Browsing by Subject "Pharmaceutical Care"
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Item Educating for action: understanding the development of pharmaceutical care practitioners.(2011-07) Losinski, VictoriaPharmaceutical care, a professional health care practice in which a practitioners works with an individual to understand the patient's medication needs and works to identify, prevent, and resolve drug therapy problems, was recently adopted as the mission and professional practice of pharmacy. The skills, knowledge, and ethics required in order to provide pharmaceutical care have not been defined or integrated as the foundation for pharmacy curricula. This research aimed to define the educational experiences required to provide pharmaceutical care, develop a curricular conceptual framework grounded in pharmaceutical care, and identify learning strategies to support the development of the pharmaceutical care practitioner. A five component developmental research process was used to develop the conceptual framework. Observations and interviews were conducted with seven pharmaceutical care practitioners in Minnesota. From field notes, interviews, and existing literature a prototype for the curricular conceptual framework was developed and refined based on additional data analysis and feedback from a panel of pharmaceutical care experts. The resulting curricular conceptual framework consisted of two structures: the curricular content and the curricular foundation. The curricular content is comprised of the clinical knowledge, clinical skills, and patient knowledge. The curricular foundation consists of practice standards, patient care ethics, and teaching, application, and evaluation techniques. Each conceptual framework component is interrelated and interdependent on the other components. The research findings and resulting conceptual framework provide the initial, required components for the development of a pharmaceutical care based curriculum.Item A Grounded Theory Approach To Determining A Patient’S Decision To Use Medication Therapy Management Services(2016-12) Cernohous, TimothyIntroduction: For every $1 spent on prescription drugs, another $1.30 is spent to correct drug-related problems. Pharmacist-delivered medication therapy management (MTM) services have been documented to decrease the number of drug-related problems; however, patient underutilization of MTM services hinders these programs from realizing their goals. Purpose: Using a grounded theory approach, explain the process by which a patient decides whether to initially attend an employer-sponsored, pharmacist-delivered MTM service by assessing the influence of social, cultural, and/or psychological variables on the patient’s decision. Methods: Focus group participants were recruited from two large self-insured employer groups in Minnesota that offered MTM services as a voluntary health insurance benefit, but which were experiencing low beneficiary enrollment. Study participants were at least 18 years old and were taking four or more prescription medications daily. Participants were assigned to focus groups based on gender, whether they were MTM-naïve or MTM-experienced, and on number of daily medications. Data regarding patient decisions to utilize healthcare services were collected during 12 focus group sessions. Sessions were audio and video recorded, and data codified by two coders. Results: Two primary determinants emerged: A patient’s Healthcare Utilization Paradigm and their Value Assessment of MTM. The resulting DECISION model describes specific variables that impact a patient’s evaluation of MTM: Healthcare Attitudes, Healthcare Team Relationship, Medication Attitudes, Monetary Impact, MTM Service Expectation, Accessibility and Convenience. Only MTM utilization status discriminated between patients within the model; MTM-naïve participants yielded twelve unique variables. This research contributes several new variables beyond what could be extrapolated from the existing Theory of Planned Behavior, Behavioral Model of Healthcare Utilization and AIDA marketing models: Cost of MTM Visit, Employer-Sponsored Healthcare Program, Dissonance of External Review, Scope of Services, Timing of MTM Recruitment, Trust of Program Sponsor, Pharmacist Relationship and Pharmacy Practice Experience. The latter four appear to most significantly impact a patient’s decision to participate in MTM. Conclusions: A patient’s social network, cultural views, economic paradigm and previous experiences play important roles in their MTM participation decision. The results of this study can enable MTM program sponsors and providers to optimize patient participation by increasing interest in MTM.