Document Detail

Pharmacist care plans and documentation of follow-up before the Iowa Pharmaceutical Case Management program.
MedLine Citation:
PMID:  15191245     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To document drug therapy problems and their causes and assess pharmacist follow-up of patients with identified drug therapy problems. DESIGN: Cross-sectional analysis. SETTING: Iowa. PARTICIPANTS: 160 pharmacists who submitted 754 pharmaceutical care plans in an effort to qualify for participation in the Iowa Pharmaceutical Case Management program. INTERVENTIONS AND MAIN OUTCOME MEASURES: Care plans were assessed for drug therapy problems and causes and for documentation of pharmacist follow-up (actual, none, or intent to follow up). RESULTS: Pharmacists documented a wide variety of drug therapy problems and causes, including adverse drug reactions (20.1% of care plans), need for additional drug therapy (18.9%), lack of patient adherence to therapy (16.3%), incorrect medication being prescribed (14.1%), and drug dose too high (10.0%). Pharmacist follow-up with patients was not optimal, with 31% of care plans providing documentation of actual follow-up. Another 42.2% of plans indicated that the pharmacist intended to contact the patient for follow-up but either did not do so or did not record the intervention. No actual follow-up or intent to follow up was recorded in 26.8% of care plans. Pharmacists practicing in independent pharmacies followed up with patients more frequently than those in other settings (36.4% of care plans, compared with 22.7%, 23.2%, and 28.4% for chain, clinic, and franchise pharmacies). Pharmacists were more likely to follow up when the identified problem involved drug safety rather than effectiveness (36.2% versus 28.3% of care plans). CONCLUSION: Documentation of pharmacist follow-up with patients was less than optimal. In addition to identifying drug therapy problems and causes, pharmacists must complete the care continuum through documentation of patient monitoring and follow-up to transform the philosophy and vision of the pharmaceutical care concept into a practice of pharmacy recognized and rewarded by patients and payers.
CoraLynn Becker; Darrel C Bjornson; Julie W Kuhle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Pharmacists Association : JAPhA     Volume:  44     ISSN:  1544-3191     ISO Abbreviation:  J Am Pharm Assoc (2003)     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-06-11     Completed Date:  2004-06-29     Revised Date:  2007-05-28    
Medline Journal Info:
Nlm Unique ID:  101176252     Medline TA:  J Am Pharm Assoc (2003)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-7     Citation Subset:  IM    
Department of Pharmacy, University of Kansas Medical Center, Kansas City, KS 66160, USA.
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MeSH Terms
Case Management / standards*
Cross-Sectional Studies
Drug Therapy* / adverse effects,  standards
Follow-Up Studies
Middle Aged
Pharmacy / standards*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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