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Singh L.G.,Veterans Affairs Maryland Health Care System VAMHCS | Accursi M.,Chalmers lie Veterans Affairs Ambulatory Care Center | Black K.K.,Veterans Affairs Maryland Health Care System VAMHCS
American Journal of Health-System Pharmacy | Year: 2015

Purpose. The use of clinical video telehealth (CVT) technology to optimize the deployment of clinical pharmacy specialist resources in a community-based outpatient clinic (CBOC) is described.Summary. In 2012, clinical pharmacy specialists at a Veterans Affairs (VA) medical center began using CVT technology to provide anticoagulation therapy management services to patients at a CBOC about 12 miles away. Using videoconferencing technology (video cameras and high-definition widescreen monitors), the remotely located pharmacists conduct patient interviews, evaluate International Normalized Ratio (INR) values, and gather other clinical data for use in therapeutic planning. Under the supervision of pharmacists, CBOC telehealth technicians perform targeted physical assessments (e.g., point-of-care INR values, measurements of vital signs), and the results are transmitted to the medical center for pharmacist evaluation. CVT policies and procedures jointly developed by pharmacy, telehealth, and CBOC nursing staff require focused training for clinic personnel and informed patient consent to receive CVT services. During the first few months of CVT clinic operations, the mean percentage of time patients' INR values were within the therapeutic range remained stable (about 81%, compared with about 77% under the previous faceto- face clinic model), and a high level of patient satisfaction was maintained. Implementation of CVT anticoagulation monitoring services enabled pharmacist resource reallocation to other duties.Conclusion. Through the use of CVT technology, high-quality anticoagulation services and patient satisfaction were maintained and the allocation of clinical pharmacy specialist resources was optimized. Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved.


Tran L.,Chalmers lie Veterans Affairs Ambulatory Care Center | Zielinski A.,Chalmers lie Veterans Affairs Ambulatory Care Center | Roach A.H.,Chalmers lie Veterans Affairs Ambulatory Care Center | Jende J.A.,Chalmers lie Veterans Affairs Ambulatory Care Center | And 7 more authors.
Annals of Pharmacotherapy | Year: 2015

Objective: To review the oral and injectable pharmacologic treatment options for type 2 diabetes. Data Sources: A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed. In addition, manual searches were performed for cross-references from publications. Package inserts, United States Food and Drug Administration (FDA) Web site, Institute for Safe Medication Practices Web site, American Diabetes Association Web site and scientific session poster presentations, and individual drug company Web pages were also reviewed. Study Selection and Data Extraction: This review focused on information elucidated over the past 10 years to assist prescribers in choosing optimal therapy based on individual patient characteristics. Studies leading to the approval of or raising safety concerns for the antidiabetic medications reviewed in this article were included. Data Synthesis: In the past 10 years, there have been 4 novel oral antidiabetic medication classes and 9 new injectable agents and insulin products approved by the FDA for the treatment of type 2 diabetes as well as new information regarding the safety and use of several older antidiabetic medication classes. The distinctions were reviewed for each individual agent, and a comparison was completed if there was more than one agent in a particular therapeutic class. Using current information available, select investigational agents in phase III trials or those with a pending new drug application were highlighted. Conclusion: There are now 9 distinct oral pharmacologic classes and a variety of insulin and noninsulin injectable medications available for the treatment of type 2 diabetes. Metformin remains the first-line treatment option for most patients. When considering options for alternative or additional treatment, prescribers must weigh the benefits and risks using individual patient characteristics. © The Author(s) 2015.


Tran L.,Chalmers lie Veterans Affairs Ambulatory Care Center | Zielinski A.,Chalmers lie Veterans Affairs Ambulatory Care Center | Roach A.H.,Chalmers lie Veterans Affairs Ambulatory Care Center | Jende J.A.,Chalmers lie Veterans Affairs Ambulatory Care Center | And 7 more authors.
Annals of Pharmacotherapy | Year: 2015

Objective: To review the oral and injectable pharmacologic treatment options for type 2 diabetes. Data Sources: A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed. In addition, manual searches were performed for cross-references from publications. Package inserts, United States Food and Drug Administration (FDA) Web site, Institute for Safe Medication Practices Web site, American Diabetes Association Web site and scientific session poster presentations, and individual drug company Web pages were also reviewed. Study Selection and Data Extraction: This review focused on information elucidated over the past 10 years to assist prescribers in choosing optimal therapy based on individual patient characteristics. Studies leading to the approval of or raising safety concerns for the antidiabetic medications reviewed in this article were included. Data Synthesis: In the past 10 years, there have been 4 novel oral antidiabetic medication classes and 10 new injectable agents and insulin products approved by the FDA for the treatment of type 2 diabetes as well as new information regarding the safety and use of several older antidiabetic medication classes. The distinctions were reviewed for each individual agent, and a comparison was completed if there was more than one agent in a particular therapeutic class. Using current information available, select investigational agents in phase III trials or with a pending new drug application were highlighted. Conclusion: There are now 9 distinct oral pharmacologic classes and a variety of insulin and noninsulin injectable medications available for the treatment of type 2 diabetes. Metformin remains the first-line treatment option for most patients. When considering options for alternative or additional treatment, prescribers must weigh the benefits and risks using individual patient characteristics. © The Author(s) 2015.


PubMed | Chalmers lie Veterans Affairs Ambulatory Care Center
Type: Journal Article | Journal: The Annals of pharmacotherapy | Year: 2015

To review the oral and injectable pharmacologic treatment options for type 2 diabetes.A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed. In addition, manual searches were performed for cross-references from publications. Package inserts, United States Food and Drug Administration (FDA) Web site, Institute for Safe Medication Practices Web site, American Diabetes Association Web site and scientific session poster presentations, and individual drug company Web pages were also reviewed.This review focused on information elucidated over the past 10 years to assist prescribers in choosing optimal therapy based on individual patient characteristics. Studies leading to the approval of or raising safety concerns for the antidiabetic medications reviewed in this article were included.In the past 10 years, there have been 4 novel oral antidiabetic medication classes and 10 new injectable agents and insulin products approved by the FDA for the treatment of type 2 diabetes as well as new information regarding the safety and use of several older antidiabetic medication classes. The distinctions were reviewed for each individual agent, and a comparison was completed if there was more than one agent in a particular therapeutic class. Using current information available, select investigational agents in phase III trials or with a pending new drug application were highlighted.There are now 9 distinct oral pharmacologic classes and a variety of insulin and noninsulin injectable medications available for the treatment of type 2 diabetes. Metformin remains the first-line treatment option for most patients. When considering options for alternative or additional treatment, prescribers must weigh the benefits and risks using individual patient characteristics.


PubMed | Chalmers lie Veterans Affairs Ambulatory Care Center
Type: Journal Article | Journal: The Annals of pharmacotherapy | Year: 2015

To review the oral and injectable pharmacologic treatment options for type 2 diabetes.A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed. In addition, manual searches were performed for cross-references from publications. Package inserts, United States Food and Drug Administration (FDA) Web site, Institute for Safe Medication Practices Web site, American Diabetes Association Web site and scientific session poster presentations, and individual drug company Web pages were also reviewed.This review focused on information elucidated over the past 10 years to assist prescribers in choosing optimal therapy based on individual patient characteristics. Studies leading to the approval of or raising safety concerns for the antidiabetic medications reviewed in this article were included.In the past 10 years, there have been 4 novel oral antidiabetic medication classes and 9 new injectable agents and insulin products approved by the FDA for the treatment of type 2 diabetes as well as new information regarding the safety and use of several older antidiabetic medication classes. The distinctions were reviewed for each individual agent, and a comparison was completed if there was more than one agent in a particular therapeutic class. Using current information available, select investigational agents in phase III trials or those with a pending new drug application were highlighted.There are now 9 distinct oral pharmacologic classes and a variety of insulin and noninsulin injectable medications available for the treatment of type 2 diabetes. Metformin remains the first-line treatment option for most patients. When considering options for alternative or additional treatment, prescribers must weigh the benefits and risks using individual patient characteristics.

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