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Patricia R. Freeman - One of the best experts on this subject based on the ideXlab platform.
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Pharmacists’ role in harm reduction: a survey assessment of Kentucky community Pharmacists’ willingness to participate in syringe/needle exchange
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci Green, Patricia R. FreemanAbstract:BackgroundPharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange.MethodsIn 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing).ResultsOf 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority ( n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists ( n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists ( n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele).ConclusionsKentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
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Pharmacists' role in harm reduction: a survey assessment of Kentucky community Pharmacists' willingness to participate in syringe/needle exchange.
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci C. Green, Patricia R. FreemanAbstract:Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange. In 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority (n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists (n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele). Kentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
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Pharmacists’ role in opioid overdose: Kentucky Pharmacists’ willingness to participate in naloxone dispensing
Journal of The American Pharmacists Association, 2017Co-Authors: Patricia R. Freeman, Amie Goodin, Suzanne Troske, Audra Strahl, Amanda Fallin, Traci C. GreenAbstract:Abstract Objectives To assess Pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified Pharmacists to dispense naloxone under a physician-approved protocol. Design Electronic survey (e-mail) gauging perception of Pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. Setting and participants All Kentucky Pharmacists with active licenses in 2015. Main outcome measures Ordinal logistic regression was used to estimate the impact of Pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Results Of 4699 practicing Kentucky Pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of Pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women Pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community Pharmacists reported barriers to naloxone access at higher rates than Pharmacists from other practice settings. Conclusion Kentucky Pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing Pharmacist confidence through appropriately designed education programs could facilitate Pharmacist participation in naloxone dispensing.
Amie Goodin - One of the best experts on this subject based on the ideXlab platform.
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Pharmacists’ role in harm reduction: a survey assessment of Kentucky community Pharmacists’ willingness to participate in syringe/needle exchange
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci Green, Patricia R. FreemanAbstract:BackgroundPharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange.MethodsIn 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing).ResultsOf 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority ( n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists ( n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists ( n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele).ConclusionsKentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
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Pharmacists' role in harm reduction: a survey assessment of Kentucky community Pharmacists' willingness to participate in syringe/needle exchange.
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci C. Green, Patricia R. FreemanAbstract:Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange. In 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority (n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists (n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele). Kentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
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Pharmacists’ role in opioid overdose: Kentucky Pharmacists’ willingness to participate in naloxone dispensing
Journal of The American Pharmacists Association, 2017Co-Authors: Patricia R. Freeman, Amie Goodin, Suzanne Troske, Audra Strahl, Amanda Fallin, Traci C. GreenAbstract:Abstract Objectives To assess Pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified Pharmacists to dispense naloxone under a physician-approved protocol. Design Electronic survey (e-mail) gauging perception of Pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. Setting and participants All Kentucky Pharmacists with active licenses in 2015. Main outcome measures Ordinal logistic regression was used to estimate the impact of Pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Results Of 4699 practicing Kentucky Pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of Pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women Pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community Pharmacists reported barriers to naloxone access at higher rates than Pharmacists from other practice settings. Conclusion Kentucky Pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing Pharmacist confidence through appropriately designed education programs could facilitate Pharmacist participation in naloxone dispensing.
Amanda Fallin-bennett - One of the best experts on this subject based on the ideXlab platform.
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Pharmacists’ role in harm reduction: a survey assessment of Kentucky community Pharmacists’ willingness to participate in syringe/needle exchange
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci Green, Patricia R. FreemanAbstract:BackgroundPharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange.MethodsIn 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing).ResultsOf 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority ( n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists ( n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists ( n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele).ConclusionsKentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
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Pharmacists' role in harm reduction: a survey assessment of Kentucky community Pharmacists' willingness to participate in syringe/needle exchange.
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci C. Green, Patricia R. FreemanAbstract:Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange. In 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority (n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists (n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele). Kentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
Traci Green - One of the best experts on this subject based on the ideXlab platform.
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Pharmacists’ role in harm reduction: a survey assessment of Kentucky community Pharmacists’ willingness to participate in syringe/needle exchange
Harm Reduction Journal, 2018Co-Authors: Amie Goodin, Amanda Fallin-bennett, Traci Green, Patricia R. FreemanAbstract:BackgroundPharmacists’ role in harm reduction is expanding in many states, yet there are limited data on Pharmacists’ willingness to participate in harm reduction activities. This study assessed community Pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange.MethodsIn 2015, all Kentucky Pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community Pharmacist respondents. Ordinal logistic regression estimated the impact of community Pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing).ResultsOf 4699 practicing Kentucky Pharmacists, 1282 Pharmacists responded (response rate = 27.3%); the majority ( n = 827) were community Pharmacists. Community Pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community Pharmacists who agreed that Pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket Pharmacists ( n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community Pharmacists ( n = 342, 41.4% of community pharmacies). Independent Pharmacists reported different barriers (workflow) than their chain/supermarket Pharmacist colleagues (concerns of clientele).ConclusionsKentucky community Pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
Julian Bourne Horst - One of the best experts on this subject based on the ideXlab platform.
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assessment of clinical Pharmacist management of lipid lowering therapy in a primary care setting
Journal of Managed Care Pharmacy, 2003Co-Authors: Traywick L Till, John C Voris, Julian Bourne HorstAbstract:BACKGROUND: Pharmacists have been shown to positively impact the outcomes of care for treatment of many different kinds of disease states. In particular, Pharmacist-run lipid clinics have enjoyed varying degrees of success, depending on the outcome assessed. At our hospital, when a patient is transferred to the Pharmacistcoordinated lipid clinic, the primary care Pharmacist is responsible for ordering and interpreting labs and prescribing and monitoring lipid-altering therapy. OBJECTIVE: This study was designed to assess if there is a statistically significant difference between the magnitude of serum cholesterol reduction for patients receiving lipid-altering pharmacotherapy when clinically trained Pharmacists are actively prescribing and adjusting the drug therapy compared to other health care practitioners (usual care). METHODS: Patient records from the hospital computer databases were retrospectively and randomly selected for analysis. Following evaluation for inclusions and exclusions, 41 patient records remained for statistical analysis for the cohort group, and 47 records remained from the group of patients managed by a clinical Pharmacist. RESULTS: Management of dyslipidemia by a clinical Pharmacist was associated with a significant reduction in overall mean low-density lipoprotein (LDL, 18.5%) compared to the cohort that did not have a clinical Pharmacist as the primary manager of dyslipidemia (6.5%, P=0.049). This suggests improved clinical outcomes, defined as greater LDL reduction, when clinical Pharmacists participate in lipid management, including drug prescribing. The magnitude reduction in LDL was found to be related to the number of clinical pharmacy visits (11.4% for 1 visit, 23.2% for 2 visits, and 23.7% for >3 visits), compared to the usual care group (-11.0%, 18.0%, and 7.4%; statistically significant, P=0.038, for >3 visits only). These results occurred even though the group of dyslipidemic patients managed primarily by a clinical Pharmacist contained a statistically greater number of patients with 2 or more risk factors and high-density lipoprotein (HDL) levels less than 40 mg/dL. CONCLUSION: Interdisciplinary medical teams that include clinical Pharmacists who are actively prescribing and adjusting lipid drug therapy may achieve greater reductions in LDL for patients who have been assessed with multiple risk factors compared to patients managed without clinical Pharmacists. Active participation by clinical Pharmacists in lipid management for patients with elevated LDL resulted in improved treatment success as measured by the magnitude reduction in LDL. The reduction in LDL was between 5% and 22% per visit greater for patients being treated by clinical Pharmacists versus usual care, even in a patient population with more risk factors. These intermediate outcomes may translate into long-term outcomes in fewer cardiovascular events, improved quality of life for patients with dyslipidemia, and lower costs associated with sequelae of dyslipidemias.
