Kendra procacci pharm d bcps ae c genine thormahlen pharm d ae c
This presentation is the property of its rightful owner.
Sponsored Links
1 / 12

Kendra Procacci, Pharm.D, BCPS, AE-C Genine Thormahlen, Pharm.D, AE-C PowerPoint PPT Presentation


  • 157 Views
  • Uploaded on
  • Presentation posted in: General

Kendra Procacci, Pharm.D, BCPS, AE-C Genine Thormahlen, Pharm.D, AE-C. History of Pharmacist intervention in asthma education. Ashville Project

Download Presentation

Kendra Procacci, Pharm.D, BCPS, AE-C Genine Thormahlen, Pharm.D, AE-C

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Kendra procacci pharm d bcps ae c genine thormahlen pharm d ae c

Kendra Procacci, Pharm.D, BCPS, AE-CGenine Thormahlen, Pharm.D, AE-C


History of pharmacist intervention in asthma education

History of Pharmacist intervention in asthma education

  • Ashville Project

    • Assessed clinical, humanistic, and economic outcomes of community pharmacy-based asthma management program in 207 patients with asthma over a 5 yr period

      • Significant improvements in lung function, asthma control, symptoms and QOL

      • Decrease in ER visits and hospitalizations

      • Total direct and indirect cost savings of $584, 307 or $1955/pt/yr

  • Numerous other studies also support pharmacists’ role in asthma education


History of pharmacist intervention in asthma education1

History of Pharmacist intervention in asthma education

  • EPR-3 guidelines place new emphasis on providing asthma education at multiple points of care and describe community pharmacies as effective sites for asthma self-management

    • Section 3, components 2, Education for a partnership in asthma care notes “studies of pharmacy-based education directed toward understanding medication and teaching inhaler and self-monitoring skills show the potential of using community pharmacies a point of care for self-management education. Studies report difficulties in implementation, but they also demonstrate benefits in improving asthma self0management skills and asthma outcomes”


Asthma collaborative practice agreement at phc

Asthma collaborative practice agreement at PHC

  • Staffing

    • Clinical pharmacist

      • UM faculty (AE-C)

  • Referrals

    • Providers (2 mid-levels, 3 MDs), Staff Pharmacist

  • Asthma clinic visit (40 min)

    • Asthma education, inhaler technique, pharmacist can add or change medications for allergies, asthma, and GERD

    • Peak flow meter asthma action plan

    • Referral to medication assistance programs

    • Spirometry


Results over 18 month period

Results over 18 month period

  • 121 patients with asthma seen in the clinic

  • 116 (96%) had mild, moderate, or severe persistent asthma

  • Only 74 (61.2%) had appropriate medications for their classifications

  • Meds added during 37 (30.5%) of consultations

  • Only 9 patients (7%) had ever used a peak flow meter at home and none were currently using peak flow meters

  • 47 (39%) had proper inhaler technique

  • 62 (51%) current smokers

  • 46 (38%) had received a flu shot in the previous year


Follow up results

Follow-up Results

  • Only 37 (31%) of patients returned for follow-up

  • 33/37 (89.1%) had documented improvement based on ACT or symptoms

  • 29/37 (78.4%) had improved compliance

  • 29/37 (78.4%) had improved inhaler technique

  • 4 patients successfully quit smoking


Barriers

Barriers

  • Time

    • Time with patient

    • Tracking information

    • Contacting patients for follow-up

    • Figuring out billing issues

  • Funding

    • Pharmacist time

    • Equipment (spacers and peak flow meters)

  • Appropriate referrals

  • Patient follow-up

    • Coming back for follow-up

    • Using peak flow meters

  • Lack of reimbursement for interventions


Shopko asthma clinic

Shopko Asthma Clinic

  • Staffing

    • 1 Clinical Pharmacist from UM (AE-C)

    • 1 fourth-year pharmacy student

  • Referrals

    • Trying to generate referrals from urgent care clinics and EDs

    • Running monthly “Asthma Clinic Walk-in Days”

  • Asthma clinic visits (45-60 minutes)

    • Asthma education (disease state, medications), inhaler technique, peak flow monitoring, avoiding/controlling triggers

    • Smoking cessation (if appropriate)

    • Spirometry


Shopko asthma clinic1

Shopko Asthma Clinic

  • Making therapy recommendations

    • Report is sent to the patient’s PCP detailing assessment and recommendations

  • Differences from PHC

    • No in-house referral source

    • No collaborative practice agreement for RPh to change medications

    • No billing department


Barriers1

Barriers

  • Referrals/Collaborative practice

    • How can we increase referrals?

    • How can we improve our advertising? Advertising is crucial because we do not have a direct referral source

    • Collaborative practice agreement would be ideal…but some physicians feel there is conflict of interest supporting a “for-profit” pharmacy chain store. How do we convince them otherwise?

  • Funding

    • Should we charge for these services ? How much?

    • Pharmacists cannot bill for asthma education. Spirometry?


Barriers2

Barriers

  • Follow-up

    • How do we encourage patients to follow-up? Difficult to get patients to follow-up, especially if we are charging them!

    • We don’t know if changes to drug therapy were made from our recommendations. How do we track this?

  • Time

    • How can we be more efficient?

    • How can we encourage more staff RPh participation because they lack the extra time to “do more work”?


Questions

Questions


  • Login