Assessing patient satisfaction after comprehensive medication review including oral chemotherapy adherence with an oncology pharmacist at the Southcoast Centers for Cancer Care (SCCC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19241-e19241
Author(s):  
Patrick John Skeffington ◽  
Laura Haynes ◽  
Donna Raymond ◽  
Heather McCarthy
Keyword(s):  
Patient Satisfaction ◽  
Community Pharmacists ◽  
Oral Chemotherapy ◽  
Third Party ◽  
Effective Counseling ◽  
Open Discussion ◽  
Specialty Pharmacy ◽  
Strongly Agree ◽  
Pharmacist Services ◽  
To Receive

e19241 Background: Use of oral chemotherapy has increased dramatically over the past few years. Patient often are required to obtain their oral chemotherapy from a third party specialty pharmacy while continuing to receive their other medications from other pharmacies. Many community pharmacists lack knowledge about oral chemotherapy, safe practices, or effective counseling of these medications. Objective: To assess patient perception and satisfaction of a pharmacist 1 on 1 appointment when starting oral chemotherapy. Methods: A program was designed at SCCC whereby all patients starting oral chemotherapy are scheduled for an appointment with a clinical oncology pharmacist to update medication lists, evaluate adherence, and conduct a "brown bag" visit where patients are allowed to voice concerns and ask questions. After each appointment patients were asked to fill out a short survey, The Patient Satisfaction with Pharmacist Services Questionnaire (PSPSQ 2.0). Results: PSPSQ 2.0 uses a Likert scale ranging from 1 to 4. From October 2016 to June 2019, 174 patients had appointments and 55 returned their surveys yielding a 30% response rate. Average scores hovered around 1 (strongly agree) for each question except question 11 (the only negatively worded question). Question 11 averaged 3.1; Disagree. Conclusions: Patients who were seen by an oncology clinical pharmacist to evaluate adherence, participate in a "brown bag" clinic and open discussion, found the appointment worthy of their time.

Should Cancer Centers start their own specialty pharmacy? Quality and economic data from the oral chemotherapy program at Smilow Cancer Hospital and Yale New Haven Health System.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 108-108 ◽  
Author(s):  
Kerin B. Adelson ◽  
Martha Stutsky ◽  
Monica Fradkin ◽  
Michelle Renee Harrison ◽  
Osama Abdelghany ◽  
...  
Keyword(s):  
Health System ◽  
Task Force ◽  
Oral Chemotherapy ◽  
Third Party ◽  
Flow Sheet ◽  
Self Administration ◽  
Assistance Program ◽  
Treatment Protocols ◽  
Patient Assistance ◽  
Specialty Pharmacy

108 Background: Recent focus has shown that oral chemotherapy is high risk for medical error. Our QOPI certification process identified that oral oncologic processes were marked by: lack of documentation in the EMR, patients receiving refills from third party pharmacies after prescription discontinuation, incorrect self-administration of medications due to lack of education, delivery delays, high copays, and underuse of available patient assistance programs. Methods: A multidisciplinary task force developed a program to expedite drug access, standardize consent, and ensure clinical support including education, adherence and toxicity monitoring. We expanded an existing health-system pharmacy to provide specialty services. Treatment protocols were created for every oral oncologic drug, which are routed to a clinical oncology pharmacist and the specialty pharmacy. Nursing and pharmacist verify all orders. Medication Assistance Program for copay support. Day 1, 5 and 21 pharmacist to patient calls. Multidisciplinary flow sheet documentation. Results: Today, 80% of our patients receive medication within 72 hours. Specialty pharmacists monitor toxicity even for patients whose prescriptions are filled by other pharmacies. Pharmacists have prevented more than 400 prescription errors. Today, monthly revenue before cost for the oral chemotherapy program is nearly than $4 million. The total revenue since initiation in February 2015 is over $44 million, yielding an approximately $9 million margin after costs. Funding through the medication assistance program exceeded $1 million thus far in 2016, with an average of 140 patients receiving assistance each month. Conclusions: A patient-centered multidisciplinary model integrating clinical, operational, financial, and IT resources optimized care for patients receiving oral oncologic therapy. This project transferred revenue from for-profit third party pharmacies to our non-profit health system, and revenue is used to provide enhanced education, monitoring, and patient assistance. Our collaborative improvement model can be adapted to many practice settings.

scholarly journals A Pharmacist-Led Oral Chemotherapy Program’s Impact on Chronic Myeloid Leukemia Patient Satisfaction, Adherence, and Outcomes

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Taylor Dennison, PharmD ◽  
Allison M. Deal, MS ◽  
Matthew Foster, MD ◽  
John Valgus, PharmD, MHA, BCOP ◽  
Benyam Muluneh, PharmD, BCOP, CPP
Keyword(s):  
Patient Satisfaction ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Chronic Myeloid Leukemia Patient ◽  
Oral Chemotherapy ◽  
Molecular Response ◽  
Patient Reported ◽  
Value Integration ◽  
Specialty Pharmacy

Patients with chronic myeloid leukemia (CML) can be treated with oral tyrosine kinase inhibitors (TKIs). Pharmacist-led oral chemotherapy programs (POCPs) can improve TKI adherence rates, but evaluation of patient satisfaction with such programs is rare. The purpose of this analysis was to compare the satisfaction of patients with CML taking TKIs enrolled in a POCP program with that of those not enrolled. Secondary objectives were to assess adherence rates, patient-reported value, early molecular response (EMR) rates, and major molecular response (MMR) rates. This study utilized an anonymous telephone survey of patients who had taken TKIs for at least 3 months. Molecular response was determined by chart review. Of 40 patients surveyed, 50% were enrolled in the POCP, and the POCP group had more African Americans than the non-POCP group. More patients in the POCP were satisfied with their care than in the non-POCP group (100% vs. 75%, p = .047). There were no differences in high patient-reported adherence (55% vs. 60%, p = 1.000), patient-reported value for integrated services (95% vs. 90%, p = 1.000), achievement of EMR (75% vs. 75%, p = 1.000), or MMR (85% vs. 85%, p = 1.000). Patients in the POCP received more structured clinical pharmacy services; however, both groups felt the clinical pharmacist played a major role in their care (85% vs. 90%, p = 1.000). Patients in the non-POCP group reported lower satisfaction than those enrolled resulting from fragmented care that was likely due to external specialty pharmacies. Irrespective of POCP enrollment, patients reported clinical pharmacists play a major role in their therapy and value integration of their specialty pharmacy and medical team.

scholarly journals The Emerging Role of Community Pharmacists in Remote Patient Monitoring Services

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 166
Author(s):  
Amina Abubakar ◽  
Jessica Sinclair
Keyword(s):  
Medication Management ◽  
Community Pharmacists ◽  
Healthcare Team ◽  
Remote Patient Monitoring ◽  
Patient Counseling ◽  
State Evaluation ◽  
Remote Patient ◽  
Enhance Patient Care ◽  
Pharmacist Services

Remote physiologic monitoring (RPM) services involve the transmission of patient-collected physiologic data to the healthcare team. These data are then analyzed to determine what changes may be needed to enhance patient care. While pharmacists may not be recognized as billing providers through some payers, there are opportunities for pharmacist collaboration with providers to enhance patient access to RPM services. Community pharmacist services are traditionally tied to a product, but pharmacists are skilled in medication management, disease state evaluation, and patient counseling, which are skills that can contribute to an elevated RPM program.

scholarly journals Persistent Misperceptions about Nicotine among US Physicians: Results from a Randomized Survey Experiment

2021 ◽  
Vol 18 (14) ◽  
pp. 7713
Author(s):  
Michelle T. Bover Manderski ◽  
Michael B. Steinberg ◽  
Olivia A. Wackowski ◽  
Binu Singh ◽  
William J. Young ◽  
...  
Keyword(s):  
Health Effects ◽  
Birth Defects ◽  
Prevalence Ratio ◽  
Chronic Obstructive ◽  
Survey Experiment ◽  
Obstructive Pulmonary Disease ◽  
Question Wording ◽  
Demographic Correlates ◽  
Strongly Agree ◽  
To Receive

We conducted a survey experiment among US physicians to evaluate whether question wording impacted perceptions about the health effects of nicotine. 926 physicians were randomized to receive one of two versions of a question matrix that asked about the “extent to which they agree or disagree that ‘nicotine’ (Version 1) or ‘nicotine, on its own,’ (Version 2) directly contributes to” birth defects, cardiovascular disease (CVD), cancer, depression, and chronic obstructive pulmonary disease (COPD). We evaluated whether question condition predicted strong agreement and/or agreement with each statement, and assessed demographic correlates of each outcome while adjusting for question version. Physicians who received Version 2 were less likely to “strongly agree” that nicotine directly caused birth defects (Prevalence Ratio (PR) 0.84, 95% CI 0.72–0.98), CVD (PR 0.89, 95% CI 0.84–0.95), cancer (PR 0.81, 95% CI 0.75–0.87), and COPD (PR 0.78, 95% CI 0.72–0.84). Females were more likely to “strongly agree” that nicotine directly contributes to birth defects and cancer, and family physicians were most likely to “strongly agree” that nicotine directly contributes to CVD, cancer, and COPD. Question wording is important when measuring physicians’ beliefs about nicotine; however, even after accounting for question version, misperceptions about the direct health effects of nicotine were common and varied by sex and specialty.

scholarly journals P071 Survey of rheumatology patient satisfaction with telephone consultations during the COVID-19 pandemic

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Management Plan ◽  
Service Development ◽  
Telephone Consultation ◽  
Face To Face ◽  
Communication Difficulties ◽  
Strongly Agree ◽  
The Uk

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.

Impact of a hospital specialty pharmacy in partnership with a free-standing care coordination organization on time to delivery and receipt of oral anticancer drugs.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 43-43
Author(s):  
Melissa Parsons Beauchemin ◽  
Morgan RL Lichtenstein ◽  
Rohit R. Raghunathan ◽  
Sahil D Doshi ◽  
Cynthia Law ◽  
...  
Keyword(s):  
Care Coordination ◽  
Multivariable Analysis ◽  
Cancer Center ◽  
Free Standing ◽  
Delivery Date ◽  
Anti Cancer ◽  
Before And After ◽  
Specialty Pharmacy ◽  
Insurance Data ◽  
To Receive

43 Background: Most oral anti-cancer drugs (OACD) prescriptions require extensive coordination between providers and payers, which can delay drug receipt. Specialty pharmacies are intended to facilitate communication between multiple entities to deliver OACDs with increased efficiency. In 2018, our cancer center partnered with Shields Health Solutions (SHS), a freestanding organization providing care coordination to implement a hospital-based specialty pharmacy. We evaluated the rate of failed drug receipt (FR) and time to drug receipt (TTR) before and after specialty pharmacy implementation. Methods: We prospectively collected data on all new OACD prescriptions for adult oncology patients at a large, urban cancer center from 1/1/2018 to 12/31/2019. In fall 2018, a specialty pharmacy was opened to facilitate drug procurement for patients. We collected patient demographic, clinical, and insurance data, OACD name, date prescribed, delivery date, and interactions with payers and financial assistance groups. For prescriptions received, TTR was the number of days from OACD prescription to patient receipt of the drug. FR was defined as failure to receive a prescribed OACD. We excluded OACD prescriptions for a washout period of two months during pharmacy initiation. We used multivariable logistic regression to examine factors associated with TTR > 7 days and FR before and after specialty pharmacy implementation. Results: In total, 883 patients were prescribed 1145 new OACDs. The majority of prescribed drugs were targeted treatment (56%, N = 646) and 72% (N = 819) required prior authorization (PA). Of all prescriptions, 86% (N = 999) were successfully received with an overall median TTR of 7 days. Adjusted analyses showed that patients were more likely to receive their drugs in less than 7 days after specialty pharmacy implementation (OR: 1.4 95% CI 1.04 – 1.81), p = 0.03). In an unadjusted analysis, patients were more likely to receive their initial medications after specialty pharmacy implementation, compared to before specialty pharmacy implementation (89% vs. 84%, p = 0.04). Multivariable analysis showed a trend toward more patients receiving drugs after specialty pharmacy implementation (OR: 1.42, 95% CI 0.98 – 2.03, p = 0.06). Conclusions: The implementation of a hospital-based specialty pharmacy in partnership with SHS decreased TTR. This difference is in part attributable to improved care coordination and communication. A centralized approach may improve overall efficiency due to fewer clinical practice disruptions.

Learning When Agents Can Talk to Drivers Using the INAGT Dataset and Multisensor Fusion

2021 ◽  
Vol 5 (3) ◽  
pp. 1-28
Author(s):  
Tong Wu ◽  
Nikolas Martelaro ◽  
Simon Stent ◽  
Jorge Ortiz ◽  
Wendy Ju
Keyword(s):  
Sensor Fusion ◽  
Deep Neural Network ◽  
False Positives ◽  
Driver Distraction ◽  
Third Party ◽  
Good Time ◽  
Visual Data ◽  
Perceived Safety ◽  
To Receive ◽  
And Training

This paper examines sensor fusion techniques for modeling opportunities for proactive speech-based in-car interfaces. We leverage the Is Now a Good Time (INAGT) dataset, which consists of automotive, physiological, and visual data collected from drivers who self-annotated responses to the question "Is now a good time?," indicating the opportunity to receive non-driving information during a 50-minute drive. We augment this original driver-annotated data with third-party annotations of perceived safety, in order to explore potential driver overconfidence. We show that fusing automotive, physiological, and visual data allows us to predict driver labels of availability, achieving an 0.874 F1-score by extracting statistically relevant features and training with our proposed deep neural network, PazNet. Using the same data and network, we achieve an 0.891 F1-score for predicting third-party labeled safe moments. We train these models to avoid false positives---determinations that it is a good time to interrupt when it is not---since false positives may cause driver distraction or service deactivation by the driver. Our analyses show that conservative models still leave many moments for interaction and show that most inopportune moments are short. This work lays a foundation for using sensor fusion models to predict when proactive speech systems should engage with drivers.

scholarly journals Community Pharmacy Response in the Aftermath of Natural Disasters: Time-Sensitive Opportunity for Research and Evaluation

2018 ◽  
Vol 9 ◽  
pp. 215013271881349 ◽  
Author(s):  
Kyle Melin ◽  
Carlos E. Rodríguez-Díaz
Keyword(s):  
Health Care ◽  
Puerto Rico ◽  
Community Pharmacy ◽  
Natural Disaster ◽  
Community Pharmacists ◽  
Evidence Base ◽  
Third Party ◽  
Future Research ◽  
Prescription Medications ◽  
Collaborative Practice Agreement

One year ago, Hurricane Maria passed over the archipelago of Puerto Rico, leaving widespread disruption of nearly all human services, including the health care sector. In the aftermath of the hurricane, limited access to medical care and prescription medications presented a serious challenge to maintaining control of preexisting chronic diseases. Many patients did not have access to refrigeration for heat-sensitive medications. Significant dietary changes due to the limited availability of shelf-stable foods further exacerbated chronic conditions such as heart failure and diabetes. The role of community pharmacists following a natural disaster has previously been documented, and may include the triage of evacuees, assessment of immunization needs, and provision of prescription medications under a collaborative practice agreement. However, our experience in Puerto Rico demonstrated a variety of barriers limited pharmacists’ ability to adequately respond to the magnitude of this disaster. These included medication shortages, extended loss of power, and limited telecommunications for contacting prescribers, disaster relief agencies, and third-party payers. Ultimately, the lack of preexisting emergency protocols made overcoming such barriers difficult. As the first and sometimes only accessible health care provider to many patients following a natural disaster, we must build a solid evidence base and better understanding of the individual, interpersonal, and environmental factors that contribute to the community pharmacist response. To date, however, a paucity of data exists on both the pharmacist and patient factors, which may contribute to an effective immediate response to patient needs at the community pharmacy following a natural disaster. Future research must focus on these multi-level factors to better inform public policy and effective disaster planning. Ultimately, such research and planning will lead to increased resiliency in our primary health care systems in the face of future disasters.

scholarly journals Translation and Validation of Patient Satisfaction with Pharmacist Services Questionnaire (PSPSQ 2.0)

2018 ◽  
Vol 10 (4) ◽  
pp. 427-432 ◽  
Author(s):  
Mohamed Azmi Hassali ◽  
Fahad Saleem ◽  
Ashutosh Kumar Verma ◽  
Weng Yan Choy ◽  
Ahmed Ibrahim Nouri ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pharmacist Services ◽  
Translation And Validation

Assessment of patient satisfaction, financial, and environmental impacts of teleoncology.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 278-278
Author(s):  
Cindy Jiang ◽  
Garth William Strohbehn ◽  
Rachel Dedinsky ◽  
Shelby Raupp ◽  
Brittany Pannecouk ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Rural Areas ◽  
Financial Burden ◽  
Veterans Health ◽  
Health Administration ◽  
Secondary Effects ◽  
Medical Needs ◽  
Care Access ◽  
Strongly Agree

278 Background: There was rapid adoption of teleoncology at Veterans Health Administration (VHA) during the COVID-19 pandemic. One-third of 9 million VHA-enrolled Veterans live in rural areas. While digital solutions can expand capacity, enhance care access, and reduce financial burden, they may also exacerbate rural-urban health disparities. Careful evaluation of patients’ perceptions and policy tradeoffs are necessary to optimize teleoncology post-pandemic. Methods: Patients with ≥1 teleoncology visit with medical, surgical, or radiation oncology between March 2020 and June 2020 identified retrospectively. Validated, Likert-type survey assessing patient satisfaction developed. Follow-up survey conducted on patients with ≥1 teleoncology visit from August 2020 to January 2021. Travel distance, time, cost, and carbon dioxide (CO2) emissions calculated based on zip codes. Results: 100 surveys completed (response rate, 62%). Table with demographics. Patients overall satisfied with teleoncology (83% ‘Agree’ or ‘Strongly Agree’) but felt less satisfied than in-person visits (47% ‘Agree’ or ‘Strongly Agree’). Audiovisual component improved patient perception of involvement in care (two-sided, p = 0.0254), ability to self-manage health/medical needs (p = 0.0167), and comparability to in person visits (p = 0.0223). Follow-up survey demonstrated similar satisfaction. Total travel-related savings: 86,470 miles, 84,374 minutes, $49,720, and 35.5 metric tons of CO2. Conclusions: Veterans are broadly satisfied with teleoncology. Audiovisual capabilities are critical to satisfaction. This is challenging for rural populations with lack of technology access. Patients experienced financial and time savings, and society benefitted from reduced carbon emissions. Continued optimization needed to enhance patient experience and address secondary effects.[Table: see text]

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