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At least 397 records · Page 22Linked to original sources
PubMed1995

University-based sports pharmacy program.

Ways for pharmacists to become involved in sports pharmacy are discussed, and a university-based sports pharmacy program is described. Sports pharmacy encompasses treating athletic injuries, distributing drugs and sports-related supplies, counseling patients, and monitoring therapeutic outcomes, along with educating athletes, trainers, and others about drug use and abuse. Pharmacists can contribute their expertise by presenting information at schools, health clubs, and other exercise-related organizations. They can serve on drug-testing crews at collegiate athletic events. Pharmacists can also provide supplies and services to schools or athletic facilities; ideally, this could be a contractual arrangement to provide comprehensive pharmaceutical care. A sports pharmacy program was implemented at the University of North Carolina at Chapel Hill in 1980. Pharmacists provide drug therapy monitoring and patient education to all patients at the school; patients' level of athletic activity is taken into consideration. Pharmacists also ensure proper use, storage, and distribution of drugs kept in clinics, training rooms, and sports medicine travel bags, as well as identifying and providing drugs and supplies that might be needed at an off-campus event. They provide inservice education to athletic trainers and physicians. The program has improved patient outcomes and helped to ensure adequate drug supplies and minimum waste. There are numerous opportunities for practitioners to become involved in sports pharmacy. A university-based sports pharmacy program improved the care of student athletes and helped contain drug costs.

Athletic Injuries↗
PubMed1996

Pharmaceutical services for a homeless population.

Participation of pharmacist volunteers in the medication program of a countrywide health care program for homeless persons is described. Pharmacist volunteers were brought in to manage medications for a health care program serving homeless persons in Ramsey County, Minnesota. After the pharmacy program was structured, volunteers were recruited from the community. Pharmacists duties initially focused on product management but were expanded to include establishing and monitoring the program formulary; reviewing patient records and prescriptions for allergies, potential drug interactions, and appropriate dosage; counseling patients on medication use; and consulting with other members of the health care team. The pharmacists' efforts led to improvements in monitoring and stocking of necessary medications. The cost of the pharmacy program decreased from $1800 a month to as little as $300 a month. The value of donated supplies and medications increased from $8,600 in 1991 to over $122,000 in 1994. Pharmacist volunteers helped to improve the cost-effectiveness and quality of medication use in a homeless population.

Community Pharmacy Services↗
PubMed1996

Formularies in integrated health systems: Fallon Healthcare System.

Formulary management implications in a Massachusetts integrated health system consisting of a physician group practice clinic, an HMO, a hospital, a long-term care facility, a physician-hospital organization, a home care agency, and a clinical laboratory are described. Two formularies govern drug therapy for most patients in the system. The formulary of the group practice (Fallon Clinic) is used for 180,000 patients covered by the HMO. The formulary of Saint Vincent Hospital influences drug use in the hospital and the system's long-term care facility. Both formularies require formal review before a drug is added and have structured processes for nonformulary requests. Entities in the health system are still being integrated at the operational level. The system does not have a formal position on integration of the formularies, but information exchange and collaboration occur because of overlap in the membership of the committees that approve the two formularies. Formulary decision-making has been coordinated to account for systemwide needs (for example, enoxaparin was not added to the hospital's formulary because of concerns about continuity of drug therapy after discharge, and the hospital's formulary includes the oral agents on the clinic's formulary). The systems uses one group-purchasing organization and one wholesaler; one person negotiates separate contracts for the hospital and the clinic. System coordination of formulary management has had little effect on daily activities of the pharmacy staff. Drug use among ambulatory patients in this integrated health system is influenced by the clinic's formulary, and drug use among patients in the hospital and subacute care beds is influenced by the hospital's formulary.

Cost Savings↗
PubMed1996

Formularies in integrated health systems: Sharp HealthCare.

Formulary management implications are described for a California health system consisting of 7 hospitals, 4 skilled-nursing centers, 22 medical clinics, 8 urgent care facilities, and a health maintenance organization. Sharp HealthCare serves nearly 1 million people in the San Diego area. A single institutional care division (ICD) pharmacy service has been created under the guidance of a steering committee consisting of a pharmacy operations coordinator and a staff pharmacist from each site, the system pharmacy director, the system senior pharmacy information systems specialists, and the system senior clinical pharmacy specialist. Operations at each site are overseen by an operations coordinator instead of a pharmacy director. Functional teams reporting to the steering committee are standardizing pharmacy processes, including formulary management; this is particularly important because the ICD has pharmacist and nurse per diem pools. Until 1995, formularies were independently managed at each site. Now, one system formulary is being developed. Standard policies and procedures, a nonformulary drug request form, and a monograph format have been completed. The hospitals' autonomous medical staffs have thus far elected to retain individual pharmacy and therapeutics (P&T) committees but approved a revamped formulary review process and systemwide P&T subcommittees. The computer system is being enhanced so that pharmacists anywhere in one of the hospitals will have access to applicable P&T committee-approved guidelines for drug use. Since vendors were advised that the system is establishing one formulary, Sharp has been able in some cases to achieve better pricing than it previously could through its purchasing group. Drug use is influenced by each site's pharmacy and therapeutics committee. The ideal, however, is to have this responsibility consolidated in a single systemwide committee.

California↗
PubMed1996

Sumatriptan use in a large group-model health maintenance organization.

The outcomes of sumatriptan use at a health maintenance organization (HMO) were studied. The study was conducted during one year beginning immediately after sumatriptan was added to the formulary of a large group-model HMO. Subjects were included on the basis of drug-use evaluation criteria, a positive response to the first dose of sumatriptan (administered at the HMO by a nurse), and ability to participate in a telephone survey. Responders to the first dose were eligible to receive up to six doses of sumatriptan for home use. The telephone survey was designed to assess sumatriptan's effects on migraine headache and to capture data on quality of life, perceived problems with sumatriptan, and patient satisfaction. Patients who received sumatriptan between April and September 1993 were interviewed in late September 1993; patients who received sumatriptan between September and April 1994 were interviewed in late April 1994. Of 180 patients surveyed, 160 (89%) had evaluable responses. Migraine headache improved in two thirds of the patients. Sumatriptan was more effective than previously used agents in three fourths. The mean number of migraine headaches per patient per month decreased from 7.4 to 4.2. Quality-of-life indicators, such as time spent with friends, improved in three fourths. Eighty-three percent reported missing fewer days from work. Ninety percent said they would continue to take the drug, despite a 44% incidence of drug-related problems. There were no unexpected problems. A retrospective review showed that utilization of the HMO's resources was reduced with sumatriptan. Placing sumatriptan on an HMO's formulary led to favorable effects on the frequency and severity of migraine headache, patient quality-of-life indicators and productivity, and resource utilization by the organization.

Adolescent↗
PubMed1998

Projecting future drug expenditures--1998.

Drug cost projections for 1998, factors that directly influence drug costs, and tools for projecting drug expenditures are discussed. The producer price index indicates that prices for drugs and pharmaceuticals increased 2.1% between January and June 1997; the increase for prescription preparations was 2.7%. Medi-Span data show an average increase for all drug products of 1.02% during the first six months of 1997; First Data-Bank reports a 1.7% increase for the same period. IMS America data, which take account of weighting for individual drugs or drug classes, show the prices of all drugs increasing 2.3% between the second quarters of 1996 and 1997. Drug industry analysts project the overall price increase in the next 12 months at 2-4%. Group purchasing organizations predict an average increase over the next 12 months of 0.56% for contracted drugs and 3.6% for noncontracted drugs. Various health care provider indexes suggest that increases in drug costs could be smaller over the next few years. The current trend of takeovers and mergers of pharmaceutical companies and health systems is likely to continue into 1998. As a result of generic competition and the loss of patent protection for many pharmaceutical products, the number of drugs to be introduced onto the market and the number of drugs in development are expected to escalate until the year 2000. These and other major changes in the health care environment, including changes in drug distribution and controversies over the use of formularies, will make future forecasting difficult. Compared with previous years, smaller increases in drug costs have been projected for 1998 and beyond, but changes in the health care environment mean that greater knowledge will be required to forecast future drug expenditures.

Drug Approval↗