In real-world practice, medication non-adherence is a common problem which has led to poor clinical outcomes, increased hospital admissions and unnecessary healthcare costs. In 2011, Kaiser Permanente Napa Solano outp...In real-world practice, medication non-adherence is a common problem which has led to poor clinical outcomes, increased hospital admissions and unnecessary healthcare costs. In 2011, Kaiser Permanente Napa Solano outpatient pharmacy implemented a new pilot program to improve adherence to statin therapy in patients at high risk of developing cardiovascular disease. Interventions included telephone reminders and personalized consultations targeting patient specific barriers. The objective of this retrospective analysis is to evaluate the impact of outpatient pharmacist interventions in addressing early non-persistence, which is defined as failure to pick up the first refill on time. The information collected included quantitative data for descriptive analysis, with the primary outcome measuring prescription pick up rate in contacted patients. Secondary outcomes included baseline characteristics, time to refill pick up after the contact and specific interventions made by pharmacists. 75 patients were identified in a six month period and 38 patients received phone consultations. The obtained results showed that 39.5% of the patients picked up the first refill within 20 days after the phone consultation, which was significantly higher compared to the baseline pickup rate of 5.4%. In regards to the secondary endpoint, patients taking no more than five medications were associated with lower response rate （P = - 0.02）.展开更多
Background:Newborns of 30-34 weeks gestation comprise 3.9%of all live births in the United States and 32%of all premature infants. They have been studied much less than very low birthweight infants. Objective:To measu...Background:Newborns of 30-34 weeks gestation comprise 3.9%of all live births in the United States and 32%of all premature infants. They have been studied much less than very low birthweight infants. Objective:To measure in-hospital outcomes and readmission within three months of discharge of moderately premature infants. Design:Prospective cohort study including retrospective chart review and telephone interviews after discharge. Setting:Ten birth hospitals in California and Massachusetts. Patients:Surviving moderately premature infants born between October 2001 and February 2003.Main outcome measures:(a) Occurrence of assisted ventilation during the hospital stay after birth; (b) adverse in-hospital outcomes-for example,necrotising enterocolitis; (c) readmission within three months of discharge. Results:With the use of prospective cluster sampling,850 eligible infants and their families were identified,randomly selected,and enrolled. A total of 677 families completed a telephone interview three months after hospital discharge. During the birth stay,these babies experienced substantial morbidity:45.7%experienced assisted ventilation,and 3.2%still required supplemental oxygen at 36 weeks. Readmission within three months occurred in 11.2%of the cohort and was higher among male infants and those with chronic lung disease. Conclusions:Moderately premature infants experience significant morbidity,as evidenced by high rates of assisted ventilation,use of oxygen at 36 weeks,and readmission. Such morbidity deserves more research.展开更多
文摘In real-world practice, medication non-adherence is a common problem which has led to poor clinical outcomes, increased hospital admissions and unnecessary healthcare costs. In 2011, Kaiser Permanente Napa Solano outpatient pharmacy implemented a new pilot program to improve adherence to statin therapy in patients at high risk of developing cardiovascular disease. Interventions included telephone reminders and personalized consultations targeting patient specific barriers. The objective of this retrospective analysis is to evaluate the impact of outpatient pharmacist interventions in addressing early non-persistence, which is defined as failure to pick up the first refill on time. The information collected included quantitative data for descriptive analysis, with the primary outcome measuring prescription pick up rate in contacted patients. Secondary outcomes included baseline characteristics, time to refill pick up after the contact and specific interventions made by pharmacists. 75 patients were identified in a six month period and 38 patients received phone consultations. The obtained results showed that 39.5% of the patients picked up the first refill within 20 days after the phone consultation, which was significantly higher compared to the baseline pickup rate of 5.4%. In regards to the secondary endpoint, patients taking no more than five medications were associated with lower response rate （P = - 0.02）.
文摘Background:Newborns of 30-34 weeks gestation comprise 3.9%of all live births in the United States and 32%of all premature infants. They have been studied much less than very low birthweight infants. Objective:To measure in-hospital outcomes and readmission within three months of discharge of moderately premature infants. Design:Prospective cohort study including retrospective chart review and telephone interviews after discharge. Setting:Ten birth hospitals in California and Massachusetts. Patients:Surviving moderately premature infants born between October 2001 and February 2003.Main outcome measures:(a) Occurrence of assisted ventilation during the hospital stay after birth; (b) adverse in-hospital outcomes-for example,necrotising enterocolitis; (c) readmission within three months of discharge. Results:With the use of prospective cluster sampling,850 eligible infants and their families were identified,randomly selected,and enrolled. A total of 677 families completed a telephone interview three months after hospital discharge. During the birth stay,these babies experienced substantial morbidity:45.7%experienced assisted ventilation,and 3.2%still required supplemental oxygen at 36 weeks. Readmission within three months occurred in 11.2%of the cohort and was higher among male infants and those with chronic lung disease. Conclusions:Moderately premature infants experience significant morbidity,as evidenced by high rates of assisted ventilation,use of oxygen at 36 weeks,and readmission. Such morbidity deserves more research.
