Pharmacy practice management quarterly最新文献

{"title":"Are pharmacists and pharmaceutical care having an impact on diabetes?","authors":"M J Monaghan,&nbsp;M S Monaghan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study sought to identify pharmacy services offered to patients with diabetes and demonstrate patients receiving pharmaceutical care services had better glucose control as measured by laboratory values and medication compliance. Two hundred randomly selected patients with diabetes were identified from a pharmacy benefits manager's database. Their pharmacists were mailed a survey requesting information concerning morbidity risk factors, concomitant disease states, concomitant medications, diabetes pharmacotherapy, blood glucose concentrations, and percent hemoglobin A1c values. Information concerning diabetes cognitive services offered was also requested. A statistically significant correlation between diabetes cognitive services and improved disease control was not demonstrated secondarily to the small number of responses returned with glucose control information. Our results indicate pharmacists must improve documentation of their services and the impact these interventions have on disease control in order to prepare for reimbursement for cognitive services.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 4","pages":"8-16"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21046571","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":"Incorporating individualized quality of life measures in the evaluation of pharmacy services: the IN*COMPASS framework.","authors":"F R Funderburk,&nbsp;D S Pathak,&nbsp;A M Pleil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quality of life is a fascinating field to researchers and practitioners alike. To some researchers, quality of life is of interest because it offers untold challenges in constructing instruments and capturing data necessary to answer key questions about health, disease, and treatment. For such researchers, quality of life is about statistical relationships among questions and about using questions to define the physical, social, and emotional domains of health. To other researchers, this field is about finding practical applications in policy and treatment decision making for the information provided by quality of life assessments. To these researchers, the focus of quality of life is on ways to apply knowledge of quality of life differences between groups with and without specific diseases or ways to use knowledge about how treatments affect the quality of life of various patient populations. To practitioners, quality of life is about treatment outcomes that impact individual patients' daily lives. It is the practitioner that Funderburk, Pleil, and Pathak are considering in their paper in this issue of Pharmacy Practice Management Quarterly. These authors give several important messages to practitioners seeking to serve their patients by incorporating quality of life into their practices. The key message in the paper is that to better understand and determine the impact of treatment on a patient's quality of life, it is critical to start with a baseline or reference point relevant to that patient. From that baseline or reference point, treatment decisions can be made and progress, in quality of life terms, can be evaluated. Critical questions in their framework, which is called the IN*COMPASS (Individualized Client Oriented Method for Preferred Alleviation of Sickness States) Approach, are \"How are you now?\" and \"How would you like to be?\" The authors do not endorse particular quality of life tools in their approach; rather they prescribe certain critical questions that must be answered if information captured by any quality of life tool is to be useful at the patient level. Readers should not be put off by the fancy acronym used in this paper; nor must readers be keen students of quality of life to appreciate its message. The IN*COMPASS approach is fundamental to good patient care and can be applied by practitioners with any level of understanding of and appreciation for quality of life assessments.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 4","pages":"54-66"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21046568","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":"What's in there for me? The Internet for pharmacists.","authors":"M C Lunik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pharmacists and other professionals must develop a strategy to take the greatest advantage of information on the Internet. Healthcare providers must work effectively with increasingly demanding and well-educated consumers to survive the turbulent environment. We focus on describing Internet sites that can be of interest and assistance to individual pharmacists researching health and professional topics. It is important for health care practitioners to have an understanding of the content of Web sites so they may use their professional judgment to determine the authenticity of information. Utilizing the Internet to augment the pharmacist's knowledge base may solve the dilemma of the pharmacist's utility in the 21st century. The practicality of the Internet is underscored by its ability to link healthcare professionals worldwide in unique collaborative efforts unmatched by any individual's output, regardless of his singular genius.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 4","pages":"37-47"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21046675","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":"Economic evaluations and diabetes.","authors":"D S Pathak,&nbsp;T A Burke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diabetes and its treatment have significant economic implications for society, as evidenced by estimated health expenditures for diabetes and its complications in the range of $85-$105 billion in the United States in 1992. With constrained resources, health care professionals need to understand the burden of any illness, benefits and costs of alternative treatments, and the process of combining benefits and costs for the purpose of comparing alternatives. The economic evaluation approach seems best suited for this task. Full and partial economic evaluation techniques will be reviewed with descriptions that have appeared in the recent diabetes literature.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 4","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21046673","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 therapy and adverse effects with antihyperglycemic agents: a focus on metformin and acarbose.","authors":"B B Phillips","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metformin and acarbose are novel antihyperglycemic agents indicated for the treatment of non-insulin-dependent diabetes mellitus. These agents offer new therapeutic options to control hyperglycemia that were previously unavailable. Common to both agents is a relatively high incidence of gastrointestinal adverse effects. Initiating therapy at a low dose and slowly titrating to therapeutic response may be the most effective way to minimize associated adverse effects. Recognition and proper management of these possible adverse effects can optimize therapy and maximize the potential for successful outcomes with these agents while limiting drug noncompliance.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"21-31"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21045824","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":"The importance of the pharmacist's expanding role on the diabetes team: reinforcing nutritional guidelines for improved glycemic control.","authors":"L C Johnson,&nbsp;E Beach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The role of the pharmacist on the diabetes care team is expanding due to the increasing number of patients diagnosed with diabetes, limited health care dollars, and the education related to and required for patients by managed care organizations and insurance companies. In the past, training of patients in diabetes self-management skills has been inadequate, and this continues to be the case. Clinical pharmacists, in cooperation with physicians, have increased opportunities to provide education about medications and may include instructions for patients regarding the interaction of food consumed with changes in blood glucose levels. Because of monthly refills on prescribed medications, a patient's interaction with the pharmacist in the setting of a commercial pharmacy is more frequent than with any other member of the diabetes team. This contact offers an ideal educational opportunity. The action and efficacy of medications that affect the pancreas, hepatic glucose production, the utilization of glucose by muscle cells, and the absorption of glucose from the intestines are influenced directly by the meal plan. Nutritional guidelines, meal planning for the Type I and Type II patient, use of the exchange system, carbohydrate counting, artificial sweeteners, alcoholic beverages, and suggestions for guiding patients to establish eating habits that lead to improved diabetes control are important issues for every member of the diabetes team to address. The reinforcement of dietary principles may occur in the educational setting of the hospital or the clinic or within the commercial pharmacy setting. When the team presents accurate and current information, continuity of care and improved patient understanding are achieved.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"32-44"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044548","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":"Exploring the role of sulfonylureas in the treatment of non-insulin-dependent diabetes mellitus.","authors":"J P Graham,&nbsp;D Stam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For the last 30 years, sulfonylureas have been the mainstay of treatment for patients with non-insulin-dependent diabetes mellitus (NIDDM). They offered patients an alternative to using insulin to lower their blood glucose. One of the advantages of these agents was that they could be taken orally as opposed to insulin, which required multiple daily injections. In addition, they are tolerable, with few side effects, and they cause less hypoglycemia than does insulin. In the past year, new agents (metformin and acarbose) have been introduced into the market and have offered practitioners an alternative to the traditional sulfonylureas. The sulfonylureas are still valuable agents in the treatment of NIDDM. Their efficacy is unsurpassed by any other oral medications. They possess the best tolerability profile of all oral agents on the market, and they possess very few contraindications or drug interactions. The sulfonylureas should still be considered first-line agents for NIDDM. Metformin and acarbose are agents that may benefit a specific patient population, but sulfonylureas are agents that can benefit most patients.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21045822","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":"Treatment of hypertension in patients with diabetes.","authors":"B G Phillips","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Approximately 3 million Americans have the dual diagnosis of hypertension and diabetes. Both conditions are associated with and are risk factors for cardiovascular events, nephropathy, and retinopathy. When these conditions coexist, the prevalence, progression, and severity of these adverse outcomes are dramatically enhanced. For these reasons, hypertension should be treated aggressively and early in the diabetic patient to curtail the morbidity and mortality associated with these disease states. To this end, a number of consensus statements have been formulated and promulgated in an effort to increase the awareness of this condition and to provide guidelines by which optimal care may be afforded to patients. In addition, specific patient and drug-related factors and conditions should be considered so patients can be committed to the optimal therapeutic plan. The outcome to attain optimal blood pressure should be mirrored by efforts to obtain glycemic and lipidemic control. By the implementation and optimization of effective therapeutic measures, which have the least amount of impact on the patient's concomitant disease states and body chemistry, positive differences in outcomes may be realized in this population.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044551","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":"Improving health care with clinical practice guidelines and critical pathways: implications for pharmacists in ambulatory practice.","authors":"S J Kernodle","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"76-89"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044555","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 therapeutic options in the treatment of diabetes mellitus.","authors":"C K Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although a number of compounds exist for the treatment of diabetes mellitus, euglycemia in many patients is still difficult or impossible to achieve. Many patients are insulin resistant, a condition that is not adequately remedied either by sulfonylureas or insulin, and usually worsens over time. In addition, there are patients that, although their fasting blood glucose is controlled, experience unacceptable postprandial glucose excursions. The newer compounds that are either approved or under development possess more novel mechanisms of action that may contribute to their efficacy in these patients. The agents reviewed in this article include those that attenuate postprandial glucose elevations by mechanisms such as delayed gastric emptying and enzyme inhibition, and those that directly increase insulin sensitivity.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"10-20"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21045823","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}