Appointment-based models: A comparison of three model designs in a large chain community pharmacy setting

Barnes, Brenda; Hincapie, Ana L.; Luder, Heidi R.; Kirby, James; Frede, Stacey M.; Heaton, Pamela C.

doi:10.1016/j.japh.2018.01.005

Cited by 26 publications

(38 citation statements)

References 11 publications

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“…During scheduled patient visits, pharmacists will assess chronic medical conditions for patients receiving drug therapy (a role that most participants in our study agreed that pharmacists can do) and take medication and health histories for new patients presenting with acute health conditions. 57 Another important challenge will be assimilating community pharmacists into the network of other health care providers. 58 A forum for regular communication about care of their mutual patients will allow pharmacists to more fully integrate into the patient's health care team.…”

Section: Discussionmentioning

confidence: 99%

Essential Attributes for the Community Pharmacist as Care Provider

O’Sullivan

Bacci

2020

American Journal of Pharmaceutical Education

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Objective. To identify skills and attributes that pharmacy students need upon graduation if planning to pursue a career path as a community pharmacy practice care provider. Methods. In-depth interviews with community pharmacy stakeholders were conducted, audio-recorded, and transcribed. Interview transcripts were thematically analyzed to identify the skills and attributes pharmacy students need upon graduation to be prepared to practice as a community pharmacy-based care provider. Results. Forty-two participants were interviewed. Identified attributes that were deemed transformative for community pharmacy practice included three behaviors, five skills, and two knowledge areas. Behavioral attributes needed by future community pharmacists were an approach to practice that is forward thinking and patient-centric, and having a provider mentality. The most commonly mentioned skill was the ability to provide direct patient care, with other skills being organizational competence, communication, building relationships, and management and leadership. Critical knowledge areas were treatment guidelines and drug knowledge, and regulatory and payer requirements. Additional skills needed by community pharmacy-based providers included identification and treatment of acute self-limiting illnesses and monitoring activities for chronic health conditions. Conclusion. Essential attributes of community pharmacists that will allow practice transformation to take place include behaving in a forward-thinking, patient-centric manner; displaying a provider mentality through use of effective communication to build relationships with patients and other providers, and learning how to meet regulatory and payer requirements for prescribers. These attributes should be fostered during the student's experiential curriculum.

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Section: Discussionmentioning

confidence: 99%

Essential Attributes for the Community Pharmacist as Care Provider

O’Sullivan

Bacci

2020

American Journal of Pharmaceutical Education

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“…While this finding was surprising, similar findings have been reported elsewhere. [24][25][26] One plausible explanation for fewer trips and prescriptions picked up from the pharmacy is that people may be obtaining some medications from mail order and also from a retail brick and mortar pharmacy which may negate the convenience aspects that mail order affords and subsequently lead to nonadherence. For example, Choudry and colleagues 25 observed that filling fewer medications per pharmacy visit was associated with less adherence, a finding that was particularly apparent among those using both retail and mail order services.…”

Section: Discussionmentioning

confidence: 99%

<p>Self-Reported Nonadherence Associated with Pharmacy and Home Medication Management Inconvenience Factors in a US Adult Population</p>

Ellis

Hertz

Callahan

et al. 2020

PPA

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Purpose: Medication nonadherence is a significant and multidimensional problem contributing to an increased risk of morbidity and mortality. Inconveniences in pharmacy and home contexts may increase nonadherence. This research examined inconveniences in pharmacy and home contexts associated with self-reported nonadherence, controlling for demographic and medication-taking covariates. Methods: Data from 4682 individuals who reported self-managing medications in an online marketing survey between October and December 2017 were analyzed in this secondary analysis. Nonadherence was dichotomized using a single question about likelihood to take medications as prescribed (adherence=always; nonadherence=most of the time, some of the time, never). Multivariable logistic regression with backwards elimination was used to examine the pharmacy (use of home delivery, number prescriptions picked up and visits to pharmacy) and home context (method used to organize/manage medications, satisfaction, and bother with management) variables and the demographic (age, sex, race/ethnicity, education, income, insurance) and medication (number of oral medications, medication changes and frequency of taking) covariates associated with nonadherence. Results: Overall, 25.8% of the responses indicated nonadherence. Nonadherence was more likely for individuals making fewer separate pharmacy trips (OR 0.98; 95% CI 0.97-0.99); picking up fewer prescriptions (OR 0.96; 95% CI 0.93-0.99); never, rarely or sometimes using mail order compared with always (OR 1.71; 95% CI 1.30-2.26); not satisfied with managing medications (OR 2.13; 95% CI 1.42-3.19); and using pill pouches and being bothered by them (OR 8.28; 95% CI 1.83-37.31). Using pill pouches or a pillbox and not being bothered by them significantly decreased nonadherence likelihood. Younger and female respondents and those reporting medication changes in the last year were also more likely to report nonadherence. Conclusion: Though reasons for nonadherence are multidimensional, this study suggests that inconveniences in both the pharmacy and home context are important. Improving adherence requires addressing issues of inconvenience across the care continuum.

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“…A comparison study by Barnes et al . suggested telephone and face-to-face ABM programs have similar effects on rates of medication refills, although it did not compare the rates or outcomes of clinical interventions by pharmacists 36. While telephone may have efficiencies, one article found it was difficult to enroll and maintain low-income patients in a telephone-based medication synchronization program – a demographic that may especially benefit from regular conversations with a pharmacist as part of an ABM 19.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of drug therapy problems identified with a telephonic appointment-based model of medication synchronization

Fitzpatrick¹,

Witry²,

Doucette³

et al. 2019

Pharm Pract (Granada)

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Objectives: To describe the drug therapy problems (DTPs) identified for patients enrolled in an Appointment Based Model (ABM) for medication synchronization, describe the pharmacist-delivered clinical interventions, and assess what patient characteristics are associated with the number of DTPs identified. Methods: A cross-sectional chart review of 1 month of pharmacist notes for telephone ABM encounters at one independent community pharmacy in the Midwest U.S. was performed for a systematic random sample of patients active in the program during September 2017. Included patients were 18 years and older and took one or more synchronized medications. Data included months in the program, gender, age, insurance type, refill interval, medications (synchronized and total), DTP category, and intervention category. Descriptive statistics were calculated, and a multiple linear regression tested the association between patient characteristics and the number of DTPs identified. Results: The study involved 209 subjects, 54% women, with a mean age of 69.5 years and. The average number of medications synchronized was 4.7, the mean total number of medications was 6.3, and mean length of time in the program was 20 months. The DTPs (n=334) identified included needs additional drug therapy (43.1%), inappropriate adherence (31.4%), unnecessary drug therapy (15.0%), and adverse drug reaction (9.6%). The regression showed age and number of medications was positively associated with number of DTPs identified, but months enrolled was not. Conclusions: This ABM approach identified several hundred DTPs with corresponding interventions within a one-month period, suggesting that ABMs have a significant potential to improve patient care. The data also suggest that pharmacist interventions within an ABM program are valuable beyond the first few fills as patients move into maintenance use of their medications, especially for patients of advancing age and polypharmacy.

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Appointment-based models: A comparison of three model designs in a large chain community pharmacy setting

Cited by 26 publications

References 11 publications

Essential Attributes for the Community Pharmacist as Care Provider

Essential Attributes for the Community Pharmacist as Care Provider

<p>Self-Reported Nonadherence Associated with Pharmacy and Home Medication Management Inconvenience Factors in a US Adult Population</p>

Retrospective analysis of drug therapy problems identified with a telephonic appointment-based model of medication synchronization

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