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Annual Meeting Abstracts 2004 FEATURE Methods: Design: Retrospective chart analysis Setting: Four community chain pharmacies in Gainesville, Florida. Patients: Those offered an existing asthma education service. Data Collection: Currently, asthma patients are evaluated by National Heart, Lung, and Blood Institute (NHLBI) Symptom Assessment, spirometry, and NHLBI control classification by symptoms to determine whether their asthma is controlled or uncontrolled. Patients with a ratio < 0.8 for forced expiratory volume in 1 second (FEV1) over forced vital capacity (FVC) predicted demonstrate airway obstruction and are classified as having poor asthma control. Based on symptom assessment and spirometry measurement, patients are classified into four different categories (i.e., mild intermittent, mild persistent, moderate persistent, and severe persistent). A drug therapy assessment is performed on patients who are determined to be uncontrolled upon evaluation. Patients’ primary care providers are contacted by phone and by mail with recommendations for changes in therapy. After 6 months of providing the asthma service, patient charts will be reviewed. Analysis Plan: The primary outcome measures will be asthma control based on symptoms versus symptoms and FEV1 and whether pharmacist contacting physician resulted in change in therapy. Data collection will include: comparison of the number of patients controlled by symptoms versus those controlled by symptoms and FEV1; comparison of mean FEV1 in controlled and noncontrolled patients; and comparison of the number of recommendations for changes to therapy versus the number of those accepted. Other Appropriate Qualitative Measures: NA. Results: Pending. Conclusions: We hypothesize that the use of spirometry in the community setting may increase the number of patients detected with poor asthma control and result in changes to therapy that may improve patient outcomes. 148—EVALUATION OF PHARMACIST INTERVENTIONS IN A COMMUNITY PHARMACY–BASED OSTEOPOROSIS SCREENING PROGRAM. Capka M, Happy Harry’s Discount Drugs. E-mail: dragonmount4@ hotmail.com Objective: To determine the outcomes of pharmacist intervention on screened patients at risk for osteoporosis and to determine the percentage of screened patients that are initiated on medications. Methods: Patients at increased risk for hip fracture (defined as any postmenopausal woman satisfying one of the following criteria: age older than 65 years, personal history of fracture, first degree relative with history of fracture, currently smoking, oral corticosteroid treatment lasting longer than 3 months, thyroid medication use, and anticonvulsant use) will be included in the study. Exclusion criteria include those patients already on bisphosphonates, selective estrogen receptor modulators, calcitonin or estrogen therapy as well as those with a history of fractures in both ankles. Patients will be recruited by on-site promotional materials, senior center visits and identification through prescription profiles with a goal of attaining 50 screened patients. These patients will be scanned in a community pharmacy setting using a Lunar Achilles Express bone densitometer. All screened patients will receive educational materials containing general information regarding osteoporosis and its management as well as strategies to help lower the risk of fracture. Those patients who receive a Stiffness Index T-score or Stiffness Index Z-score of < –1.0 will be referred to the primary care physician and for completeness, the physician will be made aware of both the T- and Z-scores via fax. Patients will be followed up via telephone interviews at 1-month and 3-month intervals post screening. Primary endpoints of the study include the percentage of screened patients who are referred to their physician, the percentage of referred patients who see their physician, the percentage of screened patients placed on medication to treat osteoporosis or osteopenia, the percentage of referred patients placed on medication to treat osteoporosis or osteopenia and the percentage of referred patients who have increased their calcium intake or amount of weight-bearing exercises. Results: NA. Conclusions: NA. 149—EVALUATION OF PHARMACY STU- DENTS’ ATTITUDES AND INTEREST ON ADMINISTERING ADULT IMMUNIZA- TIONS AS A HEALTH CARE SERVICE. Akala F, Powers M, University of Toledo. E-mail: folasade.akala@utoledo.edu Objective: To gain a better understanding and determine the attitudes and interest of pharmacy students toward the administration of adult immunizations. The study will also determine how receptive pharmacy students are toward providing this valuable health care service. Methods: A survey questionnaire evaluating the attitudes and interest of students will be conducted during December 2003 to PharmD students at a college of pharmacy. 209 students (n = 105 first professional year and n = 104 second professional year) are expected to participate in the survey. Surveys will be distributed in a classroom setting in which participation is voluntary. The survey consists of questions that either require responses in the form of a 5-point Likert scale (A = strongly agree, E= strongly disagree) or are dichotomous questions that require either a “Yes” or “No” response. The questions are divided into three subcategories (1) perceived barriers to immunization; (2) knowledge and interest; and (3) student demographics. The data collected will be analyzed using SPSS to determine correlations and compare differences and similarities in the interest and attitudes of students in the two classes. Results: Once data collection is complete and analyzed, the results will be used as a tool in designing an immunization-training course to be incorporated in the pharmacy curriculum. Conclusions: Pharmacists are the most accessible health care professionals in the community and because they are so accessible they can provide a range of health services, including immunizations. Since many pharmacy students will become the new practitioners in community pharmacies, it is essential to train and prepare pharmacy students to be competent in providing pharmaceutical care services. To prepare these students, their attitudes and interest in providing these services must be understood. 150—EVALUATION OF THE EFFECTIVE- NESS OF COMPUTER-GENERATED MEAL PLANNING WITH BEHAVIORAL COUN- SELING SESSIONS TO PROMOTE WEIGHT LOSS. Devizia R, Kerr Drug and Campbell University, Greck B, Kerr Drug. E-mail: rjd08@yahoo.com Objective: The primary outcome is to evaluate the change in weight and body mass index among participants. Secondary outcomes will include changes in fasting blood glucose, waist circumference, blood pressure, and cholesterol. Methods: A single-center randomized, quasiexperimental, longitudinal pre–post cohort study conducted in Asheville, NC. DIME (Diabetes Information Management and Evaluation Program) is the computer-generated meal planning program that will be used. During the first visit all baseline measurements will be obtained. These measurements consist of a cholesterol panel using the Cholestech LDX, weight, height, waist circumference, blood pressure using an automated Omron blood pressure monitor, and a fasting blood glucose using the One Touch Ultra glucometer. Each patient will generate a 2-week patient specific meal plan with assistance from a pharmacist. During the initial session, the participants in the intervention group will develop goals to be met throughout the 12- week period. Participants in the intervention group will receive training in behavior modification, exercise routine establishment, and meal planning in order to meet these goals. After the initial session, the intervention group will return every 4 weeks for the opportunity to adjust meal plans. Measurements of weight, waist circumference, and blood pressure will be collected at each of these sessions. Cholesterol and fasting blood glucose will be done at the end of the 12-week period. The goals developed in the initial session will be assessed at each 4- week session and adjusted as necessary. Long-term weight management assessment will be assessed at 24 weeks. This will be done only if time allows and the 24th week does not fall after July 1, 2004. Results: To be collected, assessed, and presented at the March 2004 APhA meeting and the Southeastern Residency Conference in May 2004. Conclusions: This study should demonstrate the effectiveness of community pharmacists in helping patients set attainable weight loss goals that are safe and effective. 151—EVALUATION OF THE IMPACT OF A CLINICAL PHARMACIST ON FAMILY MEDICINE RESIDENTS’ DRUG KNOWL- 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 263 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 EDGE BASED ON A NATIONAL STANDARD- IZED EXAM. Craft K, Mehra Harris I, University of Minnesota. E-mail: craft006@umn.edu Objective: The objective of this study is to evaluate the impact of regular interactions with a clinical pharmacist on family medicine residents’ drug knowledge based on a national standardized exam. Pharmacists are actively involved in 26.7% of family medicine residency programs. The effect of clinical pharmacists’ involvement on a resident’s understanding of drug therapy is unknown. Family medicine residents are required to take a yearly standardized exam, with a passing requirement, in preparation for the board exam. This In-Training Exam, from the American Board of Family Practice, is a general exam encompassing all areas of family medicine, including pharmacotherapy. Methods: The In-Training Exam does not have a separate category for drug-related questions. The exams for the past 3 years will be reviewed to determine which questions are drug related. The performance on the drug-related questions relative to the composite exam score will be compared between groups. Our family medicine residency program, which has pharmacist involvement, will be compared with a control group of residents in two other programs in areas that do not have pharmacist involvement. A separate analysis will compare performance in each of the 3 years of training the resident is in with fellow residents in the programs without a pharmacist. Results: NA. Conclusions: NA. 152—IMPACT ON MEN’S HEALTH: CO- ADMINISTRATION OF A STANDARDIZED SCREENING TOOL AND DIRECT PATIENT CARE SERVICES. Hammond J, American Pharmacy Services Corporation/ University of Kentucky, Mcintosh T, American Pharmacy Services Corporation, Freeman T, APSC Foundation for Education and Research, Inc., Blumenschein K, University of Kentucky. E-mail: jhammond@apscnet.com Objective: To determine if independent community pharmacists can identify men at risk for chronic disease and impact their access to health care, quality of life (QOL), and general satisfaction with pharmacy services using a standardized screening tool in combination with direct patient care services. Methods: Two pharmacy sites will be identified for subject recruitment; a control site and an intervention site. At each site, patients will be recruited and asked to complete an SF-12 to assess QOL and a questionnaire to obtain demographics and information on health care access and patient satisfaction. Recruited patients will be screened using a standardized screening tool—the Men’s Health Risk Assessment Tool (MHRAT) until 25 patients at each site are identified at risk for chronic disease. Intervention-site patients determined to be at risk will be asked to schedule an appointment with the pharmacist within 2 weeks of screening for education and direct patient care services using CLIAwaived testing devices. Intervention patients will be encouraged to schedule physician visits based on MHRAT results and objective test results. Controlsite patients identified at risk will be counseled to schedule a physician visit after completing the initial MHRAT screening; they will not receive any additional patient care services or education from the pharmacist. Six weeks postscreening, pharmacists at both sites will call patients to schedule appointments for completion of postintervention surveys and questionnaires. The pharmacists’ interventions will be considered a success if patients identified at risk accessed health care services or scheduled appointments to access care. Results: Pharmacist-intervention success rates between groups will be analyzed using the chisquare statistic; results from the SF-12 and patient questionnaire assessing access-to-care and satisfaction with pharmacy services will be analyzed using appropriate statistical tests. Conclusions: It is anticipated that independent community pharmacists can positively impact men’s access to health care, QOL and satisfaction with pharmacy services by administering MHRAT screenings. It is also anticipated that those pharmacists providing direct patient care services in addition to MHRAT screenings will have a greater impact than those providing screening services alone. 153—IMPLEMENTATION AND EVALUA- TION OF A SMOKING CESSATION PRO- GRAM FACILITATED BY COMMUNITY PHARMACISTS. Wilhelm M, Balls Food Stores, Kerner S, Balls Foods. E-mail: schuster@kualumni.org Objective: The goals of the project are to: (1) assist patients to quit smoking, (2) measure patient success rate, and (3) evaluate patient satisfaction of the program. Methods: The American Lung Association’s Freedom from Smoking program offers a systematic approach to quitting by progressing patients from awareness of the smoking habit to behavioral changes. Two community pharmacists will facilitate the program on a corporate campus. Marketing techniques will include: (1) campus television ads, (2) tabletop cafeteria ads, (3) break area posters, and (4) a counter sign in the campus pharmacy. Patients will enroll in the seven-session program. A survey will be conducted during the last session, at 3 weeks, and 6 weeks after completion of the program. Data from the survey will be evaluated for quitting success rate and patient satisfaction of the program. Results: The study is expected to assist patients in becoming smoke free. Patient acceptance of the program will be determined. Conclusions: The results will provide information to community pharmacists on the success of implementing and evaluating a smoking cessation program. 154—IMPLEMENTATION OF EXPANDED PHARMACIST-PROVIDED CARE IN A FAM- ILY PRACTICE CLINIC. Bratten S, University of Iowa, Shepley A, Shepley Pharmacy, Currie J, University of Iowa, Brandt K, Mt. Vernon Family Practice, Ernst M, University of Iowa, Farris K, University of Iowa, Jackson A, Clark R, Shepley Pharmacy. E-mail: shelly-bratten@uiowa.edu Objective: This paper describes and evaluates the expansion of pharmacist-provided care services in a family practice clinic. Methods: Design: A process and impact evaluation will be conducted after program implementation. This study will take place in a family practice clinic currently utilizing a clinical pharmacist to manage anticoagulation services. Program Development: A community pharmacy initiated discussions with a local family practice clinic to expand the scope and extent of services being offered. After introductory discussions, pharmacy staff members outlined potential services to be delivered. Gaps in clinical services, patient education opportunities and patient groups who could benefit from working with pharmacists were identified. Pharmacists began working with the current clinical pharmacist in the practice to become familiar with clinic procedures. Clinic times and administrative procedures are in development. Program Implementation: Program implementation began September 2003. Evaluation: To describe the processes of the new service(s), data will be collected on number and type of patients seen, types of drug therapy problems identified, recommendations made and accepted, estimates of cost savings for patients by resolved drug therapy problems and time required for service provision. The impact of the service will be evaluated by quantifying revenues generated, the percent of patients with controlled disease states, and patient and physician satisfaction. Results: To be presented. Conclusions: Collected data will be used to describe the program and assess the impact of the enhanced physician–pharmacist relationship in the comprehensive care of patients in a family practice clinic. 155—OUTCOMES OF A DIABETES CARE PROGRAM IN A CHAIN COMMUNITY PHARMACY SETTING. Patel U, University of Maryland, Baltimore, Rodriguez De Bittner M, University of Maryland at Baltimore, Layson-Wolf C, University of Maryland, Baltimore. E-mail: upatel@rx.umaryland.edu Objective: (1) Measure the clinical and humanistic outcomes of a pharmacist-managed diabetes care program in a chain community pharmacy. (2) Assess the economic impact of a diabetes care program for a chain community pharmacy. Methods: This is a retrospective study. Data from the Diabetes Care Program at Giant Pharmacy collected between November 1998 and September 2003 will be evaluated. Participating patients are greater than 18 years of age and have type 1 or type 2 diabetes. All patients included in the study have completed the eight-session diabetes care program. Patients who did not complete all eight sessions will be excluded. The outcomes measured include both clinical and humanistic. Clinical outcomes include hemoglobin A1c, blood pressure, weight, total 264 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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