scholarly journals Primary healthcare policy and vision for community pharmacy and pharmacists in the United States

2020 ◽  
Vol 18 (3) ◽  
pp. 2160
Author(s):  
Teresa M. Salgado ◽  
Meagen M. Rosenthal ◽  
Antoinette B. Coe ◽  
Tana N. Kaefer ◽  
Dave L. Dixon ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Community Pharmacy ◽  
Healthcare System ◽  
Developed Countries ◽  
The United States ◽  
Medication Therapy Management ◽  
Therapy Management ◽  
Medication Therapy ◽  
The Us

The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians and advanced practice providers (i.e., nurse practitioners and physician assistants) in a variety of settings including large health systems, federally qualified health centers or free clinics that provide care to the underserved, or specific facilities for veterans or American Indian and Alaska native peoples. Since 2010, primary care delivery has shifted toward providing patient-centered, coordinated, comprehensive care focused on providing proactive, rather than reactive, population health management, and on the quality, versus volume, of care. Community pharmacy comprises a mix of independently owned, chain, supermarket and mass merchant pharmacies. Community pharmacies provide services such as immunizations, medication therapy management, medication packaging, medication synchronization, point-of-care testing and, in specific states where legislation has been passed, hormonal contraception, opioid reversal agents, and smoking cessation services. There has been criticism regarding the lack of standard terminology for services such as medication synchronization and medication therapy management, their components and how they should be provided, which hampers comparability across studies. One of the main challenges for pharmacists in the US is the lack of provider status at the federal level. This means that pharmacists are not allowed to use existing fee-for-service health insurance billing codes to receive reimbursement for non-dispensing services. In addition, despite there being regulatory infrastructure in multiple states, the extent of service implementation is either low or unknown. Research found that pharmacists face numerous barriers when providing some of these services. State fragmentation and the lack of a single pharmacy organization and vision for the profession are additional challenges.

Review of Survey Articles Regarding Medication Therapy Management (MTM) Services/Programs in the United States

2012 ◽  
Vol 25 (4) ◽  
pp. 457-470 ◽  
Author(s):  
Abiola O. Oladapo ◽  
Karen L. Rascati
Keyword(s):  
United States ◽  
Drug Therapy ◽  
Web Sites ◽  
The United States ◽  
Medication Therapy Management ◽  
Pharmacy Students ◽  
Therapy Management ◽  
Medication Therapy ◽  
General Drug ◽  
Keyword List

Objective: To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. Methods: A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. Results: A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Conclusion: Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM services for it to be appealing to them.

Pediatric asthma medication therapy management through community pharmacy and primary care collaboration

2016 ◽  
Vol 56 (4) ◽  
pp. 455-460 ◽  
Author(s):  
Courtney L. Bradley ◽  
Heidi R. Luder ◽  
Andrew F. Beck ◽  
Rachel Bowen ◽  
Pamela C. Heaton ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Pharmacy ◽  
Pediatric Asthma ◽  
Medication Therapy Management ◽  
Asthma Medication ◽  
Therapy Management ◽  
Medication Therapy

scholarly journals Development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population

2013 ◽  
Vol 4 (4) ◽  
Author(s):  
Sarah E. Kelling ◽  
David R. Bright ◽  
Timothy R. Ulbrich ◽  
Donald L. Sullivan ◽  
James Gartner ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Care Service ◽  
Care Program ◽  
Medication Therapy Management ◽  
Original Research ◽  
Transition Of Care ◽  
Therapy Management ◽  
Medication Therapy ◽  
Medicaid Population ◽  
Managed Medicaid

Objective: To describe successes and barriers with the development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population. Setting: A single supermarket chain pharmacy Practice description: Community pharmacists provide dispensing and non-dispensing pharmacy services including medication therapy management, biometric wellness screenings, and immunizations. Practice innovation: Developed and implemented a community pharmacy medication therapy management-based transition of care program for patients with managed Medicaid Main outcome measures: Feasibility of developing and implementing a transition of care service in a community pharmacy Results: During the first six months, a total of 17 patients were seen as part of the program. Study pharmacists identified successes and potential strategies for overcoming barriers. Conclusion: Developing and implementing a community pharmacy transition of care program for patients with managed Medicaid was logistically feasible.   Type: Original Research

Physicians’ Preferences for Communication of Pharmacist-Provided Medication Therapy Management in Community Pharmacy

2016 ◽  
Vol 30 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Kendall D. Guthrie ◽  
Steven C. Stoner ◽  
D. Matthew Hartwig ◽  
Justin R. May ◽  
Sara E. Nicolaus ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Medication Therapy Management ◽  
Survey Study ◽  
Cross Sectional ◽  
Term Care ◽  
Prospective Survey ◽  
Therapy Management ◽  
Medication Therapy ◽  
Communication Practices

Objectives: (1) To identify physicians’ preferences in regard to pharmacist-provided medication therapy management (MTM) communication in the community pharmacy setting; (2) to identify physicians’ perceived barriers to communicating with a pharmacist regarding MTM; and (3) to determine whether Missouri physicians feel MTM is beneficial for their patients. Methods: A cross-sectional prospective survey study of 2021 family and general practice physicians registered with MO HealthNet, Missouri’s Medicaid program. Results: The majority (52.8%) of physicians preferred MTM data to be communicated via fax. Most physicians who provided care to patients in long-term care (LTC) facilities (81.0%) preferred to be contacted at their practice location as opposed to the LTC facility. The greatest barriers to communication were lack of time and inefficient communication practices. Improved/enhanced communication was the most common suggestion for improvement in the MTM process. Approximately 67% of respondents reported MTM as beneficial or somewhat beneficial for their patients. Conclusions: Survey respondents saw value in the MTM services offered by pharmacists. However, pharmacists should use the identified preferences and barriers to improve their currently utilized communication practices in hopes of increasing acceptance of recommendations. Ultimately, this may assist MTM providers in working collaboratively with patients’ physicians.

scholarly journals The Cross-national Applicability of Lean Implementation Measures and Hospital Performance Measures: A Case Study of Finland and the United States

2021 ◽  
Author(s):  
Elina Reponen ◽  
Thomas G Rundall ◽  
Stephen M Shortell ◽  
Janet C Blodgett ◽  
Ritva Jokela ◽  
...  
Keyword(s):  
United States ◽  
Healthcare System ◽  
Performance Measures ◽  
Service Provision ◽  
The United States ◽  
Hospital Performance ◽  
Lean Implementation ◽  
The Us ◽  
Cross National

Abstract Background Healthcare organizations around the world are striving to achieve transformational performance improvement, often through adopting process improvement methodologies such as Lean management. Indeed, Lean management has been implemented in hospitals in many countries. But despite a shared methodology and the potential benefit of benchmarking lean implementation and its effects on hospital performance, cross-national Lean benchmarking is rare. Healthcare organisations in different countries operate in very different contexts, including different healthcare system models, and these differences may be perceived as limiting the ability of improvers to benchmark Lean implementation and related organisational performance. However, there is no empirical research available on the international relevance and applicability of Lean implementation and hospital performance measures. To begin to understand the opportunities and limitations related to cross-national benchmarking of Lean in hospitals, we conducted a cross-national case study of the relevance and applicability of measures of Lean implementation in hospitals and hospital performance. Methods We report an exploratory case study of the relevance of Lean implementation measures and the applicability of hospital performance measures using quantitative comparisons of data from Hospital District of XX XX University Hospital in Finland and a sample of 75 large academic hospitals in the United States. Results The relevance of Lean-related measures was high across the two countries: almost 90% of the items developed for a US survey were relevant and available from XX. A majority of the US-based measures for financial performance (66.7%), service provision/utilisation (100.0%), and service provision/care processes (60.0%) were available from XX. Differences in patient satisfaction measures prevented comparisons between XX and the US. Of 18 clinical outcome measures, only four (22%) were not comparable. Clinical outcome measures were less affected by the differences in healthcare system models than measures related to service provision and financial performance. Conclusions Lean implementation measures are highly relevant in healthcare organisations operating in the United States and Finland, as is the applicability of a variety of performance improvement measures. Cross-national benchmarking in Lean healthcare is feasible, but a careful assessment of contextual factors, including the healthcare system model, and their impact on the applicability and relevance of chosen benchmarking measures is necessary. The differences between the US and Finnish healthcare system models is most clearly reflected in financial performance measures and care process measures.

INNOVATIONS IN THE DPRK ECONOMY IN THE ERA OF KIM JONG-UN: RESULTS, THREATS AND RISKS

2020 ◽  
pp. 96-107
Author(s):  
Marina E. Trigubenko ◽  
◽  
Tatiana V. Lezhenina ◽  
Keyword(s):  
United States ◽  
Developed Countries ◽  
The United States ◽  
Kim Il Sung ◽  
Economic Relations ◽  
Economic Program ◽  
The Us ◽  
The World ◽  
National Ideology ◽  
The Republic

During the 8 years of the DPRK leadership, Kim Jong-un has been trying to position himself as a major reformer of the economy and the main military strategist in the development of the production of the latest intercontinental missiles directed towards the United States. Kim Jong-un presented the economic program for the first time at the VII Congress of the Labor Party of Korea in 2016 in the format of the three main tasks of the first five-year plan for 2016-2020. Tasks. To summarize Kim Jong-un's innovations in economic development and prove that they will be effective in the context of expanding trade and economic cooperation between the DPRK and China, Russia, as well as reducing the US sanctions policy against the DPRK. Methodology. The use of methods of scientific knowledge of the reformation of the economy of less developed countries. Results. The scale of economic innovations of Kim Jong-un and the influence of the legacy left by Kim Il-sung and Kim Jong-il from the position of national ideology are proved to be self-reliant (Juche), which complicates and slows down the transition of North Korea to the number of democratically developed countries of the world, political and trade-economic DPRK cooperation with the Republic of Korea. Findings. Today, China has always been and remains the main military-political ally and economic partner of the DPRK. Sino-US relations have become much more complicated as a result of the trade war and US accusations of concealing by China the real reasons for the appearance and spread of COVID-19 all over the world. The DPRK's economic relations with the United States do not develop after direct contact in 2019 of Donald Trump with Kim Jong-un. External and internal threats and risks in the use of innovations remain.

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