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New research report highlights benefit of pharmacist medications reviews

BY Antoinette Alexander

TORONTO — Canada's Premiers gathered in Charlottetown for the latest Council of the Federation meeting starting on Aug. 26, and health reform is a key topic. The pharmacy community is urging provinces to consider further expanding pharmacists' role as they can make important contributions to improving patient outcomes, reducing costs and ensuring the sustainability of the health care system. 

According to a new report from Shoppers Drug Mart and CARP, the Sustainable Solutions Report: A Focus on Pharmacist Medication Reviews, one way to make real change now is for governments to support improved access to medication reviews.

These one-on-one medication reviews with a pharmacist can help individuals gain a better understanding of their medications and avoid potential health risks, Shoppers Drug Mart stated. These are particularly important since many aging adults are on multiple medications at once for various conditions — e.g., a new poll of CARP members found one-third are currently taking four to five medications.  Numerous medications can increase the risk of drug therapy problems like adverse drug reactions, negative drug interactions, improper dosing and medication adherence issues.

"This new report includes data demonstrating both the public and medical professionals see the value in pharmacists conducting medication reviews," stated Domenic Pilla, president, Shoppers Drug Mart.  "Most of our provincial governments have begun to recognize the benefits and have instituted funding for this important pharmacy service.  We now have the opportunity to make the eligibility requirements and funding for this service more consistent across the entire country to improve patient care and safety."

The pharmacy community is calling on provincial governments to take a comprehensive and universal approach to the provision of medication reviews.  Where medication reviews are funded, which is 8-out-of-10 provinces, there are significant inconsistencies in the eligibility requirements necessary to have the consultation covered.  And, many individuals may not take advantage of medication reviews because of a low awareness of their availability.

Why are Medication Reviews Important? These reviews provide the opportunity to identify and prevent drug therapy problems, including ADRs and medication non-adherence issues.  A recent survey of Canadian family physicians found more than three quarters of them (79%) believe expanding the role of pharmacists (including offering services like medication reviews) will have an impact on reducing the incidence of ADRs.  This is significant since cases of drug therapy problems are likely to increase as our population ages and more are faced with managing multiple chronic illnesses with numerous therapies.  Today, approximately 5% of all emergency room visits and 6% of all hospital stays are the result of ADRs.  And, medication non-adherence results in an annual cost of Canadian $7 billion to $9 billion to the health care system, and 125,000 unnecessary deaths per year, Shoppers Drug Mart stated.

Where medication reviews are funded, steps need to be taken to establish comprehensive and consistent eligibility criteria since they currently vary greatly by region, the company stated.  For example, Alberta has one of the most comprehensive medication reviews programs — patients must have at least one chronic medical condition from a pre-defined list and be taking three or more prescription medications.  In contrast, British Columbia patients need to be taking five different qualifying medications, but may have two reviews per year.  Seniors from New Brunswick and PEI taking three or more prescription medications for chronic conditions are eligible for one medication review per year whereas, seniors from Saskatchewan must be taking five or more chronic disease medications to be eligible.  The Ontario program is available to any Ontarian taking three or more prescription medications for chronic conditions, and it also offers different assessments based on patient needs (e.g., at-home consultation, diabetes patients, etc.).

And finally, where medication reviews are available, there needs to be a greater emphasis on promoting the service.  Getting the word out will require a joint effort between government, pharmacists and other health care professionals who can refer the service, according to Shoppers Drug Mart.  A new survey of individuals from British Columbia, Alberta and Ontario who recently completed a medication review found the majority (84%) said they heard about the medication review from their pharmacist.

The good news, noted Shoppers Drug Mart, is the same survey found people had an extremely positive experience and would recommend it to others.  One-in-two surveyed strongly agreed medication reviews are beneficial and the majority (85%) were likely to make medication reviews a regular part of managing their medications and their health.  A further 79% said they would recommend medication reviews to others they know who also take prescription medications.
 

 

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Greenway Health completes Walgreens Cloud EHR

BY Michael Johnsen

CARROLLTON, Ga. — Greenway Health on Wednesday announced the completion of one of the largest centralized pharmacy cloud-based electronic health-record systems ever deployed, Walgreens Cloud EHR. Walgreens has completed its chain-wide rollout of the Greenway Health-powered EHR solution, giving pharmacy staff at all of its more than 8,200 locations a single, complete view of patients’ prescription, immunization and health testing records.
 
The EHR platform further enables Walgreens pharmacists to identify opportunities to close gaps in care and to share patient information with other providers, helping to ensure continuity and care coordination.
 
“Having a chain-wide EHR platform enhances our pharmacists’ ability to provide individualized immunization and health testing recommendations, which is key to closing gaps in patient care that exist today,” stated Tim Theriault, SVP, chief information, innovation and improvement officer, Walgreens. 
 
Walgreens Cloud EHR operates in real-time mode and is fully interoperable with various systems within Walgreens’ operational IT infrastructure. The interoperable functionality and scale of the system supports an emerging trend in healthcare to leverage real-time electronic communication to deliver high-quality care.
 
“Consumers are demanding access to healthcare information, and Walgreens Cloud EHR delivers,” commented Greenway CEO Tee Green. “We’re proud to work with Walgreens to deliver a single system that extends to more than 27,000 pharmacists and can process 20,000 patient encounters per hour. This implementation points the way to electronic care coordination of the future.”
 
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Study: Low-dose aspirin lowers the occurrence of new venous blood clots

BY Michael Johnsen

SYDNEY — Low-dose aspirin lowers the occurrence of new venous blood clots — and represents a reasonable treatment option for patients who are not candidates for long-term anticoagulant drugs, such as warfarin, according to a new study published in Monday's issue of Circulation.
 
"The study provides clear, consistent evidence that low-dose aspirin can help to prevent new venous blood clots and other cardiovascular events among people who are at risk because they have already suffered a blood clot," stated the study's lead author, University of Sydney professor John Simes. "The treatment effect of aspirin is less than can be achieved with warfarin or other new generation direct thrombin inhibitors, which can achieve more than an 80% reduction in adverse circulatory and cardiopulmonary events," he said. "However, aspirin represents a useful treatment option for patients who are not candidates for anticoagulant drugs because of the expense or the increased risk of bleeding associated with anticoagulants."
 
Compared to placebo patients, those who took 100 mg daily of aspirin had a one-third reduction in the risk of:
 
  • Thromboembolism, which is the obstruction of a blood vessel by a clot that has dislodged from another site in the circulation;
  • Deep vein thrombosis, which is the formation of a blood clot in a deep vein, predominantly in the legs;
  • Pulmonary embolism, which is a blood clot affecting the arteries that supply blood to the lungs; and
  • Myocardial infarction (heart attack), stroke or cardiovascular death.
 
Most people who have had a blood clot in a leg vein (i.e., deep-vein thrombosis) or an embolism (i.e., where the clot blocks the blood flow) have anticoagulant drug treatment (e.g., warfarin) for at least six months, first to dissolve the clot and then to prevent it happening again.
 
However, long-term anticoagulant drugs are expensive and inconvenient, requiring frequent regular blood tests and adjustments to the dosage. Further, there is an elevated risk that the treatment could cause bleeding in some patients. For people who are not able to cope with this, the viable alternative of taking regular aspirin will be a great benefit, Simes noted.
 
"The study provides evidence that after a first venous thrombosis or embolism, daily aspirin reduces the risk of another event, without causing undue bleeding. This treatment is an alternative to long-term anticoagulation and will be especially useful for patients who do not want the inconvenience of close medical monitoring or the risk of bleeding," Simes said. "Aspirin will be ideal in the many countries where prolonged anticoagulant treatment is too expensive. A major benefit of this treatment is its cost-effectiveness. Aspirin is cheap, but it will save the treatment costs of the many recurrent clots that are prevented. This could mean a saving of millions of healthcare dollars worldwide."
 
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