Pharmacist-managed telephone clinic review of antidementia medication effectiveness. 2011

Lynda Oderda, and Christine Holman, and Ben Nichols, and Randall Rupper, and Byron Bair, and Matthew Hoffman, and Bret Hicken
Pharmacotherapy Department, University of Utah College of Pharmacy, and a clinical pharmacist, Pharmacy Department, Veterans Affairs Salt Lake City Health Care System (VASLCHCS), Salt Lake City, Utah.

OBJECTIVE To describe the development and implementation of a telephone clinic for evaluating continued effectiveness of antidementia medication therapy in patients with dementia. METHODS Ambulatory care at the Veterans Affairs Salt Lake City Health Care System. METHODS A pharmacist-directed, telephone dementia clinic review of patients taking dual antidementia therapy to determine whether a medication-discontinuation trial is appropriate based on caregiver global impressions. METHODS Pharmacists review eligible patients' electronic medical records for adherence history and caregiver impressions of response to antidementia medications to determine if a discontinuation trial of antidementia medication is warranted. Pharmacists coordinate any discontinuation discussion with caregivers and medical providers and monitor patients' response to the resultant interventions via telephone. RESULTS Pharmacist involvement allows for a structured method of monitoring adherence with antidementia medications and for determining whether they continue to provide benefit. RESULTS Expected results include percentage of patients who underwent a medication-discontinuation trial, percentage of patients who did not demonstrate clinical decline after a discontinuation trial, and percentage of patients who subsequently restarted medication because of noticeable decline after the discontinuation trial. CONCLUSIONS This telephone clinic capitalizes on the expertise of clinical pharmacists and helps establish a functional collaboration between health care providers, patients, and the electronic medical record to obtain a multiperspective evaluation of the effectiveness of antidementia therapy from a patient-centric view. This systematic approach improves patient-centered care and may have favorable impacts on antidementia medication cost utilization.

UI MeSH Term Description Entries
D010593 Pharmaceutical Services Total pharmaceutical services provided by qualified PHARMACISTS. In addition to the preparation and distribution of medical products, they may include consultative services provided to agencies and institutions which do not have a qualified pharmacist. Pharmaceutic Services,Pharmaceutical Care,Pharmacy Services,Services, Pharmaceutic,Services, Pharmaceutical,Services, Pharmacy,Care, Pharmaceutical,Pharmaceutic Service,Pharmaceutical Service,Pharmacy Service,Service, Pharmaceutic,Service, Pharmaceutical,Service, Pharmacy
D010595 Pharmacists Those persons legally qualified by education and training to engage in the practice of pharmacy. Clinical Pharmacists,Community Pharmacists,Retail Pharmacists,Clinical Pharmacist,Community Pharmacist,Pharmacist,Pharmacist, Clinical,Pharmacist, Community,Pharmacist, Retail,Pharmacists, Clinical,Pharmacists, Community,Pharmacists, Retail,Retail Pharmacist
D003704 Dementia An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000553 Ambulatory Care Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. Outpatient Care,Outpatient Health Services,Clinic Visits,Health Services, Outpatient,Outpatient Services,Services, Outpatient Health,Urgent Care,Care, Ambulatory,Care, Outpatient,Care, Urgent,Cares, Urgent,Clinic Visit,Health Service, Outpatient,Outpatient Health Service,Outpatient Service,Service, Outpatient,Service, Outpatient Health,Services, Outpatient,Urgent Cares,Visit, Clinic,Visits, Clinic
D013689 Telephone An instrument for reproducing sounds especially articulate speech at a distance. (Webster, 3rd ed) Switchboard Service,Service, Switchboard,Services, Switchboard,Switchboard Services,Telephones
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014493 United States Department of Veterans Affairs A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position. United States Veterans Administration,Veterans Administration (U.S.),Veterans Affairs (U.S.),United States Veterans' Administration,United States. Dept. of Veterans Affairs,Veterans Administration
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D054539 Medication Therapy Management Assistance in managing and monitoring drug therapy for patients receiving treatment for cancer or chronic conditions such as asthma and diabetes, consulting with patients and their families on the proper use of medication; conducting wellness and disease prevention programs to improve public health; overseeing medication use in a variety of settings. Drug Therapy Management,MEDICARE Prescription Drug Improvement and Modernization Act of 2003,Management, Drug Therapy,Management, Medication Therapy,Therapy Management, Drug,Therapy Management, Medication

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