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Annual Meeting Abstracts 2004 FEATURE chronic pain patients by establishing a collaborative project via pharmacy and primary care providers. Methods: The Kaiser Permanente Cascade Park clinic is one of 22 ambulatory care locations in the Pacific Northwest Region. In the past years, improvements were needed to provide a more methodical approach to serve chronic pain patients who required therapy with controlled substances. The collaborative project created set out to decrease workload of providers and increase patient satisfaction. The new system operates on patient lists. One week before medications are due, a pharmacist sends a message to the provider stating the following: date medication is due, the last fill of the medication, the quantity that the prescription was filled for, last patient appointment, and any special requests or concerns. An order for the patient’s medication is also created. Once the provider receives the message, the order can be approved if continued therapy is intended, and a signed prescription is sent back to the pharmacy. Pharmacy staff then files the prescription for the date that the patient is due for medication and then on date in question, the prescription is processed by pharmacy staff. Results: All clinic providers who care for chronic pain patients on controlled substances have been participating in this project, and more than 250 patients have been enrolled. Conclusions: Since this project began, provider, patient, and pharmacy satisfaction with the method of processing controlled substances for chronic pain patients has been overwhelming. A need for change was identified and satisfied with a technological update on method of service. 92—STUDYING THE PROFESSIONAL INTERRELATIONSHIP BETWEEN COMMU- NITY PHARMACISTS AND PHARMACY TECHNICIANS. Akiyode O, Bullard W, Karodeh Y, Cao T, Howard University. E-mail: oakiyode@ howard.edu Objective: To understand the professional relationship between pharmacists and pharmacy technicians. To identify the supporting and inhibiting factors toward the professional behaviors demonstrated by the two entities. Methods: Community pharmacists and pharmacy technicians will complete a survey tool that assesses their interaction with each other. The survey tool is designed to evaluate the attitudes, behaviors, perceptions, and expectations among the aforementioned entities. A total of 50 surveys will be randomly distributed to local community pharmacies. Pharmacists will receive one half of the surveys, while pharmacy technicians will receive the other half. Upon completion of the surveys, a pair of fivemember focus groups (one involving pharmacists, the other technicians) will convene to discuss the survey results and ways to improve the professional relationship. The participants of the focus group discussions will be randomly selected from the pool of the study participants. Upon completion of the focus group discussions, all participants will be asked to complete a postdiscussion questionnaire to assess what they have learned from the discussion session, and how they plan to improve their own professional relationships. Results: The outcome of the surveys, focus group discussions, and postdiscussion questionnaires will be analyzed using descriptive statistics. The study is expected to educate participants and generate ideas to improve further the relationship between pharmacists and technicians, hopefully improving the efficiency of the pharmacy and overall patient care. Conclusions: NA 93—SURVEY OF PHARMACISTS DESIRE AND READINESS FOR DISEASE STATE MANAGEMENT IN OHIO. Dorsch M, Riverside Methodist Hospital, Kier K, Mraz S, Ohio Northern University. E-mail: MDORSCH@OhioHealth.com Objective: Prescription drugs remained the fastest growing health expenditure, increasing by 15.7%. The state of Ohio follows a similar trend. Currently medications account for 15.1% of the Ohio Medicaid budget, while physician billing only comprises 6%. Due to the increasing cost of health care and medications, the Ohio Pharmacists Association (OPA) started discussions with the state about the concept of disease state management (DSM). The objective was to determine pharmacists desire and readiness to start DSM programs within the state. Methods: OPA put together a task force to discuss issues relevant to starting a statewide program in DSM. Based on task force discussions, a survey was designed and pilot tested to look at DSM issues. The survey was sent to a random selection of licensed pharmacists within the state of Ohio. The survey asked questions relating to demographics, current practice settings, current DSM practices, and preparation and desire to provide DSM services. Descriptive statistics will be used to analyze the data. Results: Initial results from the survey provided interesting feedback, especially in the area of pharmacist training and preparation for DSM. In general, pharmacists were most comfortable with the area of diabetes management. Most pharmacists indicated a willingness to take more training or certification in areas of DSM. Data analysis is ongoing. Conclusions: The results will be used by the task force to make decisions relating to pharmacist interest, training, and potentially areas for reimbursement. 94—THE DEVELOPMENT OF A PAIN SERVICE BY THE PHARMACY DEPART- MENT IN A UNIVERSITY MEDICAL CLIN- IC. Jacobson S, Massachusetts College of Pharmacy and Health Sciences, Debay G, Massachusetts Institute of Technology. E-mail: deba@med.mit.edu Objective: To provide pain management education and reference information to health care providers and patients in an outpatient ambulatory clinic and inpatient unit. Methods: A pharmacist was identified to lead an educational initiative helping pharmacists, nursing staff, physicians and other health care providers learn about effective pain management. All pharmacists were required to read and successfully complete posttests associated with journal articles. Case study discussions were also an integral part of their pain management competency training. Ongoing education for the pharmacists helped to ensure consistent communication in their clinical assistance to the medical staff and in patient counseling. Health care practitioners were provided pain management information and guidance on how to identify and refer patients to the pain service. Assessment tools such as flow sheets and narcotic conversion charts were developed by the pharmacy for use in both the inpatient and outpatient setting. Frequent meetings with the inpatient and outpatient clinical staff regarding up-to-date pain management information, assistance on the proper use of pain management assessment tools, approved formulary medications for pain, appropriate prescribing, outpatient prescription and inpatient order writing for medications, and documentation in the medical chart were imperative for the success of this service. The pharmacy department is beginning to collect data in both the inpatient and outpatient records to monitor the proper use of pain assessment tools, appropriate prescribing, and patient compliance. Results: The medical and nursing staffs have reported a positive outcome for patients involved with the pharmacy pain service. The pharmacists are finding that providing clinical information to health care providers and counseling patients receiving pain medications is a rewarding experience. Conclusions: A pharmacy-centered pain management program is beneficial to the university health system. 95—THE PHARMACIST’S ROLE IN PUB- LIC HEALTH: A SURVEY OF HEALTH DEPARTMENT OFFICIALS. Cottrell J, Albany College of Pharmacy, Blumenschein K, University of Kentucky, Paavola F, None. E-mail: cottrelj@acp.edu Objective: To examine services provided by state and local health departments, determine areas into which health departments would like to expand, and examine the public health officials’ perceptions of partnering with community pharmacists. Methods: In December 1999, 25 state health department Web sites were reviewed to determine the areas of focus that public health agents were attempting to address. From this assessment, a three-page survey was developed and sent to directors of 300 health departments, randomly selected from the National Association of County and City Health Officials (NACCHO) mailing list. Each packet contained a cover letter, a survey, and a selfaddressed stamped envelope. Surveys were approved under expedited review by the University of Kentucky Medical Institutional Review Board and contained 13 questions: 4 addressing staff composition and responsibilities, 4 addressing current and future programs, and 5 concerning perceptions of partnering with pharmacists and pharmacy ser- 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 249 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 vices. Surveys were anonymous and were collected from January to March of 2001. Results: A total of 153 surveys were returned for a response rate of 49%. Nurses were the most common health care provider on staff at health departments, and the most frequently additional personnel requested. The most common service offered by health departments was immunizations. Most respondents desired to establish preventive services such as disease management, indigent care clinics, and health information libraries. Only 13% had a pharmacist on staff, and an additional 11% partnered with their local pharmacist. Approximately 60% had not considered partnering with their local pharmacists; most stated that cost was the barrier preventing an alliance. Officials identified indigent care clinics, dispensing medications, and drug-use review as the main services they would like to see provided by pharmacists. Conclusions: Pharmacists appear to be underused in public health plans for meeting goals of Healthy People 2010. 96—MOTIVATION AND JOB SATISFAC- TION OF COMMUNITY PHARMACISTS INVOLVED WITH PHARMACEUTICAL CARE. Swensgard L, Ohio State University. E- mail: slswens@yahoo.com Objective: Community pharmacists are becoming increasingly involved with direct patient care services as a way to expand their role as health care professionals. The future success of these services depends in part on the ability of community pharmacies’ corporate management to keep the participating pharmacists motivated to continue their roles as pharmaceutical care providers and motivate other community pharmacists to become involved. The purpose of this study is to assist Kroger corporate management in identifying what motivational factors contribute to the decision of central Ohio Kroger pharmacists to become involved in or abstain from pharmaceutical care services. Also, the study will identify what barriers central Ohio Kroger pharmacists perceive to becoming involved in pharmaceutical care. Factors contributing to job dissatisfaction and job satisfaction will also be assessed. Methods: Mail surveys will be sent to two groups of central Ohio Kroger pharmacists, those actively providing patient care services and those involved solely in dispensing activities. The survey will compare and contrast both groups of pharmacists’ motivations to perform patient care services. Job satisfaction will also be assessed in both groups of pharmacists. The data collected from the survey will be used to implement new recruitment and advancement strategies to increase Kroger community pharmacist involvement in pharmaceutical care services. In addition, the information will be disseminated to other community pharmacies for use in increasing pharmacist involvement with pharmaceutical care. Results: Data collection began in November 2003. Conclusions: This project will enable corporate management of community pharmacy establishments to identify motivational forces that contribute to a pharmacist’s decision to perform pharmaceutical care services and factors that contribute to job satisfaction. Also, this project is expected to provide information regarding how best to reward pharmacists for their participation in pharmaceutical care services. 97—USING ADVANCED PRACTICE COM- MUNITY CLERKSHIP STUDENTS TO PRO- VIDE CONTINUING EDUCATION FOR RURAL PHARMACISTS. Hastings J, University of Arkansas for Medical Sciences College of Pharmacy, West D, University of Arkansas for Medical Sciences. E-mail: jkhastings@uams.edu Objective: The goal of this project is to describe how senior pharmacy students are used in the delivery of live continuing education (CE) to pharmacists in a remote region of a small southern state. Methods: The community clinical clerkship is a cooperative rotation taught by the college of pharmacy in conjunction with 24 pharmacies located throughout Arkansas. One of the assignments that senior students enrolled in this advanced community practice clerkship must complete is a clinical or management project. The board of pharmacy in this state requires pharmacists to obtain 12 hours of live, disease-related CE over a biennial licensing period. One preceptor in a rural area of the state requires each student who rotates through his site to deliver a CE presentation related to drug-therapy to pharmacists in the southeast region of the state. Results: NA. Conclusions: This unique use of students to help pharmacists comply with licensing requirements benefits everyone involved. The students have an opportunity to complete an assignment for their rotation while at the same time benefiting from the experience of researching, preparing and presenting a CE program. Pharmacists in the region benefit from the information presented by the student about the selected drug topic, are able to obtain live CE credit in a convenient manner and have the opportunity to network with their local peers on a regular basis. 98—ANALYSIS OF HYPERTENSION CONTROL IN A MIDWESTERN CARDIOLO- GY CLINIC. Glosner S, Pfizer Inc, Tynan S, Alsip D, Cline K, Midwestern University, Konczal M, Faaborg J, Marcinkowski L, Midwestern University. E-mail: scott.glosner@pfizer.com Objective: Coronary heart disease (CHD) remains the number 1 killer in the United States. CHD also costs more than $100 billion a year to treat. CHD is both financially and clinically important. Risk factors for developing CHD are elevated blood pressure (BP), tobacco use, low HDL cholesterol, family history, and age. Our purpose was to assess BP control, treatment options and comorbidities that increase CHD risk in hypertensives patients. Methods: A retrospective, chart review was performed at an Illinois cardiology practice during October 2002. The study population consisted of patients taking either antihypertensives alone (N = 401) or those taking antihypertensive agents in conjunction with medications for heart failure (N = 359). A total fo 120 patients were randomly selected and evaluated from the study population. Patient demographics, blood pressures, laboratory test results, and medications were collected. Results: Overall, 56% of participants were women. The average age for the overall population was 68 years. More than 75% of patients had a body mass index of greater than 25 kg/m 2 . Some 70% of the population had a dyslipidemia, 29% had CHD, 23% had arrhythmias, and 15% had diabetes mellitus (DM). Beta blockers (24%) and calcium-channel blockers (23%) were the most frequently used medications. BP control was noted in 47.1% of men and 51.5% of women. BP control was observed in less than 50% of each drug class except for diuretic medications (52%). A total of 62% of CHD patients had elevated BPs, and 42% of patients with CHD or DM were not at their LDL cholesterol goal of less than 100 mg/dL. Within the last year, 15% of reported patient hospitalizations were cardiac related. Conclusions: Cardiologists generally treat more complicated cardiovascular patients, yet nearly 50% of patients in this study had BPs that were uncontrolled while on medications. Practitioner education by pharmacists on national guideline attainment should help improve health outcomes (e.g., BP and cholesterol control). 99—ASSESSMENT OF MEDICATION NONADHERENCE AND DISEASE STATE KNOWLEDGE IN A COMMUNITY PHAR- MACY. Self T, University of Kentucky, Chou C, Pfizer, Inc. E-mail: tdself@hotmail.com Objective: The purpose of this project was to (1) identify patients at risk for medication nonadherence using a validated scale and to report any trends; (2) determine the need for further counseling in patients with risk behaviors for nonadherence on the benefit of prescription medications, and (3) evaluate disease knowledge and awareness of their personal laboratory values in patients indicating a history of hypertension, hyperlipidemia, or diabetes. Methods: Surveys were randomly distributed to patients 18 years of age and older at a local Kroger Pharmacy. Collected information included demographics (age and gender), chronic disease states, and self-reported medication-taking behaviors. The survey consisted of four questions (Morisky scale) in a validated tool that is used to identify and address barriers to medication adherence. Patients were considered nonadherent if one or more questions on the Morisky scale was answered “yes,” and they were then counseled on ways to increase adherence as well as the benefit of prescription medication. In addition, halfway through the survey, the method was improved by asking patients that indicated a history of hypertension, hyperlipidemia, or diabetes if they knew their current laboratory values and goals for their blood pressure, cholesterol, or blood glucose. Patients were then counseled appropriately about their diseases and goals of therapy. Results: All data will be analyzed using 250 Journal of the American Pharmacists Association www.japha.org March/April 2004 Vol. 44, No. 2 Downloaded From: http://japha.org/ on 01/25/2014
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