Implementation and outcomes of a pharmacist-managed clinical video telehealth anticoagulation clinic.

Purpose: The use of clinical video telehealth (CVT) technology to optimize the deployment of clinical pharmacy specialist resources in a community-based outpatient clinic (CBOC) is described.

Summary: In 2012, clinical pharmacy specialists at a Veterans Affairs (VA) medical center began using CVT technology to provide anticoagulation therapy management services to patients at a CBOC about 12 miles away. Using videoconferencing technology (video cameras and high-definition widescreen monitors), the remotely located pharmacists conduct patient interviews, evaluate International Normalized Ratio (INR) values, and gather other clinical data for use in therapeutic planning.

Evaluation of vitamin B12 monitoring in a veteran population on long-term, high-dose metformin therapy.

Background: Metformin can result in vitamin B(12) deficiency, potentially leading to complications such as neuropathy. Annual monitoring of vitamin B(12) has been suggested; however, it is unknown whether current practice reflects this recommendation.

Objective: To identify vitamin B(12) monitoring patterns in patients on long-term, high-dose metformin.