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Topics
- Adverse Drug Events (ADE) (3)
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- Chronic Conditions (2)
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- Elderly (3)
- Electronic Health Records (EHRs) (2)
- Electronic Prescribing (E-Prescribing) (1)
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- Intensive Care Unit (ICU) (1)
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- Medical Errors (2)
- Medication (18)
- Medication: Safety (5)
- Nursing Homes (1)
- Opioids (2)
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- Patient Experience (1)
- Patient Safety (4)
- Practice Improvement (1)
- Prevention (1)
- Primary Care (3)
- (-) Provider: Pharmacist (23)
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- Quality of Care (1)
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- Telehealth (1)
- Transplantation (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedKakani P, Chernew M, Chandra A
The contribution of price growth to pharmaceutical revenue growth in the United States: evidence from medicines sold in retail pharmacies.
This study used data from SSR Health LLC to address research questions related to the extent of pharmaceutical revenue growth’s dependance on new medicines versus increasing prices for existing medicines. The findings showed that, from 2009 to 2019, retail pharmaceutical revenue growth was primarily driven by new products, not by price increases on existing products. The authors concluded that policies restricting price growth on existing medicines should be coupled with policies that reduce launch prices to have a meaningful long-term impact on pharmaceutical revenue growth; the use of pharmaceutical list prices was an inadequate approximation for net prices, since the role of rebates has increased and varies by drug class.
AHRQ-funded; HS000055.
Citation: Kakani P, Chernew M, Chandra A .
The contribution of price growth to pharmaceutical revenue growth in the United States: evidence from medicines sold in retail pharmacies.
J Health Polit Policy Law 2022 Dec 1;47(6):629-48. doi: 10.1215/03616878-10041079..
Keywords: Medication, Provider: Pharmacist
Pitts SI, Yang Y, Thomas B
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
This study aimed to describe the proportion of discontinued outpatient medications that would result in a prescription discontinuation, or CancelRx message to understand its impact on medication safety. The authors used a data report to identify all outpatient medications discontinued in the electronic health record (EHR) of an academic health system in 1 month (October 2018). A total of 63,485 medications were discontinued, with 36.4% e-prescribed, 40.9% patient-reported or reconciled, and the remainder prescribed nonelectronically. Discontinued high-risk medications were more likely to be e-prescribed (47%). A discontinuation reason was specified in 58.9% of all discontinued medications. Approximately one-third to one-half of discontinued medications were e-prescribed within the same EHR that would result in a CancelRx message to the pharmacy. Extension of this functionality to reconciled medications in the EHR could significantly expand the impact of CancelRx on medication safety.
AHRQ-funded.
Citation: Pitts SI, Yang Y, Thomas B .
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
J Am Med Inform Assoc 2022 Nov 14;29(12):2101-04. doi: 10.1093/jamia/ocac181..
Keywords: Medication, Provider: Pharmacist, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Kang D, Charlton P, Applebury DE
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
The authors conducted a study using high-fidelity electronic health record (EHR)-based simulations with incorporated eye tracking to understand the workflow of critical care pharmacists within the EHR, with specific attention to the data elements most frequently viewed. They found that, in addition to medication information, laboratory data and clinical notes are key focuses of intensive care unit pharmacist review of patient records and that navigation to multiple screens is required in order to view these data with the EHR.
AHRQ-funded; HS023793.
Citation: Kang D, Charlton P, Applebury DE .
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
Am J Health Syst Pharm 2022 Nov 7;79(22):2018-25. doi: 10.1093/ajhp/zxac158..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Critical Care, Provider: Pharmacist
Sikora A, Martin GS
Critical care pharmacists: improving care by increasing access to medication expertise.
This article discusses the shortage and need for critical care pharmacists in ICUs to improve care and prevent medication errors. There is a gap in critical care pharmacists with both low supply and low demand. Identifying the optimal patient:pharmacist ratio in the ICU is a key question. The authors discuss ways to reduce the gap by increasing the number of critical care pharmacy residency programs and including critical care pharmacists more in multidisciplinary rounds. The authors developed a toolkit for increasing critical care pharmacy services in five actionable steps and provide an annotated bibliography of key references.
AHRQ-funded; HS028485.
Citation: Sikora A, Martin GS .
Critical care pharmacists: improving care by increasing access to medication expertise.
Ann Am Thorac Soc 2022 Nov;19(11):1796-98. doi: 10.1513/AnnalsATS.202206-502VP..
Keywords: Provider: Pharmacist, Medication, Quality Improvement, Quality of Care, Critical Care
White A, Fulda KG, Blythe R
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
The purpose of this narrative review was to further define the nature of collaboration between pharmacists and primary care providers in improving medication safety in community settings, and to describe related barriers and strategies. The researchers searched PubMed studies published between January 2000 and December 2020 using search terms including: "collaboration," "community pharmacy," "patient safety," "medication safety," and "primary care physician." The identified articles were placed into 3 categories: 1) defining collaboration, 2) types of collaboration, and 3) barriers and solutions to collaboration. The authors concluded that medication review and other strategies are a common form of collaboration between pharmacists and primary care providers, and that barriers to that collaboration can include erroneous beliefs regarding roles, variation in access to clinical information, and differences in community pharmacy practice.
AHRQ-funded; HS027277.
Citation: White A, Fulda KG, Blythe R .
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
Expert Opin Drug Saf 2022 Nov;21(11):1357-64. doi: 10.1080/14740338.2022.2147923..
Keywords: Provider: Pharmacist, Primary Care, Medication, Patient Safety, Community-Based Practice
Chui MA, Berbakov ME, Gilson AM
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
This paper is a protocol of a pilot study to address a gap in medication safety and decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The study will occur in three phases: adaptation, effectiveness using a randomized controlled trial, and sustainment. The study will take place within a regional Midwest integrated health system in conjunction with administration leadership and pharmacy sites. The authors hope this project will provide a road map for pharmacy organizations to tailor and adopt the Senior Section.
AHRQ-funded; HS027737.
Citation: Chui MA, Berbakov ME, Gilson AM .
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
Res Social Adm Pharm 2022 Nov;18(11):3953-63. doi: 10.1016/j.sapharm.2022.06.008..
Keywords: Medication, Medication: Safety, Patient Safety, Provider: Pharmacist
Campbell NL, Pitts C, Corvari C
Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure.
The purpose of this study was to assess two pilot pharmacist-based advanced practice deprescribing intervention models and their impact on patients’ exposure to high-risk anticholinergics. The researchers conducted pilot studies of a collaborative clinic-based pharmacist deprescribing intervention and a telephone-based pharmacist deprescribing intervention. Deprescribing was defined as a discontinuation or dose reduction. Patients participating in the clinic-based pharmacy model were aged 55 years and older and were referred for deprescribing at a specialty clinic. Patients participating in the telephone-based pharmacy model were aged 65 years and older and called by a clinical pharmacist for deprescribing without referral. The study found that among the 24 medications deemed eligible for deprescribing for the18 patients in the clinic-based model, 23 were deprescribed. The clinic-based deprescribing model resulted in a 93% reduction in median annualized total standardized dose (TSD), 56% lowered their annualized exposure below a cognitive risk threshold, and 17% of medications were represcribed within 6 months. Among the 24 medications deemed eligible for deprescribing for the 24 patients in the telephone-based pharmacy model, 50% were deprescribed. There was no change in the median annualized TSD, the annualized TSD was lowered below a cognitive risk threshold in 46%, and no medications were represcribed within 6 months. The researchers concluded that pharmacist-based deprescribing successfully reduced exposure to high-risk anticholinergics in the study population.
AHRQ-funded; HS24384.
Citation: Campbell NL, Pitts C, Corvari C .
Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure.
Journal of the American College of Pharmacy 2022 Oct;5(10):1039-47. doi: 10.1002/jac5.1682..
Keywords: Elderly, Primary Care, Medication, Provider: Pharmacist, Medication: Safety, Patient Safety
Pestka DL, Paterson NL, Brummel AR
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
The objective of this study was to identify barriers and facilitators when integrating pharmacist-provided comprehensive medication management (CMM) services into a health system's team-based primary care transformation (PCT) using the Consolidated Framework for Implementation Research. Findings showed that identifying and addressing implementation barriers and facilitators early during PCT rollout was critical to the success of team-based services such as CMM and becoming a learning health system. Further, clinical pharmacists providing CMM represented a valuable interdisciplinary care team member who can help to improve healthcare quality and access to primary care.
AHRQ-funded; HS026379.
Citation: Pestka DL, Paterson NL, Brummel AR .
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
Am J Health Syst Pharm 2022 Jul 22;79(15):1255-65. doi: 10.1093/ajhp/zxac104..
Keywords: Medication, Provider: Pharmacist, Primary Care, Implementation, Practice Improvement
Gonzales HM, Fleming JN, Gebregziabher M
A critical analysis of the specific pharmacist interventions and risk assessments during the 12-month TRANSAFE Rx randomized controlled trial.
The objective of this study was to describe frequency and types of interventions made during a pharmacist-led, mobile health-based intervention of high-risk kidney transplant (KTX) recipients and to assess impact on patient risk levels. Primary pharmacist intervention types were medication reconciliation, patient education, and medication changes. The authors concluded that pharmacist-led mHealth may enhance opportunities for interventions and mitigate risk levels in KTX recipients.
AHRQ-funded; HS023754.
Citation: Gonzales HM, Fleming JN, Gebregziabher M .
A critical analysis of the specific pharmacist interventions and risk assessments during the 12-month TRANSAFE Rx randomized controlled trial.
Ann Pharmacother 2022 Jun; 56(6):685-90. doi: 10.1177/10600280211044792..
Keywords: Provider: Pharmacist, Medication: Safety, Medication, Risk, Transplantation, Kidney Disease and Health, Adverse Drug Events (ADE), Medical Errors, Patient Safety
Hollowell M, Hudmon KS, Perkins SM
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
The purpose of the study was to evaluate the validity and internal consistency of the Assessment of Chronic Illness Care (ACIC) abbreviated, 12-item scale as a novel instrument for measuring Medication Therapy Management (MTM) care delivery. Researchers administered the instrument to pharmacists employed at 27,560 community pharmacies. The study concluded that when applied to the measurement of chronic illness care within the MTM setting, the abbreviated ACIC showed acceptable validity and internal consistency, and could serve as a valuable tool.
AHRQ-funded; HS022119.
Citation: Hollowell M, Hudmon KS, Perkins SM .
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
Res Social Adm Pharm 2022 May;18(5):2804-10. doi: 10.1016/j.sapharm.2021.06.006..
Keywords: Chronic Conditions, Medication, Provider: Pharmacist, Care Management
Adeoye-Olatunde OA, Curran GM, Jaynes HA
Preparing for the spread of patient-reported outcome (PRO) data collection from primary care to community pharmacy: a mixed-methods study.
This study’s aim was to prepare for implementation of PatientToc™, a patient-reported outcomes (PRO) data collection software that can be used to help facilitate resolution of non-adherence to medications. The study was a two-phase operation, but this report focuses on the phase of the evaluation which was conducted at primary care practices currently using PatientToc™ and community pharmacies in Indiana, Wisconsin, and Minnesota. One-day site visits were conducted along with observations, audio-recorded contextual inquires, semi-structured interviews with staff and patients, and post-visit site observation debriefs. Nine pharmacies, two primary care practices, and 89 individuals participated. Four major barriers, four major facilitators and 14 recommendations were identified. A stakeholder panel engaged in four Evidence-Based Quality Improvement (EBQI) implementation process sessions. The panel confirmed findings and designated high priority recommendations which included: explaining PatientToc™ and its benefits clearly and simply to patients, ensuring patients can complete questionnaires within 10 minutes, providing hands-on training/resources for pharmacy teams, and providing feedback on the adapted PatientToc™ application, and finalizing toolkit items for initial community pharmacy implementation.
AHRQ-funded; HS025943.
Citation: Adeoye-Olatunde OA, Curran GM, Jaynes HA .
Preparing for the spread of patient-reported outcome (PRO) data collection from primary care to community pharmacy: a mixed-methods study.
Implement Sci Commun 2022 Mar 14;3(1):29. doi: 10.1186/s43058-022-00277-3..
Keywords: Provider: Pharmacist, Health Information Technology (HIT), Patient-Centered Outcomes Research
Watterson TL, Stone JA, Gilson A
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
The purpose of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx. Data were collected from a midwestern academic health system’s electronic health record and pharmacy platform for 12 months prior to and for 12 months post CancelRx implementation. Findings showed that, after CancelRx implementation, there was an immediate and significant increase in the number of controlled substance medications that were successfully discontinued at the pharmacy once they were discontinued in the clinic. This change was sustained in the year following CancelRx and did not revert to pre-CancelRx levels. The health IT functionality was able to complete discontinuation tasks and potentially to reduce workload for clinic staff.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Gilson A .
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
BMC Med Inform Decis Mak 2022 Feb 25;22(1):50. doi: 10.1186/s12911-022-01779-9..
Keywords: Cancer, Medication, Health Information Technology (HIT), Provider: Pharmacist
Green TC, Soipe A, Baloy B
Pharmacy on-site overdose protocols and prevention of overdose.
The objective of this study was to assess prevalence of on-site pharmacy overdose incidents and pharmacist and site characteristics associated with having a known protocol for responding to on-site overdose emergencies. 3,100 pharmacists in Massachusetts and Rhode Island responded to an anonymous, online survey; 17.5% reported at least one suspected overdose at their practice and 42.9% reported knowledge of their practice’s overdose protocol. Pharmacists knowledgeable about protocols were also more likely to offer naloxone to patients and did not practice at chain pharmacies. The authors concluded that community pharmacies that stock and distribute naloxone are key parts of community efforts to address the opioid crisis, and that other healthcare settings should implement on-site overdose response protocols and cultivate a standard of providing naloxone to patients.
AHRQ-funded; HS024021.
Citation: Green TC, Soipe A, Baloy B .
Pharmacy on-site overdose protocols and prevention of overdose.
Subst Abus 2022; 43(1):64-68. doi: 10.1080/08897077.2020.1736236..
Keywords: Provider: Pharmacist, Opioids, Medication, Substance Abuse, Behavioral Health, Prevention
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Rowan CG, Flory J, Gerhard T
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
The researchers conducted a retrospective cohort study among patients with linked claims and EHR data in OptumLabs Data Warehouse. Their aim was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data. They concluded that, despite substantial variability among different medications, there was very good agreement between EHR-Rx data and PC-Rx data.
AHRQ-funded; HS023898.
Citation: Rowan CG, Flory J, Gerhard T .
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
Pharmacoepidemiol Drug Saf 2017 Aug;26(8):963-72. doi: 10.1002/pds.4234.
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Keywords: Data, Electronic Health Records (EHRs), Medication, Provider: Pharmacist
Calo WA, Gilkey MB, Shah P
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
The researchers sought to examine parents' willingness to get human papillomavirus (HPV) vaccination for their children at pharmacies. Overall, their national survey found that 29 percent of parents would be willing to get HPV vaccine for their children at a pharmacy. Parental willingness was associated with believing that pharmacists are skilled at administering vaccines.
AHRQ-funded; HS000032.
Citation: Calo WA, Gilkey MB, Shah P .
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
Prev Med 2017 Jun;99:251-56. doi: 10.1016/j.ypmed.2017.02.003.
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Keywords: Children/Adolescents, Infectious Diseases, Provider: Pharmacist, Sexual Health, Vaccination
Roy B, Gottlieb AS
The career advising program: a strategy to achieve gender equity in academic medicine.
This paper discusses the significant gender disparities in academic rank which exist at US medical schools, even after controlling for age, time since training, specialty, and measures of productivity, and despite increasing numbers of women entering medicine over the past 30 years. They highlight the Society of General Internal Medicine’s Women and Medicine Task Force and the model they launched in 2013 to address these disparities- the Career Advising Program (CAP).
AHRQ-funded; HS023000.
Citation: Roy B, Gottlieb AS .
The career advising program: a strategy to achieve gender equity in academic medicine.
J Gen Intern Med 2017 Jun;32(6):601-02. doi: 10.1007/s11606-016-3969-7..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist
Schroeder SR, Salomon MM, Galanter WL
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
The researchers conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. They found that across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception.
AHRQ-funded; HS021093.
Citation: Schroeder SR, Salomon MM, Galanter WL .
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
BMJ Qual Saf 2017 May;26(5):395-407. doi: 10.1136/bmjqs-2015-005099.
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Keywords: Adverse Drug Events (ADE), Medical Errors, Medication: Safety, Medication, Provider: Pharmacist
Green TC, Potter N, Bratberg J
Detecting naloxone prejudices in the pharmacy setting.
This survey asked pharmacists how concerned they would be about dispensing pain medications (or Suboxone) to customers who are getting or already have naloxone. Fifty-nine percent of respondents indicated no or little increased concern about dispensing either medication to a known naloxone recipient. Greater concern was reported by pharmacists when considering dispensing pain medications to a known naloxone recipient.
AHRQ-funded; Letter related to AHRQ-funded MOON project (HS024021).
Citation: Green TC, Potter N, Bratberg J .
Detecting naloxone prejudices in the pharmacy setting.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S10-s11. doi: 10.1016/j.japh.2016.12.068.
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Keywords: Medication, Provider: Pharmacist, Social Media, Substance Abuse
Green TC, Case P, Fiske H
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
This study examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists. It found that consumer groups differed in awareness of naloxone and availability at pharmacies, but all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria.
AHRQ-funded; HS024021.
Citation: Green TC, Case P, Fiske H .
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S19-S27.e4. doi: 10.1016/j.japh.2017.01.013.
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Keywords: Opioids, Provider: Pharmacist, Social Stigma, Substance Abuse
Kernodle AR, Frail CK, Gernant SA
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
The researchers explored patient perceptions and the practical implication of using a brief 9-item scale to screen for medication-related problems in community pharmacies. After interviewing 40 patients who completed the scale and reviewed its results with their pharmacist, they concluded that it may have value in increasing patients' understanding of and confidence in their medications, enhancing pharmacist-patient relationships, and identifying problems requiring additional interventions.
AHRQ-funded; HS022119.
Citation: Kernodle AR, Frail CK, Gernant SA .
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
J Pharm Pract 2017 Feb;30(1):49-57. doi: 10.1177/0897190015605015.
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Keywords: Medication, Patient Experience, Education: Patient and Caregiver, Provider: Pharmacist
Kane-Gill SL, Niznik JD, Kellum JA
Use of telemedicine to enhance pharmacist services in the nursing facility.
The researchers conducted a systematic literature review to determine what telemedicine services are provided by pharmacists and the impact of these services in the nursing facility setting. Since only three manuscripts met inclusion criteria, the researchers concluded that there is a general paucity of practice-related research to demonstrate potential benefits of pharmacists' services incorporating telemedicine.
AHRQ-funded; HS024208.
Citation: Kane-Gill SL, Niznik JD, Kellum JA .
Use of telemedicine to enhance pharmacist services in the nursing facility.
Consult Pharm 2017 Feb;32(2):93-98. doi: 10.4140/TCP.n.2017.93.
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Keywords: Telehealth, Nursing Homes, Medication, Elderly, Provider: Pharmacist