Impact of Specialty Pharmacists A literature review conducted by Anderson and Philbrick attempts to answer how medication therapy management (MTM) provided by pharmacists may help increase patient adherence with medications, especially DMTs. Adherence with MS medications are known to be problematic, with 17 – 40% of MS patients discontinuing DMTs within one year of therapy initiation. Nonadherence, defined as failing to fill prescriptions, missing doses, or reducing the dose or frequency of the medication, is known to lead to more frequent relapses and overall worsening health. Known barriers to adherence include high financial burden, issues with insurance, troublesome adverse drug reactions (ADRs), fear of administering injectable medications, and comorbid conditions. The authors note that there is a great shortage of pharmacists providing MTM services to MS patients. These services include …show more content…
described the specialty pharmacy model at Vanderbilt University Medical Center, Vanderbilt Specialty Pharmacy (VSP). Two dedicated pharmacists and two technicians were integrated into the MS clinic. They manage the prior authorization (PA) process, patient education of self-injectables and other medications, access to patient financial assistance programs, and overall coordination of care. After the medication is started, the pharmacist performs regular patient assessments for ADRs and adherence. The authors noted that specialty pharmacists opened clinic time to allow practitioners to see more new patients (0.36 down to 0.1 clinic visits per day) with 38% increase in new prescriptions and increased access to medication by following up and getting more PAs approved through insurance appeals or enrollment in manufacturer assistance programs. Patients had much lower than average out-of-pocket costs because pharmacists sought out grants, copay or patient assistance. Also, patient adherence, assessed through medication possession ratio, was very high, at
Indeed, this was important in establishing the rapport and the therapeutic alliance. The doctor explained to her about the nature and the course of the illness, the importance to adhere to medications and the anticipated side effects of the medications. The relationship between non-adherence and re-emergence of the symptoms was emphasized multiple times. This was because she had a past history of multiple relapses secondary to treatment non-adherence.
Pharmacists are increasingly being hired in very diverse settings. Remote order entry provides hospitals with access to the services of a remotely located pharmacist who can assist with the high volume of orders during first or second shifts. Traditionally, pharmacists are reimbursed for the prescriptions they fill, but mechanisms are becoming available to pay for clinical services. There are now ways to get reimbursed for services like diabetes management and medication therapy management (MTM). Additionally, the Medicare Modernization Act of 2003 makes provisions for reimbursement of clinical services for Medicare participants.
Limitations recognised throughout the SDM process were related to risk of further deterioration in the Consumer’s mental state. As the Consumer was slowly taken off his medications, in a safe clinical manner, his presentation deteriorated. The Consumer’s sleep pattern worsened due to the elevation in his mood, there was a noted increase in impulsivity and poor boundaries with others on the inpatient unit, leading to the Consumer becoming vulnerable. There was a prominent increase in erratic and aggressive towards others, leading to the assault of a staff member on the inpatient unit and subsequently required the use of restrictive interventions. The decline in mental state resulted in the Consumer’s father, case manager and treating team coming together for a family meeting with the Consumer present in which the previous medications the Consumer had been previously prescribed were recommenced in an attempt to re-stabilise his presentation, unfortunately this was a substituted decision made by the consumer’s father and treating tream.
Pharmacists will also follow up the patients in order to get better outcomes.
For example, Tennessee Exit Disclaimer initiated a partnership with the Tennessee Pharmacists Association to provide up to $675,000 in grants to 124 independent, community pharmacies to offset e-prescribing expenses. (4) Unsettled standards. Nationwide network still misses essential rules and standards for e-prescription messages and their validation, drug terminology and classification, application forms, medication lists and many other meeting points among physicians, pharmacies (both chain and independent) and providers. Uneducated clinicians and low PMP integration. 72% of primary care physicians are aware of their state’s PMP
I recommend that outpatient practices that still remain paper-based to transition to electronic prescribing. According to the article, most prescribing errors occur in community-based outpatient settings. Community-based practices also have the lowest rates of e-prescribing use. If more outpatient practices adopt e-prescribing, the number of prescribing errors would dramatically be reduced. Although the effects of e-prescribing seem promising, this was one of the only few studies that have been done to prove its effectiveness in outpatient setting.
Prescription drug abuse in the United States has officially been declared an epidemic by the Centers for Disease Control and Prevention (Prescription Drug Abuse Statistics, 2013). Due to the increase of prescription drug abuse, prescription narcotics have been considered the new “gateway” drug to heroin addiction. The prescription drug epidemic is being fueled by prescribers and physicians that are not utilizing proper guidelines when prescribing narcotics to patients. A major concern is that doctors are shying away from utilizing therapy and counseling, which could alleviate the use and abuse of prescription medication. With the increase of prescription medication flooding the population, this has lead to society’s concern that doctors are
Pharmacists are in a unique position to help. They have the ability and knowledge to implement programs as part of their daily practice to ensure that patients are adherent to their medications. As the medication experts, pharmacists should lead the way to improving medication adherence and providing optimal patient care. The provisions of this bill do not pose a mandate but where appropriate would require the proration of prescriptions, related cost sharing, and dispensing costs in order to conform the patient to one monthly refill that occurs on the same date each month.
Fisher Week Three Response to McConnelly Yvonne, your post was extremely intriguing to me as a community health department is not an environment I have had the privilege of experiencing. Interestingly, the utilization of computerized order entry does not prevent the prescriber from ordering an incorrect medication dose or the wrong drug (Lapane, Waring, Dube’, & Schneider, 2011). Do the facility employ process to assure nurses are checking the medication in order to avoid the administration of an incorrect drug or dosage? Distractions have been linked to medication errors, consequently, and the ability to care for a solitary patient at one time clearly minimizes the distractions and interruptions that a nurse may experience during medication
Reflection on Medication Administration Description (Competency 3j) I have looked over my moral development regarding medicine administration and have noticed there is the need for improved and has been agreed with my mentor to write a piece of reflection to identify areas of concern Feelings One of the major concern is the pace of dispensing and the time spent used to open charts and allocate them is one of my weakness. Although I am learner I need to back up the pace of dispensing so that patient doesn 't feel my skills is dull or boring and waste of time. I Had developed that feeling of being extra careful to avoid drug error and that makes me feel slightly nervous more also being under the influence of supervision as well. Evaluation
(Rissmann et al., 2012). Hence, considering the aspect of patient, NMC has picked up a cue as it is used by pharmacists while helping them in advising people in order to buy medications. Thus, this aspect is not strong enough to go into isolation as if it is combined with the charge, which ensures that medication history is taken along with OTC, herbal, POMs, allergies since patients need to explain that these aspects need to explain that which aspect is essential. Hence, assessment of holistic needs of patient looks for the determinants of health. However, patients frequently omit to explain regarding the OTC preps plus the herbal needs, which also needs to explain the usage of contraindicated drugs as it all explains the illegal needs of the
There is a lack of support from physicians as a separate medication ordering system will be used, creating an increased in workload and reduction in patient interaction time (Park et al.,
Communication can be a big factor in medication errors. Miscommunication by the members of the healthcare team can lead to deadly consequences, so orders should be repeated back and verified (Anderson, 2010.) Sometimes
Medication Adherence Reflective Writing Shaymous Juhnke As a P1 student in SDSU’s pharmacy program one of the activities required to prepare us for real world pharmacy practice would be to take part in a medication adherence simulation. The goal of this activity is to put ourselves in the patients shoes to get an idea about how patients adhere to their regimens in the real world. Through this activity I have learned that it is not always easy to take medications at the right times.
In pharmacy practice, there are always multiple solutions for a single problem. Practitioner can suggest on the medication and dosage regimen, yet the final decision should lie on the hand of patient. (Robert J.C. et al., 2012) Most of the time, patient does not understand his/her own medical condition and medication plan, let alone making decision on it. Shared decision making, patient activation and broader patient engagement can significantly improve the treatment outcomes.