102 posts categorized "Health Policy"

12/05/2014

Medication Adherence and Hospital Readmissions

Whether patients are getting medications, seeing a primary care provider, discharged from a hospital, or getting emergency care, they are being shifted between different health care providers. Transitions of care is an important aspect of healthcare because it allows smooth movement of patients from one setting to another.

Transitioning from the hospital to home can be difficult for patients, potentially leading to readmission if the transition is not well coordinated. Kirkham conducted a retrospective cohort study in two acute care hospitals in the United States to see the effect of a collaborative pharmacist-hospital care transition care program on the likelihood of 30-day readmission rates. The two-year study showed patients who did not receive bedside delivery of post discharge medications and follow-up telephone calls were twice as likely to be readmitted within 30 days of discharged than those who did receive these services. For patients greater than 65 years of age, the pharmacist transition of care resulted in a six-fold decrease in 30-day readmission rates. As this study shows, a transition of care program can be associated with a lower likelihood of readmission and pharmacist participation can be of significant benefit.  

A study conducted by Bellone reviewed 131 patients aged 18 to 65 on at least three prescription medications. The intervention group consisted of patients that pharmacists visited within 60 days of discharge to provide medication counseling or dosage adjustments, while the control group did not receive any intervention. The intervention group had an 18.2% hospital readmission rate compared to 43.1% in the control group (P = 0.002).  Pharmacists can optimize medication adherence during transitions of care to reduce readmission rates. The American Pharmacist Association and American Society of Health-System Pharmacists released a Medication Management in Care Transitions Project to display popular models from across the country that improve patient outcomes by involving pharmacists in medication-related transitions of care. Some of the roles and responsibilities of pharmacists in these practices include: medication reconciliation, counseling on medication therapy, contacting the patient’s home for follow-up, preparing medications etc. Through these interventions pharmacists are involved in patient care from inpatient to home settings.

Transition of care pharmacists can be a beneficial aspect in the health care system. By providing appropriate interventions, pharmacists can decrease the likelihood of hospital readmission.

Urvi Patel, PharmD ‘16

11/24/2014

Us and Them: Exploring Imaginary Borders with Dr. Eric G. Bing

Cohen-Event-Eblast_sidebarBy Ryan R. Latini, a freelance and fiction writer (email: ryan.latini856@gmail.com and on twitter: @RyanRLatini). Dr. Bing was the lecturer at the fifth annual Lois K. Cohen Endowed Lecture Series in Global Health at USciences on Oct. 30.

Behind Dr. Eric G. Bing, through the glass windows of the McNeil STC, is Woodland Avenue.  It is the day before Halloween.  “One thing that was always sort of interesting to me is that I used to go to cemeteries a lot,” Bing says.  The Woodlands Cemetery is about five blocks away from here.  “I would read the people’s tombstones and imagine who they were—imagine what they had done—and think about these people’s stories,” Bing continues.  “Then I would see these little babies that had died and wonder what their story was—who were they—what had happened so that they died?” 

Is Bing trying to shape a seasonal mood around All Hallows’ Eve?

No, the man is a far too buoyant spirit. 

On the walk from the parking lot with Lois Cohen, PhD., and Dean Andrew Peterson, Bing told us about the time he let his father know that he wanted to be an artist.  His father replied with an emphatic, “No.”  His father was adamant about practicality in his son’s career. In recent years, Bing was approached by his own son, who wanted to be an actor. 

“He wanted to act, so I sent him to acting school,” Bing says.  Bing vowed he would not do what his father had done to his artistic desires.  “Then, he wanted to write—so I sent him to writing school.  Now, he wants to be a novelist,” Bing says, grinning at Peterson and Cohen.  “My father was right.”

For a man like Bing, who has brought so many laughs in our short, half-hour meeting—why cemeteries?   “I’ve always sort of been fascinated with these extremes of life,” he says.  “Birth and death.  I think it allows us to strip away anything that is not important.”

It would be great to spend Halloween eve touring The Woodlands Cemetery with Bing, filling in the dashes between the dates on the nearly 30,000 tombstones, because Dr. Bing is more than a physician with an MBA and the director of global health at the George W. Bush Institute; he is more than an author and professor at Southern Methodist University; and more than someone who has consulted for health ministries, created nongovernmental organizations and research centers on different continents.

He is a great storyteller.

A tour of The Woodlands will have to wait.  Bing’s lecture must go on, so I ask him about his storytelling methods—how he wrote his book, “Pharmacy on a Bicycle.” 

“To me, these are stories of people,” he says.  “They are experiences that people have shared with me.  The way I wrote this book—I had the pictures of the patients on my screensaver.  So whenever I said, ‘I can’t do this anymore,’ I would stop typing and the screensaver would come on and it would be a patient.  I would say this is not about you, this is her story.  She could not do what you can do—do it for her.”

It was fitting to have Bing at Mayes College at a time when Ebola was crossing borders and headlines—Bing has a Ph.D. in epidemiology, and he lives in Dallas, Texas, where Thomas Duncan, the first U.S. casualty of Ebola, made headlines.

“I don’t think people knew what to do,” Bing says, after being asked if his phone was ringing a lot during the media frenzy.  “The mother of a person down the street called me up: ‘Should I make my son come home?’  And I said, ’Look, if he needs to come home from school, you would be the first to know.’  You know why?  Because he lives down the street from me, and if it’s dangerous for me to be here, I’m taking him out with me.”

The Ebola scare has solidified in Bing the notion that threats to health—communicable or non-communicable—cannot be broken down into global or national.  “I think that one of the things Ebola really showed us is that there’s no us and them.  There’s only us,” Bing says.  For him, borders, too, are just an illusion: “Diseases will cross them and good ideas will cross them as well.  I think that for students here, if you are committed to improving access to care, you don’t need to leave Philadelphia, because we have enough problems here.  That’s where it starts.  It starts with a commitment, and then you sort of take it where life takes you.” 

During his lecture, Bing hits on the point that malleability in ideology is paramount if your true goal is to help others.  He describes his journey from where he expected to go, to where he needed to be.  It began by leaving the safety of his job at Charles R. Drew University of Medicine and Science for an uncertain future as director of global health at the George W. Bush Institute.

“Can I do this?” Bing says through a high-pitched groan and whine.  “I’m comfortable where I am.  I’m almost 50 years old.”

Logistics aside, principles and politics came into play.

“I was a dyed-in-the-wool democrat and had campaigned for Obama,” Bing says.  So, he thought, and he thought some more.  He knew that former President George W. Bush was committed to solving global health problems through the President’s Emergency Plan for AIDS Relief (PEPFAR) and his investment of billions of dollars in the healthcare industries of Africa and parts of Asia.

“I knew his heart was in the right place,” Bing says.  “All I needed to do was get in alignment with my own self to say, ‘Yes I can work with people who think differently than me, because what we are committed to is solving problems in innovative ways.’  I’m going to have to cross the aisle, and so I did it, and it has been the most amazing journey of my life. To speak to people who I thought were very different from me—to realize that they are actually the same in so many different ways.”

Perhaps this was another border that was only an illusion.

11/18/2014

Philly Issues First ‘Code Blue’ of Season: USciences Prof Explains What That Means to Homeless Population

MetrauxThose fortunate enough to be somewhere warm during this recent cold snap might wonder how Philadelphia’s homeless population can survive the frigid outdoor conditions, said Stephen Metraux, PhD, associate professor of health policy and public health at University of the Sciences.

“Data on how many homeless are stuck out in the cold is difficult to come by,” said Dr. Metraux. “The homeless population is notoriously challenging to count, as they usually strive to stay inconspicuous amidst the public spaces to which they are relegated.”

The best available number comes from the City of Philadelphia’s annual “Point in Time” count, when teams of volunteers canvass the shelters and streets and count the number of homeless people and families that they encounter. Of the estimated 5,500 homeless individuals counted on a January night in 2013, 388 of them were unsheltered. That figure is down from the 526 individuals recorded on a January night in 2012.

So how do these hundreds of homeless individuals survive below-freezing conditions? The first line of defense is provided by the City of Philadelphia, which implements a “Code Blue” on any night when temperatures fall under or hover around 20 degrees, said Dr. Metraux.

On Code Blue nights, outreach workers and police can bring in any homeless person to stay in a shelter or other public facility temporarily designated for overnight accommodations. No one gets turned away and, if necessary, a Court Ordered Transportation to Shelter can be quickly obtained to bring resistant individuals indoors on occasions when leaving a person outdoors may subject him or her to danger from the cold weather elements.

“Code Blue’s success is best indicated by the rarity of hypothermia deaths among homeless persons in the past few years,” said Dr. Metraux. “But Code Blue is at best a stopgap solution; the best solution for protecting the homeless from the elements is through renewed efforts to reduce homelessness.”

The number of homeless people living on the streets across Philadelphia has been declining over the previous few years, due largely to innovative programs that engage the most recalcitrant homeless persons and provide them with housing and services, he said. 

11/10/2014

Students Prepared for Bioterrorist Attack During Medical Reserve Corps Training

Training
Left to right: Alex Fevry PharmD'17, Soonyip Alec Huang PharmD'17, Khiem Huynh PharmD'17, and Ami Patel PharmD'17

A team of eight student-pharmacists from University of the Sciences joined more than 150 new volunteers with the Philadelphia Medical Reserve Corps as they acted out a bioterrorist attack which required them to administer antibiotics to thousands of Philadelphians to help prevent the spread of a deadly bacterial infection.

This dramatic, but informational, training session was held at USciences on Saturday, Nov. 8, for these credentialed volunteers – who are typically seen providing medical care and first aid after major storms, or at large city events such as the Philadelphia Marathon.

“Bringing together such a diverse group of local healthcare professionals and students was a positive experience which reinforced USciences’ mission of promoting integrated learning and professionalism,” said Steven Sheaffer, PharmD, associate professor of clinical pharmacy.  

Although Dr. Sheaffer has been a member of the Medical Reserve Corps since 2007, he said regularly attends training sessions to keep up to speed with relief efforts and build stronger relationships with healthcare professionals across the Philadelphia region.

“I hope that more of our students across all disciplines consider attending future training programs and join the Medical Reserve Corps,” he said.

Aside from USciences pharmacy students and faculty, other volunteers at the training session included medical and doctoral students from University of Pennsylvania, nurses, as well as students and faculty from other local universities.

The Sept. 11, 2001, terrorist attacks on the World Trade Center and the mailing of anthrax-tainted letters to news media and U.S. senators painfully illustrated the need for more organized use of medical volunteers.

The Philadelphia Department of Public Health launched the city’s unit in 2005, after Congress allocated money to establish the Medical Reserve Corps program office in the U.S. Surgeon General’s Office. Philadelphia’s chapter now boasts more than 1,800 volunteers who offer their medical, pharmaceutical, behavioral health, and other skills.

“I wanted to volunteer for the medical corps to use my pharmacy education in way that allows me to give back to the community,” said Alex Fevry PharmD’17.

Media coverage:

10/28/2014

USciences Prez, Students and Faculty Attended Life Sciences Future in Philly

PABioLSF14_-138University of the Sciences President Dr. Helen-Giles Gee, as well as students and faculty from USciences, joined hundreds of life sciences leaders and innovators during the Life Sciences Future Conference on Oct. 13-14 in Philadelphia.

Life Sciences Future was a two-day event designed by Pennsylvania Bio to reflect the rapidly-evolving landscape in healthcare - which includes biopharma, medical device and diagnostics, healthcare IT, contract research organizations, medical research institutions, and the investment community.

The first day of the event kicked off with Life Sciences Future Symposium: Partnerships in Science, which was designed for an exclusive audience of academic researchers, such as USciences students and faculty, to explore best practices for engaging business development representatives at large companies as well as the next steps in developing their technologies. The second day of the conference was jam-packed with speakers, topics and features all related to advancing science and healthcare industries.

Dr. Giles-Gee and students had the opportunity to meet and speak with Michael Sofia, inventor of Sofosbuvir – known by the brand name Sovaldi, a hepatitis C therapy drug approved by the FDA last December.

“The sessions were outstanding and much appreciated by the faculty and students who attended," Dr. Giles-Gee.

10/17/2014

VIDEO: Mayes College Alumnus Shares Experiences in Ireland

 
Video by Sport Changes Life Foundation

Alumnus Patrick Connaghan PhB'14 is currently continuing his education and basketball career in Carlow, Ireland through the Sport Changes Life Foundation's Victory Scholarship program. He is pursing his Masters in Business at the Carlow Institute of Technology, and is on track to finish his degree this spring.

You can follow Patrick's journey in Ireland by following him at @Connaman on Twitter, or by reading his Sport Changes Life blog.

Continue readingRecent Grad Gives Back to the Game of Basketball, Gains Free Education

10/15/2014

Community Pharmacy Medication Adherence

Medication adherence is a growing concern for health care providers. For this reason many community pharmacies are focusing on was to increase medication adherence rates. This can be done in various ways ranging in diverse settings.

            Medication therapy management (MTM) are services provided by pharmacists to increase therapeutic outcomes. There are approximately 1.5 billion preventable adverse effects that cause $177 billion in injury and death. A major target for MTM occurs in community pharmacies. The Pennsylvania Project studied 107 Rite Aid pharmacies that trained pharmacist to perform interventions including asking questions about medication adherence and 111 control pharmacies that did not perform these interventions.  The endpoints of this study showed an increase in medication adherence (PDC >80%) in the intervention group over the control group.  There was a significant increase in adherence of 3.1% for beta-blockers and 4.8% of for anti-diabetic drugs.

            Patient counseling is a great way for community pharmacists to change medication adherence rates. In an internal study, Walgreens Pharmacy is creating a way to identify patients that may need a little more help with medication adherence by examining  poor past medication adherence rates or new medications prescribed. In a study across 76 Walgreens, these interventions showed an increase in medication possession ratio.

            Chronic medications can be difficult to control of especially if a patient is taking multiple medications. An AHRQ tool used in community pharmacies called refill reminders, can help patients pick up their medications on time.  Using this script as part of an automated reminder system, can help prompt patients to refill their prescriptions or pick up their medication.

            While at work, I have come across these methods to increase medication adherence in the community setting. It is important as pharmacist to intervene early by educating and counseling the patient, so adherence rates start off high. These methods have proven extremely beneficial in my place of work. For example, automatic courtesy refills allow all patients on maintenance medications to be reminded to pick up their medication, so they do not miss doses. These are just some examples of methods being implemented in community pharmacies to help pharmacists identify these patients and improve medication adherence.

Urvi Patel, PharmD ‘16

05/07/2014

Founder of 'We Feed the Homeless Philly' Speaks to Pharmacy Students

HomelessPrior to the end of the 2013-14 school year at University of the Sciences, pharmacy students enrolled in the elective course, "Pharmacist Role in Promoting Lifestyle Changes to Maintain Cardiovascular Health" had the opportunity to host the founder of a local volunteer organization, “We Feed the Homeless Philly.”

Grace Earl PharmD, BCPS, assistant professor of clinical pharmacy, said this particular course aimed to help students develop skills and materials to create a community health promotion event. That's why it seemed fitting for students to engage with Craig Stroman, executive director and founder of the Philadelphia-based homeless organization.

"Craig spoke about the needs of the homeless in Philadelphia, and we learned that between 750 to 1,200 children spend the night in a Philadelphia shelter," said Dr. Earl. "Through recent, informal surveys, Craig found that more than 95 percent of the local homeless did not complete high school."

Contrary to the common beliefs among society, Stroman stressed that “drugs” and “drug abuse” are not the sole causes of homelessness. He shared several heartfelt stories with the class, including how a widower lost everything he had because he was fully dependent on his late wife, and failed to pay his mortgage or bills after she died.  In another case, Stroman said a homeless family was squatting in a vacant house after the father lost his job. After driving this family to a shelter on a Saturday, Stroman learned that Philadelphia shelters only accept "new" families on Monday through Friday, through an intake process.

"As healthcare professionals, we learned that the homeless community's greatest need is food and shelter," said Dr. Earl. "Healthcare may not be the number one priority in their daily life, and that is important for us to understand in our professions."

Stroman can be seen offering meals to homeless individuals at Love Park and other areas in the city on Saturdays and Tuesdays, and he has been successful in increasing support from 40 to 700 volunteers.  He also works as a housing investigator for the Department of Housing and Urban Development.

Students in the class joined members of the University's Department of Pharmacy Practice and Administration to host a food donation drive to benefit We Feed the Homeless Philly.  For more information regarding Stroman's organization, as well as volunteer opportunities, visit wefeedthehomelessphilly.org.

04/28/2014

Taking Advantage of Adherence Programs

A simple internet search will provide both patients and health care providers with a multitude of current adherence programs/services. Both the availability of programs and participation from the patients will allow for improvement of overall medication adherence. Multiple adherence programs and the future of medication adherence will be discussed to gain a better understanding of the benefits for increasing adherence.

Adherence Programs:  Medication adherence can improve health, and reduce costs. Therefore, it is important that there are many adherence programs available for the public to take advantage of; either sponsored by a health care company, pharmacy, hospital or ambulatory care clinics. Some of the larger companies that provide adherence services include Lash Group, Optum and Humana. These companies provide supplemental services to both health care providers and patients such as personal consultation with a pharmacist or nurse, pamphlets about different disease states and personal medication reminders. These services are available to the public and it may be beneficial for patients to take advantage of such opportunity.

Pharmacist’s role: One of the easier ways to improve medication adherence is by developing a relationship between patients and their pharmacists. Pharmacists can keep track of patients’ current medication lists, refill schedules, disease states, and work to resolve any barriers that patients may have. Major drug chains such as CVS Caremark pharmacy makes an effort to understand the barriers that are preventing patients from taking their medications. In order to resolve issues CVS uses their pharmacists on the frontline to work one on one with patients to answer questions and improve adherence.

Prospect for Medication Adherence: After careful consideration of past methods and strategic research, the consultant group Frost & Sullivan provides insight on what direction medication adherence programs should be moving. Current methods of improving medication adherence include refill reminders, brochures, blister cards and telephoning. Future strategies hope to avoid general approach and instead focus on each patient’s specific needs or barriers to improve medication adherence. One of the strategies includes pharmaceutical companies to initiate a loyalty card program where patients are offered a financial discount at every fill.  While there may be some benefit to this, one does need to wonder if this strategy will be counter-productive to the pharmacist-patient or physician-patient relationship.  Moving forward technology will also play a key factor in improving adherence as discussed by the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS). With an increase use of Electronic Health Records (EHR) facilities should be able to measure level of medication adherence, evaluate economic impact, increase electronic prescribing, improve drug formulary, and initiate medication reconciliation in all healthcare facilities. Other technology adjustments such as video conferencing, smartphone applications, and electronic availability of medication list for both patients and providers will help advance medication adherence strategies.

A variety of adherence programs are available for all patients to participate in which will then help increase health outcomes. Health care systems and providers are implementing new strategies to reach the common goal of improving medication adherence. Strategies such as focusing on specific patient factors, cost incentives and availability of electronic information will help increase adherence. Taking advantage of multiple adherence programs and new strategies will benefit the future of healthcare.

Sheenu Joseph, PharmD '15

04/11/2014

VIDEO: 6abc Highlights Students, Faculty at USciences Research Day

 
 
6abc showcased the diversity and growth of research pursuits at University of the Sciences during its 12th Annual Research Day and 27th Annual John C. Krantz, Jr., Distinguished Lecture on Thursday, April 10. Research Day recognizes and highlights the research efforts of faculty, as well as undergraduate and graduate students, to encourage and promote communication and collaboration among researchers.
 
USciences distinguishes itself by offering undergraduate students the opportunity to conduct research early in their academic careers. The diverse research activity that was on display spanned several aspects of the University’s scholarly pursuits, including:
  • Determining occupational therapists’ role in working with pediatric cancer patients
  • Discovering the personality traits that cause adolescents to kill
  • Using yoga to improve quality of life for patients with anorexia nervosa
  • Identifying predictors of successful post-secondary transitions for autistic students
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