Implementation of a Pharmacist-Directed Cardiovascular Risk and Medication Management Program for Participants in a Construction Trade Benefit Trust Fund

Objectives: (1) To report the results of a pharmacist-directed cardiovascular risk management program; and (2) to identify obstacles faced by the pharmacists in the program implementation. Methods: The collaborators in this study included two local unions, a health benefit consulting company, and a community pharmacy. A total of 750 union workers with cardiovascular risk were informed about the cardiovascular risk management program. The program lasted six months, and the participation was voluntary. There were three group educational sessions with each session followed by a medication management service. A staff person of the health benefit consulting company and two pharmacists were interviewed via telephone. The interview questions were created according to the Gaps Model of Service Quality. The Gaps Model theorizes five gaps among consumer expectations, consumer perceptions, management perceptions of consumer expectations, service quality, service delivery, and external communications to consumers. The following data were collected: (1) types and quantity of drug therapy problems, (2) pharmacists' recommendations and prescribers' response, (3) patients' quality of life, disability days, and sick days, and (4) the experience of involved parties. Descriptive statistics were calculated. Results: Fifteen union workers participated in the program. For the participants, 35 drug-related problems were identified, with "need for additional therapy" and "dose too low" being the most common problems. To address these drug-related problems, pharmacists made 33 recommendations to prescribers, and prescribers accepted 55% of the recommendations. According to the interviews, there were three barriers faced by pharmacists to implement the program: lack of consensus about the recruitment, union workers' unawareness of the program's benefits, and limited support from the unions and the health benefit consulting company. Conclusions: It was difficult to recruit participants into the program. Clear agreement among collaborators on both the program's benefits and the specific roles of each collaborator may be the key to successfully implement similar programs in the future. Type: Case Stud

Feasibility of a Coordinated Human Papillomavirus (HPV) Vaccination Program between a Medical Clinic and a Community Pharmacy

Human papillomavirus (HPV) vaccination coverage could be enhanced by community pharmacies working with medical clinics to coordinate completion of the HPV vaccination series. The objective for this study was to assess the feasibility of a coordinated model of HPV vaccine delivery in which a clinic gives the first dose and refers patients to a partnering community pharmacy to receive subsequent doses. A medical clinic-community pharmacy team was established in a Midwestern state to develop and operate a coordinated care model for HPV vaccinations. Under the coordinated model, the clinic identified patients needing HPV vaccination(s), administered the first dose and described the option to complete the vaccination series at the pharmacy. Interested patients then had an information sheet faxed and electronic prescriptions sent to the pharmacy. The pharmacy contacted the patients to schedule administration of 2nd and 3rd doses of the HPV vaccine. Over a 12-month period, 51 patients were referred to the pharmacy by the clinic. Of these, 23 patients received a total of 25 vaccinations. Clinic and pharmacy personnel mostly rated the coordinated program favorably. An initial study of a coordinated HPV vaccination program between a medical clinic and a community pharmacy supported patients getting HPV vaccinations

Medication-Related Problems Identified Through Continuous Medication Monitoring

Community pharmacists performing Continuous Medication Monitoring (CoMM) systematically monitor each new prescription and refill dispensed for medication-related problems. The objectives for this study were to describe medication-related problems identified through CoMM and drug classes involved in problems. This 12-month pilot study used dispensing and clinical records from a single independent U.S. community pharmacy. Clinical records contain medication-related problems documented by the pharmacists. Problems identified for patients filling at least one prescription at the pharmacy and having at least one medication-related problem during the study period were included. A total of 8439 medication-related problems were identified for 1566 patients, an average of 5.4 problems per patient. Over 63% of problems were nonadherence. The drug class most often involved in problems was the central nervous system and analgesic class. Community pharmacists performing CoMM identified medication-related problems that might otherwise have gone undetected