Optimizing safe and effective patient care focus on clinical pharmacist services and outcomes at the Medication Therapy Management Clinic: Stroke prevention
18th International Conference on Neurology and Neurological Disorders
August 23-24, 2018 | Paris, France
Nahed Lubbad ,Fahmi Al Senani, Mohammad Memone and Mohammad Al Hazzaa
King Fahad Medical City, Saudi Arabia
Keynote : J Neurol Neurorehabil Res
Abstract:
Introduction: According to the American Heart Association
Heart Disease and Stroke Statistics 2017 updates, stroke ranks
No. 5 among all causes of death, after diseases of the heart,
cancer, chronic lower respiratory disease, and unintentional
injuries/accidents. Globally, in 2013 there were 6.5 million
stroke deaths, making stroke the second-leading cause of death
behind ischemic heart disease. Approximately 795,000 strokes
occur in the United States each year. Around 610,000 of these
are first attacks, and 185,000 are recurrent attacks. About 60%
of stroke deaths occurred outside of an acute care hospital.
Most of the stroke patients are on multiple medications which
may lead to a several negative outcomes for both patients and
healthcare facilities. These negative outcomes such as adverse
drug effects, poor patient health, and hospitalizations, as well
as economic outcomes by increasing drug expense and costs
associated with increased utilization of health services.
In the past, physicians have full responsibility to manage
their patients with chronic diseases and complex medication
regimens. Nowadays, pharmacists are increasingly responsible
for managing patients’ medication regimens to enhance patient’s
adherence, preventing adverse drug reactions, improving patient
quality of life and decreasing facility and drug costs.
Medication Therapy Management (MTM) Services in
Pharmacy Practice is designed to enhance collaboration among
pharmacists, physicians, and other healthcare professionals
to optimize and promote safe and effective medication use to
improve patient outcomes. During this service a comprehensive
assessment and evaluation of patient’s medication therapy
regimen to prevent medication errors such as drug interactions,
duplications, omissions, dosing errors, as well as to observe
patients’ compliance and adherence patterns.
In a large academic institution, MTM clinic is described as
an important service to optimize patient care by providing
patients with medications and disease states counseling. These
identified benefits of MTM clinic lead to frequent patient
referrals specifically for aid with medication adherence and
disease state management. Also, a collaborative, pharmacistled
hypertension management service can help monitor BP,
improve medication adherence, and optimize therapy in a stepwise
approach. Other study showed the exposure of pharmacist
with patients, and face-to-face Comprehensive Medication
Management services resulted in improvement of medication
adherence. A study at the medical center’s ambulatory care
clinics, the clinical pharmacist practitioner, have had a positive
influence on improving patient and cost outcomes, through
interventions contributing to reducing readmissions, and
provide indirect revenue through cost avoidance, and creating
new revenue through billing for patient visits.
Objective: To measure the outcome of clinical pharmacist
attribute in medication therapy management clinic and
intervention on patient’s outcomes by optimizing patient care
through enhancing appropriate drug use, increase adherence
to medication therapy, and improve detection of adverse drug
events to encourage patients’ safety.
Methods: Study Design Prospectively, patients who will be seen
by a clinical pharmacist in the medication therapy management Clinic which operated parallel to physician stroke prevention
clinic will involve. Comprehensive medication profile reviews and
patient interview will be performed. The interventions will be
discussed with the physician. Patients with approved interventions
related to antidiabetic agents or antihypertensive medication will
be followed by telephone call one week later and four weeks after
appointment.
Inclusion and exclusion criteria
Inclusion criteria:
All patients with appointment in the stroke prevention clinic
who received approved clinical pharmacist intervention
All patients with appointment in the stroke prevention clinic with
poor medication adherence.
Exclusion criteria:
Patients with appointment in the stroke prevention clinic who are
not on any medication.
Outcome Measures: Primary outcome: Measure the effects of
clinical pharmacist interventions by reaching the target fasting
and postprandial blood glucose level and target blood pressure
according to the case.
Secondary outcomes: Feedback of clinical pharmacist
intervention on patients reported adverse drug events.
To measure improvement of patient’s medication adherence by
decreasing the number of missing doses per week.
Biography:
Nahed Lubbad is currently working as a Clinical Pharmacist at King Fahad Medical City, Saudi Arabia. His experiences include Medication Therapy Management (MTM) Clinic, Stroke Prevention Clinical Pharmacist, Medication Utilisation Committee Coordinator, Clinical Pharmacist, Drug and Poison Information Clinical Pharmacist and Medication reconciliation Clinical Pharmacist at King Fahad Medical City from the year 2011 till present.
E-mail: nlubbad@kfmc.med.sa
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