Browsing by Author "Doucette, William R."
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Item Association Between Student Loan Debt on Graduation, Demographic Characteristics and Initial Choice of Practice Setting of Pharmacists(University of Minnesota, College of Pharmacy, 2011) Yusuf, Akeem A.; Schommer, Jon C.; Mott, David A.; Doucette, William R.; Gaither, Caroline A.; Kreling, David H.Objectives: (1) To examine trends in level of student loan indebtedness for groups of pharmacists that were first licensed between 1980 and 2006; (2) To examine if demographic variables are associated with level of student loan indebtedness; (3) To examine the association between student loan debt and choice of practice setting while controlling for demographic variables. Methods: Data for this study were collected from a national random sample of 3,000 pharmacists using a self administered survey. Descriptive statistics were used to examine trends in level of indebtedness. The relationships between level of indebtedness, demographic variables and practice setting choice were examined using Chi-square statistics. Multinomial logistic regression was used to determine the independent association of student loan debt and choice of practice setting while controlling for demographic variables. Results: The proportion of licensed pharmacists reporting student loan debt after graduation, and the mean amount of debt incurred increased between 1980 and 2006. Non-white pharmacists incurred debt at a higher proportion compared to white, and they also incurred significantly higher levels of debt. A lower level of indebtedness was associated with choosing independent practice over chain practice. Conclusions: Student loan indebtedness has been increasing over time, especially for non-white pharmacy students. Future research should be done to examine other factors that might influence student debt load, work contributions and choice of practice settings. The affordability of pharmacy education for students of color and how salaries may or may not help off-set these costs also should be examined closely.Item Evaluation of an Initiative for Fostering Provider-Pharmacist Team Management of Hypertension in Communities(University of Minnesota, College of Pharmacy, 2014) Doucette, William R.; Lickteig, Cailin; Veach, Stevie; Carter, Barry; Levy, BarceyObjectives: 1) Conduct team building activities for provider-community pharmacist teams in small communities and 2) Determine the impact of the team approach on practitioner-reported consequences and 3) Identify obstacles to the team approach and ways to overcome them. Methods: Eleven provider-pharmacist teams were recruited in rural/micropolitan communities in Iowa. The teams participated in team building sessions facilitated by the project leaders, to discuss the team approach. Decisions included patient identification, practitioner roles, and communications. Most pharmacists conducted blood pressure (BP) checks in the pharmacy and assessed the anti-hypertensive medications. If the BP was not at goal, the pharmacist worked with the patient and provider to make improvements. Teams followed their strategies for 3-5 months. Data were collected from pharmacy logs and on-line surveys of team members before and after the team period. Results: Using a multi-case approach, 4 cases were classified as Worked-Well, 5 as Limited-Success, and 2 as No-Team-Care. The Worked-Well teams provided an average of 26.5 BP visits per team, while the Limited-Success teams averaged 6.8 BP visits. The Worked-Well teams established and used a system to support the team approach. The Limited-Success teams either didn’t fully establish their team system, or used it sparingly. The No-Team-Care cases did not provide any team care. Conclusions: Factors supporting success were: positive provider-pharmacist relations, established team system, commitment to team care, and patient willingness to participate. While this program had some success, potential improvements were identified: more follow-up after the team building session, additional patient materials, and guidance for practice changes.Item Implementation of a Pharmacist-Directed Cardiovascular Risk and Medication Management Program for Participants in a Construction Trade Benefit Trust Fund(University of Minnesota, College of Pharmacy, 2010) Liu, Yifei; McDonough, Randal P.; Carruthers, Kara M.; Doucette, William R.; Miller, KathleenObjectives: (1) To report the results of a pharmacist-directed cardiovascular risk management program; and (2) to identify obstacles faced by the pharmacists in the program implementation. Methods: The collaborators in this study included two local unions, a health benefit consulting company, and a community pharmacy. A total of 750 union workers with cardiovascular risk were informed about the cardiovascular risk management program. The program lasted six months, and the participation was voluntary. There were three group educational sessions with each session followed by a medication management service. A staff person of the health benefit consulting company and two pharmacists were interviewed via telephone. The interview questions were created according to the Gaps Model of Service Quality. The Gaps Model theorizes five gaps among consumer expectations, consumer perceptions, management perceptions of consumer expectations, service quality, service delivery, and external communications to consumers. The following data were collected: (1) types and quantity of drug therapy problems, (2) pharmacists’ recommendations and prescribers' response, (3) patients’ quality of life, disability days, and sick days, and (4) the experience of involved parties. Descriptive statistics were calculated. Results: Fifteen union workers participated in the program. For the participants, 35 drug-related problems were identified, with “need for additional therapy” and “dose too low” being the most common problems. To address these drug-related problems, pharmacists made 33 recommendations to prescribers, and prescribers accepted 55% of the recommendations. According to the interviews, there were three barriers faced by pharmacists to implement the program: lack of consensus about the recruitment, union workers’ unawareness of the program’s benefits, and limited support from the unions and the health benefit consulting company. Conclusions: It was difficult to recruit participants into the program. Clear agreement among collaborators on both the program’s benefits and the specific roles of each collaborator may be the key to successfully implement similar programs in the future.Item Innovations in Pharmacy through Practice-Based Research(University of Minnesota, College of Pharmacy, 2010) Schommer, Jon C.; Brown, Lawrence M.; Doucette, William R.; Goode, Jean-Venable "Kelly" R.; Oliveira, Djenane Ramalho deThe overall purpose of this article is to serve as an invitation for submissions to the ‘Practice-Based Research’ section of INNOVATIONS in pharmacy. To provide background about this section of the journal, this paper describes: (1) the concept of innovations that we will apply, (2) the practice-based research domain, and (3) the use of practice-based research networks for this area of inquiry. We propose that uncertainty surrounding an innovation often will result in the postponement of the decision regarding its adoption until further evidence can be obtained. Such evidence often is gathered through considering the advice and experiences of opinion leaders and members of social systems who have adopted the innovation. We invite authors to present ideas, arguments, and evidence for innovations in pharmacy that arise out of practice-based research. We propose that this journal will be an excellent communication vehicle for providing convincing arguments and sound evidence in favor of innovations. Discourse regarding new ideas in such a format can further develop the ideas, create a critical mass of evidence, and be used for convincing others that the innovation should be adopted. We welcome submissions to the INNOVATIONS in pharmacy, PRACTICE-BASED RESEARCH content area that: (1) provide convincing arguments and sound evidence in favor of innovations for pharmacy, (2) are based upon practice-based research from case studies of single patients on one end of the continuum to findings from large populations of patients on the other end of the continuum, and/or (3) introduce innovations for practice-based research networks. We encourage articles from all perspectives and from all methods of inquiry.Item Older Adult Perceptions of a Self-reported Medication Risk Questionaire: A Focus Group Study(University of Minnesota, College of Pharmacy, 2011) Witry, Matthew J.; Chang, Elizabeth H.; Mormann, Megan M.; Doucette, William R.; Newland, Brand A.Background: Medication therapy management (MTM) has been shown to resolve medication-related problems and decrease health care expenses. Public and private health insurers, providers, and other stakeholders are looking for ways to involve patients in the MTM process. One option is to engage patients through the use of a medication risk questionnaire. Objective: To investigate older adults’ perceptions of completing a medication risk questionnaire and receiving a rating of their risk for medication-related problems. Methods: Four, 75 to 90 minute focus groups were conducted using a semi-structured interview guide and copies of a medication risk questionnaire to collect qualitative data from 36 community dwelling older adults in Iowa, USA. Sessions were audio-recorded, transcribed, and analyzed thematically using an iterative process. Results: The thematic analysis yielded a general theme of comprehensive medication reviews, and two themes on the medication risk questionnaire: “process and items” and “risk category reactions.” Overall, participants were unfamiliar with pharmacist services beyond counseling. They were open to the questionnaire, but suggested it would be more useful as a topic for discussion with a provider than to screen patients. Despite their medication risk rating, most did not express interest in seeking a comprehensive medication review based on the result of the questionnaire as they considered themselves at low risk for problems. Conclusions: Using a medication risk questionnaire as a topic for discussion could provide health insurance plans or providers an opportunity to increase beneficiary familiarity with MTM. These beneficiary perspectives may be useful to health plan administrators and MTM providers as they pursue new ways to involve patients in the medication management process.Item Pharmacist Contributions to the U.S. Health Care System(University of Minnesota, College of Pharmacy, 2010) Schommer, Jon C.; Planas, Lourdes G.; Johnson, Kathleen A.; Doucette, William R.; Gaither, Caroline A.; Kreling, David H.; Mott, David A.Objective: The overall goal for this study was to conduct a segment analysis of the pharmacist workforce during 2009 based upon time spent in medication providing and in patient care services. Methods: Data for this study were obtained from the 2009 National Pharmacist Workforce Survey in which a random sample of 3,000 pharmacists was selected. Cluster analysis was used for identifying pharmacist segments and descriptive statistics were used for describing and comparing segments. Results: Of the 2,667 surveys that were presumed to be delivered to a pharmacist, 1,395 were returned yielding a 52.3% overall response rate. Of these, 1,200 responses were usable for cluster analysis. Findings from this study revealed five segments of pharmacists: (1) Medication Providers, (2) Medication Providers who also Provide Patient Care, (3) Other Activity Pharmacists, (4) Patient Care Providers Who also Provide Medication, and (5) Patient Care Providers. The results showed that, in 2009, 41% of U.S. pharmacists were devoted wholly to medication providing (Medication Providers). Forty-three percent of pharmacists contributed significantly to patient care service provision (Medication Providers who also Provide Patient Care, Patient Care Providers who also Provide Medication, and Patient Care Providers) and the remaining 16% (Other Activity Pharmacists) contributed most of their time to business / organization management, research, education, and other health-system improvement activities. Conclusions: Based on the findings, we propose that the pharmacy profession currently has, and will continue to build, capacity for contributing to the U.S. health care system in new roles for which they have been identified. However, as shifts in professional roles occur, a great deal of capacity is required related to new service provision. Resources are scarce, so an understanding of the most appropriate timing for making such changes can lead to cost-effective use of limited resources for improving patient care.Item Value of Online Medication Therapy Management Resources: Community Pharmacist Perspectives(University of Minnesota, College of Pharmacy, 2014) Doucette, William R.; Nguyen, Elaine; Zhang, Yiran; Pendergast, Jane F.; Chrischilles, Elizabeth A.; Farris, Karen B.; Frank, JessicaObjectives: To describe pharmacists’ attitudes toward and satisfaction with on-line training modules on MTM tools and tips for pharmacists and to characterize how useful the tools and concepts in the modules were to pharmacists when delivering MTM services. Methods: Researchers distributed a web-based survey to pharmacists who had viewed the training modules that had been posted onto the training web site of OutcomesMTM. The majority of survey questions consisted of a 6-point Likert scale. Questions assessed pharmacists’ opinions on the use of the tools. Information also was collected on implementing MTM tips, pharmacist demographics, and practice site characteristics. Results: Respondents rated the Tool to Improve Medications in the Elderly via Review (TIMER) and DRug Adherence Work-up (DRAW) tools favorably across multiple items. Many pharmacists integrated the MTM tips into their practices, and reported increased efficiency in their delivery of MTM services. Conclusion: Pharmacist training and tools such as the TIMER and DRAW tools plus MTM practice tips can assist pharmacists in providing MTM services to patients.