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Objectives: The primary objective of this project was to determine the difference in medication list accuracy between an initial and follow-up medication reconciliation visit in a primary care office. Secondary objectives were to identify the difference in medication-related problems most commonly encountered during the visits, factors that may influence patient understanding of their medication regimen, and physician perceptions of the medication review visit., Setting: Quasi-experimental study part of a larger pilot project to address the ability of how health information technology can be used to maintain an active medication list., Practice Description: Three family medicine residency clinics in the Midwest. Adult patients with diabetes or chronic obstructive pulmonary disease who had 6 or more long-term medications listed in the electronic health record (EHR) were recruited to participate., Practice Innovation: An initial comprehensive medication reconciliation visit was conducted by a resident physician and a pharmacist with the goal of ensuring an accurate, easy-to-follow, electronically developed medication list. A follow-up visit with the pharmacist occurred 3-6 months after the initial visit., Evaluation: Medication list accuracy and medication-related problems were assessed at the initial and follow-up visits. Patient-related factors that could affect medication understanding were collected at the initial visit with status of enrollment in the EHR patient portal., Results: Fifty-seven of 65 patients completed the study. The number of patients with an accurate medication list increased from 40% to 49% (P = 0.38). The number of medication-related problems decreased from 146 to 91 (P < 0.001). The use of special tools (e.g., pillboxes) was associated with fewer medication regimen errors (P = 0.036). Patients enrolled in the EHR patient portal were more likely to know the purpose of their medications as compared with those not enrolled (P = 0.019)., Conclusion: An intentionally scheduled medication review with a primary care provider and pharmacist did not significantly improve the accuracy of the medication list, but it was associated with fewer drug-related problems., (Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: As pharmacists assume a larger role in prenatal and preconception care, providing an evidence-based recommendation for a prenatal vitamin is essential.Objectives: To identify the prenatal vitamins that community pharmacists are recommending to patients and compare the contents with national and international standards. The secondary objectives were to compare responses between the type of pharmacy (chain, grocery, or independent) and region of Michigan.Methods: A female student pharmacist posing as a patient anonymously interviewed 60 community pharmacists distributed across 5 different regions of Michigan through telephone to determine prenatal vitamin recommendations for preconception use. The regions of Michigan were included to determine if sociodemographic factors were associated with varying responses or recommendations.Results: Of the pharmacists interviewed, 97% recommended a prenatal vitamin, with 81% recommending an over-the-counter (OTC) prenatal vitamin. Only 33% of the pharmacists provided a specific brand name. Folic acid was the most common ingredient that the pharmacists identified to look for in a prenatal vitamin, followed by docosahexaenoic acid and iron. No difference was detected in the pharmacist responses across type of pharmacy (chain, grocery store chain, or independent). A difference was found between regions of Michigan and recommendations for a specific prenatal vitamin brand (P = 0.017).Conclusion: Most of the community pharmacists recommended an OTC prenatal vitamin with an adequate amount of folic acid. Considering the broad range of prenatal vitamins on the market, a clear recommendation from a pharmacist about a specific prenatal vitamin that contains adequate nutrients is paramount. Expanding the knowledge and understanding of key prenatal vitamin ingredients and availability may strengthen future recommendations. [ABSTRACT FROM AUTHOR]

The opioid crisis represents one of the largest failures of our current health care system as it continues to claim lives at an unprecedented rate and has caused a devastating range of preventable morbidity. Although the availability of highly potent synthetic opioids has amplified the urgency of the crisis for patients and communities, this problem has evolved over several decades. Pharmacists are in a position to offer many potential solutions due to their widespread accessibility, extensive drug knowledge, and integration into various health care settings. This opinion paper challenges the status quo by calling on all pharmacists to embrace evidence‐based opioid stewardship and harm reduction practices, contribute to the medical management of opioid use disorder, and address the misconceptions and prejudices that serve as barriers to effective, compassionate patient care. Regardless of practice setting or available resources, pharmacists can take deliberate and impactful steps to address the opioid crisis. Some pharmacists may be positioned to implement innovative and far‐reaching pharmacist‐led clinical services, while others may simply begin with careful consideration of the language they use when speaking to and about patients with substance use disorders. To optimize patient outcomes, the ineffective laws, regulations, and policies that negatively impact pain and addiction care must be addressed so that evidence‐based solutions can be widely disseminated. Pharmacists must aggressively advocate for the removal of barriers preventing high‐level clinical practice or policies that perpetuate patient harm and abandonment. Finally, there must be support for continued research on pain and opioid use disorder treatments and services, as well as the impacts of harm reduction practices and pharmacist‐led clinical services, so that resources can be allocated effectively. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the Michigan Society of Health-System Pharmacists (MSHP) Ambulatory Care Summit held in September 2014. The conference was keynoted by Mary Ann Kliethermes after which the participants discussed current ambulatory practices in Michigan and identified perceived gaps in the practice. The MSHP also created a pharmacy practice committee to make recommendations from the findings in the summit.