Pharmacy Administration, Policy and Regulation Commons^™

Patient Satisfaction With Substance Use Disorder Rehabilitation Services, Trupti Dhumal

Electronic Theses and Dissertations

Background: Patient satisfaction is considered as an important indicator in the evaluation of healthcare quality across an array of treatments and services. It is deemed vital especially in the field of substance use disorder (SUD) research due to an increased emphasis on understanding patients’ perceptions regarding their treatment and the attributes that drive their progress towards recovery. Despite the potential value, gaps have been recognized in the exploration of these satisfaction-related assessments among patients undergoing SUD treatment in residential rehabilitative settings. Thus, there is a need for understanding the dimensions contributing to satisfaction which would facilitate the development of …

Impact Of Required Antibiotic Stop Dates And Indications On Length Of Treatment In Hospitalized Patients With Pneumonia, Amanda Haddad, Kathryn Hernando, Kayihura Manigaba, Abigail Antigua

Infectious Disease

Purpose: The CDC Core Elements of Hospital Antibiotic Stewardship Programs recommends implementing policies to support optimal antibiotic prescribing including documentation of dose, duration and indication. On January 31, 2017, the study institution implemented new physician order entry screens in the electronic health record requiring the input of indication and duration on all antibiotic orders. The objective of this study is to determine if implementation of mandatory indication and duration for antibiotic orders decreases antibiotic duration of therapy in hospitalized patients with pneumonia.

Methods: This study was submitted to the Institutional Review Committee for approval. The clinical pharmacy surveillance platform, …

Utility Of Push Dose Vasopressor In The Emergency Department, Paul Nguyen, Daniel Giddings, Scott Dietrich, Kathryn Merkel

Emergency Medicine

Purpose: The purpose of this study is to evaluate push dose vasopressor (PDV) usage patterns, efficacy, and safety in a single community hospital emergency department when used for rapid sequence intubation (RSI). Pre-intubation hypotension is a positive correlator to incidences of cardiac arrest. Precautions should be in place to prevent and treat hypotension during emergent intubation. The emerging strategy of utilizing PDV in emergency department (ED) patients is an underexplored and potentially efficacious option.

Methods: This study will be submitted to the Institutional Review Board for approval. This retrospective evaluation will identify critically ill patients receiving phenylephrine or epinephrine PDV …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Improving Medication Information Presentation Through Interactive Visualization In Mobile Apps: Human Factors Design, Don Roosan, Yan Li, Anandi Law, Huy Truong, Mazharul Karim, Jay Chok, Moom Roosan

Pharmacy Faculty Articles and Research

Background: Despite the detailed patient package inserts (PPIs) with prescription drugs that communicate crucial information about safety, there is a critical gap between patient understanding and the knowledge presented. As a result, patients may suffer from adverse events. We propose using human factors design methodologies such as hierarchical task analysis (HTA) and interactive visualization to bridge this gap. We hypothesize that an innovative mobile app employing human factors design with an interactive visualization can deliver PPI information aligned with patients’ information processing heuristics. Such an app may help patients gain an improved overall knowledge of medications.

Objective: The …

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation …

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

Professional Leadership Development, Jena Schlabach, Meagan Brandt, Olivia Vanscoy, Kasie Bellmann, Jenelle Sobotka, Marianne F. Ivey

Pharmacy and Wellness Review

No abstract provided.

Sterile Compounding: Regulations Addressed After The Meningitis Outbreak Of 2012, Kelly M. Dye, Tara M. Tokar, Halle M. Orlinski, Heather Helsel, Marcia M. Worley

Pharmacy and Wellness Review

No abstract provided.

Common Questions And Answers Regarding Oarrs For Pharmacists, Brittany M. Dye, Victoria S. Pennington, Rachel J. Pucel, Lindsay A. Fleegle, Donald L. Sullivan

Pharmacy and Wellness Review

No abstract provided.

Decoding The Prescription, Kim Baucher, Jessica Langhals, Ross Robison, Kristen Finley Sobota

Pharmacy and Wellness Review

No abstract provided.

Understanding Drug Shortages As A Pharmacist, Heather Helsel, Thomas Otroba, Juliana Zschoche, Elizabeth Dodds-Ashley

Pharmacy and Wellness Review

No abstract provided.

Legislation Across The Nation And The Impact On Pharmacy Practice, Sabrina Hamman, Hannah Lamb, Jennifer Harklerode, Elizabeth Kramer, Steven Martin

Pharmacy and Wellness Review

Pharmacy legislation is constantly being updated, giving pharmacists a larger role in the health care field. In the past 20 years, pharmacists have seen expansions to legislation involving contraceptive authority, medical marijuana, vaccines and provider status. There is a greater pharmacist impact from legislation passed on the state level in comparison to the national level. As a result, pharmacists have different opportunities to provide new and advanced services to patients based on the state in which they are practicing. Comparing these various laws across the nation allows the profession to determine which sections of the law are problematic and which …

Changing Roles In Leadership For Today's Pharmacist - A Look Into The New Acpe Draft Leadership Standards, Maureen Moynihan, Sabrina Hamman, Rachel Muhlenkamp, Steven Martin, Jenelle Sobotka

Pharmacy and Wellness Review

With the advancement of the profession of pharmacy, the demand for pharmacist leadership continues to rise. In order for pharmacists to acquire the necessary leadership skills for the profession, there is a call for colleges of pharmacy to incorporate leadership development into their academic programs. The Accreditation Council for Pharmacy Education (ACPE) has released the new 2016 Standards and Guidance Documents for institutions to follow in order for their pharmacy students to graduate with leadership skills.

Achieving Provider Status For Pharmacists, Kasie Bellmann, Alexandra Dimit, Kelsey Weisenburger, Donald L. Sullivan

Pharmacy and Wellness Review

In order to receive payment for medical services through Medicare Part 8, health care professionals must be identified as "providers" under the Social Security Act. Pharmacists currently are not included in the list of providers and, therefore, cannot provide many services to patients. Through their extensive education and training, accessibility and immense trust in their profession, pharmacists are the ideal health care professionals to help expand the continuity of care of our nation's patients. On Jan. 1, 2014, Senate Bill 493 was passed into law recognizing pharmacists in the state of California as providers. With this new legislation, the pharmacists' …

Legislation Editorial, Kent Wilin, Kaitlin Horton, Maria Laikos

Pharmacy and Wellness Review

No abstract provided.

An Update On Acetaminophen Labeling Changes: A Pharmacist's Call To Action, Rebecca Airel, Kayla Durkin, Taylor Gauthier, Jamie Amero, Natalie A. Dipietro

Pharmacy and Wellness Review

Due to the number of acetaminophen overdoses each year, the Food and Drug Administration and the National Center for Prescription Drug Programs made changes and recommendations regarding the labeling of acetaminophen-containing products. It is important for pharmacists to understand these changes and to educate patients on the correct use of these products.

Rems: Risk Management Strategies, Current Issues, And The Pharmacist's Role, Kristen Thatcher, Megan Stojic

Pharmacy and Wellness Review

Risk Evaluation and Mitigation Strategies (REMS) are the most recent risk management initiative put forth by the Food and Drug Administration (FDA) that decreases the risk associated with certain medications. They may be mandatory by the FDA or can be produced voluntarily by the manufacturer in order for a drug associated with significant risk to be approved. REMS may include one or multiple elements, including a Medication Guide (MedGuide), Communication Plan, Elements to Assure Safe Use (ETASU), Implementation Plan, and Timetable for Submission of Assessments. Although REMS enhance patient care by reducing risk and maintaining patient safety, an unbalanced burden …

The 340b Program, Contract Pharmacies, Hospitals, And Patients: An Evolving Relationship Impacting Health Care Delivery, Morgan Ruley, Morgan Belcher, Hannah Sayre, Alberto Coustasse

Management Faculty Research

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices. The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to more than 35 000 individual health care facilities and sites certified by the US Department of Health and Human Services, …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Drug Safety Scientometrics Overview Highlights Public Health Issues, Philippe Gorry, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

"Drug Safety (DS) also known as Pharmacovigilance, is the science of monitoring ADR (Cobert, 2012). Despite that DS has a social welfare function, it has not been the study of any scientometrics analysis... Our goal is to fill this gap by mapping the DS literature. This analysis might highlight some trends, the role of drug regulatory and firms in diffusing information, understand better some DS controversial events, help scholars in mastering pharmacovigilance literature, and it contribute to further development on literature-based discovery of ADR [adverse drug reactions] with the help of natural language processing."

The Power Of Pharmacist-To-Pharmacist Handoffs During Transitions Of Care, Jessica Wooster, Laressa Bethishou

Pharmacy Faculty Articles and Research

"Hospital readmissions are often medication-related and potentially preventable. Pharmacists can play a vital role in improving medication outcomes during transitions of care (TOC). Although numerous TOC practice models have been described, it remains unclear what practices will promote optimal continuity of care."

Co-Located Retail Clinics And Pharmacies: An Opportunity To Provide More Primary Care., Katherine K. Knapp, Keith Yoshizuka, Debra Sasaki-Hill, Rory Caygill-Walsh

Faculty Publications & Research of the TUC College of Pharmacy

This paper proposes that co-located retail clinics (RCs) and community pharmacies can increase opportunities to provide more accessible, affordable, and patient-friendly primary care services in the United States. RCs are small businesses of about 150-250 square feet with a clientele of about 10-30 patients each day and most frequently staffed by nurse practitioners (NPs). Community pharmacies in the U.S. at ~67,000 far outnumber RCs at ~2800, thereby opening substantial opportunity for growth. Community pharmacies and pharmacists have been working to increase on-site clinical services, but progress has been slowed by the relative isolation from other practitioners. An ideal merged facility …

Association Of Naloxone Coprescription Laws With Naloxone Prescription Dispensing In The United States, Minji Sohn, Jeffery C. Talbert, Zhengyan Huang, Michelle R. Lofwall, Patricia R. Freeman

Institute for Pharmaceutical Outcomes and Policy Faculty Publications

Importance: To mitigate the opioid overdose crisis, states have implemented a variety of legal interventions aimed at increasing access to the opioid antagonist naloxone. Recently, Virginia and Vermont mandated the coprescription of naloxone for potentially at-risk patients.

Objective: To assess the association between naloxone coprescription legal mandates and naloxone dispensing in retail pharmacies.

Design, Setting, and Participants: This was a population-based, state-level cohort study. The sample included all prescriptions dispensed for naloxone in the retail pharmacy setting contained in IQVIA's national prescription audit, which represents 90% of all retail pharmacies in the United States. The unit of observation was state-month …

The Landscape Of Cellular And Gene Therapy Products: Cost, Approvals, And Discontinuations, Vaishali Shukla, Enrique Seoane-Vazquez, Souhiela Fawaz, Lawrence M. Brown, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Background The past 10 years witnessed a significant increase in the approval of cellular and gene therapy products worldwide. The US Food and Drug Administration (FDA) approved 3 gene therapy products within the last 4 months of 2017. The objective of this study was to examine the approval characteristics, discontinuations and cost of all cellular and gene therapy products approved worldwide. Data and Methods We conducted an electronic search of approved cell and gene therapy products from the databases of the main drug regulatory agencies including the US Food and Drug Administration, the European Medicines Agency (EMA), the Korea Ministry …

Improving Physician Office Quality Measures By Evaluating Statin Prescribing In Type 2 Diabetic Patients, Choniece Phillips, Kathleen Dawson, Lindsay Roberts, Jamie Mcconaha, Megan Bookser

Undergraduate Research and Scholarship Symposium

Abstract

Objective

The focus of this study was to evaluate the impact of pharmacist’ intervention on quality metrics focusing on patients with a diagnosis of diabetes mellitus type II (T2DM) not currently prescribed statin therapy.

Methods

This retrospective cohort investigational study was conducted in four lowest performing office locations of a nineteen regional primary care physician group practice. Inclusion criteria were diagnosis of T2DM without active statin therapy. Data was excluded from analysis for patients younger than age 40 or older than age 75, or if the most recent LDL documented was less than 70 mg/dL. Recommendations for initiation of …

The Importance Of Goal Setting: Why Every Pharmacist Should Make Goal Setting A Habit, Albert Bach, Laressa Bethishou

Pharmacy Faculty Articles and Research

"But how many of us actually practice what we preach? We have pledged to apply our knowledge, experience, and skills to the best of our ability to assure optimal outcomes for our patients. As the pharmacy profession evolves, and as we train future generations of pharmacists, we have increased opportunities to expand our role and impact as a pharmacist. Goal setting is an important and valuable tool to support us in our personal and professional growth."

Evidence-Based Toolkit For Reduction Of Overdose Risk In Primary Care Patients On Opioid Therapy, Katelin A. Aris

Doctoral Projects

Introduction: Opioids are powerful pain killing medications that can be highly addictive and can cause risk for overdose and even death (Michigan Prescription Drug and Opioid Task Force, 2015). Many primary care providers treat patients with acute and chronic pain, although it is recognized that many receive inadequate training in pain management and feel unprepared in the complexities of caring for these patients (Becker, Bair, Picchioni, Starrels, and Frank, 2018). To treat these patients safely, provider education and adherence to guidelines put forward by these initiatives is essential.

Methods: An evidence-based prescribing toolkit was devised using guidance from the literature …

2018-2019 Acip Immunization Updates: Highlights For Pharmacists, Laressa Bethishou, Luma Munjy, Jeff Goad

Pharmacy Faculty Articles and Research

"Vaccinations have significantly reduced the burden of infectious diseases, preventing almost 6 million deaths worldwide.^1,2 In the United States, vaccines have led to a decrease in incidence of vaccine-preventable illness, mortality, and disease sequelae.³ Despite the proven benefit of vaccines, misinformation and failure to vaccinate has led to outbreaks of vaccine-preventable diseases. As of December 29, 2018, 372 cases of measles (from 17 outbreaks) and 2251 cases of mumps were reported in the United States in 2018.^4,5 These outbreaks support the need for continued education of patients and active immunization by pharmacists."

Evaluating Naloxone Access And Prescribing Requirements In The Opioid Epidemic Across The United States, Krista Brooks, Tom Davis, Khoa Nguyen, Ngan-Dinh Nguyen, Tashrique Rahman, Lucero Villa

Faculty Articles & Research

• Deaths related to opioid overdose has been an increasing problem in the United States
• Deaths related to opioid overdoses can be prevented by the use of naloxone which reverses the effects of opioids
• Approaches to promote naloxone access have been described by federal agencies, including the Substance Abuse and Mental Health Services Administration