Impact of Pharmacist Transitions of Care on 30-Day Readmissions Within a Primary Care-Based Accountable Care Organization.

Previous studies in the ambulatory care setting have shown inconsistent results in regard to, or with respect to pharmacist telephonic transitions of care (TOC) encounters and reduction in 30-day readmission rates. No studies that have been completed within an accountable care organization (ACO) evaluating the impact of telephonic TOC encounters performed by a pharmacist have been identified. The objective of this study was to analyze the impact of clinical pharmacy telephonic TOC encounters on readmission rates within a primary care-based ACO.

Real-World Analysis of Long-Acting and NPH-Containing Insulins on Glycemic Control.

Affordability of insulin products has become a concern in the past several years as the average price of various insulin products has increased. While awaiting legislation at the federal level that would address issues leading to high insulin costs, providers may have shifted prescribing practices to prescribe the lowest-priced insulin products to achieve patients' treatment goals. To compare the prevalence of hypoglycemic events between patients receiving lower-cost neutral protamine Hagedorn (NPH)-containing human insulins and higher-cost long-acting insulin analogs in Medicare Part D enrollees within a management services organization, as well as assessing glycemic control and changes in body mass index.

Evaluating Pharmacist-Driven Interventions in a Primary Care Setting to Improve Proportion of Days Covered and Medication Adherence.

Medication nonadherence is the leading cause of poor health outcomes and increased risk of hospitalizations. Previous studies have shown that pharmacist interventions can help improve medication adherence and CMS quality measures. The purpose of this study was to examine the impact of clinical pharmacists' interventions on medication adherence and PDC scores for ACEi/ARBs, statins, and noninsulin antidiabetic medications in the primary care setting.

Students' Perceptions and Lessons Learned From Virtual APPE Rotations: A Multi-Institutional Perspective.

The COVID-19 pandemic caused disruption in pharmacy experiential learning as clinical practice sites restricted student access to onsite rotations. Therefore, colleges of pharmacy across the country likely included virtual advanced pharmacy practice experiences (APPEs) to fulfill experiential education requirements. The objective of this paper is to evaluate students' perceptions of virtual APPEs during the 2020-2021 academic year.

Development of a combination didactic-experiential elective course within a college-based pharmacy call center.

Background: Pharmacy graduates should be prepared to provide patient care in a variety of healthcare settings as members of an interprofessional collaborative team. College-based pharmacy call centers can serve as settings to promote interprofessional practice through didactic and experiential coursework. An elective course, Team-Based Medication Management Practices, was developed to provide student pharmacists the opportunity to learn about pharmacy-led services within value-based care models and to prepare them for interprofessional care by incorporating experiential activities within a college-based call center.

Effects of a Therapeutic Interchange Between Branded and Generic Inhaled Therapy on Chronic Obstructive Pulmonary Disease.

To evaluate the difference in the occurrence of chronic obstructive pulmonary disease (COPD) exacerbations six months preconversion compared with six months postconversion from the branded inhaled corticosteroid/long-acting beta 2-agonist inhalers to the generic fluticasone/salmeterol inhalers. Retrospective cohort study using a six-month pre-/post-test design Three primary care offices within a Management Service Organization (MSO) in South Florida. Patients were included in the study if they had a diagnosis of COPD (in electronic medical record [EMR]), were at least 18 years of age, were under the care of a provider at one of the three primary care clinics within an MSO, and were switched from a branded ICS/LABA inhaler to a generic ICS/LABA inhaler between May 2019 and February 2020.

impact of a Pharmacy-Led Transitions of Care Program Within a Primary Care-Based Accountable Care Organization.

Objective: To assess the impact of pharmacist-led transitions of care program on 30-day readmission rates in the accountable care organization (ACO) primary care setting.

Design: Retrospective cohort study.

Setting: Two primary care provider (PCP) offices with an ACO in South Florida.

The Pharmacist as Part of the Primary Care Team During the COVID-19 Pandemic.

Pharmacists' roles and training have evolved to prepare pharmacists to provide clinical patient care services as part of interdisciplinary teams in primary care settings. Especially now, amidst a global health crisis such as COVID-19, patients may become more aware of their health status and be exposed to increased medical information in the media. Additionally, some patients may have delayed routine care, which may result in exacerbations of chronic disease states.

Training pharmacy residents as transitions of care specialists: a United States perspective.

Transitions of care has emerged as a point of vulnerability in global health care systems, which can lead to potential avoidable medical errors. In the United States, pharmacist-led transitions of care programs are increasing in number, with many hospitals offering discharge prescription services. However, the required training for these positions remains unclear.

Evaluating a Pharmacist-Led Intervention on Cardiovascular- and Diabetes-Related Quality Measures in a Primary Care-Based Accountable Care Organization.

Background: The Centers for Medicare and Medicaid Services (CMS) publishes quality measures to gauge performance in Accountable Care Organizations (ACOs). ACO-27 (Diabetes Mellitus: Hemoglobin A1c Poor Control) and ACO-41 (Diabetes: Eye Exam), are 2 components for the Diabetes Composite measure. ACO-42 focuses on Statin Therapy for the Prevention and Treatment of Cardiovascular (CV) Disease.

Strategies for Managing Pharmacy Experiential Education During COVID-19.

In recent months, the coronavirus pandemic has significantly affected almost every industry in the United States, including health care and higher education. Faculty and students at colleges and schools of pharmacy nationwide have needed to quickly adapt as the delivery of curricula has shifted to primarily online format. Additionally, experiential rotations have been significantly affected as practice settings such as hospitals and outpatient clinics have limited students' interactions with patients or stopped allowing students on-site altogether.

Efficacy and Usability of Intranasal Glucagon for the Management of Hypoglycemia in Patients With Diabetes: A Systematic Review.

Purpose: Hypoglycemia is a common and sometimes life-threatening adverse event associated with insulin, sulfonylurea, and meglitinide therapies. In patients who are disoriented or unconscious, treatment with injectable glucagon is recommended, along with a call for emergency medical assistance. However, limitations of this formulation include difficulty with reconstitution and an unwillingness to administer an injection.

Improving Medication Adherence in an ACO Primary Care Office With a Pharmacist-Led Clinic: A Report From the ACORN SEED.

Background: As health care moves into the era of value-based medicine, both ambulatory and acute settings are being held accountable for the quality of care provided to patients. Previous studies have shown improved clinical outcomes through medication therapy management (MTM) due to improved medication adherence.

Objective: The purpose of this study is to assess the effects of a pharmacist-led MTM clinic in an accountable care organization (ACO) affiliated primary care office on adherence to renin-angiotensin system (RAS) antagonists, diabetic medications, and/or statin medications reported through Healthcare Effectiveness Data and Information Set (HEDIS) Medicare Star Ratings.

Development and evaluation of physician-precepted advanced pharmacy practice experiences (APPEs) within an accountable care organization (ACO).

Background And Purpose: The American Council of Pharmaceutical Education (ACPE) standards emphasize that pharmacy graduates should be "practice- and team-ready," and the American Society for Health-System Pharmacists (ASHP) Task Force on accountable care organizations (ACOs) states that curricula at pharmacy schools should be evaluated and reworked to prepare students to practice effectively as members of the health care team within ACOs. The objective of this study was to describe the development of an ACO-based advanced pharmacy practice experience (APPE) rotation block, clinical activities and interventions completed by students during the experience, and perceptions of students, patients, and physician preceptors regarding the experience.

Educational Activity And Setting: The rotation block was within outpatient ACO offices and consisted of a four-week rotation with one pharmacy faculty, immediately followed by a four-week elective experience in a different office with a physician serving as primary preceptor.

The Report of the 2018-2019 Professional Affairs Standing Committee: The Role of Educators in Pharmacy Practice Transformation.

The 2018-2019 Professional Affairs Committee examined the potential roles and needs of clinical educators (faculty and preceptors) in leading transformation in pharmacy practice. The committee was charged to (1) discuss the potential roles and responsibilities of faculty and preceptors leading transformation and enhanced patient care services in pharmacy practice; (2) describe factors, including clinician well-being and resilience, which may influence faculty and preceptor involvement in practice transformation and the enhancement of patient care services; and (3) recommend how the efforts and successes of faculty and preceptors involved in pharmacy practice transformation can be replicated and recognized as well as identify the types of continuing professional development (CPD) that should be available to enable the influence and implementation of patient care services. This report provides a framework for addressing the committee charges by examining the roles of advocacy, collaboration, continuing professional development, and clinician resilience and well-being.

Impact of pharmacist-led heart failure tool kits on patient-reported self-care behaviors in a primary care-based accountable care organization.

Objective: The goal of this project is to evaluate the impact of a pharmacist-led heart failure (HF) intervention, using an educational toolkit, on patient-reported self-care maintenance, management, and confidence at 30 days.

Setting: Three Accountable Care Organization (ACO) primary care provider offices in South Florida from January to March 2018.

Practice Description: Each primary care clinic was staffed with at least 1 physician, nurse practitioners, a clinical pharmacy faculty member, pharmacy residents and students, and ancillary staff.

Conjugated Estrogens and Bazedoxifene Improve Cell Function in Obese Menopausal Women.

Context: Studies suggest that menopausal hormone therapy (MHT) prevents type 2 diabetes (T2D). The combination of conjugated estrogens (CE) with the selective estrogen receptor modulator bazedoxifene (BZA) is an MHT that improves obesity and T2D in preclinical models of menopausal metabolic syndrome. The effect of CE/BZA on adiposity and glucose homeostasis in obese postmenopausal women is unknown.

Chronic Obstructive Pulmonary Disease and Heart Failure Self-Management Kits for Outpatient Transitions of Care.

Objective: To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions.

Setting: Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies.

Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.

Background: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal.

Program Description: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care.

Assessing the Effect of Pharmacist Care on Diabetes-Related Outcomes in a Rural Outpatient Clinic: A Retrospective Case-Control Study.

Background: The care of diabetic patients in rural areas is complicated by factors such as poor health literacy, cultural barriers, and primary care provider (PCP) shortages. Integrating pharmacist care in diabetes management in these settings may increase access to care and improve patient outcomes.

Objective: To evaluate differences in diabetes-related outcomes in patients with type 2 diabetes (T2DM) managed by a pharmacist diabetes clinic compared with patients only managed by PCPs in a rural family medicine clinic.

Repenser ensemble le concept d'autonomie alimentaire.

C'est au cœur du projet de recherche-action participative « Vers une autonomie alimentaire pour tou-te-s : agir et vivre ensemble le changement » (VAATAVEC) que s'est élaborée une définition nouvelle et évolutive de l'autonomie alimentaire. De ce projet regroupant des personnes en situation de pauvreté, chercheurs et intervenants, a émergé une conceptualisation résultant à la fois d'une méthode de réflexion collective et d'un processus d'analyse collective, inspiré de la théorisation ancrée et de l'analyse conceptualisante de Paillé et Mucchielli (2003). Le recours à l'expertise des personnes en situation de pauvreté, expertes du vécu de l'insécurité alimentaire, a contribué à ancrer cette définition dans les causes structurelles de l'insécurité alimentaire dans une perspective de développement d'un pouvoir d'agir collectif, de toutes les personnes concernées.

Review of Continuing Education and Published Literature Related to Women's Health and Pharmacy.

In 2004, the American Association of Colleges of Pharmacy and collaborating organizations created a framework for women's health instruction as a guide for integrating women's health into pharmacy curricula. This article expands on the findings of that project by identifying educational opportunities with a women's health focus that are available for pharmacists. : To review educational opportunities available to pharmacists related to women's health and to review the pharmacist's role in women's health in the published literature.

Insulin pump therapy started at the time of diagnosis: effects on glycemic control and pancreatic β-cell function in type 1 diabetes.

Background: In the interest of preserving residual insulin secretory capacity present at the time of diagnosis with type 1 diabetes (T1D), we compared the efficacy of starting insulin pump therapy at diagnosis with standard multiple daily insulin injections (MDIs).

Methods: We conducted a prospective, randomized, pilot trial comparing MDI therapy with continuous subcutaneous insulin therapy (pump therapy) in 24 patients, 8-18 years old, with newly diagnosed T1D. Subjects were evaluated at enrollment and 1, 3, 6, 9, and 12 months after initial diagnosis of T1D.

Disease and gender-specific dysregulation of NGAL and MMP-9 in type 1 diabetes mellitus.

Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal injury, can bind matrix metalloproteinase-9 (MMP-9) and inhibit its degradation, thereby sustaining MMP-9 proteolytic activity. MMP-9 is produced by renal podocytes, and podocyte MMP production can be modified by high ambient glucose levels. Moreover, dysregulation of MMP-9 activity, gene expression, or urine concentrations has been demonstrated in T2DM-associated nephropathy and in non-diabetic proteinuric renal diseases.