scholarly journals A Lifestyle Medicine Clinic in a Community Pharmacy Setting

2010 ◽  
Vol 1 (1) ◽  
Author(s):  
Thomas L. Lenz ◽  
Jessica Skradski ◽  
Maryann Z. Skrabal ◽  
Liz Ferguson ◽  
Michael S. Monaghan
Keyword(s):  
Community Pharmacy ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Weight Control ◽  
Tobacco Cessation ◽  
Lifestyle Modification ◽  
Lifestyle Medicine ◽  
Medication Therapy ◽  
Significant Burden ◽  
Pharmacy Setting

Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drug therapy for patients with chronic diseases can be improved through medication therapy management (MTM) services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to more comprehensively prevent and manage chronic conditions. The lifestyle medicine program consists of designing seven personalized programs for patients to address physical activity, nutrition, alcohol consumption, weight control, stress management, sleep success, and tobacco cessation (if needed). The lifestyle medicine program complements existing MTM services for patients with hypertension, dyslipidemia, and/or diabetes. This program is innovative because pharmacists have developed and implemented a method to combine lifestyle medicine with MTM services to not only manage chronic conditions, but prevent the progression of those conditions and others. Several innovative tools have also been developed to enhance the effectiveness of a lifestyle medicine program. This manuscript describes the program's pharmacy setting, pharmacy personnel, participants and program details as well as the tools used to integrate a lifestyle medicine program with MTM services. Type: Clinical Experience

scholarly journals Racial Differences in the Effect of Alzheimer’s Disease on Adherence to Medication Therapy for Chronic Diseases

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Arseniy Yashkin ◽  
Anatoliy Yashin ◽  
Galina Gorbunova ◽  
Igor Akushevich
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Chronic Diseases ◽  
Racial Differences ◽  
Chronic Conditions ◽  
Single Individual ◽  
Medication Therapy ◽  
Adherence To Medication ◽  
Race Ethnicity ◽  
Reduced Adherence

Abstract Multiple dementia (the presence of one or more types of dementia in a single individual) and multi-morbidity (the presence of multiple chronic diseases in an individual) present a major challenge to the U.S. healthcare system. The reduction in cognitive function associated with neurocognitive disorders such as Alzheimer’s Disease (AD) and Related Dementias (ADRD) reduce the ability of the affected individual to take care of him/herself. This can manifest as reduced adherence to medication regimens designed to manage other chronic conditions, in reduced ability to engage in healthy behavior such as exercise, or in other ways. The result is an increase in the probability of otherwise avoidable adverse health outcomes and related healthcare costs. In this study, we showcase two high impact chronic conditions common in the elderly: hypertension and type 2 diabetes mellitus (T2D). Using a 5% sample of the total Medicare population we identify groups of individuals with AD/ADRD and i) hypertension, ii) T2D or iii) both. Each group is then propensity-score-matched to similar individuals with hypertension, T2D or both but without a diagnosis of AD/ADRD. The primary explanatory variable of interest is the medication possession ratio (MPR) calculated at 1-year intervals for prescribed diabetes and/or hypertension medications. MPRs were compared between the two groups using t-tests and standardized differences each year after baseline and until death/censoring. A Cox proportional hazard model was then used to estimate differences in survival between these two groups and across race/ethnicity-related strata. Reduced adherence with time and notable race/ethnicity-related differences were identified.

scholarly journals RxIALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043612
Author(s):  
Yazid N Al Hamarneh ◽  
Carlo Marra ◽  
Robert Gniadecki ◽  
Stephanie Keeling ◽  
Andrea Morgan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Community Pharmacy ◽  
Risk Reduction ◽  
Tobacco Cessation ◽  
Ldl Cholesterol ◽  
Individual Risk ◽  
Inflammatory Conditions ◽  
Pharmacy Setting

Patients with inflammatory conditions are at high risk for cardiovascular (CV) disease. Despite such elevated risk, their CV risk factors are suboptimally managed.ObjectiveTo evaluate the effect of a pharmacist-led intervention on CV risk in patients with inflammatory conditions.MethodsDesignProspective pre–postintervention.Setting17 community pharmacies across Alberta.PopulationAdults with inflammatory conditions (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, systemic lupus erythematosus, psoriasis vulgaris) who had at least one uncontrolled risk factor (A1C, blood pressure, LDL-cholesterol or current tobacco users).InterventionAll patients enrolled in the study received: physical and laboratory assessment, individualised CV risk assessment and education regarding this risk, treatment recommendations, prescription adaptation and prescribing where necessary to meet treatment targets, regular communication with the patient’s treating physician(s) and regular follow-up with all patients every month for 6 months.OutcomesPrimary: change in estimated CV risk (risk of a major CV event in the next 10 years) after 6 months. Secondary: change in individual risk factors (blood pressure, LDL-cholesterol, A1C and tobacco cessation) over a 6-month period.ResultsWe enrolled 99 patients. The median age was 66.41 years (IQR 57.64–72.79), More than half of them (61%) were female and more than three-quarters (86%) were Caucasians. After adjusting for age, sex and ethnicity and centre effect, there was a reduction of 24.5% in CV risk (p<0.001); including a reduction of 0.3 mmol/L in LDL-c (p<0.001), 10.7 mm Hg in systolic blood pressure (p<0.001), 1.25% in A1C (p<0.001). There was a non-significant trend towards tobacco cessation.ConclusionThis is the first study on CV risk reduction in patients with inflammatory conditions in a community pharmacy setting. RxIALTA provides evidence for the benefit of pharmacist care on global cardiovascular risk reduction as well as the individual cardiovascular risk factors in patients with inflammatory conditions.Trial registration numberNCT03152396.

Reliability of a Modified Medication Appropriateness Index in Community Pharmacies

2003 ◽  
Vol 37 (1) ◽  
pp. 40-46
Author(s):  
Rosemin Kassam ◽  
Linda G Martin ◽  
Karen B Farris ◽  
Homero A Monsanto ◽  
Jean-Marie Kaiser
Keyword(s):  
Community Pharmacy ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Community Setting ◽  
Medication Appropriateness Index ◽  
Paired Samples ◽  
Psychometric Data ◽  
Ambulatory Patients ◽  
Pharmacy Setting ◽  
Medication Appropriateness

Background The medication appropriateness index (MAI) has demonstrated reliability in selected outpatient clinics where medical data were easily accessible from medical charts. However, its use in the community setting where patient data may be limited has not been examined. Objective To evaluate the usefulness of a modified MAI for use in the community pharmacy setting by testing interrater reliability using 3 different rating schemes. Methods Two raters evaluated 160 medications for 32 elderly ambulatory patients. Patient information was acquired using community pharmacist-collected medication histories. A summated MAI score, percent agreement, κ, positive agreement, negative agreement, and intraclass correlation coefficient were calculated for each criterion using 3 scoring schemes. A paired samples t-test (95% CI) was used to test interrater reliability. Results The κ statistics were >0.75 for indication and effectiveness, but good (0.41–0.66) for the remaining criteria using the Hanlon scoring scheme. The intraclass coefficients (0.82, 0.86, 0.87) and overall κ (0.65, 0.66, 0.61) were similar for the 3 schemes. Conclusions This study suggests that the modified MAI has the potential to detect medication appropriateness and inappropriateness in the community pharmacy setting; however, it is not without limitations. Because the MAI has the most clinimetric and psychometric data available, the instrument should be studied further to increase its reliability and generalizability.

scholarly journals Group-Based Trajectory Models: Assessing Adherence to Antihypertensive Medication in Older Adults in a Community Pharmacy Setting

2017 ◽  
Vol 103 (6) ◽  
pp. 1052-1060 ◽  
Author(s):  
Paul Dillon ◽  
Derek Stewart ◽  
Susan M. Smith ◽  
Paul Gallagher ◽  
Gráinne Cousins
Keyword(s):  
Older Adults ◽  
Community Pharmacy ◽  
Antihypertensive Medication ◽  
Trajectory Models ◽  
Pharmacy Setting

Pharmacy student driven detection of adverse drug reactions in the community pharmacy setting

2010 ◽  
Vol 20 (4) ◽  
pp. 399-404 ◽  
Author(s):  
Søren Troels Christensen ◽  
Birthe Søndergaard ◽  
Per Hartvig Honoré ◽  
Ole Jannik Bjerrum
Keyword(s):  
Community Pharmacy ◽  
Adverse Drug Reactions ◽  
Pharmacy Student ◽  
Drug Reactions ◽  
Pharmacy Setting
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