Special Issue "Pharmacist Services"

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 July 2019).

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Jon Schommer
Website
Guest Editor
College of Pharmacy, University of Minnesota, 308 Harvard Street, SE, Minneapolis, Minnesota, USA
Interests: information processing and decision making related to the provision, use, and evaluation of drug products and pharmacist services
Special Issues and Collections in MDPI journals
Dr. Anthony Olson
Website
Guest Editor
College of Pharmacy, University of Minnesota, 308 Harvard Street, SE, Minneapolis, Minnesota, USA
Interests: improved understanding, development, and evaluation of pharmacist-delivered patient-centered care within health systems and policy
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

We invite you to submit a manuscript to the “Pharmacist Services” Special Issue in the journal Pharmacy—an open access journal with a focus on pharmacy education and practice.

As an example, you may wish to take a look at previous special issues: https://www.mdpi.com/journal/pharmacy/special_issues

If the Special Issue publishes more than 10 papers, the publisher will print a book edition. The book would be made available, in digital format (for free) and paperback copies (ordered via Amazon) on the MDPI platform (http://books.mdpi.com).

Pharmacy (ISSN 2226-4787) is an international scientific open access journal on pharmacy education and practice published quarterly online by MDPI. The journal has already been indexed by PubMed, ESCI (Emerging Sources Citation Index), and Web of Science. Furthermore, Pharmacy is a member of the Committee on Publication Ethics (COPE), and, accordingly, submissions are peer reviewed rigorously to ensure that they conform to the highest standards in their field.

For the Special Issue on “Pharmacist Services” we seek a full breadth of manuscripts including, but not limited to the following topics: (1) the history and development of pharmacist services, (2) service settings, (3) service management, (4) service profitability, (5) service recovery, (6) service relationships, (7) service quality, (8) service tailoring, (9), service design and standards, (10) service performance, and (11) service evaluation. We seek manuscripts of all types including: (1) reviews, (2) commentaries, (3) idea papers, (4) case studies, (5) demonstration studies, and (6) research studies.

The overall goal of this Special Issue on “Pharmacist Services” is to give the reader a state-of-the-art synopsis of the pharmacist services domain at this point in time. To accomplish this goal, we seek papers that address the social, psychosocial, political, legal, historic, clinical, and economic factors that are associated with pharmacist services. Papers that translate concepts from other domains into the pharmacist services realm will be instructive to our audience and are welcome for this Special Issue.

Please note that we have framed this special issue using ideas published by renowned experts in the services management and marketing domains including: Teresa Swartz, Dawn Iacobucci, Roland Rust, Richard Oliver, Valerie Zeithaml, and Mary Jo Bitner. We will certainly consider papers that use other frameworks, but wanted to let you know about the foundational context that we will be using as we construct this Special Issue.

Thank you for considering this invitation.

Dr. Jon Schommer
Dr. Anthony Olson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Pharmacist Services
  • Service Development and Implementation
  • Service Quality
  • Service Marketing and Management
  • Service Evaluation

Published Papers (35 papers)

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Editorial

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Open AccessEditorial
Pharmacist Services
Pharmacy 2019, 7(4), 141; https://doi.org/10.3390/pharmacy7040141 - 10 Oct 2019
Abstract
Welcome to the “Pharmacist Services” special issue in the journal Pharmacy, an open access journal with a focus on pharmacy education and practice [...] Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available

Research

Jump to: Editorial, Review, Other

Open AccessArticle
Advancing Pharmacist Collaborative Care within Academic Health Systems
Pharmacy 2019, 7(4), 142; https://doi.org/10.3390/pharmacy7040142 - 11 Oct 2019
Abstract
Introduction: The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. Summary [...] Read more.
Introduction: The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. Summary: We describe the successful development, implementation and outcomes of three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist–interprofessional teams and (3) physician–pharmacist teams. The outcome measurement of these pharmacist care models varied from the design phase to patient volume measurement and to comprehensive quality dashboards. All of these practice models have been successfully funded by affiliated health systems or grants. Conclusions: The expansion of pharmacist services delivered by clinical faculty has several benefits to affiliated health systems: (1) significant improvements in patient care quality, (2) access to experts in specialty areas, and (3) the dissemination of outcomes with national and international recognition, increasing the visibility of the health system. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Impact of the 2016 Policy Change on the Delivery of MedsCheck Services in Ontario: An Interrupted Time-Series Analysis
Pharmacy 2019, 7(3), 115; https://doi.org/10.3390/pharmacy7030115 - 12 Aug 2019
Abstract
MedsCheck (MC) is an annual medication review service delivered by community pharmacists and funded by the government of Ontario since 2007 for residents taking three or more medications for chronic conditions. In 2010, MC was expanded to include patients with diabetes (MCD), home-bound [...] Read more.
MedsCheck (MC) is an annual medication review service delivered by community pharmacists and funded by the government of Ontario since 2007 for residents taking three or more medications for chronic conditions. In 2010, MC was expanded to include patients with diabetes (MCD), home-bound patients (MCH), and residents of long-term care homes (MCLTC). The Ontario government introduced an abrupt policy change effective 1 October 2016 that added several components to all MC services, especially those completed in the community. We used an interrupted time series design to examine the impact of the policy change (24 months pre- and post-intervention) on the monthly number of MedsCheck services delivered. Immediate declines in all services were identified, especially in the community (47%–64% drop MC, 71%–83% drop MCD, 55% drop MCH, and 9%–14% drop MCLTC). Gradual increases were seen over 24 months post-policy change, yet remained 21%–76% lower than predicted for MedsCheck services delivered in the community, especially for MCD. In contrast, MCLTC services were similar or exceeded predicted values by September 2018 (from 5.1% decrease to 3.5% increase). A more effective implementation of health policy changes is needed to ensure the feasibility and sustainability of professional community pharmacy services. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Feasibility of a Coordinated Human Papillomavirus (HPV) Vaccination Program between a Medical Clinic and a Community Pharmacy
Pharmacy 2019, 7(3), 91; https://doi.org/10.3390/pharmacy7030091 - 14 Jul 2019
Abstract
Human papillomavirus (HPV) vaccination coverage could be enhanced by community pharmacies working with medical clinics to coordinate completion of the HPV vaccination series. The objective for this study was to assess the feasibility of a coordinated model of HPV vaccine delivery in which [...] Read more.
Human papillomavirus (HPV) vaccination coverage could be enhanced by community pharmacies working with medical clinics to coordinate completion of the HPV vaccination series. The objective for this study was to assess the feasibility of a coordinated model of HPV vaccine delivery in which a clinic gives the first dose and refers patients to a partnering community pharmacy to receive subsequent doses. A medical clinic-community pharmacy team was established in a Midwestern state to develop and operate a coordinated care model for HPV vaccinations. Under the coordinated model, the clinic identified patients needing HPV vaccination(s), administered the first dose and described the option to complete the vaccination series at the pharmacy. Interested patients then had an information sheet faxed and electronic prescriptions sent to the pharmacy. The pharmacy contacted the patients to schedule administration of 2nd and 3rd doses of the HPV vaccine. Over a 12-month period, 51 patients were referred to the pharmacy by the clinic. Of these, 23 patients received a total of 25 vaccinations. Clinic and pharmacy personnel mostly rated the coordinated program favorably. An initial study of a coordinated HPV vaccination program between a medical clinic and a community pharmacy supported patients getting HPV vaccinations. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
“It Made a Difference to Me”: A Comparative Case Study of Community Pharmacists’ Care Planning Services in Primary Health Care
Pharmacy 2019, 7(3), 90; https://doi.org/10.3390/pharmacy7030090 - 11 Jul 2019
Cited by 3
Abstract
In some jurisdictions, governments and the public look to community pharmacies to provide expanded primary health care services, including care plans with follow-up. Care planning services, covered by the Compensation Plan in Alberta, Canada, require pharmacists to assess an eligible patient’s health history, [...] Read more.
In some jurisdictions, governments and the public look to community pharmacies to provide expanded primary health care services, including care plans with follow-up. Care planning services, covered by the Compensation Plan in Alberta, Canada, require pharmacists to assess an eligible patient’s health history, medication history, and drug-related problems to establish goals of treatment, interventions, and monitoring plan. Follow-up assessments are also covered by the Compensation Plan. A comparative case study method facilitated an in-depth investigation of care planning services provided by four community pharmacy sites. Data from 77 interviews, 61 site-specific documents, and 94 h of observation collected over 20 months were analyzed using an iterative constant comparative approach. Using a sociomaterial theoretical framework, the perceived value of care planning services was examined through an investigation of the relationships and interactions between people and information. Patients perceived the value of care planning as related to waiting time to access care and co-creating individualized plans. Physicians and other health care professionals valued collaboration, information sharing, and different perspectives on patient care. Pharmacists valued collaboration with patients and other health care professionals, which renewed their sense of responsibility, increased satisfaction, and gave meaning to their role. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Using the Theory of Planned Behavior to Understand Factors Influencing South Asian Consumers’ Intention to Seek Pharmacist-Provided Medication Therapy Management Services
Pharmacy 2019, 7(3), 88; https://doi.org/10.3390/pharmacy7030088 - 11 Jul 2019
Abstract
The study purpose was to use the theory of planned behavior to understand factors influencing South Asian consumers’ intention to seek pharmacist-provided medication therapy management services (MTMS). Specific objectives were to assess effects of attitude, subjective norm (SN), perceived behavioral control (PBC), and [...] Read more.
The study purpose was to use the theory of planned behavior to understand factors influencing South Asian consumers’ intention to seek pharmacist-provided medication therapy management services (MTMS). Specific objectives were to assess effects of attitude, subjective norm (SN), perceived behavioral control (PBC), and socio-demographics on South Asian consumers’ intention to seek MTMS. Participants who were ≥18 years of age, of South Asian origin, with a previous visit to a pharmacy in the US for a health-related reason, and with ability to read and comprehend English were recruited from independent pharmacies in New York City. Responses were obtained through a self-administered survey. Descriptive statistics were performed, and multiple linear regression analysis was conducted to assess the study objective. SPSS was used for data analyses. Out of 140 responses, 133 were usable. Mean scores (standard deviation) were 4.04 (0.97) for attitude, 3.77 (0.91) for SN, 3.75 (0.93) for PBC, and 3.96 (0.94) for intention. The model explains 80.8% of variance and is a significant predictor of intention, F (14,118) = 35.488, p < 0.05. While attitude (β = 0.723, p < 0.05) and PBC (β = 0.148, p < 0.05) were significant predictors of intention, SN (β = 0.064, p = 0.395) was not. None of the socio-demographics were significant predictors of intention. Strategies to make South Asians seek MTMS should focus on creating positive attitudes and removing barriers in seeking MTMS. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Reducing Medication Therapy Problems in the Transition from Hospital to Home: A Pre- & Post-Discharge Pharmacist Collaboration
Pharmacy 2019, 7(3), 86; https://doi.org/10.3390/pharmacy7030086 - 09 Jul 2019
Cited by 1
Abstract
Background: With 30-day Medicare readmission rates reaching 20%, a heightened focus has been placed on improving the transition process from hospital to home. For many institutions, this charge has identified medication-use safety as an area where pharmacists are well-positioned to improve outcomes by [...] Read more.
Background: With 30-day Medicare readmission rates reaching 20%, a heightened focus has been placed on improving the transition process from hospital to home. For many institutions, this charge has identified medication-use safety as an area where pharmacists are well-positioned to improve outcomes by reducing medication therapy problems (MTPs). Methods: This system-wide (425 bed community hospital plus 18 primary care clinics) prospective study recruited inpatient and ambulatory pharmacists to provide comprehensive medication management before and after hospital discharge. The results analyzed were the success rate and timing of the inpatient to ambulatory pharmacist handoff, as well as the number, type, and severity of MTPs resolved in both settings. Results: Of the 105 eligible patients who received a pharmacist evaluation before discharge, 61 (58%) received follow-up with an ambulatory pharmacist an average of 2.88 days after discharge (range 1–8 days). An average of 5 and 1.4 MTPs per patient were identified and resolved in the inpatient vs. ambulatory setting, respectively. Although average MTP severity ratings were higher in the inpatient setting, the highest severity rating was seen most frequently in the ambulatory setting. Conclusions: In the transition from hospital to home, pharmacist evaluation in both the inpatient and ambulatory settings are necessary to resolve medication therapy problems. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Patients’, Pharmacy Staff Members’, and Pharmacy Researchers’ Perceptions of Central Elements in Prescription Encounters at the Pharmacy Counter
Pharmacy 2019, 7(3), 84; https://doi.org/10.3390/pharmacy7030084 - 04 Jul 2019
Cited by 1
Abstract
Background: Studies suggest that the way pharmacy counselling takes place does not fully support patients in obtaining optimal medicine use. To understand the basis of current challenges in pharmacy counselling, we investigated which selected related cues, i.e., objects, sounds, or circumstances in [...] Read more.
Background: Studies suggest that the way pharmacy counselling takes place does not fully support patients in obtaining optimal medicine use. To understand the basis of current challenges in pharmacy counselling, we investigated which selected related cues, i.e., objects, sounds, or circumstances in prescription encounters, patients, and pharmacy staff notice, and how they interpret these cues. Pharmacy practice researchers’ cue orientation was also investigated to explore possible differences to those of staff and patients. Methods: Twelve focus group interviews representing 5 community pharmacies (staff and patients) and 2 universities (researchers) were conducted during 2017–2018 in Denmark. A total of 20 patients, 22 pharmacy staff, and 6 pharmacy researchers participated. A theoretical analysis based on cue orientation and social appraisal was conducted. Results: Pharmacy staff, patients and researchers noticed different selected related cues in prescription encounters. Staff particularly noticed ‘types of patients’. Patients were more divided and grouped into three overall categories: ‘types of staff’, medical content, and the situation around the encounter. Pharmacy researchers noticed multiple cues. Different emotions were integrated in the construction of the cues. Conclusion: Differences in the cue orientation between all three groups were identified. The identified types of cues and emotions can explain an underlying dissatisfaction with the encounters. Patients lack, in particular, more personal contact. Staff need to consider these aspects to provide relevant counselling. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
A Primer on Quality Assurance and Performance Improvement for Interprofessional Chronic Kidney Disease Care: A Path to Joint Commission Certification
Pharmacy 2019, 7(3), 83; https://doi.org/10.3390/pharmacy7030083 - 03 Jul 2019
Cited by 1
Abstract
Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity [...] Read more.
Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity to hospital administration and enhances visibility to patients and referring providers. This is a single-center, retrospective study describing quality assurance and performance improvement in chronic kidney disease, Joint Commission certification and quality outcomes. A total of 440 patients were included in the analysis. Thirteen quality indicators consisting of clinical and process of care indicators were developed and measured for a period of two years from 2009–2017. Significant improvements or at least persistently high performance were noted for key quality indicators such as blood pressure control (85%), estimation of cardiovascular risk (100%), measurement of hemoglobin A1c (98%), vaccination (93%), referrals for vascular access and transplantation (100%), placement of permanent dialysis access (61%), discussion of advanced directives (94%), online patient education (71%) and completion of office visit documentation (100%). High patient satisfaction scores (94–96%) are consistent with excellent quality of care provided. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Measuring Adherence: A Proof of Concept Study for Multiple Medications for Chronic Conditions in Alternative Payment Models
Pharmacy 2019, 7(3), 81; https://doi.org/10.3390/pharmacy7030081 - 02 Jul 2019
Abstract
Adherence to renin angiotensin system antagonists (RASA), non-insulin diabetes medications (NIDM) and statins has been included in the Medicare Star Ratings program since 2012. The long-term use of these measures emphasizes adherence to a limited number of chronic medications and may present opportunities [...] Read more.
Adherence to renin angiotensin system antagonists (RASA), non-insulin diabetes medications (NIDM) and statins has been included in the Medicare Star Ratings program since 2012. The long-term use of these measures emphasizes adherence to a limited number of chronic medications and may present opportunities for Part D plan sponsors to misuse the measures to influence their Medicare Part D Star Rating. It also does not capture the adherence needs of high-risk patients with multiple chronic conditions. The objective of this study was to describe the development of a new measure to capture adherence to multiple medications for chronic conditions (MMCC). The MMCC measure captures adherence to 71 different therapeutic categories of medication and was constructed using North Carolina Medicaid prescription claims data from 2015 to 2017. This measure was validated against the existing RASA, NIDM and statin adherence measures. This new measure was highly correlated with Star Rating measures, captured a greater number of eligible patients than these existing measures and had a lower proportion of patients meet the adherence threshold than the existing Star Ratings adherence measures. There is an opportunity to develop new measures, which include adherence to multiple medications in populations with multiple chronic conditions. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Community Pharmacist-Provided Wellness and Monitoring Services in an Employee Wellness Program: A Four-Year Summary
Pharmacy 2019, 7(3), 80; https://doi.org/10.3390/pharmacy7030080 - 02 Jul 2019
Cited by 1
Abstract
Objective: To assess the clinical outcomes of participants of an employee wellness program during four years of service implementation. Methods: A prospective cohort study was conducted at 15 independent community pharmacy chain locations in northwest and central Missouri. A total of 200 participants [...] Read more.
Objective: To assess the clinical outcomes of participants of an employee wellness program during four years of service implementation. Methods: A prospective cohort study was conducted at 15 independent community pharmacy chain locations in northwest and central Missouri. A total of 200 participants were enrolled in an employee wellness program, and the program included five monitoring groups—cholesterol, blood pressure, blood glucose, weight, and healthy participant groups. Participants selected a pharmacist wellness coordinator and wellness appointments were conducted, consisting of education, goal-setting, and monitoring through physical assessment and point of care testing. The primary outcome measures were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), body mass index (BMI), and waist circumference (WC). The secondary outcome measures were the proportion of patients who achieved the clinical value goals at baseline versus 48 months. The primary outcome measures among data collection time points were compared using one-way analysis of variance (ANOVA) tests, and the secondary outcomes were compared between baseline and 48 months by Chi-square or Fisher’s exact tests. One-way ANOVA post hoc tests were also performed using least significant difference, to further identify which time points differed from each other. Results: At baseline, there were 134 patients in the cholesterol monitoring group, 129 in the weight monitoring group, 117 in the blood pressure monitoring group, 46 in the blood glucose monitoring group, and 26 in the healthy participant monitoring group. For patients in the blood pressure monitoring group, compared with baseline, there was a significant decrease in DBP at months 12, 24, 36, and 48, and a significant increase in the proportion of patients achieving blood pressure goals at 48 months. For patients in the blood glucose monitoring group, compared with baseline, there was a significant decrease in FBG at months 12, 24, 36, and 48, and a significant increase in the proportion of patients achieving blood glucose goals at 48 months. Conclusions: Pharmacist-led wellness visits provided to employee wellness patients in a community pharmacy may lead to improvements in BP and FBG values. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Development, Testing and Results of a Patient Medication Experience Documentation Tool for Use in Comprehensive Medication Management Services
Pharmacy 2019, 7(2), 71; https://doi.org/10.3390/pharmacy7020071 - 20 Jun 2019
Cited by 1
Abstract
The medication experience is an individual’s subjective experience of taking a medication in daily life and can be at the root of drug therapy problems. It is recommended that the patient-centered approach to comprehensive medication management (CMM) starts with an understanding of the [...] Read more.
The medication experience is an individual’s subjective experience of taking a medication in daily life and can be at the root of drug therapy problems. It is recommended that the patient-centered approach to comprehensive medication management (CMM) starts with an understanding of the patient’s medication experience. This study aims to develop a medication experience documentation tool for use in CMM services, and to understand the usefulness and challenges of using the tool in practice. The tool was developed based on previous research on patients’ medication experiences. It was tested in two rounds by ten CMM pharmacists utilizing the tool as they provided care to patients. Focus groups were conducted to revise the tool after each round and to understand pharmacists’ experiences. The tool was tested for 15 weeks in 407 patient encounters. There was at least one medication experience documented in the electronic medical record 62% of the time. Pharmacists found the tool helpful in raising awareness of the medication experience and motivational interviewing strategies, planning for follow-up visits, as a teaching tool, and making pharmacists realize the fluidity of the medication experience. The tool offered pharmacists a better way to recognize and address medication experiences affecting medication taking behaviors. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
An Improved Comprehensive Medication Review Process to Assess Healthcare Outcomes in a Rural Independent Community Pharmacy
Pharmacy 2019, 7(2), 66; https://doi.org/10.3390/pharmacy7020066 - 17 Jun 2019
Cited by 2
Abstract
For years many pharmacists have been performing ‘brown bag’ medication reviews for patients. While most pharmacists and student pharmacists are familiar with this process, it is important to determine the value patients receive from this service. Over the course of this study the [...] Read more.
For years many pharmacists have been performing ‘brown bag’ medication reviews for patients. While most pharmacists and student pharmacists are familiar with this process, it is important to determine the value patients receive from this service. Over the course of this study the authors attempted to modernize the medication reconciliation process and collect data on patient prescription drug and over-the-counter drug use, along with quantifying the types of interventions the pharmacy’s clinical staff performed for patients during this process. The pharmacy partnered with a Quality Improvement Organization to trial their Blue Bag Intervention (BBI) program. The BBI program offered several additional services to the traditional brown bag review. The BBI was instituted as a follow-up tool in the pharmacy’s diabetes self-management education/training clinic to aid in patient follow-up and help the clinical staff identify medication-related events such as medication adherence issues and drug–drug interactions. The clinical staff identified approximately 2.2 events per patient with over 50% being issues that affected patient safety. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
An Ethical Analysis of Pharmacy Benefit Manager (PBM) Practices
Pharmacy 2019, 7(2), 65; https://doi.org/10.3390/pharmacy7020065 - 14 Jun 2019
Abstract
The high costs associated with pharmaceuticals and the accompanying stakeholders are being closely evaluated in the search for solutions. As a major stakeholder in the U.S. pharmaceutical market, the practices of pharmacy benefit manager (PBM) organizations have been under increased scrutiny. Examples of [...] Read more.
The high costs associated with pharmaceuticals and the accompanying stakeholders are being closely evaluated in the search for solutions. As a major stakeholder in the U.S. pharmaceutical market, the practices of pharmacy benefit manager (PBM) organizations have been under increased scrutiny. Examples of controversial practices have included incentives driving formulary status and prohibiting pharmacists from disclosing information on lower-cost prescription alternatives. Ethical investigations have been largely omitted within the debate on the responsibilities of these organizations in the health care system. Ethical analysis of organizational practices is justified based on the potential impact during health care delivery. The objective of this study was to analyze several specific PBM practices using multiple ethical decision-making models to determine their ethical nature. This study systematically applied multiple ethical decision-making models and codes of ethics to a variety of practices associated with PBM-related dilemmas encountered in the pharmaceutical environment. The assessed scenarios resulted in mixed outcomes. PBM practices were both ethical and unethical depending on the applied ethical model. Despite variation across applied models, some practices were predominately ethical or unethical. The point of sale rebates were consistently determined as ethical, whereas market consolidation, gag clauses, and fluctuation of pharmacy reimbursements were all predominantly determined as unethical. The application of using provider codes of ethics created additional comparison and also contained mixed findings. This study provided a unique assessment of PBM practices and provides context from a variety of ethical perspectives. To the knowledge of the authors, these perspectives have not been previously applied to PBM practices in the literature. The application of ethical decision-making models offers a unique context to current health care dilemmas. It is important to analyze health care dilemmas using ethics-based frameworks to contribute solutions addressing complexities and values of all stakeholders in the health care environment. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Systematic Analysis of the Service Process and the Legislative and Regulatory Environment for a Pharmacist-Provided Naltrexone Injection Service in Wisconsin
Pharmacy 2019, 7(2), 59; https://doi.org/10.3390/pharmacy7020059 - 12 Jun 2019
Cited by 1
Abstract
Community pharmacists are viewed by the public as convenient and trustworthy sources of healthcare and pharmacists likely can play a larger role in addressing the major public health issue of the opioid epidemic affecting Wisconsin residents. Approved medications, including long-acting injectable naltrexone, can [...] Read more.
Community pharmacists are viewed by the public as convenient and trustworthy sources of healthcare and pharmacists likely can play a larger role in addressing the major public health issue of the opioid epidemic affecting Wisconsin residents. Approved medications, including long-acting injectable naltrexone, can transform the treatment of individuals with opioid use disorder (OUD). Due to shortages of behavioral health providers in the U.S., and pharmacists’ knowledge about the safe use of medications, pharmacists can be a significant access point for treating OUD with naltrexone. Wisconsin’s pharmacy practice laws authorize pharmacists to administer medications via injection, and a small number of pharmacists currently are using this authority to provide a naltrexone injection service. This exploratory study had two objectives: (1) describe the pharmacist injection service process and identify barriers and facilitators to that service and (2) analyze the legislative/regulatory environment to ascertain support for expanding naltrexone injection service. Semi-structured pharmacist interviews (n = 4), and an analysis of Wisconsin statutes/regulations governing public health and social services, were undertaken to explore the objectives. Findings suggest that the service process requires considerable coordination and communication with practitioners, patients, and pharmacy staff, but many opportunities exist to broaden and sustain the service throughout Wisconsin. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
Pharmacy 2019, 7(2), 58; https://doi.org/10.3390/pharmacy7020058 - 12 Jun 2019
Cited by 1
Abstract
The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian [...] Read more.
The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian PHC setting. A quasi-experimental study was performed with patients followed-up for two years (n = 90). Factors associated with the detection of four drug therapy problems (DTP) or more in the initial assessment were evaluated (univariate and multivariate analyses), as well as the clinical impact observed in laboratory parameters (HbA1c, Blood Pressure, LDL- and HDL-covariance analysis). A predominance of women (61.1%), a mean age of 65.5 years, and a prevalence of polypharmacy (87.8%)—use of five or more drugs—were observed. A total of 441 DTP was identified, 252 required interventions with the prescriber, 67.9% of which were accepted and 59.6% were solved. The main DTP were ‘non-adherence’ (28.1%), ‘need for additional drug therapy’ (21.8%), and ‘low dose’ (19.5%). Hypertension was positively associated with the identification of four DTP or more. A statistically significant reduction was detected in all assessed laboratory parameters (p < 0.05). CMM services contributed to the resolution of DTP and improved clinical outcomes. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
A Study to Identify Medication-Related Problems and Associated Cost Avoidance by Community Pharmacists during a Comprehensive Medication Review in Patients One Week Post Hospitalization
Pharmacy 2019, 7(2), 51; https://doi.org/10.3390/pharmacy7020051 - 29 May 2019
Cited by 1
Abstract
Objectives: To determine the numbers of medication discrepancies and medication-related problems (MRPs) identified and resolved when providing a transitions of care comprehensive medication review (CMR) after hospital discharge within a community pharmacy; and to estimate the cost-avoidance value of this service. Methods: Community [...] Read more.
Objectives: To determine the numbers of medication discrepancies and medication-related problems (MRPs) identified and resolved when providing a transitions of care comprehensive medication review (CMR) after hospital discharge within a community pharmacy; and to estimate the cost-avoidance value of this service. Methods: Community pharmacists provided CMRs to covered employees and dependents of a self-insured regional grocery store chain who were discharged from the hospital. Data was collected prospectively over 4 months. Discrepancies were identified among patients’ medication regimens by comparing the hospital discharge record, the pharmacy profile, and what the patient reported taking. MRPs were categorized into ten categories, as defined by the OutcomesMTM® Encounter Worksheet. Interventions were categorized using the severity scale developed by OutcomesMTM®, a Cardinal Health company. Data were analyzed using descriptive statistics and bivariate correlations. Results: Nineteen patients were enrolled in the program. Pharmacists identified 34 MRPs and 81 medication discrepancies, 1.8 and 4.3 per patient, respectively. The most common type of MRP was underuse of medication (70.6%). Significant positive correlations were found between the number of scheduled prescription medications and the number of medications with discrepancies (p ≤ 0.01; r = 0.825) and number of scheduled prescription medications and the number of MRPs (p ≤ 0.01; r = 0.697). Most commonly, the severity levels associated with the MRPs involved the prevention of physician office visits or addition of new prescription medications (n = 10 each); however, four emergency room visits and three hospitalizations were also avoided. The total estimated cost avoidance was $92,143, or $4850 per patient. Extrapolated annual cost savings related to this service would be $276,428. Conclusions: This transitions of care service was successful in identifying and addressing MRPs and discrepancies for this patient population. By providing this service, community pharmacists were able to prevent outcomes of various severities and to avoid patient care costs. Full article
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Open AccessArticle
Gender and Age Variations in Pharmacists’ Job Satisfaction in the United States
Pharmacy 2019, 7(2), 46; https://doi.org/10.3390/pharmacy7020046 - 17 May 2019
Abstract
While several studies have attested the presence of systematic gender and age variations in pharmacists’ satisfaction with their jobs, only a few of them have considered both classifications simultaneously. None have done so while systematically examining multiple facets of practitioners’ work. This article [...] Read more.
While several studies have attested the presence of systematic gender and age variations in pharmacists’ satisfaction with their jobs, only a few of them have considered both classifications simultaneously. None have done so while systematically examining multiple facets of practitioners’ work. This article estimated U.S. pharmacists’ satisfaction levels with various facets of their work, compared them simultaneously between genders and among age groups, and tested for the presence of gender–age interaction effects. The study was based on self-reported survey data collected from 701 pharmacists (31.0% response rate). Mean and standard deviation values for 18 indices related to pharmacists’ work were calculated. When age groups were controlled, female pharmacists expressed overall higher levels of satisfaction with their job than male pharmacists; they also expressed greater satisfaction with multiple specific facets and with the profession, as well as greater workload and stress than male pharmacists. The findings revealed few significant differences among age groups and a limited gender–age interaction effect for pharmacists’ satisfaction with key facets of their work. These findings should contribute to the development and refinement of rational criteria for increasing sources of satisfaction in pharmacy settings. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Uptake of Travel Health Services by Community Pharmacies and Patients Following Pharmacist Immunization Scope Expansion in Ontario, Canada
Pharmacy 2019, 7(2), 35; https://doi.org/10.3390/pharmacy7020035 - 13 Apr 2019
Cited by 2
Abstract
In December 2016, pharmacists in Ontario, Canada with authorization to administer injections saw an expansion in their scope from a restriction to the influenza vaccination only to now including an additional 13 vaccine-preventable diseases, largely those related to travel. It was uncertain whether [...] Read more.
In December 2016, pharmacists in Ontario, Canada with authorization to administer injections saw an expansion in their scope from a restriction to the influenza vaccination only to now including an additional 13 vaccine-preventable diseases, largely those related to travel. It was uncertain whether this change in scope would see sufficient uptake, or translate to a corresponding expansion in other travel health service offerings from community pharmacies. In October/November 2017 a survey was conducted of all licensed community pharmacists in Ontario, followed by semi-structured interviews with 6 survey respondents in June 2018. A web-based survey of members of the public from a single region of the province was also conducted in September 2018 to assess uptake of expanded vaccination services. Broad variability in uptake of these services was noted, ranging from the dispensing of travel-related medications and vaccinations only through to vaccine administration and prescribing under medical directive; however, uptake was generally at the lower end of this spectrum. This was evidenced by 94% of pharmacists reporting administering fewer than 10 travel vaccinations per month, fewer than 10% of patients reporting receiving a travel vaccine administered by a pharmacist, and a maximum of 30 pharmacies (of nearly 6000 in the province) designated to provide yellow fever vaccinations. Fewer than 1 in 3 pharmacists reported performing some form of pre-travel consultation in their practice, often limited to low-risk cases only. Barriers and facilitators reported were similar for these services as they were for other non-dispensing services, including insufficient time to integrate the service into their workload, perceived lack of knowledge and confidence in travel health, and low patient awareness of these new services available to them through community pharmacies. Full article
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Open AccessArticle
Opportunities for Outpatient Pharmacy Services for Patients with Cystic Fibrosis: Perceptions of Healthcare Team Members
Pharmacy 2019, 7(2), 34; https://doi.org/10.3390/pharmacy7020034 - 03 Apr 2019
Cited by 1
Abstract
Cystic fibrosis (CF) is one of the most common life-threatening, genetic conditions. People with CF follow complex, time-consuming treatment regimens to manage their chronic condition. Due to the complexity of the disease, multidisciplinary care from CF Foundation (CFF)-accredited centers is recommended for people [...] Read more.
Cystic fibrosis (CF) is one of the most common life-threatening, genetic conditions. People with CF follow complex, time-consuming treatment regimens to manage their chronic condition. Due to the complexity of the disease, multidisciplinary care from CF Foundation (CFF)-accredited centers is recommended for people with CF. These centers include several types of healthcare professionals specializing in CF; however, pharmacists are not required members. The purpose of this study was to identify the outpatient care needs of people living with CF that pharmacists could address to improve their quality of care. Healthcare members from a CFF accredited center and pharmacists were recruited to participate in semi-structured, audio-recorded interviews. Prevalent codes were identified and data analysis was conducted, guided by the systems engineering initiative for patient safety (SEIPS) model. The objective was to understand the medication and pharmacy-related needs of patients with CF and care team perspectives on pharmacists providing support for these patients. From the themes that emerged, pharmacists can provide support for people living with CF (medication burden, medication access, medication education) and the CF care team (drug monitoring and adherence, prior authorizations and insurance coverage, refill history). Pharmacists are well-positioned to address these difficulties to improve quality of care for people living with cystic fibrosis. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Health Workers’ Perceptions and Expectations of the Role of the Pharmacist in Emergency Units: A Qualitative Study in Kupang, Indonesia
Pharmacy 2019, 7(1), 31; https://doi.org/10.3390/pharmacy7010031 - 22 Mar 2019
Cited by 1
Abstract
Background. An essential way to ensure patient safety in the hospital is by applying pharmacy services in emergency units. This strategy was implemented in Indonesia several years ago, with the aim of ensuring that adequate pharmacy services are given to patients in [...] Read more.
Background. An essential way to ensure patient safety in the hospital is by applying pharmacy services in emergency units. This strategy was implemented in Indonesia several years ago, with the aim of ensuring that adequate pharmacy services are given to patients in hospitals. To achieve this, pharmacists are required to cooperate with other health workers via inter-professional teamwork. This study intended to identify the perceptions and expectations of health workers with respect to pharmacy services in emergency units. Methods. This was a qualitative study, using a phenomenological approach with a semi-structured interview technique to obtain data. This study was performed at the Prof. Dr. W.Z. Johannes Hospital Kupang from June to September 2018. The results of the interviews were thematically analyzed using QSR NVivo software 11. Results. The themes identified in this study included: (1) The positive impact of pharmacists in service; (2) Badan Penyelenggara Jaminan Sosial (BPJS) influence; (3) Acceptance of health workers; (4) Medication administration information; and (5) Expectations of health workers. Various perceptions were conveyed by participants regarding the emergency unit services in the hospital’s pharmaceutical department. Data obtained proved that the existence of a pharmacist increased the efficiency of time for services and prevented human error. Conclusion. Pharmacists and policy-makers play a significant role in providing appropriate pharmaceutical services in emergency units. Pharmacists also need to improve their quality of practice in accordance with their competence. They must review the patient medical history and physician’s prescriptions, educate the patients and other health workers, so that the workload and service time will be reduced. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessArticle
Administration, Billing, and Payment for Pharmacy Student-Based Immunizations to Medicare Beneficiaries at Mobile Medicare Clinics
Pharmacy 2019, 7(1), 22; https://doi.org/10.3390/pharmacy7010022 - 25 Feb 2019
Abstract
Training student pharmacists to administer vaccinations requires a substantial investment in vaccines, supplies, and time. Few schools of pharmacy seek out or receive any reimbursement for the provision of vaccines, despite the fact it is a covered service. This study sought to implement, [...] Read more.
Training student pharmacists to administer vaccinations requires a substantial investment in vaccines, supplies, and time. Few schools of pharmacy seek out or receive any reimbursement for the provision of vaccines, despite the fact it is a covered service. This study sought to implement, deliver, and demonstrate an innovative, financially sustainable curriculum-based immunization program by trained pharmacy students as part of their experiential learning. Thirty-nine community health clinics targeting Medicare beneficiaries were conducted throughout Northern/Central California during Medicare’s fall open enrollment periods between 2014–2016. American Pharmacists Association (APhA)-trained student pharmacists (under licensed pharmacist supervision) administered 1777 vaccinations. Vaccines were billed via a secure Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant web-based portal. The total net income was $11,905 and $8032 for 2015 and 2016, respectively. Return on investment was greatest for the influenza vaccine > Tdap > pneumococcal. Pharmacy students are already being trained to provide immunizations and can utilize their skills to deliver financially viable public health programs. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessArticle
Dispensing of Prescribed Medicines in Swiss Community Pharmacies-Observed Counselling Activities
Pharmacy 2019, 7(1), 1; https://doi.org/10.3390/pharmacy7010001 - 21 Dec 2018
Cited by 1
Abstract
Background: Patient counselling and addressing drug-related problems are the pharmacist’s key activities to ensure the safe and effective use of medicines. This study aimed to describe the dispensing practice of prescribed medicines in daily community pharmacy practice and to identify factors influencing [...] Read more.
Background: Patient counselling and addressing drug-related problems are the pharmacist’s key activities to ensure the safe and effective use of medicines. This study aimed to describe the dispensing practice of prescribed medicines in daily community pharmacy practice and to identify factors influencing counselling provision; Methods: An observational study was conducted in community pharmacies in Basel, Switzerland. One master student in pharmacy performed non-participatory observations for one day at each of the participating community pharmacies. Patient characteristics, counselling content, additional activities, and pharmaceutical interventions were documented on a structured checklist; Results: 556 prescription encounters (PE) in 18 participating community pharmacies were observed (269 first prescriptions; 287 refill prescriptions). Patients were regular customers (n = 523, 94.1%) and 53.8 ± 23.4 years old. Counselling was provided to 367 (66.0%) customers on 2.9 ± 3.1 themes per PE. Factors influencing counselling were dispensing by the pharmacist, new customer, customer who did not refuse counselling, customer with a first prescription, with a prescription resulting in a pharmaceutical intervention, and a prescription filled by carers. During 144 PEs, 203 interventions were documented. Pharmacists proposed few additional activities and performed no cognitive pharmaceutical service; Conclusions: Our study quantified counselling and additional services at the dispensing of prescribed medicines and identified influencing factors on counselling provision at the patient, prescription, and pharmacy level. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Review

Jump to: Editorial, Research, Other

Open AccessReview
Community-Based Pharmacy Practice Innovation and the Role of the Community-Based Pharmacist Practitioner in the United States
Pharmacy 2019, 7(3), 106; https://doi.org/10.3390/pharmacy7030106 - 04 Aug 2019
Cited by 2
Abstract
Community-based pharmacy practice is evolving from a focus on product preparation and dispensing to becoming a health care destination within the four walls of the traditional community-based pharmacy. Furthermore, community-based pharmacy practice is expanding beyond the four walls of the traditional community-based pharmacy [...] Read more.
Community-based pharmacy practice is evolving from a focus on product preparation and dispensing to becoming a health care destination within the four walls of the traditional community-based pharmacy. Furthermore, community-based pharmacy practice is expanding beyond the four walls of the traditional community-based pharmacy to provide care to patients where they need it. Pharmacists involved in this transition are community-based pharmacist practitioners who are primarily involved in leading and advancing team-based patient care services in communities to improve the patient health. This paper will review community-based pharmacy practice innovations and the role of the community-based pharmacist practitioner in the United States. Full article
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Open AccessReview
Towards a Greater Professional Standing: Evolution of Pharmacy Practice and Education, 1920–2020
Pharmacy 2019, 7(3), 98; https://doi.org/10.3390/pharmacy7030098 - 20 Jul 2019
Cited by 3
Abstract
The history of community pharmacy in America since the 1920s is one of slow progress towards greater professional standing through changes in pharmacy education and practice. The history of American community pharmacy in the modern era can be divided into four periods: 1920–1949 [...] Read more.
The history of community pharmacy in America since the 1920s is one of slow progress towards greater professional standing through changes in pharmacy education and practice. The history of American community pharmacy in the modern era can be divided into four periods: 1920–1949 (Soda Fountain Era), 1950–1979 (Lick, Stick, Pour and More Era), 1980–2009 (Pharmaceutical Care Era), and 2010–present (Post-Pharmaceutical Care Era). As traditional compounding has waned, leaders within community pharmacy have sought to shift focus from product to patient. Increasing degree requirements and postgraduate training have enhanced pharmacists’ ability to provide patient care services not directly associated with medication dispensing. However, the realities of practice have often fallen short of ideal visions of patient-focused community pharmacy practice. Positive trends in the recognition of the impact of community pharmacists on healthcare value and the need for more optimal medication management suggest that opportunities for community pharmacists to provide patient care may expand through the 21st century. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessReview
Using Service Blueprints to Visualize Pharmacy Innovations
Pharmacy 2019, 7(2), 43; https://doi.org/10.3390/pharmacy7020043 - 08 May 2019
Abstract
Background: Applying the principles of service design can help pharmacists manage both the quality and patient perceptions of the services they provide. Service blueprints are a widely used service design tool that are rare in the healthcare literature. They can be used [...] Read more.
Background: Applying the principles of service design can help pharmacists manage both the quality and patient perceptions of the services they provide. Service blueprints are a widely used service design tool that are rare in the healthcare literature. They can be used to design new services or revisit the design of established services. This paper describes service blueprints and their uses, and illustrates how to build one using an example. Methods: A blueprint is built for appointment-based medication synchronization services to illustrate the tool. Conclusions: Service blueprints permit pharmacists to better see and understand service processes. They clarify the process of service delivery and the roles of customers, service providers, and supporting services. They provide a way of depicting complex services in a concise visual way that communicates details at a glance. Pharmacists who utilize service blueprints can improve the consistency and quality of services provided, and they can increase the chance that every interaction with patients sends a positive message about the value of pharmacist services. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Other

Open AccessConcept Paper
Training Community Pharmacy Staff How to Help Manage Urgent Mental Health Crises
Pharmacy 2019, 7(3), 133; https://doi.org/10.3390/pharmacy7030133 - 16 Sep 2019
Cited by 1
Abstract
Nearly 44 million Americans are affected by mental illness every year. Many individuals, however, are not diagnosed and/or do not receive treatment. The present manuscript reviews the incidence of mental illness, the continuum from mental wellness to mental illness, and the role of [...] Read more.
Nearly 44 million Americans are affected by mental illness every year. Many individuals, however, are not diagnosed and/or do not receive treatment. The present manuscript reviews the incidence of mental illness, the continuum from mental wellness to mental illness, and the role of the pharmacy staff in helping individuals manage different mental health needs. In particular, there is discussion of stigma of mental illness that those with mental health needs experience by those around them including health professionals such as pharmacy staff. One way to resolve such stigma is through training such as Mental Health First Aid (MHFA). The paper reviews key aspects of MHFA, the evidence supporting MHFA, and how MHFA relates specifically to pharmacy practice and services. A conceptual framework for MHFA and its relationship to individual factors, attitudes, behaviors, and outcomes. Lastly, a discussion is presented that briefly compares MHFA to other similar approaches to helping those in mental health crises, the limits of what is known about MHFA, and what future research might explore to better understand the outcomes of pharmacy staff providing mental health education, support, and referral to care. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessCommentary
Applying Contemporary Management Principles to Implementing and Evaluating Value-Added Pharmacist Services
Pharmacy 2019, 7(3), 99; https://doi.org/10.3390/pharmacy7030099 - 20 Jul 2019
Abstract
Value-added pharmacy services encompass traditional and emerging services provided by pharmacists to individual and entire populations of persons increasingly under the auspices of a public health mandate. The success of value-added pharmacy services is enhanced when they are carried out and assessed using [...] Read more.
Value-added pharmacy services encompass traditional and emerging services provided by pharmacists to individual and entire populations of persons increasingly under the auspices of a public health mandate. The success of value-added pharmacy services is enhanced when they are carried out and assessed using appropriate theory-based paradigms. Many of the more important management theories for pharmacy services consider the “servicescape” of these services recognizing the uniqueness of each patient and service encounter that vary based upon health needs and myriad other factors. In addition, implementation science principles help ensure the financial viability and sustainability of these services. This commentary reviews some of the foundational management theories and provides a number of examples of these theories that have been applied successfully resulting in a greater prevalence and scope of value-added services being offered. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessCommentary
Co-located Retail Clinics and Pharmacies: An Opportunity to Provide More Primary Care
Pharmacy 2019, 7(3), 74; https://doi.org/10.3390/pharmacy7030074 - 26 Jun 2019
Cited by 1
Abstract
This paper proposes that co-located retail clinics (RCs) and community pharmacies can increase opportunities to provide more accessible, affordable, and patient-friendly primary care services in the United States. RCs are small businesses of about 150–250 square feet with a clientele of about 10–30 [...] Read more.
This paper proposes that co-located retail clinics (RCs) and community pharmacies can increase opportunities to provide more accessible, affordable, and patient-friendly primary care services in the United States. RCs are small businesses of about 150–250 square feet with a clientele of about 10–30 patients each day and most frequently staffed by nurse practitioners (NPs). Community pharmacies in the U.S. at ~67,000 far outnumber RCs at ~2800, thereby opening substantial opportunity for growth. Community pharmacies and pharmacists have been working to increase on-site clinical services, but progress has been slowed by the relative isolation from other practitioners. An ideal merged facility based on an integrated platform is proposed. NPs and pharmacists could share functions that fulfill documented consumer preferences and still maintain separate practice domains. Potential benefits include a broader inventory of clinical services including laboratory tests, immunizations, patient education, and physical assessment, as well as better patient access, interprofessional training opportunities, and economies related to the use of resources, day-to-day operations, and performance metrics. Challenges include the availability of sufficient, appropriately trained staff; limitations imposed by scope of practice and other laws; forging of collaborative relationships between NPs and pharmacists; and evidence that the merged operations provide economic benefits beyond those of separate enterprises. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessOpinion
Alignment of Community Pharmacy Foundation Grant Funding and the Evolution of Pharmacy Practice in the United States of America
Pharmacy 2019, 7(2), 63; https://doi.org/10.3390/pharmacy7020063 - 14 Jun 2019
Abstract
The Community Pharmacy Foundation is a non-profit organization dedicated to the advancement of community pharmacy practice and patient care delivery through grant funding and resource sharing. Since 2002, CPF has awarded 191 grants and over $9,200,000 (US dollars) in research and project grants. [...] Read more.
The Community Pharmacy Foundation is a non-profit organization dedicated to the advancement of community pharmacy practice and patient care delivery through grant funding and resource sharing. Since 2002, CPF has awarded 191 grants and over $9,200,000 (US dollars) in research and project grants. The purpose of this manuscript is to highlight the evolution of pharmacy practice and pharmacy education in the United States through the presentation of exemplary cases of Community Pharmacy Foundation funding that is aligned with new care delivery models and approaches to the advancement of patient-centered pharmacy care. Pharmacy began in colonial America as the United States of America was just beginning to form with apothecary shops and druggists. Over time, the pharmacy industry would be revolutionized as America became urbanized, and drug products became commercially produced. The role of the pharmacist and their education evolved as direct patient care became a clear expectation of the general public. By the 1990s, the pharmacy profession had carved out a new path that focused on pharmacist-led, patient-centered pharmaceutical care and medication therapy management services. The Community Pharmacy Foundation grant funding has aligned with this evolution since its founding in 2000, and multiple exemplary grants are presented as support. As the role of pharmacists again transitions from a fee-for-service model to a value-based model, the Community Pharmacy Foundation continues to provide grant funding for research and projects that support the advancement of community pharmacy practice, education, and expanded training of pharmacists. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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Open AccessBrief Report
Innovative Collaboration between a Medical Clinic and a Community Pharmacy: A Case Report
Pharmacy 2019, 7(2), 62; https://doi.org/10.3390/pharmacy7020062 - 14 Jun 2019
Cited by 1
Abstract
As value-based payments become more common in healthcare, providers can develop collaborative relationships to support performance. A medical clinic and community pharmacy worked together to deliver collaborative medication management services to targeted patients in an accountable care organization. The community pharmacy was paid [...] Read more.
As value-based payments become more common in healthcare, providers can develop collaborative relationships to support performance. A medical clinic and community pharmacy worked together to deliver collaborative medication management services to targeted patients in an accountable care organization. The community pharmacy was paid by the clinic to conduct comprehensive medication reviews (CMRs) for 116 patients. The CMRs initially were delivered to patients taking at least 10 medications and to patients rated as high cost/risk by the clinic. The most common medication-related problem types were Needs additional therapy (38.8%) and Suboptimal therapy (19.0%). The most common pharmacist actions were to Change medication (18.1%) and Initiate new therapy (13.8%). Financial analyses showed net savings in annual patient out-of-pocket expenses just over $15,000 for the cohort of patients, and net annual direct cost savings from a payer perspective of about $70,000. This innovative partnership between a medical clinic system and a regional pharmacy chain built upon initial discussions and planning. The partners were able to address problems that arose with their collaboration, changing their approach as needed. The outcomes were positive for the clinic and pharmacy, their patients and the payer(s). Interested providers are encouraged to pursue similar collaborations, which could be key to success in today’s healthcare environment. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessCommentary
Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States
Pharmacy 2019, 7(2), 60; https://doi.org/10.3390/pharmacy7020060 - 13 Jun 2019
Cited by 4
Abstract
Introduction: Pharmacist roles promoting safe opioid use are recognized in literature and practice. Pharmacists can offer services such as counseling on opioid risks, naloxone dispensing, education on opioid storage and disposal, prescription drug monitoring program (PDMP) utilization, opioid deprescribing, and providing resources for [...] Read more.
Introduction: Pharmacist roles promoting safe opioid use are recognized in literature and practice. Pharmacists can offer services such as counseling on opioid risks, naloxone dispensing, education on opioid storage and disposal, prescription drug monitoring program (PDMP) utilization, opioid deprescribing, and providing resources for addiction treatment to help mitigate the opioid crisis. Objective: This commentary seeks to describe current and potential roles for pharmacists to combat the United States opioid crisis and identify key factors affecting service provision. Methods: The paper summarizes evidence-based studies describing current pharmacist roles and services, factors affecting service implementation, and strategies to further improve pharmacist roles and services related to promoting safe opioid use for patients. Results: Pharmacists recognize their roles and responsibilities to counsel patients on opioid risks, dispense naloxone, educate on opioid storage and disposal, utilize prescription drug monitoring programs (PDMPs), offer opioid deprescribing, and provide resources for addiction treatment. However, pharmacists express low confidence, time, and training as barriers to service provision. This suggests a need for structured training, resources, and organizational support for pharmacists to improve confidence and participation in such services. Conclusions: Although pharmacists are aware of roles and responsibilities to help reduce the opioid crisis, more training, education, organizational support and resources are needed to increase their ability to embody these roles. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessCommentary
Preparing Pharmacists for Collaborative/Integrated Health Settings
Pharmacy 2019, 7(2), 47; https://doi.org/10.3390/pharmacy7020047 - 20 May 2019
Cited by 1
Abstract
Pharmacy practice is changing to accommodate the need for pharmacists to be better team members in newly emerging collaborative care and integrated health systems. Pharmacy schools could lead this change by educating students to be effective participants in these relatively new models of [...] Read more.
Pharmacy practice is changing to accommodate the need for pharmacists to be better team members in newly emerging collaborative care and integrated health systems. Pharmacy schools could lead this change by educating students to be effective participants in these relatively new models of care. Schools are encouraged to follow the approach outlined in the recent guidance published by the Health Professions Accreditors Collaborative (HPAC) for interprofessional practice and education (“the new IPE”). This approach includes articulating an IPE plan, establishing goals, assessing student achievement of the necessary IPE competencies, developing educational plans that are multi-faceted and longitudinal, and modifying the existing assessment/evaluation process to ensure the quality of the IPE effort. These curricular decisions should be based on existing and new research on the effectiveness of IPE on student’s attitudes, knowledge, skills, and behavior. A key decision is how to create effective interactions between pharmacy students and those of other professions. Educational emphasis should be directed toward team building skills, not just individual competencies. The pharmacy faculty probably need to enhance their teaching abilities to accommodate this change, such as learning new technology (e.g., simulations, managing online exchanges) and demonstrating a willingness to teach students from other professions. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessBrief Report
Development of a Unique Student Pharmacist Internship in a Primary Care Provider System
Pharmacy 2019, 7(2), 36; https://doi.org/10.3390/pharmacy7020036 - 13 Apr 2019
Abstract
Purpose: To describe a unique pharmacy intern program in a group of federally qualified health center (FQHC) outpatient primary care provider clinics. Summary: A pharmacy intern program was created at the North Central Nursing Clinics in Indiana, a group of four FQHC outpatient [...] Read more.
Purpose: To describe a unique pharmacy intern program in a group of federally qualified health center (FQHC) outpatient primary care provider clinics. Summary: A pharmacy intern program was created at the North Central Nursing Clinics in Indiana, a group of four FQHC outpatient primary care provider facilities. Intern-performed tasks included: Prior authorization (PA) requests, medication assistance program (MAP) applications, sample procurement and inventory, and contraceptive devices for implantation inventory management. Interns interacted with clinic administration, nurse practitioners, and medical staff to complete their assigned responsibilities. Over a one-year period, the interns completed documentation on more than 2000 charts during a combined 12 h a week. Interns identified the interprofessional interactions as the most beneficial experience, while providers acknowledged no difference in the processing of paperwork during the transition of duties from pharmacy fellow to intern. Conclusion: This unique pharmacy intern program was successfully created and implemented in a primary care provider office, resulting in learning opportunities for pharmacy interns, as well as operational efficiencies to fellows, providers, and the organization. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
Open AccessPerspective
Establishing a New Ambulatory Care Practice Site as a Pharmacy Practice Faculty
Pharmacy 2018, 6(4), 111; https://doi.org/10.3390/pharmacy6040111 - 11 Oct 2018
Cited by 1
Abstract
There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will [...] Read more.
There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will be able to provide adequate resources and support to establish a successful practice. This may be challenging to pharmacy practice faculty in settings where clinical pharmacy services have never been utilized. Topics include the pre-work needed prior to approaching a new practice site, assessing the need for physical requirements, meeting key personnel, marketing clinical skills and services, implementing, and evaluating practice site. Preparation includes having a clear vision of the pharmacist services, ensuring that stakeholders have an understanding of the pharmacy services inquiring the site support and resources for the pharmacist, and regularly communicating. Full article
(This article belongs to the Special Issue Pharmacist Services) Printed Edition available
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