AND FACTORS AFFECTING TO MEDIACTION ADHERENCE IN ASTHMA PATIENTS BY CLINICAL PHARMACIST  [PDF]
Hinchageri S. S,Neelkanthreddy Patil,Khavane Karan,Bhanda Shalini
International Research Journal of Pharmacy , 2012,
Abstract: Asthma is a major public health problem affecting a large number of individuals of all ages. The effectiveness of medications depends not only on the efficacy and appropriateness of the drugs used, but also on patient adherence to the intended regimen. Adherence with medication regimens is essential for attaining maximal therapeutic benefits. The main objective of the study was to assess the medication adherence and to identify the reasons for non-adherence to prescribed therapy. The medication adherence was assessed by using Morisky Medication Adherence Assessment questionnaires. Assessment of patient’s adherence from baseline to first follow up showed a mean increase in medication adherence level of 2.735 ± 0.1762 and P < 0.0001 which is statistically significant. Assessment of patient’s adherence from baselines to second follow up shows a mean increase of 3.211 ± 0.172 and P < 0.0001 which is statistically significant. The study concludes that pharmacist provided patient counseling found to have significant influence on improvement in the patient’s adherence to prescribed therapy.
Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic  [cached]
Lim PC,Lim K
Pharmacy Practice (Granada) , 2010,
Abstract: Patient adherence to prescribed medication regimens is important in diabetes care to prevent or delay microvascular and macrovascular complications such as retinopathy, nephropathy and myocardial infarction. In Penang Hospital, Malaysia, pharmacists collaborate with physicians in diabetes care through a pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) in the Endocrine Clinic, in operation since 2006. Objective: To evaluate the effectiveness of the pharmacist-managed DMTAC program in improving glycaemic control, lipid parameters and patients’ medication adherence. Method: A retrospective study among patients enrolled in the DMTAC program was conducted between September 2007 and December 2008. Data was included from patients with a glycosylated haemoglobin (HbA1c) >8% and who had completed eight visits with the pharmacists. Medical records and DMTAC forms that provided patients’ demographics, medication regimens, adherence and laboratory parameters as well as pharmacists’ interventions were reviewed. HbA1c, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL), triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were evaluated. Documented data of patients’ adherence to medication regimen [Modified Morisky Medication Adherence Score (MMMAS); high adherence if score >8, medium adherence if score 6 to <8 and low adherence if score <6] was also evaluated. Results: A total of 43 patients (53.5% females; 46.5% Malays, 44.2% Chinese and 9.3% Indians) were included in the analysis. A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved. The difference in TG and HDL cholesterol were not significant. Patients’ adherence to medication regimens improved significantly with an increase in the mean MMMAS score from 7.00 to 10.84 (p<0.001) after completion of the DMTAC program. Conclusion: The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.
Impact of pharmacist interventions on patients' adherence to antidepressants and patient-reported outcomes: a systematic review
Al-Jumah KA, Qureshi NA
Patient Preference and Adherence , 2012, DOI: http://dx.doi.org/10.2147/PPA.S27436
Abstract: ct of pharmacist interventions on patients' adherence to antidepressants and patient-reported outcomes: a systematic review Review (4429) Total Article Views Authors: Al-Jumah KA, Qureshi NA Video presented by Naseem Akhtar Qureshi Views: 106 Published Date January 2012 Volume 2012:6 Pages 87 - 100 DOI: http://dx.doi.org/10.2147/PPA.S27436 Received: 18 October 2011 Accepted: 30 November 2011 Published: 31 January 2012 Khalaf Ali Al-Jumah1, Naseem Akhtar Qureshi2 1Specialist Pharmacist, Al-Amal Mental Health Complex, Riyadh, 2General Administration for Medical Research and Mental Health and Social Services, Ministry of Health, Riyadh, Kingdom of Saudi Arabia Background: Pharmacist intervention in improving patient adherence to antidepressants is coupled with better outcomes. Aims: The aim of this investigation was to systematically examine the published literature to explore different types of pharmacist interventions used for enhancing patient adherence to antidepressant medications. Three specific questions guided the review: what is the impact of pharmacist interventions on adherence to antidepressant medication? What is the impact of pharmacist interventions on patient-reported outcomes and patient satisfactions? What are the types of interventions used by pharmacists to enhance patients' adherence to antidepressants? Search strategies: A systematic review of the literature was conducted during August–November 2010 using PubMed, BIOSIS Previews Web of Science, ScienceDirect, the Cochrane Library, PsycINFO , IngentaConnect , Cambridge Journals Online, and Medscape databases. Key text words and medical subject headings included pharmacist intervention, medication intervention, depression, medication adherence, health-related quality of life, patient-reported outcomes, and antidepressants. Results: A total of 119 peer-reviewed papers were retrieved; 94 were excluded on the basis of abstract review and 13 after full-text analysis, resulting in twelve studies suitable for inclusion and intensive review. The most common intervention strategy that pharmacists utilized was a combination of patient education and drug monitoring. A cumulative patient adherence improvement in this review ranged from 15% to 27% attributed to utilization of different interventions and different combinations of interventions together with patient satisfaction with the treatment when depression improved. Conclusion: This review suggests that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. This may be a basis for more studies examining the effectiveness of innovative interventions by pharmacists to enhance patient adherence to antidepressant medications.
The effect of patient satisfaction with pharmacist consultation on medication adherence: an instrumental variable approach
Gu,Ning Yan; Gai,Yunwei; Hay,Joel W.;
Pharmacy Practice (Internet) , 2008, DOI: 10.4321/S1886-36552008000400006
Abstract: there are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. objectives: the objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. methods: we analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in kaiser permanente southern california from 1993 to 1996. we compared treating patient satisfaction as exogenous, in a single-equation probit model, with a bivariate probit model where patient satisfaction was treated as endogenous. different sets of instrumental variables were employed, including measures of patients' emotional well-being and patients' propensity to fill their prescriptions at a non-kaiser permanente (kp) pharmacy. the smith-blundell test was used to test whether patient satisfaction was endogenous. over-identification tests were used to test the validity of the instrumental variables. the staiger-stock weak instrument test was used to evaluate the explanatory power of the instrumental variables. results: all tests indicated that the instrumental variables method was valid and the instrumental variables used have significant explanatory power. the single equation probit model indicated that the effect of patient satisfaction with pharmacist consultation was significant (p<0.010). however, the bivariate probit models revealed that the marginal effect of pharmacist consultation on medication adherence was significantly greater than the single equation probit. the effect increased from 7% to 30% (p<0.010) after controlling for endogeneity bias. conclusion: after appropriate adjustment for endogeneity bias, patients satisfied with their pharmacy services are substantially more likely to adhere to their medication. the results have important policy implications given the increasing focus on the roles of pha
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