Design and implementation of population-based specialty care programs.

Purpose: The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted.

Summary: The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

Study Objective: This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team.

Methods: This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors.

Ambulatory clinical pharmacy specialty services: the Kaiser Permanente Colorado experience.

Health care in the United States is increasingly being delivered during ambulatory care visits.1 As new investment in health care shifts from the inpatient to outpatient setting, the role of ambulatory clinical pharmacists (CP) are expanding. While dispensing pharmacists provide clinical screening and patient education for potential drugrelated problems, CPs provide services that complement the care provided by dispensing pharmacists by directly advising and educating other health care providers and patients on appropriate pharmaceutical use and dosing.

Actual versus projected cost avoidance for clinical pharmacy specialist-initiated medication conversions in a primary care setting in an integrated health system.

Background: Primary care clinical pharmacy specialists (PCCPSs) are positioned to promote effective, safe, and affordable medication use. Documentation of performed interventions is difficult because the diversity of performed interventions in a variety of disease states in some practice settings. Validation of cost-avoidance projections is also difficult because traditional projection methods have several limitations.

Liver function test abnormalities and pruritus in a patient treated with atorvastatin: case report and review of the literature.

The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (also known as statins) are associated with elevated transaminase levels in 1-3% of patients. Therapy with these drugs requires monitoring of alanine aminotransferase (ALT) levels because animal studies and premarketing clinical trials showed signs of hepatotoxicity that were primarily minor elevations of ALT. Nevertheless, postmarketing experience suggests that hepatotoxicity is rare, and that elevated ALT levels are reversible with continued therapy and probably are related to cholesterol lowering.