Impact of passive and active promotional strategies on patient acceptance of medication therapy management services

Objectives To assess the impact of passive and active promotional strategies on patient acceptance of medication therapy management (MTM) services, and to identify reasons for patient acceptance or refusal. Methods Four promotional approaches were developed to offer MTM services to eligible patients, including letters and bag stuffers (“passive” approaches), and face-to-face offers and telephone calls (“active” approaches). Thirty pharmacies in a grocery store chain were randomized to one of the four approaches. Patient acceptance rates were compared among the four groups, and between active and passive approaches using hierarchical logistic regression techniques. Depending on their decision to accept or decline the service, patients were invited to take part in one of two brief telephone surveys. Results No significant differences were identified among the four promotional methods or between active and passive methods in the analyses. Patients’ most frequent reasons for accepting MTM services were potential cost savings, review of how the medications were working, the expert opinion of the pharmacist, and education about medications. Patients’ most frequent reasons for declining MTM services were that the participant already felt comfortable with their medications and felt their pharmacist provides these services on a regular basis. Conclusion No significant difference was found among any of the four groups or between active or passive approaches. Further research is warranted to identify strategies for improving patient engagement in MTM services

Healthy People 2020: Identifying Roles for Pharmacists in Public Health

Healthy People, sponsored by the United States Department of Health and Human Services, utilizes evidence-based medicine to create objectives addressing significant preventable health issues. The vision of Healthy People is to improve the quality and length of life free from preventable disease, disability, injury and death. Based on objectives outlined by Healthy People 2020 (HP 2020) pharmacists can play a role in public awareness, collaborate with other health care professionals and help achieve goals set forth by HP 2020. Based on the expertise and accessibility of the pharmacist, pharmacists can impact nine of the 13 new focus areas pf HP 2020, including adolescent health, blood disorders and safety, dementias, early/middle childhood, global health, health care-associated infections, older adults, emergency preparedness, and sleep health. HP 2020 is now an Internet-accessible, user-friendly, interactive database, that can further enhance communication between patients and pharmacists. Pharmacists and student pharmacists can use the various tools and resources available to them to implement these health improvement priorities and realize the goals and objectives set forth by HP 2020

The Importance of Early Diagnosis and Treatment of Postpartum Depression

Postpartum depression (PPD) is a major depressive episode following childbirth that can have serious consequences affecting the family. Consequences range from marital problems and issues with child development to maternal suicide and infantcide. Depression in mothers can lead to cognitive and social impairment in the child as well as paternal postpartum depression in the father. Due to the severity of these problems, it is important to diagnose and treat mothers as soon as possible. There are several symptoms that are evident in mothers suffering from PPD that lead to diagnosis. Symptoms are similar to those of major depressive episodes, but they occur 24 hours to several months postpartum. Treatment options for PPD include psychotherapy as well as tricyclic antidepressants and selective serotonin reuptake inhibitors. While these medications have been shown to be the most effective pharmacological options, more research needs to be conducted to establish their effects on the infants. The possibility of preventative therapy also needs to be addressed to minimize the long-term effects of the disorder

Management of Hypertensive Emergencies in Pediatrics

As hypertension becomes more prevalent in the pediatric population, clinicians are more likely to encounter hypertensive emergencies in children, which require pharmacists and physicians to be educated on the therapeutic options for these emergencies. However, the strict governmental requirements on the testing of these drugs in pediatric patients have limited the amount of available evidence on which to base clinical decisions. This review will highlight the available evidence and preferred treatment options for the management of pediatric hypertensive emergencies

The Use of Propranolol in the Treatment of Posttraumatic Stress Disorder

This article examines the rising issue of post-traumatic stress disorder (PTSD) and possible treatment options. PTSD is a behavioral disorder resulting from memory formation and association with a traumatic event. A search of the published literature reveals several positive studies and case reports suggesting that propranolol, a beta adrenergic receptor antagonist, may be useful for both treatment and prevention of PTSD. Additionally, current studies are being completed in different population groups to determine the overall effectiveness and mechanism by which propranolol is able to provide relief from certain symptoms common to the disorder. This article discusses the medical evidence and possible treatment role of propranolol for patients suffering from PTSD

Treatment Options for Seasonal Affective Disorder

Many patients who have undiagnosed Seasonal Affective Disorder (SAD) may come into the pharmacy to try to self-treat their symptoms with over-the-counter and herbal drugs. Often, patients don\u27t recognize their symptoms as a true depressive disorder since they are not constant. The pharmacist has the opportunity to talk to these patients, educate them on the disease state and explain that they do have options, both pharmacologic and non-pharmacologic. It also is important for pharmacists to point out any interactions that the herbal or over-the-counter medications may have with other medications and to refer patients to their physician for further treatment. Currently, the Diagnostic and Statistical Manual for Mental Disorders (DSM) IV does not recognize SAD as a separate disorder but rather a specifier of Major Depressive Disorder (MDD). However, there are currently recommendations to include SAD as a distinct disorder in DSM V, which is to be released in May 2013

Fragment-Based Approach to the Development of an Orally Bioavailable Lactam Inhibitor of Lipoprotein-Associated Phospholipase A2 (Lp-PLA₂)

Lp-PLA₂ has been explored as a target for a number of inflammation associated diseases, including cardiovascular disease and dementia. This article describes the discovery of a new fragment derived chemotype that interacts with the active site of Lp-PLA₂. The starting fragment hit was discovered through an X-ray fragment screen and showed no activity in the bioassay (IC₅₀ > 1 mM). The fragment hit was optimized using a variety of structure-based drug design techniques, including virtual screening, fragment merging, and improvement of shape complementarity. A novel series of Lp-PLA₂ inhibitors was generated with low lipophilicity and a promising pharmacokinetic profile