Expansion of clinical pharmacy through increased use of outpatient pharmacists for anticoagulation services

Philip, Achsah; Green, Monica H.; Hoffman, Therese; Gautreaux, Stefani; Wallace, David; Roux, Ryan; Garey, Kevin W.

doi:10.2146/ajhp140404

Cited by 10 publications

(17 citation statements)

References 10 publications

(11 reference statements)

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“…Table 1 and Table 2 summarize study characteristics for the pediatric and adult populations, respectively. Out of the 32 studies, 16 (50%) were conducted in the United States [ 52 , 53 , 55 - 57 , 60 , 62 , 63 , 65 , 69 , 71 - 73 , 77 , 78 , 81 ], 6 (19%) in Canada [ 58 , 64 , 68 , 74 , 75 , 79 ], 2 (6%) each in Australia [ 42 , 61 ], India [ 51 , 76 ], and Italy [ 54 , 70 ], and 1 (3%) each in Brazil [ 80 ], France [ 59 ], Germany [ 66 ], Ireland [ 67 ], and Rwanda [ 81 ]. Although the search retrieval included results published since 1980, the earliest eligible study was from 1998, which corresponds to our knowledge of when telemedicine was first introduced [ 71 ].…”

Section: Resultsmentioning

confidence: 99%

“…The sample size ranged from 1 [74] to 217,014 [62], with a median of 157 and a mean of 7977 participants per study. Overall, 21 studies enrolled ≥100 participants [51,[53][54][55][56][57][58][59][60]62,63,[65][66][67][68][69][70]72,73,76,80] and 11 had <100 participants [42,52,61,64,71,74,75,[77][78][79]81].…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

“…Of the 32 included studies, 12 (34%) studied malignant hematological conditions [42,53,[58][59][60][61]64,67,69,77,80,81], 18 (59%) studied nonmalignant conditions with percentages [51,52,[54][55][56][57]62,63,65,66,68,[70][71][72][73][74]76,78], and 2 (6%) studied both malignant and nonmalignant conditions [75,79]. [68,79], 1 (3%) was a case study [74], 1 (3%) was a pre-post study [54], 1 (3%) was a noncomparative prospective study [59], and 1 (3%) was a prospective cohort study [66].…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

“…Follow-up activity after the telemedicine interventions was tracked in six of the studies in the forms of postintervention neuroimaging examination (n=1, 17%) [77], follow-up assessments (n=3, 50%) [52,53,64], number of patient visits (n=1, 17%) [62], and interview (n=1, 17%) [82]. Based on the GRADE criteria, four included studies were rated as "moderate" [52,53,69,77], four were rated as "low" [54,61,70,79], and 24 were rated as "very low" [42,51,[55][56][57][58][59][60][62][63][64][65][66][67][68][71][72][73][74][75][76]78,80,81]. The "low" and "very low" ratings were mainly a result of the type of study and indirectness of evidence.…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

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Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies

Shah

O’Dwyer

Badawy

2021

JMIR Mhealth Uhealth

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Background Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care. Objective We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions. Methods Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes. Results A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions. Conclusions Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Description Of the Included Studiesmentioning

confidence: 99%

Section: Description Of the Included Studiesmentioning

confidence: 99%

Section: Description Of the Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies

Shah

O’Dwyer

Badawy

2021

JMIR Mhealth Uhealth

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“…Martinez studies the implementation of a pharmacist-led heart titration clinic that employs telemonitoring for the daily monitoring of patient body weight (Martinez et al, 2013 ). Philip analyses the expansion of clinical pharmacy through increased use of outpatient pharmacists for anticoagulation services (Philip et al, 2015 ). Verbosky assesses the implementation of diabetes management via telehealth, whilst Owsley evaluates telemedicine for diabetic eye screening (Owsley et al, 2015 ; Verbosky et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of the Quality and the Design of Evaluations of Mobile Health, Telehealth, Smart Pump and Monitoring Technologies Performed in a Pharmacy-Related Setting

et al. 2018

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Background: There is currently a need for high quality evaluations of new mobile health, telehealth, smart pump and monitoring technologies undertaken in a pharmacy-related setting. We aim to evaluate the use of these monitoring technologies performed in this setting.Methods: A systematic searching of English articles that examined the quality and the design of technologies conducted in pharmacy-related facilities was performed using the following databases: MEDLINE and Cumulative index to Nursing and Allied Health Literature (CINAHL) to identify original studies examining the quality and the design of technologies and published in peer-reviewed journals. Extraction of articles and quality assessment of included articles were performed independently by two authors. Quality scores over 75% are classed as being acceptable using a “relatively conservative” quality benchmark. Scores over 55% are included using a “relatively liberal” cut-off point.Results: Screening resulted in the selection of 40 formal evaluations. A substantial number of studies (32, 80.00%) were performed in the United States, quantitative in approach (33, 82.50%) and retrospective cohort (24, 60.00%) in study design. The most common pharmacy-related settings were: 22 primary care (55.00%); 10 hospital pharmacy (25.00%); 7 community pharmacy (17.50%); one primary care and hospital pharmacy (2.50%). The majority of the evaluations (33, 82.50%) reported clinical outcomes, six (15.00%) measured clinical and economic outcomes, and one (2.50%) economic only. Twelve (30.00%) quantitative studies and no qualitative study met objective criteria for “relatively conservative” quality. Using a lower “relatively liberal” benchmark, 27 quantitative (81.82%) and four qualitative (57.41%) studies met the lower quality criterion.Conclusion: Worldwide, few evaluations of mobile health, telehealth, smart pump and monitoring technologies in pharmacy-related setting have been published.Their quality is often below the standard necessary for inclusion in a systematic review mainly due to inadequate study design.

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Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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IntroductionTelehealth offers a promising opportunity for the delivery of clinical pharmacy services by increasing the accessibility of health care, extending the reach of clinical services, and allowing pharmacists to engage with patients who might otherwise be overlooked. The objectives of the project were to discover effective strategies for the delivery of clinical pharmacy services via telehealth and to identify core components of comprehensive medication management (CMM) that are deliverable via telehealth.MethodsA systematic literature review was performed by searching four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], PubMed, Scopus, and Web of Science) for relevant citations using keywords and subject headings relating to telemedicine, clinical pharmacy services, and health conditions. Studies were eligible for inclusion in the review if the interventions they describe involved telehealth technologies and pharmacist care. Blind screening of abstracts and full‐text review was completed by six researchers divided into teams of two. Any discrepancies were resolved by the corresponding author.ResultsFifty‐nine studies met the inclusion criteria, most (n = 53) of which were conducted in the U.S. Five studies (8.5%) reported pharmacist training as an implementation strategy. The telehealth technologies most regularly utilized were telephone‐based interventions (n = 45), videoconferences (n = 13), and web‐based (n = 4) interventions, with five studies using a combination of technologies. Most studies focused on hypertension (n = 22), diabetes (n = 20), or lipid‐related (n = 14) disease state management. Eighteen studies qualified as CMM (n = 18), with most involving all five essential CMM functions.ConclusionThis systematic review study highlights opportunities for pharmacists to deliver clinical pharmacy services using telehealth. The majority of clinical pharmacy services described in the accessed literature was provided via telephone and focused on targeted monitoring of disease states. While studies reporting the use of CMM interventions were limited, there is an opportunity to increase the application of CMM principles as healthcare systems transition to providing more telehealth services.

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Expansion of clinical pharmacy through increased use of outpatient pharmacists for anticoagulation services

Abstract: The implementation of a clinical pharmacy telephone service for patients receiving anticoagulation at an outpatient center resulted in increased patient clinic visits without adversely affecting patient outcomes or increasing personnel or costs.

Cited by 10 publications

References 10 publications

Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies

Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies

A Scoping Review of the Quality and the Design of Evaluations of Mobile Health, Telehealth, Smart Pump and Monitoring Technologies Performed in a Pharmacy-Related Setting

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

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