Continuous Care Provided Through Comprehensive Medication Management in an Acute Care Practice Model

Marr, Timothy; Pinelli, Nicole R.; Jarmul, Jamie A.; Waldron, Kayla M; Eckel, Stephen F.; Cicci, Jonathan D.; Bates, Jill; Amerine, Lindsey B.

doi:10.1177/1060028017738071

Cited by 20 publications

(18 citation statements)

References 8 publications

(9 reference statements)

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“…Failure to clarify roles in our trial may be reflected in pharmacists not being perceived as an integrated part of the ward team and physicians not being well-informed about the trial's interventions and working processes. Consistent with previous research [20,21,24,38,39], we identified more barriers related to teamwork and collaboration, like pharmacists not always being present at the ward, frequent staff rotations and a lack of time for physician-pharmacist contact. Having pharmacists structurally participate in medical ward rounds may facilitate collaboration.…”

Section: Discussionsupporting

confidence: 89%

“…These tools may require selfassessment by the patient [35] or algorithm-based screening of the electronic medical record [36,37]. Our findings seem consistent with those from qualitative research on CMRs and related interventions by multiprofessional ward teams in other countries and regions [20,21,24,38,39]. Physicians think that pharmacists are reliable and add knowledge to the team [20,21,24]; they perceive positive contribution to the shared goal to improve patient care and safety [21,38,39], and presence by pharmacists at the ward is essential to build professional relationships [21,24].…”

Section: Discussionsupporting

confidence: 83%

“…Our findings seem consistent with those from qualitative research on CMRs and related interventions by multiprofessional ward teams in other countries and regions [20,21,24,38,39]. Physicians think that pharmacists are reliable and add knowledge to the team [20,21,24]; they perceive positive contribution to the shared goal to improve patient care and safety [21,38,39], and presence by pharmacists at the ward is essential to build professional relationships [21,24]. Theories on interprofessional collaboration and the CFIR emphasise the importance of these facilitators [31,40].…”

Section: Discussionsupporting

confidence: 81%

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Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Kempen

Kälvemark

Sawires

et al. 2020

Eur J Clin Pharmacol

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Purpose There is a lack of knowledge about factors that influence the performance of comprehensive medication reviews (CMRs) by multiprofessional teams in hospital practice. This study aimed to explore the facilitators and barriers for performing CMRs and post-discharge follow-up in older hospitalised patients from the healthcare professional perspective. Methods Physicians and ward-based pharmacists were recruited from an ongoing trial at four hospitals in Sweden. Semistructured interviews were conducted with 16 physicians and 7 pharmacists. Interview topics were working processes, resources, competences, medication-related problems, intervention effects and collaboration. The interviews were audio-recorded, transcribed verbatim and thematically analysed using the Consolidated Framework for Implementation Research (CFIR). Identified subthemes were categorised as facilitators or barriers and grouped into overarching main themes. Results In total, 21 facilitators and 25 barriers were identified across all CFIR domains and grouped in 6 main themes: (a) CMRs and follow-up are needed, but not in all patients; (b) there is a general belief in positive effects; (c) lack of resources is an issue, although the performance of CMRs may save time; (d) pharmacists' knowledge and skills are valuable, but they need more clinical competence; (e) compatibility with hospital practice is challenging, and roles and responsibilities are unclear and (f) personal contact at the ward is essential for physician-pharmacist collaboration. Conclusion Multiple facilitators and barriers for performing CMRs and post-discharge follow-up in older hospitalised patients exist. These factors should be addressed in future initiatives with similar interventions by multiprofessional teams to ensure successful implementation and performance in hospital practice.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Kempen

Kälvemark

Sawires

et al. 2020

Eur J Clin Pharmacol

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“…[12][13][14][15] They also outline the potential role of the pharmacist in an oncology setting; however, there was minimal reporting on the nature and incidence of actual or potential drug-related problems (DRPs) where targeted chemotherapy and/or immunotherapy was used to treat patients diagnosed with cancer. 13,14,[16][17][18][19][20][21] The pharmacist as a healthcare professional is actively involved in the identification of patients' treatment-related needs, verification of chemotherapy protocols, drug compounding, detection and prevention of adverse effects, and drug interactions in oncology settings. 22,23 It has been reported that the identification of DRPs by a pharmacist can help to improve patient adherence to drug treatment, treatment outcomes, and maintain or improve quality of life of patients receiving cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

Kucuk

Bayraktar-Ekincioglu

Erman

et al. 2019

J Oncol Pharm Pract

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Background Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting. Methods Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist. Results A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was “adverse drug event” (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an “adverse drug event.” Conclusion Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

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“…29 Furthermore, Marr and colleagues implemented a comprehensive medication management strategy in the cardiology, hematology/oncology, and surgery transplant acute care services and noticed a reduction in 30-day readmission rates and emergency department visits. 30 Acute care pharmacists can also have significant impacts on health-care costs for both the institution and patient through various operational and clinical strategies. 31 Clinical initiatives, such as extended infusion of piperacillin/tazobactam, led to optimized patient outcomes and decreased medication-related expenditures.…”

Section: Advantages and Challenges Of Acute Care Pharmacy Practicementioning

confidence: 99%

Acute Care Pharmacy Practice: A Perspective for Pharmacy Students, Residents, and Other Health-Care Providers

Dunn

Cho

Parmentier

2018

Journal of Pharmacy Practice

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Purpose: To describe the acute care setting with a specific focus on acute care pharmacy practices. Summary Acute care is the sector of health care where time-sensitive episodes of illness are managed. Acute care pharmacy practice includes both hospital and clinical pharmacists serving, in a variety of domains, as medication experts and authority on patient-centered medication therapy. Pharmacists serving in this area can have a beneficial impact on patient care and the health-care system. Conclusion: The demand for acute care services is likely to grow as the population continues to grow and age. Pharmacists are key members of interdisciplinary teams in the acute care setting.

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Continuous Care Provided Through Comprehensive Medication Management in an Acute Care Practice Model

Abstract: This study demonstrated successful implementation of a CMM model that positively affected organizational, patient, and financial outcomes.

Cited by 20 publications

References 8 publications

Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

Acute Care Pharmacy Practice: A Perspective for Pharmacy Students, Residents, and Other Health-Care Providers

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