Change in Proportion of Days Covered for Statins Following Implementation of a Pharmacy Student Adherence Outreach Program

Tamargo, Chloe; Sando, Karen R; Prados, Yesenia; Cowart, Kevin

doi:10.18553/jmcp.2019.25.5.588

Cited by 6 publications

(8 citation statements)

References 17 publications

(15 reference statements)

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“…13 This is comparable to previously described pharmacy student adherence outreach programs, which excluded patients unable to be contacted, and demonstrated PDC improvements of 6% to 13%. [36][37] For the secondary efficacy outcome, the odds of a patient in the intervention group becoming adherent was 2.46 (95% CI 1.20-5.05) vs the control group, which is comparable to a similar outreach program that provided MI through a centralized setting (OR 1.87, 95% CI 1.18-2.95). 37 One goal of this study was to develop tools to facilitate intervention application in other healthcare systems where pharmacy students complete rotations.…”

Section: Quality Of Project Materialsmentioning

confidence: 81%

“…Previous research illustrates that MI performed by pharmacy students can improve statin adherence. [34][35][36][37] Increased comfort level with statin medication counseling 5 1…”

Section: Discussionmentioning

confidence: 99%

“…within a centralized medication therapy management (MTM) service. [36][37] Additionally, electronic medical record access may have simplified provider communication as students could directly route notes to PCPs to suggest a medication change or request updates to prescription instructions.…”

Section: Quality Of Project Materialsmentioning

confidence: 99%

“…With an average of 1.5 completed calls per patient, this intervention was less resource-intensive than several previous studies. 34,[36][37] Performing chart review before contacting a patient may allow for more directed and deliberate outreach, with less telephone calls required to overcome barriers to adherence.…”

Section: Quality Of Project Materialsmentioning

confidence: 99%

“…22 Strategies utilizing pharmacy students have demonstrated efficacy and may be more costfeasible. [33][34][35][36][37] Such interventions align with accreditation standards for pharmacy education, which mandate student competence in providing both patient-centered and population-based care. 38 However, student-perceived value is unknown, and is a critical factor to the continuous quality-improvement process necessary to optimize an intervention.…”

Section: Introductionmentioning

confidence: 99%

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A shared decision‐making intervention by pharmacy students to improve statin adherence

Osbaugh

Billups

2021

J Am Coll Clin Pharm

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Introduction: Despite the well-established value of statins in reducing cardiovascular events, nearly half of patients fail to receive maximum benefit due to nonadherence.Studies indicate that motivational interviewing (MI) by pharmacy students can improve statin adherence. The benefit of incorporating an individualized approach, including shared-decision making (SDM), is unknown, as is the student-perceived value of this activity in their professional development.Objectives: To (a) measure the effect of an individualized telephone intervention conducted by pharmacy students in improving statin adherence and (b) assess the selfreported value of intervention participation to guide continual quality improvement. Methods: A prospective, quality-improvement project was conducted among patients receiving care at a university-based healthcare system through a commercial or Medicare Advantage plan. Pharmacy claims data identified nonadherent patients based on a six-month proportion of days covered (PDC) <0.80 for statin prescriptions. A sample of these patients was randomly selected to receive the intervention from July 2019 to April 2020, while remaining patients served as controls. The intervention included 1-2 telephone calls by pharmacy students to deliver individualized evidence-based education, including SDM and MI strategies. Mean PDC change and proportion of patients converted to adherent (PDC≥0.80) were evaluated 6 months post-intervention using the intention-to-treat principle.Results: There were 58 patients in the intervention group, 52 of whom (90%) received at least one telephone call, and 82 controls. Six months post-intervention mean PDC increased significantly in the intervention vs control group (12.8% vs 0.7%, P = .004), and 66% of the intervention group were adherent compared to 41% of controls [P = .005, adjusted OR = 2.46 (1.20-5.05)]. Seven students participated in the intervention, with 83% of survey responders reporting positive professional development value during the experience. Conclusion: Pharmacy trainees may successfully deliver individualized interventions capable of improving statin adherence while positively contributing to their professional development.

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Section: Quality Of Project Materialsmentioning

confidence: 81%

“…Previous research illustrates that MI performed by pharmacy students can improve statin adherence. [34][35][36][37] Increased comfort level with statin medication counseling 5 1…”

Section: Discussionmentioning

confidence: 99%

Section: Quality Of Project Materialsmentioning

confidence: 99%

Section: Quality Of Project Materialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A shared decision‐making intervention by pharmacy students to improve statin adherence

Osbaugh

Billups

2021

J Am Coll Clin Pharm

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Improvement of proportion of days covered for denosumab under implementation of clinical pharmacist adherence management system: normal and COVID-19 period

Yang,

He,

Yuan

2023

Osteoporos Int

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Summary We established a clinical pharmacist adherence management system (CPAMS) led by clinical pharmacists to examine whether denosumab adherence could be improved. The results showed that CPAMS could effectively improve adherence to denosumab and the treatment of osteoporosis. However, this effect weakened during the spread of infectious diseases such as COVID-19. Purpose Denosumab is currently one of the drugs that can effectively reduce the risk of clinical fracture. However, as a drug requiring long-term subcutaneous injection, patient adherence to denosumab is the most important factor affecting its therapeutic efficacy. Therefore, we established a clinical pharmacist adherence management system (CPAMS) led by clinical pharmacists and examined whether denosumab adherence could be improved. Methods Data were collected from patients receiving denosumab in our hospital between March 2021 and May 2022. The patients who participated in the CPAMS were in the intervention group, and the rest were in the control group. We analysed the proportion of days covered (PDC) value of denosumab, distribution of subsequent visits, and proportion of patients who continued participating during the normal and coronavirus (COVID-19) periods. Results Eighty-five patients were enrolled in this retrospective study: 32 in the intervention group and 53 in the control group. The PDC values were significantly higher in the intervention group (0.9875, 0.9025–1) than in the control group (0.5, 0.5–0.5) after 1 year. The subsequent visit rate in the intervention group was 93.80%. However, none of the patients in the control group returned. In the intervention group, the ratio of timely to delayed subsequent visits was 11:19. After the COVID-19 pandemic, the PDC value of the intervention group (0.957, 0.5–1) was lower than that before COVID-19, and the ratio of timely to delayed subsequent visits was 9:13. Conclusions Clinical pharmacist-led CPAMS could effectively improve adherence to denosumab and the treatment of osteoporosis. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-023-06933-1.

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Pharmacist Interventions to Improve Specialty Medication Adherence: Study Protocol for a Randomized Controlled Trial

Kibbons

Peter

DeClercq

et al. 2020

Drugs - Real World Outcomes

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Background The effectiveness of specialty medications in complicated clinical conditions depends on adherence to therapy. However, specialty medications pose unique barriers to adherence. Objective This study aims to determine whether pharmacist interventions improve specialty medication adherence. Methods This is a single-center, pragmatic, randomized controlled trial ongoing since 10 May 2019 at an integrated health system specialty pharmacy. This study evaluates usual care compared with usual care plus patient-tailored adherence interventions. Study design and procedures were informed by focus groups with patients and specialty pharmacists. Patients at Vanderbilt Specialty Pharmacy with a proportion of days covered (PDC) < 90% in the previous 4 months are identified by a daily query of the electronic pharmacy database. A pharmacist reviews these patients' electronic health records to identify and exclude ineligible patients. Eligible patients are randomized evenly to the control or intervention arm and stratified by historical clinic nonadherence rates. Patients randomized to the intervention arm undergo a baseline assessment to clarify reasons for nonadherence and subsequently receive patient-tailored interventions based on their specific reasons. Interventions and follow-up are provided at the discretion of the intervening pharmacist. The primary outcome is PDC calculated at 8 months post-enrollment. Enrollment of 438 participants will provide 90% power to detect a 5% difference in PDC between the two arms within each nonadherence risk stratum. Discussion This trial will evaluate the effect of patient-tailored interventions on specialty medication adherence and will inform how often and why patients are misidentified as nonadherent. Registration The trial was deemed a quality improvement initiative by the Vanderbilt University Institutional Review Board. It was registered in ClinicalTrials.gov (NCT03709277) on

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Change in Proportion of Days Covered for Statins Following Implementation of a Pharmacy Student Adherence Outreach Program

Cited by 6 publications

References 17 publications

A shared decision‐making intervention by pharmacy students to improve statin adherence

A shared decision‐making intervention by pharmacy students to improve statin adherence

Improvement of proportion of days covered for denosumab under implementation of clinical pharmacist adherence management system: normal and COVID-19 period

Pharmacist Interventions to Improve Specialty Medication Adherence: Study Protocol for a Randomized Controlled Trial

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