scholarly journals The Effect of Zero Copayments on Medication Adherence in a Community Pharmacy Setting

2019 ◽  
Vol 10 (2) ◽  
pp. 16
Author(s):  
Melissa Jimenez ◽  
Goar Alvarez ◽  
Albert Wertheimer ◽  
Leanne Lai ◽  
Leroy Koh ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Community Pharmacy ◽  
Financial Burden ◽  
Prescription Medication ◽  
Original Research ◽  
Article Type ◽  
Significant Difference ◽  
Generic Medications ◽  
Proportion Of Days Covered ◽  
Prescription Refill

Background: Prescription medication copayments can be a financial burden to many patients. When patients cannot afford their medications, they may become nonadherent, and as a result, this can lead to an increase in chronic disease complications and healthcare costs. Objective: The objective of this study was to determine if zero copayments have an effect on medication adherence in a community pharmacy. Methods: This retrospective cohort study examined the prescription refill records of patients who filled specific generic medications for hypertension, hyperlipidemia, and gastroesophageal reflux disease (GERD) in 2016 at the NSU Clinic Pharmacy. The adherence rates of patients with zero copayments were compared to the adherence rates of patients with copayments greater than $0. Adherence was determined by calculating the proportion of days covered (PDC). Patients were considered adherent if their PDC was greater than or equal to 80%. Results: GERD patients with no copayments had average PDC ratios of 87.4% and were statistically significantly more adherent than GERD patients with copayments, who had average PDC ratios of 76.7% (P = 0.042). Hyperlipidemia and hypertension patients with no copayments had average PDC ratios of 89.3% and 90.3%, respectively, and those with copayments had PDC ratios of 85.3% (P = 0.314) and 87.9% (P = 0.534). Conclusion: Overall, patients with $0 copayments had higher adherence rates than patients with copayments greater than $0. GERD patients with no copayments were significantly more adherent than GERD patients with copayments. However, no statistically significant difference was found between patients with or without copayments in the hyperlipidemia and hypertension cohorts. Further studies are recommended to analyze additional factors that may influence medication adherence.   Article Type: Original Research

scholarly journals "Until they know how much you care": A qualitative analysis of an innovative practice in community pharmacy

2011 ◽  
Vol 2 (2) ◽  
Author(s):  
Michael Melczak ◽  
Janice Pringle
Keyword(s):  
Medication Adherence ◽  
Therapeutic Alliance ◽  
Community Pharmacy ◽  
Patient Outcomes ◽  
Qualitative Content Analysis ◽  
Original Research ◽  
Routine Practice ◽  
Medication Therapy ◽  
Advantages And Disadvantages ◽  
Innovative Practice

Purpose: This qualitative study was concerned with investigating community pharmacists' thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM) services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy) setting as part of a previous parent study. We describe this practice (using these scales in a novel setting) as an innovative practice, report on the pharmacists' experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice. Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions. Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (mis)understanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients. Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure patient outcomes and therapeutic alliance. Pharmacists had varying opinions on the degree to which the use of these scales could impact patient medication adherence, although they perceived other value and benefits secondary to the interactions. While most pharmacists did not maintain formal use of the scales after study end, they took away general principles of patient-centered care and individualized feedback.   Type: Original Research

scholarly journals Characteristics of Patients Accepting and Declining Participation in a Transition of Care Service Provided by a Community Pharmacy

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Julianne M Kowalski ◽  
Amanda R Margolis ◽  
Nicole Schreiner ◽  
Jeff Kirchner
Keyword(s):  
Community Pharmacy ◽  
Health Beliefs ◽  
Community Pharmacist ◽  
Conflict Of Interest ◽  
Care Service ◽  
Transitions Of Care ◽  
Risk Category ◽  
Original Research ◽  
Transition Of Care ◽  
Significant Difference

Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service. Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis. Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%). None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29). Of the 66 patients who declined, 51 gave a reason (77.3%). Thirty-nine patients saw no benefit (76.5%), five patients had perceived barriers (10%), and seven patients gave reasons that fell into both categories (13.5%). Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential patients. Conflict of Interest Disclosures: The authors have no actual or potential conflict of interest in relation to this evaluation. This evaluation was presented as a poster presentation at American Pharmacists Association Annual Meeting and Exposition, March 4-7, 2016 and at the Pharmacy Society of Wisconsin Education Conference, April 5-6, 2016. This evaluation was presented as a podium presentation at Great Lakes Residency Conference, April 27-29, 2016.   Type: Original Research

scholarly journals Evaluation of a Novel Pharmacist-Delivered Adherence Improvement Service via Telehealth

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 140
Author(s):  
Srujitha Marupuru ◽  
Harman Dhatt ◽  
Jennifer M. Bingham ◽  
Terri Warholak
Keyword(s):  
Medication Adherence ◽  
A Priori ◽  
Pharmacist Intervention ◽  
Chronic Medication ◽  
Comparator Group ◽  
Medication Refill ◽  
Significant Difference ◽  
Proportion Of Days Covered ◽  
Alpha Level ◽  
Adherence Intervention

Nearly half of all patients prescribed a chronic medication do not adhere to their regimen. Conversion from a 30- to 90-day medication refill is associated with improved adherence. The objective of the study was to assess the change in proportion of days covered (PDC) in those who converted to a 90-day fill and those who did not after a telehealth pharmacist-delivered, medication adherence intervention. This retrospective review involved data collected between May and December 2018. Patients with ≤85% baseline PDC rates were targeted. One group included patients who converted to a 90-day fill after the pharmacist intervention. The comparator group did not convert to a 90-day fill. Differences in median end-of-year (EOY) PDC rates for each medication class were compared between groups. An alpha level of 0.05 was set a priori. Overall, 237 patients converted to a 90-day fill and 501 did not. There was no significant difference in age, sex, and total number of drugs per patient. A Mann–Whitney U test revealed statistically significant improvements in median EOY PDC in the group that converted to a 90-day fill (+9% vs. −3%, p < 0.001). Pharmacist-delivered telehealth interventions were associated with improved PDC rates in those who converted to a 90-day fill.

scholarly journals Medication adherence and its relationship to the therapeutic alliance: Results from an innovative pilot study within a community pharmacy MTM practice

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Janice Pringle ◽  
Michael Melczak ◽  
Arnie Aldridge ◽  
Margie Snyder ◽  
Randall Smith
Keyword(s):  
Medication Adherence ◽  
Therapeutic Alliance ◽  
Community Pharmacy ◽  
Comparison Group ◽  
Intervention Group ◽  
Community Pharmacists ◽  
Original Research ◽  
Percentage Point Increase ◽  
Medication Therapy ◽  
Quasi Experimental

Objectives: To determine whether patients who received Medication Therapy Management (MTM) from community pharmacists using a brief scale to measure Therapeutic Alliance (i.e., MTM + TA) would show better medication adherence than patients who received MTM without use of the TA scale (MTM only). Design: Quasi-experimental, using a direct intervention group (MTM + TA) and a comparison group of randomly selected claims records from patients who received only the MTM service (MTM only). We used a doubly robust propensity score approach to estimate the average effect of therapeutic alliance on medication adherence. The analysis was limited to the following broad medication categories: antihypertensives, antidiabetic agents, and antihyperlipidemics. Setting: The direct intervention group included patients receiving MTM services from pharmacists in a community pharmacy chain setting. Participants: After matching with claims data, the direct intervention group was n=117, with an average age of 76.4. The comparison group was n=146, with an average age of 76.2. Intervention: Administration of two brief scales designed to measure general health outcomes and TA within the context of MTM (with focus on TA scale administration). Main Outcome Measures Proportion of Days Covered (PDC) and PDC80. Results: Using the therapeutic alliance scales in the context of community pharmacist-provided MTM was associated with a 3.1 percentage point increase in patients' overall PDC (p<.001) and an increase of 4.6 percentage points in PDC80 (p=.02) as compared to patients receiving MTM without use of the therapeutic alliance scales. Conclusion: Measuring therapeutic alliance in the context of MTM is associated with improved medication adherence and represents one strategy for enhancing the effectiveness of MTM encounters. Furthermore, administration of the therapeutic alliance scales used very little time; therefore it is likely feasible for pharmacists to routinely use the scales in their practice. Type: Original Research

scholarly journals Vial-to-Pen: Community Pharmacists Converting Insulin Regimens

2019 ◽  
Vol 10 (3) ◽  
pp. 3
Author(s):  
Ashley Hannings ◽  
Natasha Michaels ◽  
Debbie Hiller ◽  
Macary W Marciniak ◽  
Stefanie Ferreri
Keyword(s):  
Success Rate ◽  
Human Subjects ◽  
Community Pharmacists ◽  
Original Research ◽  
Post Intervention ◽  
Community Based ◽  
Article Type ◽  
Patients With Diabetes ◽  
Prescription Refill ◽  
Delivery Options

  Objective: To describe a vial-to-pen conversion program driven by community-based pharmacists and determine conversion success rate. Methods: A report based on prescription claims was generated and identified 200 prescriptions filled for an insulin vial product and syringes. Patients were contacted by community-based pharmacists during a five-month period and were informed of the availability and potential benefits of insulin pen delivery systems (IPDS). If the patient agreed to the switch, the pharmacist contacted the prescriber to obtain a new prescription. Prescription refill records were tracked for six months post-intervention to determine whether patients who were converted remained on the IPDS.  Results: The overall vial-to-pen conversion success rate was 26% out of 121 potential conversions. In addition, 52% of patients reached were willing to switch and prescribers approved 71% of the recommendations to switch from vial-to-pen. Of the prescriptions successfully converted to an IPDS, 84% of prescriptions were still dispensed as pen products six months following the conversion.  Conclusion: Community-based pharmacists can serve as a resource to provide education on insulin delivery options and increase use of IPDS in patients with diabetes.  Treatment of Human Subjects: IRB review/approval required and obtained   Article Type: Original Research

Predictive Model for Live Birth at 12 Months After Starting In-Vitro Fertilization Treatment

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 5-20
Author(s):  
Vu Ho ◽  
Toan Pham ◽  
Tuong Ho ◽  
Lan Vuong
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Cox Regression ◽  
Financial Burden ◽  
Oocyte Retrieval ◽  
Operating Characteristics ◽  
Vitro Fertilization ◽  
Cox Regression Analysis ◽  
Significant Difference

IVF carries a considerable physical, emotional and financial burden. Therefore, it would be useful to be able to predict the likelihood of success for each couple. The aim of this retrospective cohort study was to develop a prediction model to estimate the probability of a live birth at 12 months after one completed IVF cycle (all fresh and frozen embryo transfers from the same oocyte retrieval). We analyzed data collected from 2600 women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) at a single center in Vietnam between April 2014 and December 2015. All patients received gonadotropin-releasing hormone (GnRH) antagonist stimulation, followed by fresh and/or frozen embryo transfer (FET) on Day 3. Using Cox regression analysis, five predictive factors were identified: female age, total dose of recombinant follicle stimulating hormone used, type of trigger, fresh or FET during the first transfer, and number of subsequent FET after the first transfer. The area under the receiver operating characteristics curve for the final model was 0.63 (95% confidence interval [CI] 0.60‒0.65) and 0.60 (95% CI 0.57‒0.63) for the validation cohort. There was no significant difference between the predicted and observed probabilities of live birth (Hosmer-Lemeshow test, p > 0.05). The model developed had similar discrimination to existing models and could be implemented in clinical practice.

scholarly journals Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3694
Author(s):  
Irina Paula Doica ◽  
Dan Nicolae Florescu ◽  
Carmen Nicoleta Oancea ◽  
Adina Turcu-Stiolica ◽  
Mihaela-Simona Subtirelu ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Pilot Study ◽  
Multidisciplinary Approach ◽  
Therapy Monitoring ◽  
Antiviral Agents ◽  
Item Score ◽  
Hcv Therapy ◽  
Viral Hepatitis C ◽  
Significant Difference

The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.

scholarly journals Are We Closer to International Consensus on the Term ‘Food Literacy’?: A Systematic Scoping Review of Its Use in the Academic Literature (1998–2019)

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2006
Author(s):  
Courtney Thompson ◽  
Jean Adams ◽  
Helen Anna Vidgen
Keyword(s):  
Scoping Review ◽  
International Agency ◽  
Original Research ◽  
International Consensus ◽  
Food Literacy ◽  
Academic Literature ◽  
Review Articles ◽  
Article Type ◽  
Definition Of ◽  
Over Time

(1) Background: The term ‘food literacy’ has gained momentum globally; however, a lack of clarity around its definition has resulted in inconsistencies in use of the term. Therefore, the objective was to conduct a systematic scoping review to describe the use, reach, application and definitions of the term ‘food literacy’ over time. (2) Methods: A search was conducted using the PRISMA-ScR guidelines in seven research databases without any date limitations up to 31 December 2019, searching simply for use of the term ‘food literacy’. (3) Results: Five hundred and forty-nine studies were included. The term ‘food literacy’ was used once in 243 articles (44%) and mentioned by researchers working in 41 countries. Original research was the most common article type (n = 429, 78%). Food literacy was published across 72 In Cites disciplines, with 456 (83%) articles from the last 5 years. In articles about food literacy (n = 82, 15%), review articles were twice as prevalent compared to the total number of articles (n = 10, 12% vs. n = 32, 6%). Fifty-one different definitions of food literacy were cited. (4) Conclusions: ‘Food literacy’ has been used frequently and broadly across differing article types and disciplines in academic literature internationally. However, agreement on a standardised definition of food literacy endorsed by a peak international agency is needed in order to progress the field.

Medication adherence in adolescents in current practice: community pharmacy staff's opinions

2014 ◽  
Vol 23 (3) ◽  
pp. 221-224 ◽  
Author(s):  
Ellen S. Koster ◽  
Daphne Philbert ◽  
Nina A. Winters ◽  
Marcel L. Bouvy
Keyword(s):  
Medication Adherence ◽  
Community Pharmacy ◽  
Current Practice ◽  
Practice Community

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluative Study (Preprint)

2021 ◽  
Author(s):  
Cynthia F. Corbett ◽  
Elizabeth M. Combs ◽  
Peyton S. Chandarana ◽  
Isabel Stringfellow ◽  
Karen Worthy ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Medication Adherence ◽  
Feasibility Study ◽  
Global Public Health ◽  
Constructive Feedback ◽  
The Past ◽  
Significant Difference ◽  
Mcnemar’S Test ◽  
Medication Reminder ◽  
Mcnemar's Test

BACKGROUND Medication non-adherence is a global public health challenge that results in sub-optimal health outcomes and increases healthcare costs. Forgetting to take medicines is one of the most common reasons for unintentional non-adherence. Research findings indicate that voice-activated virtual home assistants (VHAs), such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence. OBJECTIVE Create a medication adherence app (skill) for Amazon Echo devices and measure the use, usability, and usefulness of that skill. METHODS A single-group mixed methods cohort feasibility study was conducted with females who took oral contraceptives (n=25). Participants were undergraduate students (mean age = 21.8, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy, a new medication reminder skill for Echo devices created by our team, attached to their study account, which they used for 60 days. Participants self-reported baseline and post-study medication adherence. MedBuddy use was objectively evaluated by tracking the participants’ interaction with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a post-study interview with participants responding to both quantitative and qualitative questions. RESULTS Participants’ interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean of 50.97, SD 29.5). Compared to baseline, at study end participants reported missing their medication less in the past one and six months (χ 2 = .884 and .420 respectively, McNemar’s test p < .001 for both). However, there was no significant difference in participants’ reported adherence to consistently taking medication within the same two-hour time frame each day the past one or six months at the end of the study compared to baseline (χ 2 = 3.544 and 5.526 respectively, McNemar’s test p = .63 and p = .13 respectively). Overall feedback about usability was positive, and participants provided constructive feedback about features of the skill that could be improved. Participants’ evaluation of the usefulness of Medbuddy was overwhelmingly positive. Most participants (65.2%, n=15) said they would continue to use MedBuddy as a medication reminder in the future if provided the opportunity and the majority (91.3%, n=21) said they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, being able to hear the reminder prompt from a separate room, multiple reminders, and verbal responses as prompts. CONCLUSIONS The results of this feasibility study indicate the MedBuddy medication reminder skill may be useful in promoting medication adherence, but the skill could benefit from further usability enhancements.

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