Development of the Asthma Medication Therapy Management (MTM) Protocol

Objective: To describe the process of developing an asthma Medication Therapy Management (MTM) protocol with the aim of improving the clinical and humanistic outcomes of asthmatic patients. Background: Asthma is one of the most common chronic diseases which affects approximately 26 million Americans. Achieving a controlled asthma regimen is challenging because ineffective therapy can lead to poor outcomes and serious complications. Pharmacists’ involvement in patient care can optimize outcomes and deliver patient-centered care. One of the services known to optimize outcomes for the pharmacist is an MTM program. Despite this, little is known about a standardized model to integrate an MTM pharmacist for the care of asthmatic patients. Method: An asthma MTM protocol was established after an intensive literature review. The protocol was developed with the help of the primary investigator, the NSU Pharmacy team, and the MTM ICUBA Cares Call Center using the Global Initiative for Asthma (GINA) 2019 guidelines and retrospective literature. The protocol was approved by the NSU institutional board review as a part of an MTM pilot program for this population. Result: The asthma MTM protocol was developed to determine whether the goals of asthma therapy are being achieved and asthma is controlled. The protocol comprised of core elements of MTM, such as performing medication therapy review, providing a personal medication record, completing a medication-related action plan, providing recommendations and/or referral, and scheduling a follow-up visit. Conclusion: This paper is the first to describe the process of creating an asthma MTM protocol. It is anticipated that the developed asthma MTM protocol will be utilized to demonstrate that MTM service leads to improvements in the clinical and humanistic outcomes of this population. Fund: This program was funded by the HPD Grant

Development and Validation of Florida Pharmacists’ Knowledge Scale of Medicare Part D Pharmacist-Based Medication Therapy Management

Objective: The aim of this study was to expand the theory of planned behavior model by adding knowledge construct to assess whether pharmacists’ overall knowledge level about MTM impacts the pharmacists’ perception to provide such services. Background: MTM model is required by the Medicare Modernization Act 2003 as one of the services that take care of the patients. Under the Affordable Care Act (ACA) of 2010, there were significant changes in MTM programs through expanded requirements and improvement measures to further support MTM programs. Little is known about pharmacists’ knowledge of MTM after the changes that resulted from the ACA of 2010. Method: Knowledge scale was created after an intensive literature review. The scale was generated based on face and content validity and the reliability and internal consistency. The internal consistency was improved to purify the scale. The scale was reduced from 33 to 24 items; include background and process sub-dimensions. The “mock” survey was applied to third-year Pharm.D students at NSU using survey monkey. Result: Cronbach’s Alpha coefficients were 0.962 for the entire scale, 0.923 for the background subscale, and 0.947for the process subscale. The scale was assessed to understand the factors loadings of the knowledge scale. The results indicated 5-factor solution. Conclusion: This study is the first to identify construct of interest in assessing pharmacists’ knowledge regarding MTM services and offered evidence of the reliability of the scale. It is anticipated that the scale will be utilized to assess the change in knowledge level as MTM services expanded as results of ACA

COVID-19 Vaccine Acceptance and Hesitancy among Migrants, Refugees, and Foreign Workers: A Systematic Review and Meta-Analysis

Despite the effectiveness of current vaccines in reducing the spread and severity of SARS-CoV-2 infections, many people, including migrants, refugees, and foreign workers, are hesitant to be vaccinated. This systematic review and meta-analysis (SRMA) was conducted to determine the pooled prevalence estimate of the acceptance and hesitancy rates of the COVID-19 vaccine among these populations. A comprehensive search of the peer-reviewed literature indexed in PubMed, Scopus, Science Direct, and Web of Science databases was conducted. Initially, 797 potential records were identified, of which 19 articles met the inclusion criteria. A meta-analysis of proportions using data from 14 studies revealed that the overall acceptance rate of COVID vaccination among 29,152 subjects was 56.7% (95% CI: 44.9–68.5%), while the prevalence of vaccine hesitancy among 26,154 migrants reported in 12 studies was estimated to be 31.7% (95% CI: 44.9–68.5%). The acceptance rate for the COVID-19 vaccination first declined from 77.3% in 2020 to 52.9% in 2021 and then slightly increased to 56.1% in 2022. The most frequent factors influencing vaccine hesitancy were worries about vaccine efficacy and safety. Intensive vaccination campaigns should be implemented to raise vaccination awareness among migrants, which will increase the acceptance rate for the COVID-19 vaccine and result in herd immunity