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 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 Hypertensive Patient Compliance with Pharmacist Intervention: A Systematic Review

2021 ◽  
pp. 85-97
Author(s):  
Abdullah M. Alshahrani ◽  
Marzoq S. Al-Nasser ◽  
Saif T. Alhawashi ◽  
Saad Alqahtani ◽  
Ali A. Alqahtani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Hypertensive Patient ◽  
Patient Compliance ◽  
Intervention Group ◽  
Pressure Control ◽  
Pharmacist Intervention ◽  
Control Group ◽  
Improve Medication Adherence ◽  
Significant Difference

Background: Pharmacists and physicians can work together to improve patient compliance especially for the management of hypertension. Medication adherence leads to advance health and reduces hospitalizations (morbidity), death (mortality) and healthcare costs. Objectives: Involvement of pharmacist in treatment intervention can result in improved understanding about hypertension and it can increase medication adherence to antihypertensive therapy which ultimately advance overall quality of life. Study design and methods: A comprehensive research study was conducted using two eminent databases i.e. PUBMED and EMBASE. The research articles from 1996 to 2015 were analyzed. All the selected articles were about pharmacist intervention, hypertensive patient compliance and hypertension medication adherence. Results: Some studies show no control in BP; however, there was significant difference in the systolic and diastolic BP pre and post pharmacist intervention (Systolic from 158.1±14.4 to 143.8 ± 10.7, Diastolic from 100.6 ±11.5 to 89.8 ± 9.7). Conversely, in some studies BP was controlled in about 29.9% of control group and in 63% of the intervention group. Conclusion: Results showed many methods can improve medication adherence and blood pressure including counseling patients in person, collaboration between pharmacists and physicians, and using technology like telecommunication to intensify patients counseling. Pharmacist intervention can significantly increase disease-related knowledge, blood pressure control and medication adherence in patients with hypertension.

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 48. Association of Rapid Pathogen Identification and Pharmacist Intervention on Time to Optimal Antimicrobial Therapy for Bloodstream Infections at Two Community Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Bryant M Froberg ◽  
Nicholas Torney
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Pharmacist Intervention ◽  
Pathogen Identification ◽  
Community Hospitals ◽  
Significant Difference

Abstract Background As many as 1 in 3 patients with bloodstream infections at community hospitals receive inappropriate empiric antimicrobial therapy. Studies have shown that the coupling of real-time intervention with rapid pathogen identification improves patient outcomes and decreases health-system costs at large, tertiary academic centers. The aim of this study was to assess if similar outcomes could be obtained with the implementation of real-time pharmacist intervention to rapid pathogen identification at two smaller, rural community hospitals. Methods This was a pre-post implementation study that occurred from September of 2019 to March 2020. This study included patients ≥18 years of age admitted with one positive blood culture. Patients were excluded if they were pregnant, had a polymicrobial blood culture, known culture prior to admission, hospice consulted prior to admission, expired prior to positive blood culture, or transferred to another hospital within 24 hours of a positive blood culture. Endpoints of patients prior to intervention were compared to patients post-implementation. The primary endpoint was time to optimal antimicrobial therapy. Secondary endpoints included time to effective antimicrobial therapy, in-hospital mortality, length of hospital stay, and overall cost of hospitalization. Results Of 212 patients screened, 88 patients were included with 44 patients in each group. Both groups were similar in terms of comorbidities, infection source, and causative microbial. No significant difference was seen in the mean time to optimal antimicrobial therapy (27.3±35.5 hr vs 19.4± 30 hr, p=0.265). Patients in the post-implementation group had a significantly higher mean hospitalization cost ($24,638.87± $11,080.91 vs $32,722.07±$13,076.73, p=0.013). There was no significant difference in time to effective antimicrobial therapy, in-hospital mortality, or length of hospital stay. Conclusion There were no between-group differences in the primary outcome of time to optimal therapy, with a higher mean hospitalization cost after implementation. These results suggest further antimicrobial stewardship interventions are needed, along with larger studies conducted in the community hospital settings. Disclosures All Authors: No reported disclosures

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.

scholarly journals THE EFFECT OF SHORT MESSAGE SERVICE (SMS) TEXTING ON MEDICATION ADHERENCE AMONG TUBERCULOSIS PATIENTS

2019 ◽  
Vol 13 (1) ◽  
pp. 49
Author(s):  
Yunus Adhy Prasetyo
Keyword(s):  
Medication Adherence ◽  
Short Message Service ◽  
T Test ◽  
Control Group ◽  
Short Message ◽  
Tuberculosis Patients ◽  
The Public ◽  
Significant Difference ◽  
Message Service ◽  
Experimental Group

The study was conducted to examine the effect of Short Message Service (SMS) Texting on medication adherence among tuberculosis patients. 68 persons diagnosed with tuberculosis and registered in the public health center in Klari, Karawang, West Java, Indonesia, were randomly appointed to an experimental or control group; 34 persons assigned to each group. Participants in the experimental group received routine SMS Texting, while those in the control group receive none. Data were analyzed using Dependent t-test and Independent t-test. The results indicated that after participating by receiving SMS texting, there was a significant improvement in medication adherence in TB patients in the experimental group, which was shown by significant difference in mean score of medication adherence. In addition, after participating in the program, there was a meaningful difference in mean scores of medication adherence between the experimental group (X=6.38, SD=0.85) and the control group (X=3.64, SD=1.04), p<0.01. The SMS Texting method appears to be effective in improving medication adherence among TB patients.

Evaluation of Real-World Smart Sock-Based Temperature Monitoring Data as a Physiological Indicator of Early Diabetic Foot Injury: Case-Control Study (Preprint)

2021 ◽  
Author(s):  
Alexander M Reyzelman ◽  
Chia-Ding Shih ◽  
Gregory Tovmassian ◽  
Mohan Nathan ◽  
Ran Ma ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Monitoring Program ◽  
Temperature Monitoring ◽  
Lower Extremity Injury ◽  
Study Cohort ◽  
Temperature Differential ◽  
Comparator Group ◽  
Foot Injury ◽  
Useful Signal ◽  
Significant Difference

BACKGROUND Diabetic foot ulcers represent major health care complications both in terms of cost and impact to quality of life for patients with diabetic peripheral neuropathy. Temperature monitoring has been shown in previous studies to provide a useful signal of inflammation that may indicate the early presence of a foot injury. OBJECTIVE In this study we evaluated the temperature data for patients that presented with a diabetic foot injury while utilizing a sock-based remote temperature monitoring device. METHODS The study abstracted data from patients enrolled in a remote temperature monitoring program in year 2020-2021 using a smart sock (Siren Care, San Francisco, California, USA). In the study cohort, a total of 5 participants with a diabetes-related lower extremity injury during study period were identified. In the second comparison cohort, a total of 26 patients met the criteria for monitoring by the same methods that did not present with a diabetes-related podiatric injury during the same period. The 15-day temperature differential between six defined locations on each foot was the primary outcome measure among subjects who presented a diagnosed foot injury. Paired t-tests were used to compare the differences between the two groups. RESULTS A significant difference in temperature differential was observed in the group that presented with a podiatric injury over the course of evaluation vs. the comparator group that did not present with a podiatric injury with temperature measured in °F. The average difference from all six measured points was 1.4°F between the injury group (mean 3.6 +/- 3.0) and the comparator group (mean 2.2 +/- 2.5, t=-71.4; P<.000). CONCLUSIONS The presented study demonstrated significant temperature difference for patients presenting with a foot injury in a 15-day period prior to the diagnosis of an injury compared with a similar period for patients without an injury. The findings suggest temperature monitoring may be a predictor of a developing foot injury. The continuous temperature monitoring system employed has implications for further algorithm development to enable early detection. The study was limited by a nonrandomized, observational design with limited injuries present in the study period.

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