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An appointment-based medication synchronization programme in community pharmacies resulted in improved adherence and increased percentage of on-time refills.

The primary and secondary objectives of this study were to evaluate stress and health-related quality of life experienced by non-native English speakers enrolled in a Doctor of Pharmacy program. Methods. This study assessed Doctor of Pharmacy students at a single institution through completion of a selfadministered questionnaire using an online survey tool, QuestionPro. The primary outcome of the study was a comparison of Perceived Stress Scale (PSS) scores. Secondary outcomes were the Medical Outcome Study SF-12 Health Questionnaire scores. An independent samples t-tests was conducted to compare differences between non-native and native English speakers for both primary and secondary outcomes. Results. Three criteria were used to evaluate the language status of a student including, their preference to speak English (91/113 participants), if their primary caregiver spoke English at home (63/113 participants), and the individual student thinking in English (90/113 participants). Evaluation of the primary outcome of PSS score and secondary outcome of SF-12 mental and physical health; revealed no significant difference between native and non-native English speakers using each of the three language related criteria. Conclusion.The results of this study showed native language spoken did not significantly increase stress or decrease quality of life for students in a Doctor of Pharmacy program. However, the survey results indicate experiencing more stress correlated to a decrease in mental health-related quality of life, which indicates the need for further research to identify students at risk for this negative outcome.

Objective: Although the use of dipeptidyl peptidase-4 (DPP-4) inhibitors has been increasing after their first approval in 2006, little is known about their prescribing pattern. Therefore, the objective of this study is to evaluate the prescribing pattern of the DPP-4 inhibitors for the treatment of type 2 diabetes mellitus (T2DM) and examine sociological factors associated with physician prescribing behavior in the U.S. outpatient setting. Methods: This cross-sectional study was conducted utilizing data from the 2006-2010 National Ambulatory Medical Care Survey (NAMCS) and employed the Eisenberg model that explains physician decision making in the context of sociologic influences. For independent variables, the following characteristics were determined based on the Eisenberg model: patient characteristics, physician characteristics, the physician-health care system interaction, and the physician-patient relationship. The dependent variable was the use of DPP-4 inhibitors. Multivariate logistic regressions were used for analyses. Results: The estimated population size was 535,158,796 patients during five years, and 3.85% of them were prescribed DPP-4 inhibitors. Among the patient characteristic-related factors, the odds of the use of DPP-4 inhibitors was 73% lower in patients with Medicaid compared to patients with private insurance (OR = 0.27; 95% CI, 0.08-0.88; p = .030). For the physician characteristic-related factor, the odds of prescribing DPP-4 inhibitors for primary care physicians are about 86% higher than the odds for non-primary care physicians (OR = 1.86; 95% CI, 1.17-2.95; p = .008). In addition, physicians in private offices were 3.01 times more likely to prescribe DPP-4 inhibitors than physicians in the health maintenance organizations (HMO) (OR = 3.01; 95% CI, 1.03-8.78; p = .043). Conclusions: Patient characteristics, physician characteristics, and the physician's relationship with the health care system were associated with an increased use of DPP-4 inhibitors. However, the physician's relationship with the patient was not associated with an increased use of DPP-4 inhibitors.

Aim: Unnecessary medications are defined as medications that provide no benefit in terms of survival, quality of life, or symptom control for this particular population. However, there is limited data available to guide as to which medications are approrpriate to be prescribed. This study focuses on the use of unnecessary medications in hospice patients, using standards of practice in palliative care. Materials and methods: This was a retrospective study involving chart review of hospice patients. Descriptive and inferential statistics were conducted. Data was analyzed using SPSS version 24. Result: 53 chart reviews were conducted. 62% of the study population was taking atleast one unnecessary medication. Vitamins/ minerals were the most frequently prescribed unnecessary medications. Conclusion: Results of this study suggest that hospice patients were on medications that did not provide any therapeutic benefit. By identifying unnecessary medications in this population, the economic burden on healthcare costs and the adverse events associated with these medications can be significantly reduced.

Purpose This quality improvement project aimed to assess the elements of the current workflow process that meets requirements for transitions of care from a family medicine inpatient to outpatient service following the Transitional Care Management (TCM) program developed by the Centers for Medicare & Medicaid Services. The purpose of the study was to assess the current family medicine workflow and determine whether the current process meets the criteria for billing and calculate the potential loss of reimbursement. Methods Interviews with key personnel, review of practice policies, and a retrospective chart review were performed for clinic patients discharged from the inpatient to outpatient family medicine service. Results A total of 37 patients met inclusion criteria for the chart review. Of these, 8% of patients seen at the outpatient clinic met all criteria for TCM. Potential reimbursement for those who met TCM criteria was $293.14 USD; the estimated potential TCM reimbursement for patients not meeting criteria was $1997.76 USD. Conclusion Standardized, team-based TCM services have shown to decrease readmission rates for high-risk patient populations. Results from this project identified processes in place at the family medicine practice to facilitate the development of a standardized transitional care service which could meet both TCM and best practice models.