Browsing by Author "DiDonato, Kristen L."
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Item Examining the Effect of a Medication Synchronization or an Education Program on Health Outcomes of Hypertensive Patients in a Community Pharmacy Setting(University of Minnesota, College of Pharmacy, 2014) DiDonato, Kristen L.; Vetter, Kristin R.; Liu, Yifei; May, Justin R.; Hartwig, D. MatthewObjective: To examine the effect of a medication synchronization or education program on hypertensive health outcomes. Methods: This study used a design of randomized controlled trial lasting four months taking place within a family-owned community pharmacy chain in a U.S. Midwestern state. A total of 302 hypertensive patients were randomized into 3 study groups – control, medication synchronization, and education. Interventions included management of medication refills through a medication synchronization program for the medication synchronization group, and monthly hypertension (HTN) education for the education group. Outcome measures included systolic blood pressure (SBP), diastolic blood pressure (DBP), percentage of patients at blood pressure (BP) goal, self-rated change in medication adherence, and patients’ HTN knowledge. Results: All groups had significant decline of SBP from baseline; however the final analysis showed no significant SBP differences among study groups. The proportion of patients achieving BP goals in both the control (p=0.005) and education (p=0.019) groups increased at Month 4. Changes in self-reported adherence were not significant for any groups. All groups showed positive changes on HTN knowledge questions with the education group showing the greatest change. Conclusion: Compared to the control group, there was no difference in the primary outcomes. However, this study demonstrated that educational materials written at an appropriate level and presented by community pharmacists to patients may have been associated with an increase in HTN knowledge and a significant increase in the proportion of patients achieving their BP goal. These educational interventions had a greater impact on helping patients achieve their blood pressure goals than medication synchronization. This may indicate that further intervention is needed to impact adherence aside from ensuring that patients have their medication on hand. Taking the time to educate patients about hypertension led to self-reported positive change with being more careful about taking medications and with not forgetting to take medications when they felt better.Item Implementation of a financially incentivized weight loss competition into an already established employee wellness program(University of Minnesota, College of Pharmacy, 2014) Schramm, Andrew M.; DiDonato, Kristen L.; May, Justin R.; Hartwig, MatthewObjective: To assess improvement in clinical outcomes and patient satisfaction of a financially incentivized weight loss competition adjunct to a currently established pharmacist-directed employee wellness program. Design: Retrospective, cohort, pilot study Setting: 6 independent community pharmacy chain locations, two long-term care pharmaLJ ůŽĐĂƚŝŽŶƐ and a pharmacy corporate office in northwest and central Missouri, from January 2013 to April 2013. Participants: 24 benefit-eligible patients employed by the self- insured pharmacy chain. Intervention: A financially incentivized weight loss competition focusing on healthy lifestyle practices was implemented at nine pharmacy locations over an eight week period. Main outcome measure(s): Change from baseline in mean total cholesterol, serum triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and body mass index (BMI). Patient satisfaction was also assessed after completion. Results: 24 patients completed the competition. The average weight loss among all participants was 10 ± 7.3 pounds. A mean decrease in serum triglycerides was significant at 36.9 mg/dL per participant (p<0.05) ŝŶ ƐƵďŐƌŽƵƉ ĂŶĂůLJƐŝƐ. Pearson correlation coefficients between healthy lifestyle practice points earned and clinical measurements were significant for total cholesterol (r = -0.54), LDL-C (r = -0.50) and triglycerides (r = -0.49). Conclusion: The implementation of a financially incentivized weight loss competition provided significant short-term weight loss to a patient population that was already enrolled in an established pharmacist-directed employee wellness program and had not shown clinical improvement prior to the intervention. Overall the patients were satisfied, felt healthier, and agreed to continue following the recommendations of the program.