Some two centuries after Jenner's investigation, in 1977 all known cases of smallpox were eliminated with the introduction of universal vaccination. By the beginning of the 17th century in New England, a considerable number of "apothecary shops" had opened up in communities, providing patients with a variety of herbal remedies.7-8 In 1752, Jonathan Roberts became the first dedicated apothecary at the nation's earliest hospital in Pennsylvania.7 Spread responsibilities of the pharmacist set the precedent for two major roles in modern pharmaceutical care: community pharmacy and institutional pharmacy. After the end of the Revolutionary War, apothecaries and apothecaries began to work with many chemicals for their medicines, including sulfuric acid, a chemical still widely used for pharmaceutical purposes today.7 In 1821 it was.
Recognizing the need for pharmacy education, the University of Mississippi established the state's first and only School of Pharmacy in September. The original School of Pharmacy consisted of seven faculty members and only 15 students.9 After 108 years of growth, the School of Pharmacy currently includes 114 faculty members and more than 350 professional students who strive to advance the profession of pharmacy. More than 150,000 pharmacists have received training to administer many vaccinations, including the annually recommended flu shot.14 According to the Centers for Disease Control (CDC), between 5 and 20 percent of the U.S. population becomes infected with the influenza virus each year.14 During Over the past thirty years, flu-related deaths have ranged from 3,000 to 49,000 annually.14 Patients who decide to get the flu vaccine can benefit financially from fewer doctor visits and less time off work. Subjective information can be uncovered by directly interviewing the patient, the patient's family, and the physicians.18 Objective information is obtained by counting pills, checking pharmacy refills, and using electronic medication monitoring systems.18 Pharmacists have the ability to directly monitor the medications dispensed. while also providing individualized adherence management by involving the patient in MTM services.
According to Cossman, only 12% of primary care physicians working in Mississippi practice in the Delta, although nearly 20% of the state's population lives in this region.22 The lack of providers in the Delta creates even more barriers to access for primary care services. . As the practice of pharmacy continues to change within the health care system, the utmost importance remains centered. This study is important in the field of pharmacy practice because it seeks information about ways.
Literature Review Literature Review
The current state of health in the United States, especially in Mississippi, requires serious attention. When nearly 80% of the state does not have adequate access to primary care, the costs associated with treating chronic diseases such as diabetes and cardiovascular disease (CVD) will inevitably rise. Herd immunity is defined as "the resistance of a group to attack by a disease due to the immunity of a large proportion of its members ... so that not everyone in a population needs to be immunized to eliminate disease."30 Thus, fewer patients receive immunizations. in Mississippi will result in more of the population getting the flu virus.
Lemay notes that with the busy atmosphere common to many pharmacies, MTM offers the pharmacist direct, uninterrupted communication with their patient.34 For. When performing a CMR, the pharmacist should review the patient's current medications, both prescription and over-the-counter, with the goal of improving the outcome of drug therapy.16,34. The pharmacist then begins the PMR, including information such as the patient's name, date of birth, emergency contact, primary care physician, allergies, and current medications the patient is taking.16 After looking for potential drug therapy problems (DTPs), the next step for the pharmacist includes suggest solutions to any problems uncovered via the MAP.34 the patient can then use the MAP in future visits to their doctor. Both PMR and MAP should be updated as often as possible to reflect changes in the patient's drug regimen.34.
After completing the first 3 steps, the pharmacist may choose an intervention by communicating directly with the patient about DTPs and adherence or by contacting other health care providers such as the patient's physician.16 In some cases, the pharmacist may refer a patient to a specific health professional. For example, the pharmacy could send a patient with type II diabetes mellitus to meet with a dietitian. Proper documentation enables the patient's physician to understand the pharmacist's recommendations, maintains professional responsibility for the pharmacist, and further supports the value placed on pharmacist-delivered MTM.16.
Study participants valued MTM services provided by pharmacists in face-to-face meetings over alternative settings such as telephone or home.23 Participants responded most positively to the duration of MTM sessions. MTM holds the promise of increasing patient adherence levels, but MTM also provides pharmacists with an opportunity to improve disease management in chronic conditions such as diabetes. The topic of health disparities is especially important when considering the Mississippi Delta, which has twice the national poverty rate and an obesity rate of 38 percent.37 Poverty and obesity are undoubtedly factors in the very high incidence of diabetes found in the Delta.
This research project by Bunting and Cranor considered the following measures of health status: blood pressure (systolic and diastolic) and cholesterol (LDL and total).38 For both of these measures, the improvement in patient health was statistically significant. over the 5-year duration of the MTM study.38 Improved patient health status was reflected in a significant reduction in cardiovascular (CV) events among the cohort.38 The definition of CV events included. After a thorough evaluation of the scientific literature regarding medication therapy management, pharmacist delivery of immunizations, and the impact of MTM on health disparities, pharmacists are in a prime position to provide clinical and
Research Methodology Research Methodology
The instrument used to measure patients' opinions and perceptions was an in-person, paper-based survey. The survey used in this study was designed to assess patient perceptions after receiving clinical pharmacy services from student pharmacists. Many questions used a dichotomous yes or no measure. The initial part of the survey contained nine questions that focused on medication use and perceptions.
Five of the MTM questions received Likert-type responses on a scale of 1 to 5 (strongly disagree to strongly agree). The survey included measures adapted from a survey administered by Law, Okamoto, and Brock.24 Permission to use and modify questions was obtained by contacting the principal investigator, Anandi V. Demographic questions were placed at the bottom of the survey for two purposes: first, because patients were screened on the basis of prescription drug use rather than demographic information, and second to ensure that the most important questions about adherence and MTM were answered before patients were exhausted.
The survey attempted to maintain an appropriate logical flow starting with questions on medication use and pharmacists' roles before moving on to questions about MTM services. The Department of Health and Human Services has designated Southaven as a medically underserved area of the state. Those not taking prescription medications were not eligible to participate in MTM services.
Before patients were offered the survey, student pharmacists followed a script (Appendix D) asking about their willingness to participate in the study and requiring them to be at least 18 years of age. While all collected surveys did not include personal information, each survey and DRAW tool was identified with a unique number. Likert-type questions provided descriptive ordinal data to rank the patient's agreement or disagreement on a scale of 1 to 5 (not at all agree to strongly agree.
According to Sullivan and Artin, “the differences between 'always', 'often' and 'sometimes' on a frequency response Likert scale are not necessarily the same. For aim 5, dichotomous survey questions were stratified by DRAW response and self-reported non-adherence for analysis of paired nominal data using McNemar's test.
Results
As patients have experienced first-hand the provision of medication therapy review, the beliefs presented demonstrate trust in pharmacists as clinical providers of medication management services. Two out of three patients (66.7%) did not know about drug treatment before the service event. Approximately 64% of the sample reported increased understanding of accurate medication use as a result of the MTM intervention.
Getting my flu shot and Drug Therapy Review at the same time is a helpful service. The primary aim of this research project was to assess current perceptions on adherence to targeted drug therapy management as part of. No previous study in Mississippi provides a summary of combined influenza immunizations and drug therapy.
Statistical analysis of the study was at risk of not recognizing statistical significance (Type II error). 34;People at High Risk for Developing Influenza-Related Complications." Centers for Disease Control and Prevention. 34; Mississippi's Physician Labor Force: A Look at Primary Care Physicians." Mississippi Health Policy Research Center.
34;Conjoint Analysis of Patient Preferences on Medicare Medication Therapy Management." Journal of the American Pharmacists Association. Perceptions of Medicare Part D enrollees about pharmacists and their role as providers of medication therapy care." J Am Pharm Assoc (2003). Designing a medication adherence management program for Medicare beneficiaries: qualitative findings from patients and physicians.” Am J Geriatr Pharmacother.
34;Patient Perceptions of Medicare Part D Medication Therapy Management Services." Journal of the American Pharmacists Association. Pharmacy Delivery of Influenza Vaccines in Medically Underserved Communities." Journal of the American Pharmacists Association 52.1 01 Jan. The Asheville Project: Long-Term Clinical, Humanistic, and Economic Outcomes of a Community-Based Medication Therapy Management Program for Asthma.” Journal of the American Pharmacists Association.
34; Impact of an Elective Course on Pharmacy Students' Attitudes, Beliefs, and Competence Regarding Medicare Part D." American Journal of Pharmaceutical Education.
