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Abstract

Objectives To improve understanding of the logistics of transitions of care (TOC) clinics and to provide guidance to pharmacists in developing and implementing a new TOC clinic or improving an existing one.

Setting Outpatient TOC clinic within an ambulatory care practice.

Practice description Two general internal medicine practices collaborated with a university health system to create an interdisciplinary TOC clinic to improve quality and continuity of patient care. The clinic accommodates any patients of the practice who are not able to get an appointment with their primary care physician within 1 to 2 weeks of discharge from any hospital. Physician residents, an attending physician, a clinical pharmacist, a nurse, medical assistants, and a social worker (if necessary) are involved in the patient's care during the transition process.

Practice innovation Pharmacists can play a vital role in developing and implementing a TOC clinic or enhancing a current one. There are many logistical components to consider in developing a clinic, and this article provides guidance in the various steps required in creating a clinic, including support and coordination, personnel, workflow, operations, reimbursement, marketing, metrics, and measures.

Conclusion This tool may help pharmacists implement or enhance an outpatient TOC clinic to improve patient care, quality, and continuity.

(full text req. subscrip.)

Donnie Calhoun, RPh, PD, National Community Pharmacists Association Foundation vice president, discusses the integrated resource and support center and how it can help pharmacists with their contingency planning.

Ron Lanton with True North Political Solutions interviews Jennifer Mallon, VP & General Counsel of NCPA (National Community Pharmacists Association) on the Health Policy Check-up segment. Ms. Mallon gives great insight on the status of PBM (pharmacy benefit manager) litigation in IA and AR that affects pharmacy.  (podcast 19 min)

James Schiffer, RPh, associate at Allegaert Berger & Vogel LLC, talks about the 18 times he was burglarized over the course of his career.

As part of its advocacy and community outreach efforts during American Pharmacists Month, the American Pharmacists Association is partnering with the co-chairs of the House Community Pharmacy Caucus, the National Association of Chain Drug Stores, the National Community Pharmacists Association, the American Society of Health-System Pharmacists, and Walgreens to host the 3rd Annual Capitol Hill Health Fair on October 28. Flu shots and health screenings, including bone density, glucose, cholesterol, blood pressure, and body composition will be available to members of Congress, staff, and the general public in the Rayburn Foyer in the Rayburn House Office Building from 10:00 am to 2:00 pm.

Pharmacists from Walgreens and student pharmacists from:

• University of Maryland Eastern Shore School of Pharmacy
• University of Maryland School of Pharmacy
• Notre Dame of Maryland University School of Pharmacy
• Howard University College of Pharmacy
• Shenandoah University Bernard J. Dunn School of Pharmacy
• Virginia Commonwealth University School of Pharmacy

Next week, on October 27 and 28, the FDA Pharmacy Compounding Advisory Committee is reviewing ten (nine) active pharmaceutical ingredients to be included on the list of approved bulk drugs that traditional compounders can use in preparing prescriptions. As required within 503A, a bulk ingredient must have an applicable USP monograph, be a component of an FDA approved drug, or be added to an official list authorized by the Secretary of Health and Human Services. The ten (nine) drugs to be reviewed were nominated by stakeholders…in response to formal requests issued by the agency…FDA has released documents for the PCAC that show their recommendations on each of the nominated drugs. (each item, FDA does not recommend addition to the approved bulk ingredient list)

1. Methylsulfonylmethane
2. Curcumin
3. Germanium Sesquioxide
4. Rubidium Chloride
5. Deoxy-D-Glucose
6. Alanyl–L-Glutamine
7. Glycyrrhizin
8. Glutaraldehyde
9. Domperidone

In a setback to AbbVie, the Food and Drug Administration yesterday warned of liver damage from its two hepatitis C treatments, setting off a chain reaction that is reverberating across the pharmaceutical industry. With as many as seven patient deaths and several liver transplants attributed to the drugs, AbbVie stock plummeted and Wall Street fortune tellers went to work betting on winners and losers…FDA review found five cases that were probably related to the drugs, called Viekira Pak and Technivie…Another five were possibly related. Of the 10 patients, seven died and each seemed to have advanced liver disease or cirrhosis before using the drug. So the FDA is not willing to rule out the possibility that “some events might have occurred even if the patient hadn’t received treatment.”

You and your practice team could be spending several hundred hours on prescription renewals each year. What if you could get most of that time back while also ensuring your patients don’t run out of medications between appointments? Here’s a physician-proven solution that you can implement in your practice right away…Random prescription renewals have become so ingrained in office-based practices that you may not have even realized that it was an inefficient allocation of resources. But synchronizing prescription renewals—renewing all of a patient’s stable medications for 12-15 months—can save your practice time and money, so you can dedicate more time to directly caring for patients.

Follow these three steps to synchronize prescription renewals.

1. At a dedicated annual comprehensive care visit, renew all medications for chronic illness for the maximum duration allowed by state law.
2. Include instructions for the pharmacy on all prescription modifications and renewals as applicable.
3. Take the opportunity to review all of the patient’s prescriptions for chronic conditions when you receive a prescription renewal request.

A panel of medical experts said…the prices of prescription medicines in the United States need to be brought in line with the value they bring to patients instead of continuing to let drugmakers set any price they choose…Americans at the same time are getting tremendously ripped off with drugs and also getting tremendous value and we almost never know when we're getting ripped off and when we're getting real value and that has to change…not in favor of solutions that remove incentives for drugmakers to spend money needed to develop important new medicines.

Eli Lilly & Co., seeking to rebound from declining sales, reported third-quarter profit that topped analysts’ estimates and raised its forecast for the year as revenue from key drugs exceeded expectations…Adjusted earnings of 89 cents a share beat the average analyst estimate of 76 cents. Revenue rose 2 percent to $4.96 billion, compared with the $4.98 billion average projection of analysts. Lilly shares climbed 3.5 percent to $79.71 in early trading. (video, John Lechleiter, CEO)