Browsing by Author "Lenz, Thomas L."
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Item Comparison of Traditional Versus Evidence-Based Journal Club Formats(University of Minnesota, College of Pharmacy, 2011) Packard, Kathleen; Herink, Megan; Lenz, Thomas L.Purpose: The objective of the study was to compare a traditionally structured journal club with an evidence based structured journal club during an advanced clinical pharmacy rotation and to determine the best utilization that aligns with recent changes to the pharmacy school accreditation standards. Methods: The study included 21 students who completed journal club utilizing the traditional journal club format and 24 students who utilized an evidence based journal club format. Background characteristics, student reported beliefs, and mean critical evaluation skills scores were evaluated and compared in each group. Results: There were no statistically significant differences between the two cohorts in mean overall percentage grade for the activity. Students in the traditional cohort received significantly higher grades for the Study Analysis and Critique section (90.97 + 12.18 versus 81.25 + 11.18, P=0.01) as well as for the Preparedness section (96.11 + 8.03 versus 85.0 + 17.13, P=0.002). Students in the evidence based cohort received statistically superior grades for the Presentation Skills section (96.43 + 6.39 versus 82.47 + 14.12, P=0.0004). Conclusion: An evidence based journal club is a reasonable and effective alternative to the traditionally structured journal club when the primary objective is to assist students in understanding evidence based concepts and to apply current literature to clinical practice.Item Development and Implementation of a Novel Lifestyle Medicine Advanced Pharmacy Practice Experience Elective(University of Minnesota, College of Pharmacy, 2012) Gillespie, Nicole D.; Lenz, Thomas L.Objective: To develop and implement an Advanced Pharmacy Practice Experience (APPE) to increase student’s awareness and use of lifestyle modifications in chronic disease prevention and management. Design: A five-week APPE was developed that utilized a wide variety of activities, including direct patient care, patient education, case studies, journal clubs and reflective assessment and writing to explore various lifestyle modifications and their relation to chronic disease prevention and management. Conclusion: The novel lifestyle medicine APPE provides students a unique opportunity to advance their knowledge in therapeutic lifestyle changes and expand their understanding of the pharmacist’s role in chronic disease prevention and management.Item Health-Related Quality of Life Impact in Employees Participating in a Pharmacist-Run Risk Reduction Program(University of Minnesota, College of Pharmacy, 2012-12) Lenz, Thomas L.; Gillespie, Nicole D.; Skrabal, Maryann Z.; Faulkner, Michele A.; Skradski, Jessica J.; Qi, Yongyue; Coleman, Abby W.Health related quality of life (HRQOL) and self-perceived well-being have been shown to be associated with lower healthcare utilization and costs in people with chronic diseases. A pharmacist-run employee health program started in 2008 sought to improve HRQOL through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participant’s self-reported general health rating significantly improved compared with their baseline rating (p < 0.001). Participants also reported a significantly lower number of days within a month when they did not feel physically and/or mentally well at baseline vs. one-year, respectively (10.3 days vs. 6.0 days, p < 0.01). Pharmacists can positively impact self-reported HRQOL when working in an employee health setting.Item A Lifestyle Medicine Clinic in a Community Pharmacy Setting(University of Minnesota, College of Pharmacy, 2010) Lenz, Thomas L.; Skradski, Jessica; Skrabal, Maryann Z.; Ferguson, Liz; Monaghan, Michael S.Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drug therapy for patients with chronic diseases can be improved through medication therapy management (MTM) services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to more comprehensively prevent and manage chronic conditions. The lifestyle medicine program consists of designing seven personalized programs for patients to address physical activity, nutrition, alcohol consumption, weight control, stress management, sleep success, and tobacco cessation (if needed). The lifestyle medicine program complements existing MTM services for patients with hypertension, dyslipidemia, and/or diabetes. This program is innovative because pharmacists have developed and implemented a method to combine lifestyle medicine with MTM services to not only manage chronic conditions, but prevent the progression of those conditions and others. Several innovative tools have also been developed to enhance the effectiveness of a lifestyle medicine program. This manuscript describes the program’s pharmacy setting, pharmacy personnel, participants and program details as well as the tools used to integrate a lifestyle medicine program with MTM services.Item Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program(University of Minnesota, College of Pharmacy, 2012-12) Lenz, Thomas L.; Gillespie, Nicole D.; Faulkner, Michele A.; Skrabal, Maryann Z.; Skradski, Jessica J.; Qi, Yongyue; Larson, Jessica C.Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.Item Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program(University of Minnesota, College of Pharmacy, 2012-12) McKenzie, Mallory C.; Lenz, Thomas L.; Gillespie, Nicole D.; Skradski, Jessica J.Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization’s outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM), lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC) and the Medication Possession Ratio (MPR). Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01). The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence) for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01). The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence) pre enrollment versus post enrollment (+10%, P=0.086). The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for at least one year and was shown to be better when compared to a matched cohort of similar age, condition and region.