Journal of Managed Care Pharmacy最新文献

{"title":"Evaluation of Blood Pressure and Adverse Effects in Patients Converted from Lisinopril to Benazepril","authors":"W. Cantrell","doi":"10.18553/JMCP.1999.5.1.52","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.1.52","url":null,"abstract":"OBJECTIVE: To compare blood pressure, serum creatinine, and serum potassium in stable patients before and after conversion from lisinopril to an equivalent dose of benazepril. DESIGN: A retrospective analysis of computer medical and pharmacy records during a one-year period, to obtain the last measured blood pressure, serum creatinine, and serum potassium obtained while patients were receiving lisinopril and again after conversion to benazepril. Certain measurements were excluded to decrease the influence of factors others than the angiotensin converting enzyme (ACE) inhibitors. SETTING: A Veterans Affairs Medical Center located in the western United States. PATIENTS: 687 patients were evaluated for blood pressure; 433 for serum creatinine; and 422 for serum potassium. The patients were predominantly elderly males. MAIN OUTCOME MEASURES: Measures of blood pressure, serum potassium and serum creatinine. RESULTS: No statistical difference was found for systolic blood pressure, diastolic blood pressure, or s...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.18553/JMCP.1999.5.1.52","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67487642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Pharmacy Risk in Physician Groups","authors":"L. Delaet","doi":"10.18553/jmcp.1999.5.5.382","DOIUrl":"https://doi.org/10.18553/jmcp.1999.5.5.382","url":null,"abstract":"During the last 15 years, the number and type of managed care contracts has grown appreciably As health plans have struggled to meet the mandate to control costs, they have revamped old tools and applied them in new ways. One such technique involves phaffi1acy cost risk sharing with physician groups. Pharmacy risk sharing invites all P?rties to manage the pharmacy benefit jointly and share the positive or negative financial consequences. Long used in California, risk sharing is becoming more common in other parts of the country and has presented a new opportunity for pharmacists to apply their clinical and","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimbursement for Pharmacy Cognitive Services: Pharmacists' Assessment","authors":"D. Scott","doi":"10.18553/JMCP.1999.5.5.420","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.5.420","url":null,"abstract":"OBJECTIVE: To assess the willingness of insurance carriers to reimburse for pharmaceutical care and to determine the extent and success of the Pharmacist Care Claim Form (PCCF) used in obtaining reimbursement. DESIGN: A nine-item survey addressing the PCCF (compiled by the National Community Pharmacists Association, formerly the National Association of Retail druggists. Reimbursement was sent to a random sample of insurance carriers including Blue Cross/Blue Shield, health maintenance organizations (HMOs), preferred provider organizations (PPOs), and commercial insurance companies. RESULT: Overall, 116 of 311 (37.3%) surveys were returned (Blue Cross, 57.4%; HMOs, 41.6%; PPOs, 30.7%; and commercial carriers, 27.0%). Of insurance carriers, 6.9% of 116 respondents reported they had reimbursed pharmacists for nondispensing activities. Two carriers reported reimbursement for \"monitoring of drug therapy\" and \"prescription counseling.\" Only two health insurance carriers reported reimbursement to pharmacists usi...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bargaining Between Community Pharmacies and Third-Party Payors: Influences on Bargaining Outcomes","authors":"W. Doucette","doi":"10.18553/JMCP.2001.7.1.43","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.1.43","url":null,"abstract":"OBJECTIVES: To address the gaps in knowledge of pharmacies' evaluation of third-party contracts and the bargaining process between community pharmacies and third parties by: (1) assessing what activities pharmacies regularly perform in evaluating and signing a third-party contract; (2) determining which bargaining activities are occurring between pharmacies and third-party payors; and (3) evaluating the associations among the characteristics of the bargaining parties, the bargaining process, and bargaining outcomes with community pharmacies and third-party payors. DESIGN: Mail survey. PARTICIPANTS: A random sample of 900 independent and small-chain pharmacies. RESULTS: Ofthe 863 delivered surveys, 308 (35.7%) were returned and analyzed. Respondents did not report a high level of formal contract evaluation. They reported, on average, that they rarely requested a change in a contract. This was consistent with the finding that third parties usually refuse to negotiate changes in a contract. The respondents reported that sometimes they did not sign a contract because of unacceptable terms. Multiple regres~ sions for two bargaining outcomesequity of contractual terms and satisfaction with a third party payor-were significant. The same bargainer and bargaining process variables were used as the independent variables in the regressions. For equity of contractual terms (R Square=0.442), significant associations were found for contending, problem solving, and dependence symmetry. For satisfaction with a third-party payor (R Square=OA29), significant associations were found for collaborative communication, contending, and dependence symmetry. CONCLUSIONS: Pharmacies should develop strategies to improve communication with third parties. The symmetry of dependence between a pharmacy and a third-party payor is a key influence on bargaining outcomes. The strategies employed during bargaining, such as contending or problem solving, also affect bargaining outcomes.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prescription for Change: Bridges to Cross the Quality Chasm","authors":"L. Norton","doi":"10.18553/JMCP.2001.7.4.309","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.4.309","url":null,"abstract":"The second report of the Committee on the Quality of Health Care in America, Crossing the Quality Chasm: A New Health System for the 21st Century is currently available as an advanced copy (uncorrected proofs). It expands the committee's work beyond the focus on medical and medication error in To Err Is Human: Building a Safer Health System to a larger issue: the need to improve the quality of health care. 2 The new report outlines aims and principles for an improved design for the delivery of care. The text emphasizes that it is written not to present specifics but to present a new perspective on the purpose, intents, interactions, and processes of health care. The authors acknowledge that it will be necessary to redesign structures and processes of organizations and of professionals and their interactions. They also acknowledge that the practices of the nation's health care system, providers, and users must change to include improvements in dissemination and application of knowledge and potential advanc...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Standards To Prevent Needle-stick Injury","authors":"J. Wick","doi":"10.18553/jmcp.2001.7.5.349","DOIUrl":"https://doi.org/10.18553/jmcp.2001.7.5.349","url":null,"abstract":"ecent legislation revising the Occupational Safety and Health Administration’s (OSHA’s) regulations on preventing needle-stick injuries (NSI) became mandatory in April 2001 and impacts managed care providers and their members in interesting ways. The most immediate impact requires the consideration of the use of sharps that employ safety features; if alternatives to the use of sharps exist, these too should be employed. Say “occupational hazard” and most people will envision hard hats, safety glasses, and heavy industrial equipment. But carpal-tunnel syndrome and back strain have largely displaced mangled limbs as occupational hazards. Consequently, workplace hazards don’t seem as dangerous. Workers routinely develop healthy respect for certain tools, and circumstances command appropriate precautions. For health care workers, the hypodermic syringe is one such tool. Federal interventions address all types of sharps (any device that has a needle or sharp device attached to it). Syringes, however, are of most importance to managed care pharmacy. Certain questions arise regarding their use. Why are syringes and needles such a problem? In an era in which cost containment is an increasing challenge, what budget impact will new safety devices have? How will the switch to non-injectable alternatives affect the formulary or the multi-tiered payment structure? Will legislation, particularly at the state level, eventually extend to outpatient dispensing of syringes? Should these safety devices be covered for members who use injectable drugs at home now? Unquestionably, syringes and needles save lives and are a staple in our arsenal of medical devices, but we have known for decades that injury with a contaminated needle can transmit disease. For years, our main concern was hepatitis. Today, more than 20 blood-borne pathogens have been transmitted via a needlestick-related injury. Three are of particular concern: hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Table 1, page 350, describes the perils associated with each of these. In 1983, 17,000 workers acquired hepatitis B; today experts estimate that better work practices have reduced the number remarkably—to 800 annually. Better work practices, education, and personal protective equipment have successfully reduced transmission of all blood-borne pathogens over the past decades. They have, however, reached the limits of their efficacy. Changes in equipment design are now necessary to further decrease NSI.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cost Analysis of Four Benefit Strategies for Managing a Cox II Inhibitor","authors":"G. Tucker, A. Moore, Deborah D. Avant, M. Monteiro","doi":"10.18553/JMCP.2001.7.3.224","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.3.224","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Etiology - Specific Diagnosis","authors":"W. Berge, G. Ledgerwood, O. Shoheiber, D. Giaquinta, E. Cannon","doi":"10.18553/jmcp.2001.7.s2.4","DOIUrl":"https://doi.org/10.18553/jmcp.2001.7.s2.4","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67490173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Blood Cholesterol and ATP III: Guidelines for Health Benefit and Health Care Providers","authors":"Marcus C. Ravnan","doi":"10.18553/JMCP.2001.7.6.482","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.6.482","url":null,"abstract":"Health care and health benefit providers are faced, now more than ever, with the increasing need to provide aggressive lipid management in an attempt to reduce cardiac-related morbidity and mortality and the associated human and system costs. Amid this growing need, we are faced with new challenges. The removal of a recently approved cholesterol-lowering drug (cerivastatin, Baycol by Bayer) from the market has raised doubts in the minds of Americans currently using the hydroxymethylglutaryl-coenzyme. A reductase inhibitors or so-called statins for cholesterol management. Compounding the problem, the media has highlighted the issue, and many patients now question the safety of other cholesterol-lowering medications. In addition, the release of the Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP), which builds on two previous cholesterol guidelines, expands the role of intensive cholesterol-lowering therapy in clinical practice. 1-3 Providers need to be well educate...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67490530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assessment and Quality Assurance of Pharmacy Services","authors":"D. Christensen, P. Penna","doi":"10.18553/JMCP.1995.1.1.40","DOIUrl":"https://doi.org/10.18553/JMCP.1995.1.1.40","url":null,"abstract":"OBJECTIVE: To review the concept of quality, the processes of quality assurance, and the methods of quality assessment as they relate to the delivery of pharmaceutical services. DATA SOURCES: Recent management and pharmacy literature. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: Quality implies value, worth, and degree of excellence. The structure-process-outcome paradigm of Donabedian is an often applied measure of quality. Quality assurance (QA) is the process by which we ensure that services are appropriate, effective, and efficient. Examples of QA programs in pharmacy are those of the performance indicators of the Joint Commission on Accreditation of Healthcare Organizations, criteria used in drug-use evaluations, disease-specific profiles used in disease management, and profiling of provider care systems using instruments such as the Health Plan Employer Data and Information Set (HEDIS, now in version 2.0). CONCLUSION: The next few years will witness much experime...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.18553/JMCP.1995.1.1.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68347243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}