Pharmacotherapy Consultation on Polypharmacy Patients in Ambulatory Care

Jameson, John Paul; VanNoord, Glenn R

doi:10.1345/aph.10259

Cited by 54 publications

(92 citation statements)

References 18 publications

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“…Studies exploring polypharmacy have been conducted in different clinical settings, in out-patients/ambulatory patients (14,25,(30)(31)(32)(33), hospitalised patients (26,(34)(35)(36), patients in nursing homes (37,38), and elderly patients (25)(26)(27)32,33,39). Studies have also been performed based on data from prescription or population databases (13,28,(40)(41)(42).…”

Section: Frequency Of Polypharmacymentioning

confidence: 99%

The Janus face of polypharmacy – overuse versus underuse of medication

Viktil¹,

Blix²,

Reikvam³

2009

Nor J Epidemiol

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As modern guidelines may recommend several drugs for a single medical condition, it follows that many patients, especially if co-morbidity is present, use a number of medications. Also, an aging population implies more morbidity and consequently will have the result that many patients use many drugs -a situation often referred to as polypharmacy. Polypharmacy has been linked to negative health outcomes such as adverse drug reactions, interaction problems, poor patient adherence, and hospitalisations. Such experiences have led to the attitude that efforts should be made to reduce polypharmacy. However, this approach might prevent patients from obtaining optimal treatment. There is no universal definition of polypharmacy and measuring of a reduction in polypharmacy becomes problematic. Because polypharmacy is an imprecise term it should be used with caution in research as well as in patient management. Moreover, studies have shown that undertreatment occurs frequently also among patients using many drugs. This is the Janus face of polypharmacy: too many drugs should be avoided, but the individual patient should receive the appropriate drugs that have the potential to reduce morbidity and improve quality of life. It is the individual drugs themselves, along with patient specific factors, and not a fixed number of drugs, that we should pay attention to.

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Section: Frequency Of Polypharmacymentioning

confidence: 99%

The Janus face of polypharmacy – overuse versus underuse of medication

Viktil¹,

Blix²,

Reikvam³

2009

Nor J Epidemiol

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“…Another issue is the public's low perceived value of MTMS which creates a gap between how pharmacists and patients view the benefits of this service [17][18][19][20][21][22][23][24]. Research has shown that perceived benefits of MTMS were low even among high prescription users [17] and may be due to lack of exposure and poor understanding of what the service provides [21].…”

Section: Introductionmentioning

confidence: 99%

“…Of this group, 75% named their physician as the provider they would visit for medication problems [17]. Although there is a general trust in pharmacists' abilities, 70% of those surveyed specified that this trust only extends towards prescription dispensing, with only 45% trusting their pharmacist for providing advice on adverse effects, contraindications, and other "problems" *17+.Another issue is the public's low perceived value of MTMS which creates a gap between how pharmacists and patients view the benefits of this service [17][18][19][20][21][22][23][24]. Currently, there is little specific information on creating and evaluating a comprehensive MTMS marketing plan.…”

mentioning

confidence: 99%

“…Currently, there is little specific information on creating and evaluating a comprehensive MTMS marketing plan. Broad suggestions in the literature entail increasing public awareness of pharmacists' clinical abilities, increasing word of mouth promotion, addressing patient barriers to MTMS, and developing MTMS tailored to patient needs and wants [17,[20][21][22][23][24][25][26]. More specific suggestions focus on collaborating with physicians and other health care workers to help them learn about the benefits of MTMS and then rely on these clinicians to identify patients who they believe would benefit the most with a resultant referral to a pharmacist [25].…”

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confidence: 99%

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Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

Isetts¹,

Schommer²,

Westberg³

et al. 2012

Innov Pharm

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We greatly appreciate the assistance of Marj Schneider and her colleagues at Tybee Types during the focus group transcription process.The authors gratefully acknowledge Dr. Serguei Pakhomov for expert consultation during natural language processing analysis. Declarations and Disclosures:The authors declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.Institutional review board (IRB) approval was obtained through the University of Minnesota Research Subjects Protection Program and assigned the code number 1009E90532.Confidentiality Agreements were used in this project to protect the proprietary rights of each project site and the marketing company. Abstract The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementation, and (6) marketing plan evaluation. The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS). Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers. IntroductionMedication Therapy Management Services (MTMS) have been designed to optimize therapeutic outcomes for people taking medications. There is evidence for improvement in clinical, economic, and humanistic outcomes through this service [1][2][3][4][5]. However, a number of barriers to the delivery of MTMS have been documented during its implementation including: pharmacist training, staffing, management, documentation, access to medical records, consumer awareness, marketing, provider recognition, and payment for services [6][7][8].As barriers to building practices supporting the delivery of this service are being addressed [9][10][11][12][13], the practice management challenge of marketing MTMS to consumers remains. For example, individuals who receive MTMS overwhelmingly report: (1) a favorable evaluation of pharmacist-provided MTMS, (2) that they would use this service again...

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“…However, although Parkinson's disease is the second most common neurodegenerative disorder in the elderly population, very few such studies exist in this area [12]. Given that age, multi-morbidity and polypharmacy are known risk factors for DRPs, Parkinson's disease outpatients are at particular risk of experiencing problems associated with long-term drug treatment [13,14]. Not least, Parkinson's disease patients in the more severe stages of their disease often take up to 10 or more tablets/day for Parkinson's disease alone [15], thus confirming a patient population at risk for DRPs.…”

Section: Introductionmentioning

confidence: 99%