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Vest MH, Weber T, Savage S, Lovince J, McKnight L, Zachary D, Rush J. Development of an innovative partnership between a health-system department of pharmacy and external community pharmacies. Am J Health Syst Pharm 2022; 79:2040-2046. [PMID: 35373251 DOI: 10.1093/ajhp/zxac097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE Our organization implemented a health-system pharmacy/community pharmacy transitions of care (TOC) program, developing a scalable model to improve care transitions from the health system to the community setting for shared patients. SUMMARY In this report, we describe our organization's experiences in taking a purposeful approach to building and pilot testing a partnership between our department of pharmacy and 14 community pharmacies within a larger statewide network to improve TOC across care settings. We have been successful in partnering with our electronic health record (EHR) vendor to enhance access capabilities to allow for documentation by community pharmacists (external to the organization) to be included in the patient record as a note. The goal of the partnership with community pharmacies is to elevate TOC for patients, identify and resolve medication therapy problems that may occur post discharge and lead to poor outcomes, and improve continuity of care across practice settings. CONCLUSION Our department of pharmacy has led a successful initiative to promote collaboration with local external community pharmacies. This program has led to innovative advancements in EHR capabilities, promoting transparency in the documentation of pharmacy services and making this documentation visible to all care team members.
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Affiliation(s)
- Mary-Haston Vest
- Department of Pharmacy, UNC Health, Morrisville, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Tim Weber
- Department of Pharmacy, UNC Health, Morrisville, NC, USA
| | - Scott Savage
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Judith Lovince
- University of North Carolina Medical Center, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Lauren McKnight
- University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Debbie Zachary
- University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Jordan Rush
- Department of Pharmacy, UNC Health, Morrisville, NC, USA
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Abstract
In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Affiliation(s)
- Jill M Kolesar
- Markey Cancer Center, Lexington, KY.,University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Lee C Vermeulen
- University of Kentucky College of Pharmacy, Lexington, KY, USA.,UK HealthCare, Lexington, KY
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Kalus JS, Dagam JK, Hoying M, Erdman D, Mieure KD, Melroy MJ, Beehrle-Hobbs D, Silvester JA. Enhancing pharmacy residency training program quality and efficiency through alignment of pharmacy residency programs within a multihospital health system. Am J Health Syst Pharm 2021; 78:2167-2174. [PMID: 33999157 DOI: 10.1093/ajhp/zxab205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Affiliation(s)
- James S Kalus
- Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
| | - Julie K Dagam
- Department of Pharmacy Services, Aurora St. Luke's Medical Center-Aurora Health Care, Milwaukee, WI, USA
| | - Michael Hoying
- Cleveland Clinic Akron General Medical Center, Akron, OH, USA
| | - Diane Erdman
- Ascension St. Joseph Hospital, Milwaukee, WI, USA
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Gibson M, Nguyen PA(A, Casserly EA, Efird LE, Kuester MK, Masters P, Miller L, Lewis DA, Weber RJ. Pain Management Stewardship Programs, Part I: A Review of Legislative and Regulatory Changes. Hosp Pharm 2021; 56:124-132. [PMID: 33790488 PMCID: PMC7958363 DOI: 10.1177/0018578719868408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Opioid use is classified as an epidemic by many due to the impact of these medications on society. Federal and state laws for prescribing and dispensing opioids have changed rapidly in a short period of time to hopefully balance proper pain control with their use. Pharmacy directors must be informed of these rapid changes to effectively work as part of any opioid stewardship team. Objective: The objective of this study was to provide foundational leadership guidance to pharmacy directors on current opioid legislation, literature, and best practices to assist in improving opioid use. Methods: A review of the literature from 2003 to the present was conducted along with collating important up to date resources and other publications that provide foundational information to help support a comprehensive management of opioid use. A summary of these data has been collated into an easy to use table and summarized throughout this article. Conclusion: The information provided in this article helps to properly inform pharmacy leaders to the resources available to improve the prescribing, dispensing, and monitoring of opioids and alternatives.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Robert J. Weber
- The Ohio State University Wexner Medical Center, Columbus, USA
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Rough S, Shane R, Armitstead JA, Belford SM, Brummond PW, Chen D, Collins CM, Dalton H, Dopp AL, Estevez MM, Hager DR, Halbach B, Hays R, Knoer S, Kotis D, Montgomery D, Plummer B, Riester MR, Schreier DJ, Simonson D, Siska MH, Waier K, Vermeulen LC. The high-value pharmacy enterprise framework: Advancing pharmacy practice in health systems through a consensus-based, strategic approach. Am J Health Syst Pharm 2021; 78:498-510. [DOI: 10.1093/ajhp/zxaa431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
AbstractPurposeThe high-value pharmacy enterprise (HVPE) framework and constituent best practice consensus statements are presented, and the methods used to develop the framework’s 8 domains are described.SummaryA panel of pharmacy leaders used an evidence- and expert opinion–based approach to define core and aspirational elements of practice that should be established within contemporary health-system pharmacy enterprises by calendar year 2025. Eight domains of an HVPE were identified: Patient Care Services; Business Services; Ambulatory and Specialty Pharmacy Services; Inpatient Operations; Safety and Quality; Pharmacy Workforce; Information Technology, Data, and Information Management; and Leadership. Phase 1 of the project consisted of the development of draft practice statements, performance elements, and supporting evidence for each domain by panelists, followed by a phase 2 in-person meeting for review and development of consensus for statements and performance elements in each domain. During phase 3, the project cochairs and panelists finalized the domain drafts and incorporated them into a full technical report and this summary report.ConclusionThe HVPE framework is a strategic roadmap to advance pharmacy practice by ensuring safe, effective, and patient-centered medication management and business practices throughout the health-system pharmacy enterprise. Grounded in evidence and expert recommendations, the statements and associated performance elements can be used to identify strategic priorities to improve patient outcomes and add value within health systems.
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Affiliation(s)
| | - Rita Shane
- Cedars-Sinai Medical Center, Los Angeles, CA, and UCSF School of Pharmacy, San Francisco, CA
| | | | | | | | - David Chen
- American Society of Health-System Pharmacists, Bethesda, MD
| | | | | | | | | | | | | | - Ryan Hays
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - Scott Knoer
- American Pharmacists Association, Washington, DC
| | - Desi Kotis
- University of California San Francisco, San Francisco, CA, and UCSF Health, San Francisco, CA
| | | | | | | | | | | | | | - Kelsey Waier
- University of California San Francisco, San Francisco, CA, and UCSF Health, San Francisco, CA
| | - Lee C Vermeulen
- University of Kentucky, Lexington, KY, and UK HealthCare, Lexington, KY
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Vest MH, Colmenares EW, Pappas AL. Transforming data into insight: Establishment of a pharmacy analytics and outcomes team. Am J Health Syst Pharm 2020; 78:65-73. [PMID: 33325486 DOI: 10.1093/ajhp/zxaa411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The importance of a data management strategy is increasingly necessary for demonstrating value and driving performance within pharmacy departments. Data analytics capabilities often do not match the pace of data accumulation. At our organization, the establishment of an embedded pharmacy analytics and outcomes (PAO) team has been instrumental to pharmacy services in generating and demonstrating value and proactively supporting a business intelligence strategy grounded in a data-driven culture. SUMMARY The PAO team was established to support the operational and strategic needs of clinical, financial, and operational pharmacy services. The team is charged with implementing the vision of extending medication-use influence and data insight to drive value-based patient care outcomes while decreasing waste, optimizing therapeutic decisions, and achieving medication management standardization across the continuum of healthcare. The PAO team is composed of 3 pharmacist full-time equivalents (FTEs), 5 business analyst FTEs, 1 biostatistician FTE, 0.2 pharmacy intern FTE, and 1 pharmacy manager FTE. Pharmacy services leaders believe it is necessary to have a mix of both clinical and analytical skill sets, given the clinical nature of the data managed by team and complexities of the medication-use process. CONCLUSION Pharmacy reporting and analytics should require the same depth of scrutiny and overview as any other step in the medication-use process where pharmacists are held accountable. For our organization, it was critical to establish pharmacist-level oversight into every portion of the analytics process where medication data are involved. This structure has led to measurable improvements in patient outcomes, operational efficiency, and financial performance.
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Affiliation(s)
- Mary-Haston Vest
- UNC Health, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC
| | - Evan W Colmenares
- UNC Health, Chapel Hill, NC, and Division of Pharmaceutical Outcomes and Policy (PhD student), UNC Eshelman School of Pharmacy, Chapel Hill, NC
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Schutz N, Olsen CA, McLaughlin AJ, Yi WM, Nelson SD, Kalichira AL, Smith AH, Miller KA, Le T, Chaffee BW, Worthy Woodbury CDRK, Patel H. ASHP Statement on the Use of Artificial Intelligence in Pharmacy. Am J Health Syst Pharm 2020; 77:2015-2018. [DOI: 10.1093/ajhp/zxaa249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Casey A Olsen
- Pharmacy Department, Advocate Aurora Health, Oak Brook, IL
| | | | - Whitley M Yi
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | | | - Asha L Kalichira
- Enterprise Information Services, Cedars-Sinai Health System, Los Angeles, CA
| | | | | | - Trinh Le
- Information Services Division, UNC Health, Morrisville, NC
| | - Bruce W Chaffee
- Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI
| | - C D R Kendra Worthy Woodbury
- Food and Drug Administration, CDER Office of Translational Sciences, Office of Computational Science, Silver Spring, MD
| | - Hardik Patel
- Pharmacy Department, NorthShore University HealthSystem, Evanston, IL
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Przybylski DJ, Dow-Hillgartner EN, Reed MP, Fallon MJ. Current state assessment survey of challenges of pharmacogenomics within oncology pharmacy practice. J Oncol Pharm Pract 2020; 26:1374-1381. [DOI: 10.1177/1078155219896395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The goal of this survey was to identify opportunities for health systems to increase implementation and adoption of oncology-focused pharmacogenomics services. Methods An online survey assessing respondent demographics, baseline knowledge and training in pharmacogenomics, comfort level with pharmacogenomic data, and challenges of implementing clinical pharmacogenomic platforms was distributed to professional colleagues and over national oncology pharmacy listservs. Pharmacists were grouped based on their comfort level with pharmacogenomic data. Results were analyzed utilizing Pearson chi-square test. A p value of <0.05 was considered significant. Results A total of 84 participants from 58 cancer centers participated in the survey. Most participants were post-graduate year 2 trained and a majority reported being comfortable assessing oncology pharmacogenomic data. Respondents indicated that pharmacogenomics reported within the electronic medical record was the most common institutional process to support pharmacogenomics for oncology patients. Despite this, poor visibility of pharmacogenomics within the electronic medical record was the most challenging aspect of implementing a pharmacogenomic program. Additional challenges included lack of resources for pharmacogenomic programs, insurance denials for pharmacogenomic-driven testing and medication, and prolonged turnaround time of pharmacogenetic results. Length of practice, post-graduate year 2 residency training, institutions with pharmacist involvement on hematology/oncology molecular tumor board, and institutions where a pharmacist helped create local pharmacogenomic policies were significantly associated with respondents’ comfortability in assessing pharmacogenomics. Conclusion Oncology pharmacists reported substantial challenges in implementing a pharmacogenomic program. Future efforts to assist in developing pharmacogenomic efforts should focus on increasing pharmacist involvement, expanding education and training, and improving clinical decision support tools.
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Affiliation(s)
- Neil J MacKinnon
- James L. Winkle College of Pharmacy University of Cincinnati Cincinnati, OH
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Schumock GT, Stubbings J, Hoffman JM, Wiest MD, Suda KJ, Rim MH, Tadrous M, Tichy EM, Cuellar S, Clark JS, Matusiak LM, Hunkler RJ, Vermeulen LC. National trends in prescription drug expenditures and projections for 2019. Am J Health Syst Pharm 2020; 76:1105-1121. [PMID: 31199861 DOI: 10.1093/ajhp/zxz109] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Historical trends and factors likely to influence future pharmaceutical expenditures are discussed, and projections are made for drug spending in 2019 in nonfederal hospitals, clinics, and overall (all sectors). METHODS Drug expenditure data through calendar year 2018 were obtained from the IQVIA National Sales Perspectives database and analyzed. New drug approvals, patent expirations, and other factors that may influence drug spending in hospitals and clinics in 2019 were also reviewed. Expenditure projections for 2019 for nonfederal hospitals, clinics, and overall (all sectors) were made through a combination of quantitative analyses and expert opinion. RESULTS U.S. prescription sales in calendar year 2018 totaled $476.2 billion, a 5.5% increase from 2017 spending. The top 3 drugs by expenditures were adalimumab ($19.1 billion), insulin glargine ($9.3 billion), and etanercept ($8.0 billion). Prescription expenditures in nonfederal hospitals totaled $35.8 billion, a 4.8% increase from 2017. Expenditures in clinics in 2018 increased by 13.0% to $80.5 billion. The increase in spending in nonfederal hospitals was largely driven by new products and increased utilization of existing products. The list of the top 25 drugs by expenditures in nonfederal hospitals and clinics was dominated by specialty drugs. CONCLUSION We predict continued moderate growth of 4-6% in overall drug expenditures (across the entire U.S. market). We expect the clinic sector to continue to experience high (11-13%) growth in drug spending in 2019. Finally, for nonfederal hospitals we anticipate growth in the range of 3-5%. These estimates are at the national level. Health-system pharmacy leaders should carefully examine local drug utilization patterns to determine their own organization's anticipated spending in 2019.
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Affiliation(s)
- Glen T Schumock
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL
| | - JoAnn Stubbings
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL
| | - James M Hoffman
- Pharmaceutical Sciences and Office of Quality and Patient Care, St. Jude Children's Research Hospital, Memphis, TN
| | - Michelle D Wiest
- UC Health, and James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH
| | - Katie J Suda
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, and Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL
| | - Matthew H Rim
- University of Utah Health, and College of Pharmacy, University of Utah, Salt Lake City, UT
| | - Mina Tadrous
- Ontario Drug Policy Research Network (ODPRN), Women's College Hospital and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | | | - Sandra Cuellar
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL
| | - John S Clark
- Michigan Medicine, University of Michigan, and University of Michigan College of Pharmacy, Ann Arbor, MI
| | | | | | - Lee C Vermeulen
- Colleges of Medicine and Pharmacy, University of Kentucky, and UK HealthCare, Lexington, KY
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Wheeler JS, Gray JA, Gentry CK, Farr GE. Advancing pharmacy technician training and practice models in the United States: Historical perspectives, workforce development needs, and future opportunities. Res Social Adm Pharm 2019; 16:587-590. [PMID: 31103338 DOI: 10.1016/j.sapharm.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/12/2019] [Indexed: 12/19/2022]
Abstract
The United States healthcare system faces immense challenges related to cost, quality, and access. As the pharmacy profession addresses these challenges by shifting toward a practice model centered around direct patient care clinical services, a competent and capable technician workforce is needed to support the roles of pharmacists. Until recently, little focus has been paid to pharmacy technicians or their role as they relate to practice model change. With ongoing pharmacist practice transformation, an approach that ensures uniform technician education, training, registration, and certification is vital to support a practice model designed to transform medication management across the continuum of care. The purpose of this commentary is three-fold: to review the history of pharmacy technician training and practice, discuss current and future technician practice models, and examine workforce development implications.
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Affiliation(s)
- James S Wheeler
- Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 1924 Alcoa Hwy, Box 117, Knoxville, TN, 37920, USA.
| | - Jeffrey A Gray
- Bill Gatton College of Pharmacy, East Tennessee State University, USA.
| | | | - Glen E Farr
- Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, USA.
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