Rosser S.,Kroger Pharmacy |
Frede S.,Kroger Pharmacy |
Conrad W.F.,University of Cincinnati |
Heaton P.C.,University of Cincinnati
Journal of the American Pharmacists Association | Year: 2013
Objectives: To develop, implement, and evaluate a depression screening program performed by pharmacists in the community setting; to determine the ability of this screening to identify and refer patients with symptoms of depression; and to determine whether physician referral results in initiation or modification of treatment. Design: Prospective study. Setting: 32 locations of a large grocery chain pharmacy in the Cincinnati and Dayton, OH, area from February 8, 2010, to March 30, 2011. Patients: 3,726 patients 18 years or older. Intervention: Patients were screened for depression using the Patient Health Questionnaire (PHQ). Patients who screened positive on the two-item PHQ (PHQ-2) then were given the nine-item PHQ (PHQ-9). Patients who screened positive on the PHQ-9 were referred to their physician. Pharmacists followed up with these patients to determine the action that was taken following the screening. Main outcome measures: Number of patients with a positive PHQ-9, number of patients referred to their physician, and number of patients for whom treatment was initiated or modified as a result of screening. Results: 3,726 patients were screened for depression by pharmacists during the study period. A total of 67 (1.8%) patients screened positive on the PHQ-2. Of the patients who completed the PHQ-9, approximately 25% met the criteria for consideration of diagnosis and were referred to their physician. Five patients presented with suicidal thoughts and were referred for urgent treatment. Approximately 60% of patients with a positive PHQ-9 had initiated or modified treatment at the time of follow-up. Conclusion: A screening program for depression was successfully developed and implemented in the community pharmacy setting. Using the PHQ, pharmacists were able to quickly identify undiagnosed patients with symptoms of depression. The majority of patients with a positive screening had initiated or modified treatment at the time of follow-up.
Wenthur C.J.,Vanderbilt University |
Cross B.S.,Saint Marys Health Care |
Vernon V.P.,Richard L. Roudebush VAMC |
Shelly J.L.,University of North Carolina at Chapel Hill |
And 4 more authors.
Research in Social and Administrative Pharmacy | Year: 2013
Background: Substance abuse and addiction are growing public health problems. Pharmacists are potentially in a position to be of great assistance in ameliorating these threats yet might not be receiving the education and training to do so effectively. Objective: To assess the relative perceived importance of substance abuse topics in pharmacy education among student pharmacists and pharmacy practitioners in the state of Indiana. Methods: Questionnaires were administered in class to students at Purdue University College of Pharmacy and via direct mail to the home addresses of randomly selected licensed Indiana pharmacists in 2009 to elicit information on the relevance and interest for particular topics within addiction education, prior education received regarding addiction, and the frequency of professional interactions that involved addiction. Results: Three hundred fifty students (74%) and 625 pharmacists (26%) responded to the survey. The average interest across all surveyed topics was 3.18/4.00 for students and 3.47/4.00 for practitioners. Areas rated highly by both groups included withdrawal, pain management, and recognition of signs and symptoms of addiction in patients. Qualitative responses from practitioners suggest strong interest in further education in this area and a perceived need for increased educational exposure during the student pharmacist experience. The average pharmacist respondent spent 6.94% of the time dealing with people who were addicted, and 22.2% had independent addiction education. Conclusions: Pharmacists and pharmacy student respondents overwhelmingly felt that educational preparation in this area is important. A significant portion of time in practice is spent managing addiction-related issues, and further educational opportunities are being pursued beyond graduation to fulfill the educational needs of the practitioner respondents. © 2013 Elsevier Inc.
Grimm M.,University of Georgia |
Ford H.,University of Georgia |
Grubbs K.,Kroger Pharmacy |
Sarao S.,University of Georgia
Journal of Pharmacy Technology | Year: 2013
Background: Research has shown that medication adherence is strongly associated with improved patient outcomes and lower health care costs. Although adherence strategies, including automatic prescription refill programs, improve medication adherence to varying degrees, no report to date has examined patient perceptions of and barriers to enrollment in automatic refill programs. This study analyzes patient perceptions of and predictors of enrollment in automatic prescription refill programs through a cross-sectional analysis of patients at a grocer-based community pharmacy. Objectives: To determine patient perceptions regarding automatic prescription refill programs and identify potential barriers to enrollment. Methods: Patient perceptions regarding an automatic refill program were gathered through a survey and assessed using exploratory factor analysis and binary logistic regression techniques for significant predictors of program enrollment. A convenience sample of pharmacy patrons 18 years of age and older was identified at a grocer-based community pharmacy. Results: A total of 110 surveys were evaluated. Hypertension and mental health conditions were the most commonly reported disorders (29.1% and 26.4%, respectively). Enrollment in the program more than doubled during the study period, and all participants enrolled at baseline chose to remain in the program. Eight different perceptions were identified that accounted for approximately 79.14% of data variance. Of the perceptions identified, patients' sense of satisfaction, in terms of receiving timely, convenient medication refills and not running out of medications, significantly predicted enrollment in the automatic refill program (P = .0036). Conclusions: Automatic prescription refill programs are known to support patient adherence to medications. Promoting a refill program as a timely and convenient means of safeguarding against running out of medications or medication refills may increase program enrollment and, consequently, medication adherence. © 2013 The Author(s).
Kisor D.F.,Ohio Northern University |
Bright D.R.,Ohio Northern University |
Conaway M.,Kroger Pharmacy |
Bouts B.A.,Blanchard Valley Medical Assoc. |
Gerschutz G.P.,Blanchard Valley Medical Assoc.
Journal of Pharmacy Practice | Year: 2014
Introduction: Although antiplatelet therapy is a mainstay of postpercutaneous coronary intervention therapy, pharmacogenetic (PGt) considerations of therapy are often ignored despite related Food and Drug Administration warnings. Pharmacists are well situated to provide PGt guidance, and the community pharmacy is one setting where PGt testing, interpretation, and recommendations can take place to ensure optimal therapeutic outcomes. Case Report: A 65-year-old man who had a myocardial infarction that was treated with PCI and stent placement was determined by a community pharmacist to be a candidate for PGt testing to ensure optimal antiplatelet therapy. The patient was seen in the pharmacy as a part of a medication therapy management encounter and underwent genetic testing. Results of the genetic testing indicated the need for modification of therapy. The community pharmacist interpreted the results and made the appropriate recommendation to the cardiologist who in turn modified antiplatelet therapy appropriately. Conclusion: This case describes the potential for collaboration between pharmacists and physicians to optimize antiplatelet therapy through PGt testing. Points of consideration for others looking to implement related PGt services are also discussed. © The Author(s) 2014 Reprints and permission: sagepub.com/journalsPermissions.nav.
Sevin A.M.,Ohio State University |
Romeo C.,BTG |
Gagne B.,Kroger Pharmacy |
Brown N.V.,Ohio State University |
Rodis J.L.,Ohio State University
BMC Public Health | Year: 2016
Background: Adult vaccination rates in the United States are well below recommendations with disparities in race, ethnicity, and education level resulting in even lower rates for these populations. This study aimed to identify the barriers to and perceptions of immunizations in adults in an urban, underserved, multicultural community. Understanding the factors that influence adults' decisions to receive routinely recommended vaccines will aid health care providers and public health officials to design programs to improve vaccination rates. Methods: This cross-sectional, survey-based study was conducted in January 2014 in Columbus, Ohio. Participants were recruited from four urban federally-qualified health centers and four grocery stores affiliated with those clinics. The survey gathered self-reported receipt of immunizations, knowledge about indications for immunizations, and factors influencing decisions to receive an immunization. Data was analyzed in 2014. Descriptive statistics were generated for all survey items and Chi-Square or Fisher's Exact tests were used as appropriate to test for associations between demographic characteristics and factors influencing immunization decisions. Results: The top five factors likely to affect the decision to receive an immunization among the 304 respondents were: "doctor's recommendation" (80.6 %), "knowing why I should get a vaccine" (78.2 %), "knowing which vaccines I need" (75.5 %), cost (54.2 %), and "concern about getting sick if I get a vaccine" (54.0 %). Significant differences in factors influencing the immunization decision exist among respondents based on ethnicity and education level. For those participants with self-identified diabetes, heart disease, or asthma, less than half were aware that certain immunizations could reduce the risk of complications associated with their disease(s). Conclusions: Data from this study may inform and shape patient education programs conducted in clinics, retailers, and communities, as well as advocacy efforts for adult immunizations. Results from this study suggest that patients would respond to programs for promoting vaccine uptake if they focused on benefits and indications for vaccines. The results also highlighted the need for education regarding immunizations for patients with chronic diseases and special indications. The differences in perceptions found between groups can be used to create targeted interventions based on the needs of those patient populations. © 2016 Sevin et al.
Fuller L.,Kroger Pharmacy |
Fuller L.,University of Cincinnati |
Conrad W.F.,University of Cincinnati |
Heaton P.C.,University of Cincinnati |
And 3 more authors.
Journal of the American Pharmacists Association | Year: 2012
Objectives: To implement a spirometry-based chronic obstructive pulmonary disease (COPD) screening in a community pharmacy chain, determine whether pharmacists can accurately perform spirometry screenings and interpret results, and determine whether performing screenings improved enrollment in smoking cessation programs. Design: Prospective study. Setting: Kroger pharmacies in the Cincinnati-Dayton Kroger Marketing Area and off-site screening events in Cincinnati, OH, from March to December 2010. Patients: Consenting individuals older than 35 years who met inclusion and exclusion criteria. Intervention: Specially trained community pharmacists administered a validated COPD screening questionnaire and performed spirometry. The results were interpreted, given to the patient, and faxed to the primary care physician. Any patient who was currently smoking was offered smoking cessation counseling. Main outcome measures: Spirometry technical quality and interpretation accuracy, screening questionnaire scores in relationship to spirometry results, number of patients enrolled in smoking cessation programs. Results: Of the 185 patients, 10 were excluded due to inability to perform spirometry. After review, 174 (99%) of the spirometries were judged acceptable and 157 (90%) demonstrated reproducible results. The mean (±SD) score on the COPD Population Screener questionnaire was 2.3 ± 1.6 (range 0-8). Airflow limitation (defined as forced expiratory volume in 1 second/forced vital capacity < lower limit of normal) was detected in 16 (9%) of the patients. Although 12 (75%) of these patients were former or current smokers, only 3 (19%) were at increased risk for COPD based on their screening questionnaire scores. Of the nine current smokers who participated in a follow-up interview, two had successfully abstained from smoking for 6 months after the screening and five others had made an attempt to quit. Conclusion: This study demonstrated that pharmacists are able to perform accurate and reproducible spirometry in a community pharmacy setting.
PubMed | Blanchard Valley Medical Associates, Ohio Northern University and Kroger Pharmacy
Type: Journal Article | Journal: Journal of pharmacy practice | Year: 2016
Although antiplatelet therapy is a mainstay of post-percutaneous coronary intervention therapy, pharmacogenetic (PGt) considerations of therapy are often ignored despite related Food and Drug Administration warnings. Pharmacists are well situated to provide PGt guidance, and the community pharmacy is one setting where PGt testing, interpretation, and recommendations can take place to ensure optimal therapeutic outcomes.A 65-year-old man who had a myocardial infarction that was treated with PCI and stent placement was determined by a community pharmacist to be a candidate for PGt testing to ensure optimal antiplatelet therapy. The patient was seen in the pharmacy as a part of a medication therapy management encounter and underwent genetic testing. Results of the genetic testing indicated the need for modification of therapy. The community pharmacist interpreted the results and made the appropriate recommendation to the cardiologist who in turn modified antiplatelet therapy appropriately.This case describes the potential for collaboration between pharmacists and physicians to optimize antiplatelet therapy through PGt testing. Points of consideration for others looking to implement related PGt services are also discussed.
Winfrey C.,Kroger Pharmacy |
Wortman S.,Kroger Pharmacy |
Frede S.,Kroger Pharmacy |
Kunze N.,Kroger Pharmacy |
And 2 more authors.
Journal of the American Pharmacists Association | Year: 2011
Objectives: To evaluate the feasibility of implementing a pharmacist-initiated peripheral arterial disease (PAD) screening program in the community setting and to determine the ability of this screening to increase the number of patients identified with PAD. Design: Prospective study. Setting: Three locations of a large pharmacy grocery chain in the Cincinnati and Dayton, OH, area, from February 3, 2009, to May 31, 2009. Patients: 39 patients 50 years or older with a diagnosis of hypertension, dyslipidemia, and/or diabetes. Intervention: PAD screening, including an assessment of PAD symptoms and an ankle-brachial index (ABI) calculation using a handheld Doppler. Patients who screened positive were provided with appropriate counseling on possible treatments, medications, and lifestyle modifications and referred to their primary care physician for further evaluation. Main outcome measures: Successful implementation of program, number of patients referred to their physician for follow-up, and number of patients with ABI scores indicating PAD. Results: 17 of the 39 patients screened (44%) were referred to their physician for follow-up because they had ABI scores indicating PAD, symptoms indicating PAD, or noncompressible vessels. Using ABI scores, PAD was detected in nine patients (23.1%). Pharmacists implemented the program successfully. Conclusion: This study successfully demonstrated the feasibility of implementing a pharmacist-initiated PAD screening program in the community setting. The implementation of this screening program included the acquisition of affordable equipment, training of pharmacists, and access to the appropriate patient population. This study also was effective in increasing the recognition of PAD in patients screened in the community setting.
Hui-Callahan B.C.,Kroger Pharmacy |
Luder H.R.,University of Cincinnati |
Frede S.M.,Kroger Pharmacy
Journal of the American Pharmacists Association | Year: 2013
Objectives: To determine whether patients with diabetes who used a financial rewards program in a grocery chain pharmacy had increased rates of self-reported healthy behaviors, to measure the impact of the program on glycosylated hemoglobin (A1C), and to measure the impact of the program on grocery store sales. Methods: This prospective study took place at one location of a grocery chain pharmacy in Cincinnati, OH. Adult patients with diabetes on at least one diabetes medication were eligible to participate. Participants received a $5 incentive for each weeklong behavior log completed and reviewed with the pharmacist, who provided counseling on improving healthy behaviors. Change in self-reported healthy behaviors, A1C, grocery store expenditure, and program satisfaction were measured. Results: During the 12-week study, 25 patients enrolled in the program. A total of 13 participants completed the poststudy survey and reported increased rates of self-monitoring of blood glucose and blood pressure and increased exercise frequency. Differences in A1C and grocery store expenditures were unable to be detected. Satisfaction with the pay-for-performance-for-patients (P4P4P) program was favorable (8.6 on a 10-point scale). Conclusion: Participants given small, frequent financial incentives had increased frequency of healthy behaviors and were satisfied with the P4P4P program.
Metzger A.,University of Cincinnati |
Nagaraj T.,Kroger Pharmacy
Consultant Pharmacist | Year: 2015
OBJECTIVE: This article serves as a resource for health care professionals by providing a summary of primary literature and guidelines for use of the available oral anticoagulant agents. The cost vs. efficacy aspects and reversibility of these medications are also addressed. DATA SOURCES, STUDY SELECTION, AND DATA SYNTHESIS: A PubMed search and Cochrane database review were conducted between June 15 and June 30, 2014, to find appropriate primary literature on each of the new oral anticoagulants. All phase 3 trials for apixaban, rivaroxaban, dabigatran, and edoxaban for the treatment of stroke prevention in atrial fibrillation (AF) and venous thromboembolism (VTE) were included. The American College of Chest Physicians guideline recommendations for stroke prevention in AF and VTE treatment, and the American Heart Association/American College of Cardiology guidelines for AF were reviewed, and pertinent information regarding the new anticoagulants from these guidelines is included in this review. A PubMed search was also used to identify cost-efficacy references and articles on reversibility of bleeding discussed in this paper. For all these articles, no further data analysis was performed; rather summaries and discussions of all of the articles included are provided in this review. CONCLUSION: The new oral anticoagulant agents have great potential in becoming standard therapy in both VTE and stroke prevention with AF. Initial clinical evidence proves they are clinically effective and potentially cost-effective for patients searching for an alternative for warfarin. Once reversal agents are developed and long-term use data become available, these agents will likely become common in many clinical practices. © 2015 American Society of Consultant Pharmacists, Inc. All rights reserved.