Evaluation of a Community Pharmacy–Based Screening Questionnaire to Identify Patients at Risk for Drug Therapy Problems

Pammett, Robert; Blackburn, David; Taylor, Jeff; Mansell, Kerry; Kwan, Debbie; Papoushek, Christine; Jorgenson, Derek

doi:10.1002/phar.1633

Cited by 7 publications

(19 citation statements)

References 19 publications

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“…[6][7][8] Despite this work, DTPs are not typically classified with a severity score. Previous studies have evaluated predictors for total number of DTPs, 10,11 with one considering the severity of the DTPs as low, moderate, or severe. 10 Quintana-Bárcena developed a validated process to rate severity of DTPs in chronic kidney disease patients in community pharmacies based on interventions required to manage DTPs, but is not generalizable due to limitations of contextual design and population.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have evaluated predictors for total number of DTPs, 10,11 with one considering the severity of the DTPs as low, moderate, or severe. 10 Quintana-Bárcena developed a validated process to rate severity of DTPs in chronic kidney disease patients in community pharmacies based on interventions required to manage DTPs, but is not generalizable due to limitations of contextual design and population. 12 Dean and Barber created a validated tool to assess severity of medication errors using a 1 to 10 scale, as assessed by various health care professionals, but it is not clear if this can be applied more broadly to DTP severity.…”

Section: Introductionmentioning

confidence: 99%

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Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Westberg

Derr

Weinhandl

et al. 2017

Journal of Pharmacy Technology

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Background: Pharmacists influence health care outcomes through the identification and resolution of drug therapy problems (DTPs). Objective: The objectives of this study were to describe number, type, and severity of DTPs based on clinical significance and likelihood of harm in patients transitioning from hospital to home as assessed during a comprehensive medication management (CMM) visit with a pharmacist. Secondary objectives were to assess intrarater reliability in severity ratings and assess likelihood of harm for adverse drug reactions (ADR) by drug classes. Methods: Retrospective review of 408 patients having a face-to-face, telephonic, or virtual CMM visit within the Fairview Health System. Teams of 3 investigators reviewed each DTP from the electronic medical record for each of the 408 patients and assigned a severity score (0-10) for clinical significance and likelihood of harm. Main Results: The highest severity DTP classes were adherence and ADR. The lowest severity DTP class was unnecessary drug therapy. An average of 2.5 DTPs was found per patient at the index CMM visit following hospital discharge. The most common DTP classes were needs additional therapy and dose too low. There were statistically significant differences in DTP severity scoring between reviewer types, though differences were <5%. Drug classes with the highest severity ADR included diabetes, cardiovascular, and anticoagulant/antiplatelet agents. Conclusions: The DTP severity ratings indicated that reviewers found ADR and adherence DTPs were potentially the most severe. There were differences in DTP ratings between reviewer types, though clinical significance of these differences is unclear.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Westberg

Derr

Weinhandl

et al. 2017

Journal of Pharmacy Technology

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

“…We strongly advocate using an evidence-based screening tool such as a Medication Risk Assessment Questionnaire (MRAQ) to help identify patients who may benefit from pharmacist consultation. 3,4 Recommendation 6: Be highly visible and accessible The simple, but invaluable, concept that the guidelines refer to as "strategic loitering" highlights one way to remain visible and accessible to other PCPs. For example, many PCPs in Chilliwack frequent the physicians' lounge at the hospital-many physicians emphasized this location as the most impactful site for strategic loitering in the whole city.…”

Section: Recommendation 4: Educate Yourself About the Roles Of The Otmentioning

confidence: 99%

Applying the guidelines for pharmacists integrating into primary care teams

Barry

Pammett

2016

Can Pharm J

Self Cite

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Background: In 2013, Jorgenson et al. published guidelines for pharmacists integrating into primary care teams. these guidelines outlined 10 evidencebased recommendations designed to support pharmacists in successfully establishing practices in primary care environments. the aim of this review is to provide a detailed, practical approach to implementing these recommendations in real life, thereby aiding to validate their effectiveness.

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“…However, increasingly, short questionnaires are being used to enable risk identification for public health intervention, 14 to inform the pharmacist about patient’s medicines taking and tailor their intervention accordingly, 12 and, when combined with the patient medication record, to determine the need for drug-related intervention. 15 …”

Section: Patient Medication Recordsmentioning

confidence: 99%

Community pharmacy: an untapped patient data resource

Wright¹,

Twigg²

2016

IPRP

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As community pharmacy services become more patient centered, they will be increasingly reliant on access to good quality patient information. This review describes how the information that is currently available in community pharmacies can be used to enhance service delivery and patient care. With integration of community pharmacy and medical practice records on the horizon, the opportunities this will provide are also considered. The community pharmacy held patient medication record, which is the central information repository and has been used to identify non-adherence, prompts the pharmacist to clinically review prescriptions, identify patients for additional services, and identify those patients at greater risk of adverse drug events. While active recording of patient consultations for treatment over the counter may improve the quality of consultations and information held, the lost benefits of anonymity afforded by community pharmacies need to be considered. Recording of pharmacy staff activities enables the workload to be monitored, remuneration to be justified, critical incidents to be learned from, but is not routine practice. Centralization of records between community pharmacies enables practices to be compared and consistent problems to be identified. By integrating pharmacy and medical practice records, patient behavior with respect to medicines can be more closely monitored and should prevent duplication of effort. When using patient information stored in a community pharmacy, it is, however, important to consider the reason why the information was recorded in the first instance and whether it is appropriate to use it for a different purpose without additional patient consent. Currently, community pharmacies have access to large amounts of information, which, if stored and used appropriately, can significantly enhance the quality of provided services and patient care. Integrating the records increases opportunities to enhance patient care yet further. While community pharmacies have significant amounts of information available to them, this is frequently untapped.

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Evaluation of a Community Pharmacy–Based Screening Questionnaire to Identify Patients at Risk for Drug Therapy Problems

Abstract: The screening questionnaire was a reliable method for identifying patients in community pharmacies who have a large number of DTPs.

Cited by 7 publications

References 19 publications

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Applying the guidelines for pharmacists integrating into primary care teams

Community pharmacy: an untapped patient data resource

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