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Languages : en
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Author: Meera Viswanathan
Publisher:
ISBN:
Category :
Languages : en
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Book Description
OBJECTIVES: To describe intervention components and implementation features (Key Question [KQ]1) for outpatient medication therapy management (MTM) interventions with comprehensive medication review, followup, education, and care coordination; assess the effectiveness of these MTM interventions on intermediate, patient-centered, or resource utilization outcomes (KQ 2); identify intervention features (KQ 3) and patient characteristics (KQ 4) that moderate the effect of an intervention on outcomes; and assess harms associated with interventions (KQ 5). DATA SOURCES: MEDLINE(r), Cochrane Library, International Pharmaceutical Abstracts, gray literature, additional studies from reference lists and technical experts REVIEW METHODS: Two trained reviewers selected, extracted data from, and rated the risk of bias of relevant trials and cohort studies. We used random-effects models to estimate pooled effects for outcomes with three or more similar studies with a low or medium risk of bias. For other outcomes, we synthesized the data qualitatively. RESULTS: We included 44 eligible studies (21 randomized controlled trials, 4 controlled clinical trials, and 19 cohort studies) reported in 61 articles, described in detail in the report (KQ 1). Evidence was insufficient on the effect of outpatient MTM interventions on most outcomes (KQ 2). In a few instances, described below, the evidence led us to conclude benefit or lack of benefit. Specifically, we found evidence that MTM results in improvement when compared with usual care for some measures of medication adherence and appropriateness; medication dosing; health plan expenditures on medication costs; and, for patients with diabetes, the proportion hospitalized and costs of hospitalization. Similarly, we conclude, based on a low strength of evidence, that MTM confers no benefit for patient satisfaction and most measures of health-related quality of life. We found evidence on five intervention components and intervention features (KQ 3). One study provided information on each feature and yielded insufficient evidence for most outcomes, with the following two exceptions. An MTM program with pharmacist access to brief clinical summaries from the medical record reduces the mean number of adverse drug events when compared with a basic MTM program without such access (low strength of evidence). Community pharmacists increase the generic dispensing ratio more than call-center-based pharmacists (low strength of evidence). We found no relevant studies on patient characteristics moderating the effect of MTM interventions (KQ 4). Similarly, the evidence on harms associated with MTM was limited to one study on inconvenience and was rated as insufficient (KQ 5). CONCLUSIONS: The evidence base offers low evidence of benefit for a limited number of intermediate and health utilization outcomes. We graded the evidence as insufficient for most other outcomes because of inconsistency in direction, magnitude, and precision, rather than lack of evidence. Wide variations in populations and interventions, both within and across studies, likely explain these inconsistencies. Given the widespread implementation of MTM and urgent need for actionable information, optimal investments in new research require a process of research prioritization in which the value of information from each proposed study is carefully considered. Studies designed to identify causal relationships between MTM interventions and their outcomes require adequate controls for confounding but may offer limited information on the factors that explain program success or failure. Studies designed to explore the reasons for program success or failure using qualitative or single-arm designs may offer hypotheses-generating rather than hypotheses-confirming insights on MTM effectiveness. New research, regardless of specific focus, will likely continue to find inconsistent results until underlying sources of heterogeneity are accounted for.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309101476
Category : Medical
Languages : en
Pages : 481

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In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

Author: Henri Richard Manasse
Publisher: ASHP
ISBN: 1585280895
Category : Medical
Languages : en
Pages : 394

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Book Description
Medication safety is the most challenging goal for pharmacy practice and patient safety professionals in all health care facilities. This book serves as an essential reference guide for planning and implementing a medication safety program. Written by nationally-recognized experts, Medication Safety: A Guide for Health Care Facilities provides a comprehensive analysis of principles and practices associated with the prevention and identification of medication errors, as well as interdisciplinary, facility-wide recommendations for achieving medication safety in all settings. This book is divided into four sections so users can easily find the information they need: the Importance of Medication Safety, the Medication Safety Team, Building a Safe Medication Use System, and Measuring Medication Safety.

Author: Caroline S. Zeind
Publisher: Lippincott Williams & Wilkins
ISBN: 1975167104
Category : Medical
Languages : en
Pages : 6301

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Book Description
50th Anniversary Edition of the groundbreaking case-based pharmacotherapy text, now a convenient two-volume set. Celebrating 50 years of excellence, Applied Therapeutics, 12th Edition, features contributions from more than 200 experienced clinicians. This acclaimed case-based approach promotes mastery and application of the fundamentals of drug therapeutics, guiding users from General Principles to specific disease coverage with accompanying problem-solving techniques that help users devise effective evidence-based drug treatment plans. Now in full color, the 12th Edition has been thoroughly updated throughout to reflect the ever-changing spectrum of drug knowledge and therapeutic approaches. New chapters ensure contemporary relevance and up-to-date IPE case studies train users to think like clinicians and confidently prepare for practice.

Author: Terri L. Warholak
Publisher: McGraw Hill Professional
ISBN: 0071603867
Category : Medical
Languages : en
Pages : 292

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Book Description
Gain a complete understanding of the principles of quality improvement and their application to present and future pharmacy practice "This book is a great resource for pharmacists and pharmacy students who want to learn about safety and quality in pharmacy practice."--Laura Cranston, RPh, Executive Director, The Pharmacy Quality Alliance Quality and Safety in Pharmacy Practice details the principles, approaches, strategies, and actions necessary to improve the overall safety and effectiveness of pharmacy services. Although one of the book’s primary goals is to enhance the quality of future health care, you will find guidelines that can be implemented immediately to improve today’s pharmacy practice. This comprehensive text offers a complete overview of quality in general, the reasons for improving practice, and actual day-to-day changes and approaches that will positively impact the patient. Quality and Safety in Pharmacy Practice is divided into five parts, covering: The current and future landscape of health care quality and the business case for quality improvement and value-driven health care Quality improvement concepts and tools, including statistical process control Quality and safety measurement, including mechanisms for gathering consumer feedback Incentives and other drivers of quality improvement Application of the principles of quality improvement to pharmacy practice -- complete with case examples

Author: Lauren B. Angelo
Publisher: American Pharmacists Association (APhA)
ISBN: 9781582122168
Category : Pharmacy
Languages : en
Pages : 0

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Book Description
The medication therapy management (MTM) process gives pharmacists an opportunity to work directly with patients to optimize their medication use. A key component of MTM is the comprehensive medication review (CMR). This guidebook provides pharmacists with a detailed description of each step in the process. Following the steps outlined in this guidebook will ensure a standardized and comprehensive approach to the delivery of MTM services.

Author: John P. Rovers
Publisher: American Pharmacists Association (APhA)
ISBN:
Category : Medical
Languages : en
Pages : 344

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Book Description
Offers guidance on launching a pharmaceutical care practice. This title includes chapters on disease management, self-care, wellness, outcomes assessment, and collaborative practice. It covers identifying drug therapy problems, collecting data, developing care plans, marketing, staffing and layout, and getting paid.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309486483
Category : Medical
Languages : en
Pages : 175

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Book Description
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Author: Karen J. Tietze
Publisher: Elsevier Health Sciences
ISBN: 032308222X
Category : Medical
Languages : en
Pages : 214

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Book Description
Covering the skills needed for pharmaceutical care in a patient-centered pharmacy setting, Clinical Skills for Pharmacists: A Patient-Focused Approach, 3rd Edition describes fundamental skills such as communication, physical assessment, and laboratory and diagnostic information, as well as patient case presentation, therapeutic planning, and monitoring of drug intake. Numerous case examples show how skills are applied in clinical situations. Now in full color, this edition adds more illustrations and new coverage on taking a medication history, physical assessment, biomarkers, and drug information. Expert author Karen J. Tietze provides unique, pharmacy-specific coverage that helps you prepare for the NAPLEX and feel confident during patient encounters. Coverage of clinical skills prepares you to be more involved with patients and for greater physical assessment and counselling responsibilities, with discussions of communication, taking a medical history, physical assessment, reviewing lab and diagnostic tests, and monitoring drug therapies. A logical organization promotes skill building, with the development of each new skill building upon prior skills. Learning objectives at the beginning of each chapter highlight important topics. Self-assessment questions at the end of each chapter help in measuring your comprehension of learning objectives. Professional codes of ethics are described in the Ethics in Pharmacy and Health Care chapter, including confidentiality, HIPAA, research ethics, ethics and the promotion of drugs, and the use of advance directives in end-of-life decisions. Numerous tables summarize key and routinely needed information. Downloadable, customizable forms on the companion Evolve website make it easier to perform tasks such as monitoring drug intake and for power of attorney.