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4. Veteran Adherence to Oral Versus Injectable Alcohol Use Disorder Medication Treatment

Author

Dorflinger, Charles, Carey, Heather, Roche, Jennifer, Burant, Christopher, LeHew, Colleen, Stewart, Hayden, Mitchell, Brian, Ayanga, Daniel, Walder, Annette, Cooler, Jordan, Wu, Shuwen, Frey, Theresa, Wenthur, Cody, Burk, Bradley, Ward, Alex, Clark, Brooke, Leung, Jonathan G, Kutzke, Jade, May, Heather P, Maehler, Colin, Kummer, Bethany, Hamner, Jennifer, Ariefdjohan, Merlin, Stutzman, Danielle L, Kicklighter, Jackson, Musco, Shaina, Singson, Grace Marielle, Pamintuan, Claire, Francisco, Janelle, Phan, Tam, Sevak, Rajkumar J, Rogan, Edward L, Kehoe, William A, Halliwell, Robert F, Kanter, Joel, Ryan, Holly, Patel, Krupa, Moukaddam, Nidal, Saunders, John, Fernandez, Luis, Shah, Asim, Wong, Jerry, Erowele, Goldina, Ruppelt, Sara, Tillery, Erika E, Baker, Joni, Loflin, Bobbi Jo, Gray, Emily, Conley, Giulia, Hembree, Amanda, Sterling, Jacyntha, Buige, Ashley N, Nguyen, Mimi, Harris, Suzanne C, Bhavsar, Nisha, Shah, Niti, Lee, Bona, Jeong, Seoyoung, Maroney, Megan E, Whalen, Eric D, Maloney, Rebecca M, Hagemeier, Nicholas E, Takamura, Kay, Rice, Amanda G, Furbish, Amelia B, Hebbard, Amy M, Ross, Clint, Cumbie, Holly, Hickey, J. Scott, Lalani, Falak, Mucha, Hannah, Saklad, Stephen R, Ma, Connie, Lee, Kelly, O’Donnell, Carolyn, Jackson, Sarah, Albee, Jennifer Nelson, Yapel, Ann, Nash, Cynthia, MacDonald, Danielle, King, Amelia, Schneiderhan, Mark, Hager, Keri, Bell Lynum, Karimah S, Nash, Abigail, Fu, Dong Jing, Ionescu, Dawn F, Sliwa, Jennifer Kern, Turkoz, Ibrahim, Dorson, Peter G, Canuso, Carla, Hsia, Stephanie, Nguyen, Julie, La, Amenda, Gruenberg, Katherine, MacDougall, Conan, Brockbank, Josh, Wong, Kara, Schultz, Erica, Pinchinat, Jessica, Thibeaux, Taylor M, McCants, Tamara, Lam, Jason, Diaz-Luna, Jose, Nguyen, Jennifer, Yokoyama, Melissa, Albiar, Olivia, Bradley, Bridget, Popish, Sarah J, Bounthavong, Mark, Lau, Marcos K, Wells, Daina L, Kay, Chad L, Harvey, Michael A, Himstreet, Julianne E, Christopher, Melissa L.D, Weeda, Erin R, McGraw, Daniel J, Gonzalez, Misty L, Pardo-Pfeiffer, Carlos, Rodeghiero, Abigail, Zhang, Lusi, Brown, Sarah Jane, Shan, Yuting, Lee, Adam M, Allen, Josiah D, Eum, Seenae, Bishop, Jeffrey R, Gonzalez, Rolando, Wahl, Kimberly, Naglich, Andrew, Ayson, Marl, Thomas, Kelan, Renfro, Mandy L, Loera, Lindsey J, Hill, Lucas G, Tirado, Carlos, Delerme, Dante, Dean, Taylor, Cullen, Marissa, Straley, Craig M, Carr, Chelsea N, Sun, Wendy, Alzouby, Hiba, Harris, Suzanne, Banker, Christopher M, Cook, Sarah F, Muir, Justin, Brodie, Daniel, Cremers, Serge, Bies, Robert R, Dzierba, Amy L, Moton, Robert, Saklad, Stephen, Ferris, Ryan E, Noble, Brie N, Hartung, Daniel M, Tjia, Jennifer, Furuno, Jon P, Ibrahim, Hajer, Duong, Dat, Malcolm, Benjamin, Gogineni, Hyma P, Zahn, Amy L, Alibeckoff, Chloe C, Connor, Sharon, Buranosky, Raquel, Livezey, Sabrina N, Daniell, Jessica, DeClercq, Josh, Choi, Leena, Zuckerman, Autumn, Shah, Nisha B, Kang, Ashley, Anksorus, Heidi, Troglin, Courtney G, Bouldin, J. Brooke, Schreiner, Shannon, McKinney, Mariah, Brown, Stacy D, Pond, Brooks B, Nguyen, Thu, Chin, Hyun Ji, Dambly, Nicolle, Augsten, Alberto, Themas, Samantha, Vicencio, Claudia, Horner, Caroline, Covert, Kelly, Lewis, Paul, Tharp, Jen, Sommi, Roger W, Bidollari, Ilda, Still, Daniel, Du, Yangchun, Yagoda, Sergey, Weiden, Peter J, Long, Katelyn, Vandiver, Emily, Johnson, Stephanie, Darazs, Brooks, Tillery, Erika, Silvia, Richard J, Lee, Kelly C, Bien, Ivy, Farahmand, Khodayar, Goldsmith, Hannah, Farrar, Mallory, Le, Hadley, Huynh, Quynh, Kim, Jane, McCausland, Kristen, Haider, Batool, White, Michelle K, O’Sullivan, Amy K, Rychlec, Kaitlin, Akerman, Sarah, Fratantonio, James, Saxon, Andrew, Thase, Michael E, Parikh, Sagar V, Maheshwari, Priya, Rothschild, Anthony J, Dunlop, Boadie W, DeBattista, Charles, Conway, Charles R, Forester, Brent P, Shelton, Richard C, Macaluso, Matthew, Brown, Krystal, Li, James, Jablonski, Michael R, Greden, John F, Gidal, Barry, Patsalos, Philip, Szaflarski, Jerzy, VanLandingham, Kevan, Critchley, David, Morrison, Gilmour, Weiss, Catherine, Meehan, Stine Rasmussen, Ouyang, John, Hobart, Mary, Rowe, William, Vanover, Kimberly E, Kane, John M, Satlin, Andrew, Durgam, Suresh, Davis, Robert E, Mates, Sharon, Correll, Christoph U, Tamminga, Carol, Rabon, Hannah, Smith, Jordan, Squires, Karrie, VanDaele, Madeline, Logan, Linda D, Zhang, Feng, DeSousa, Norberto J, Sallee, F. Randy, Lickrish, David, Incledon, Bev, Smith, Joseph L, Candon, Molly, Fadeyibi, Oluwatoyin, Connolly, K. Ryan, Lim, Suet, Neimark, Geoffrey, Mandell, David, Newcomer, John W, Silverman, Bernard, DiPetrillo, Lauren, Graham, Christine, Jiang, Ying, Simmons, Adam, Hopkinson, Craig, McDonnell, David, Kahn, Rene, King, Thomas R, Kando, Judith C, Pardo, Antonio, King, Thomas, Edwards, John B, Chen, Richard, Huo, Jason, Cutler, Andrew J, Fawver, Jay, Flanagan, Mindy, Smith, Thomas, Drouin, Michelle, Mirro, Michael, Yatham, Lakshmi N, Vieta, Eduard, McIntyre, Roger S, Jain, Rakesh, Earley, Willie R, Patel, Mehul, Brown, Lisa, Sehgal, Rahul, Yu, Ken, Al Habbab, Talal, Johnson, Holly, Dechairo, Bryan, Chen, Jack J, Singer, Carlos, Marder, Stephen R, Comella, Cynthia L, Shah, Chirag, Jimenez, Roland, Goodwin, Heather, Morrow, Gina, Tewksbury, Ashley, Waters, Kristin, Eggert, Robyn, Tallian, Kimberly, Sepulveda, Joe A, Rojas, Sarah, Sikand, Harminder, Sutera, Nathan, Iuppa, Courtney A, Nelson, Leigh Anne, Kriz, Carrie R, Burns, Nicole A, Lang, Shelby E, Elliott, Ellie S.R, Luong, Uyen, Elsobky, Teresa, Abelleira, Audrey, Awan, Sundus, Dume, Roberta, Dilich, Adam, Anderson, Mikaela, Park, Priscilla, Moehnke, Austin, Aebi, Cydreese, Feighner, Lydia, Vernon, Martein, Streit, Jessica, Kauer, Jill, Lemons, Amber, Diefenderfer, Lauren A, Moon, Joseph, Smith, Jordan O, Franck, Hugh A, Randle, C. Hope, Hedgepeth Kennedy, M. Lindsey, James, Shannon, Coplan, Benjamin, Ruekert, Laura, Puri, Shilpa, Yeleti, Ramya, Cathright, Sela, Coveart, Stephanie, Regen, Sloan, Stewart, Shannon, Stratton, Miranda, Haight, Robert, Hoeft, Dawn, Bishop, Danielle, De La Cruz, Austin, Aurelio, Mariellee, Prestenback, Autumn, Price, Paul L, Makuch, Christian X, Salisbury, Nicole M, Koch, Jessa, Palmer, Melissa C, Chace, Ashley, Price, Cristofer, Putney, Jessica, Khan, Fatima, Huntsman, Amanda, Hutcheson, Brooklyn, Hightower, Sharae, Ott, Carol A, Scott, Catherine, Balser, Amanda, Karas, Andrew, Hsu, Michael, Malin, Maureen, Robert, Sophie, Leung, Edwina, Mierzwa, Mark, Kay, Lehua, Bowling, Dalia, Allen, Sabrina, Weingartner, Melissa, Ventricelli, Daniel, Santa, Heather, Nowalk, Alexandra, Downs, George, Le, N, Mospan, C, Burton, Caitlin, Mathys, Monica, Gutierrez, Erika, Ali, Sarah, Chang, Joni, Holzum, Dorothy N, Griffith, June A, Morgan, Katherine T, Laguado, S. Andrea, Steavenson, Rosana, Mehvar, Mina, Bechtold, Carson L, Kim, Heesoo, Dopheide, Julie Ann, Anderson, Lindsey, Kleyn, Thomas, DiRenzo, Baely, Walroth, Todd, Adamczyk, Raechel, Kendrick, Jenna, Thomas, Christopher, Mailloux, Lindsay M, Haas, Matthew T, Larew, Janel M, Stohs, Matthew E, DeJongh, Beth M, Satow, Britney A, Titus-Lay, Erika, Clark, Suzanne, Dike, Dozie, Pinsonnault, John, Gamber, Joy, Roseberry, Samantha, Mitchell, Brian G, Nguyen, Mai, Willborn, Robert, Roche-Desilets, Jennifer, Dailey, Alison, Ignatowski, Michael, Routhieaux, Melanie, Kawsky, Jaclyn, Stratman, Jennifer, Corboy, Alexander, Norberte, Cherisse, Gross, Tonya, Daniel, Jeremy, Tran, Aaron N, Wary, Megan, Kostric, Anna, Schaller, Samantha, Shin, Yunjung, Maroney, Megan, Hampton, Chanese, Krieger, Kelly, Hartwig, Rachel, Thamawatanakul, Rani, Wilbur, Eileen, Shofner, Steven, Butler, Justin, Moody, Breanna, Davis, Elizabeth, Hofammann, Elizabeth, Liveoak, Katie, Mitchell, McKinley, Lebrecht, Morgan, Hawley, Joanne, Smigiel, Joe, Radtke, Michelle, Walkerly, Autumn, King, Morgan, Wakefield, Andrew, Downs, Mona, Hudson, Nancy, Burghart, Steven, Reynoldson, Jill, Booth, Macey, Ishino, Risa, Lee, Tammie, Wright, Melissa, Boggs, Angela, Kaur, Rajandeep, Patel, Parth, Smith, Thomas R, Theriault, Sarah, Okusaga, Olaoluwa, Reinstatler, Kristina, Hawk, David, Rush, Stephen, Vachuska, Michaela, Powell, Elizabeth, Lacro, Jonathan, Chehovich, Charisse, Demler, Tammie Lee, deRosas, Andrea, Trigoboff, Eileen, Taylor, Aminah, Singh, Divita, Burdge, Gary, Reynolds, Jamie, Kriz, Carrie, Burns, Nicole, Sommi, Roger, Yabs, Melanie, Sarpal, Deepak, Fabian, Tanya, Bartos, Lindsey, Tallman, Kristin, Johnson, Dara, Taylor, Daniel, Hogan, Brendon, Kwan, Peter, Bast, Aubree, Sanchez, Apolinar, Maglalang, Patricia D, Scheible, Mahli M, Skurat, McKenzie K, Jackson, Sarah K, Belknap, Jazmin N, Ostfeld, Larissa, Fahy, Megan, Nguyen, Tuyen, Bui, Hoa, Little, Meg M, Seifert, Randall, Maister, Ashley, McCarthy, Caitlin, Burger, Emily, Mullen, Sandy, Cusimano, Joseph, VandenBerg, Amy, Duquette, Meghan, Guttenberg, Viktoria, Matsunaga, Candace, White, Shelby, Richard, Andrea, Jones, Jessica, Morgan, Kaitlyn, Kelsey, Taylor, Sartin, Carrie J, Rickert, Leah, Ferrill, Laine, Vallabh, Anuja, Jhawar, Archana, Barrett, Monica, Ward, Sarah, Colvard, Michelle, Phan, Joann, Preinitz, Jennifer, Ellis, Marcus, Gibu, Matthew, Kivlehan, Audrey, Chiulli, Dana, Rhodes, Kirby, Brewer, T. Amber, Richard, Michelle, Kirwan, Brigit, Flowers, Gary, Albritton, Melinda, Sutton, Caroline M, McEachern, Sydney, Miskle, Benjamin, Barr, Rachel, Thomas, Chris, Yang, Waverly, Vogt, Caitlin, Charles, Amanda, Mathews, Alisha, Bhandari, Deepali, Olsen, Emily, Garling, Ashley, Liszka, Jessica, Goodman, Courtney S, Smith, Tammy, Barron, Ana, Williams, Andrew, Zuloaga, Andrea, Parra, Brianne, Miller, Joy, Blake, Jennifer, Toney, Gregory, Galeano, Kathleen, Morabito, Brianna, Smith, Sydney, Miller, Lindsey, Fleisch, Sheryl, Kim, Erika, Kurz, Troy, Peterson, Angela M, Gruca, Justin, McGuire, Michael, Stummer, Lauren, Yip, Agustin, Rodriguez-Villa, Fernando, Wilson, Jennifer, Sutton, Caroline, Owings, R. Laney, Herbst, Claire, Hosmer, Kane, Wulff-Burchfield, Elizabeth, Ramion, Shelby, Brown, Lauren, Shishko, Ilona, Allen, Sarah, Nichols, Taylor, Fawcett, Janet, Trent, Kelley N, Eatmon, Courtney V, Hershberger, Allie, Roads, Mary, Pittenger, Amy L, Dadebo, Victoria, Tomko, John R, Simeone, Danielle, Sherwood, Devon A, Morgan, Katherine, White, C. Whitney, Holzum, Dorothy, Adetunji, Oluwaseyi, Blalock, Meredith, Snyder, Sabrina Domicoli, Kneebusch, Jamie, Mitchell, Melissa, Butala, Niyati, McHugh, Trisha, McGuire, J Michael, Moller, Karen, Melton, Brittany, Mitchell, Melissa M, Chaplin, Kyrsten, Canto, Samantha, Hang Vu, Thi Thuy, Rey, Jose A, Elmaoued, Amre Adel, Hopper, Jessica, Do, Annette, Leckband, Susan G, Abraham, Dana L, Haught, Emma J, Kobulinsky, Lawrence R, Fabian, Tanya J, Greenwood, Jessica, Rey, Jose, Chen, Emily, Farhadian, Sanaz, Smith, Austin M, Hopkins, Tiffany M, Deardorff, O. Greg, Jenne, Victoria, Wood, Joshua, Trout, Megan, Beck, Niels C, Pals, Hale, Frazier, Erica, Cavaliere, Vincent S, DiPaula, Bethany A, Glassman, Matthew, Wehring, Heidi J, Mackowick, Marie, Park, Jaeboon, Love, Raymond C, Kelly, Deanna L, Newbold, Mervan, Fioravanti, Nicole, Brown, Matthew J, Casey, Emily R, Nadkarni, Neha, Oh, Sarah, Patel, Romi, Riedley, Taylor, Mathis, Erin, Fadden, Patrick, Madden, Cristina, Schneiderhan, Mark E, Hintsala, Madelynn, Stenehjem, David, Rufus, Krystal M, Elhakim, Athar, Zolezzi, Monica, Elamin, Waad M, Homs, Shorouk, Qubaiah, Iman K, Mahmoud, Doaa A, Tawfik, Enge M, Fritz, Merideth, Alman, Brianne, Wartman, Carolanne, Clark, Megan, Ott, Carol, Rainey, Carly A, Mann, Elise, Modany, Madison, Schoettmer, Amanda, Buckley, Tiffany, Patwardhan, Vidisha, Boyle, Cynthia J, Gardner, Kristen N, Hamby, Kerri, Ngo, Nichol, Kim, Lila Q, Chen, Steven W, Mosley, Scott, Dadiomov, David, Goldstone, Lisa W, DellaVecchia, Matthew J, Cauffield, Jacintha, Grim, Hannah, Eschler, Anna, Aladeen, Traci, Blondell, Richard, Capote, Horacio, Rainka, Michelle, Lee, Ashley, Shelley, Maria, Stoncius, Kristina, Berry, Jonathan, Doroudgar, Shadi, Johnson, Kayla, Pouliot, Jonathon, Rarrick, Christine, Hebbard, Amy, Shikwana, Sara, Koller, Katherine, Reed, Ellen, Hoefling, Austin D, Miles, Talia M, Ansara, Elayne D, Titova, Viktoriya, Kandela, Dalea, Douglass, Amber R, Ehrhard, Kimberly, Stanley, Madison, Ganihong, Carissa, Liu, Mei T, Bohnenberger, Kristin, Zuber, Nicole, Plunkett, McKenzie, Axelrod, Chelsey, Lightfoot, Myaa, Moore, Miranda, Crouse, Ericka, Olazo, Muriel, Taormina, Stephanie, Reiss, Rebecca, Denno, Nora, Johnson, Braniesha, Wilkening, Gwendolyn Lucy, Andrews, Haley, Neumeister, Kristen, Murad, Muhammad Ubaidullah, Reid, Bailey, Franco, Ashley, Stutzman, Danielle, Jorgensen, Jennifer, Basit, Saadia, Jensen, Aimee, Nadal, Celeste N, Truong, Quynh-Nhu, Jameson, Melanie, Knox, Erin D, Bota, Robert G, Wieruszewski, Patrick M, and Leung, Sarah B

Subjects
CPNP Foundation Strategic Goals Award Finalists, Therapeutic Case Report Abstracts, Original Research Abstracts, Therapeutic Case Report Award Finalists, Article, Encore Presentation Abstracts, Work in Progress Abstracts, Neuropsychology and Physiological Psychology, Original Research Award Finalists, Research Trainee Award Finalists, Pharmacology (medical), Neurology (clinical), General Pharmacology, Toxicology and Pharmaceutics, Innovative Practices Abstracts, Innovative Practices Award Finalists, Scientific Posters
Published
2020

5. Pharmacoeconomic, Medication Access, and Patient-Satisfaction Analysis of a Pharmacist-Managed VTE Clinic Compared to Primary Care Physician Outpatient Therapy.

Author

Howell, Chandler Wayne, Walroth, Todd A., Beam, Daren M., Geik, Christopher A., Howell, Molly M., Macik, Monica R., Schmelz, Andrew N., and DiRenzo, Baely M.

Subjects
OCCUPATIONAL roles, HEALTH services accessibility, VEINS, CONFIDENCE intervals, ORAL drug administration, MEDICAL care costs, PATIENT satisfaction, ANTICOAGULANTS, RETROSPECTIVE studies, COMPARATIVE studies, THROMBOEMBOLISM, DESCRIPTIVE statistics, OUTPATIENT services in hospitals, PATIENT safety
Abstract

Venous thromboembolism (VTE) is a common medical condition often treated with direct oral anticoagulants (DOACs). Current literature supports outpatient treatment of select, low-risk VTE patients by a pharmacist with DOACs; however, no studies exist to demonstrate if a pharmacist-managed VTE clinic provides financial benefit compared to physician-managed outpatient care. To compare the financial implications and patient satisfaction of pharmacist-managed VTE care versus outpatient VTE care by a primary care physician. A single-center retrospective chart review was conducted on all patients seen at a pharmacist-managed VTE clinic for safety and reimbursement outcomes between August 1, 2018 and July 31, 2019. These data points were used to assess the primary endpoint of net gain per patient visit and secondary outcomes, including patient satisfaction score. The primary outcome median (IQR) for net gain per visit was $16.57 (16.57, 16.57) for the pharmacist-managed group and $64.37 (47.04, 64.37) in the physician-managed group with a 95% CI of 39.13-47.80. The median cost to the organization per visit was $4.96 (4.96, 4.96) for the pharmacist-managed group and $39.41 (23.65, 39.41) for the physician managed group with a 95% CI of 26.57-34.45. Statistical difference was also found for a secondary outcome of percentage of days covered for the pharmacist-managed group compared to the physician managed group, median (IQR) 100% (76,100) vs 92.2% (67.2, 98.9) respectfully, with a p-value of 0.043. The pharmacist-managed VTE clinic, although financially sustainable, provides significantly less net revenue per patient than physician managed clinics, demonstrating the need for increased payer recognition for pharmacists. [ABSTRACT FROM AUTHOR]

Published
2022
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8. Implementation and Preliminary Clinical Outcomes of a Pharmacist‐managed Venous Thromboembolism Clinic for Patients Treated With Rivaroxaban Post Emergency Department Discharge.

Author

DiRenzo, Baely M., Beam, Daren M., Kline, Jeffrey A., Deodhar, Karishma S., Weber, Zachary A., Davis, Christie M., and Walroth, Todd A.

Subjects
HEMORRHAGE diagnosis, DRUGS, HEMORRHAGE, HOSPITAL care, HOSPITAL pharmacies, HOSPITAL emergency services, ORAL drug administration, PATIENT compliance, PHARMACISTS, GENERAL practitioners, THROMBOEMBOLISM, VEINS, VITAMIN K, DISEASE relapse, DISCHARGE planning, TREATMENT effectiveness, RIVAROXABAN, CHEMICAL inhibitors, DIAGNOSIS
Abstract

Abstract: Objective: The objective was to describe the implementation, work flow, and differences in outcomes between a pharmacist‐managed clinic for the outpatient treatment of venous thromboembolism (VTE) using a non‐vitamin K oral anticoagulant versus care by a primary care provider (PCP). Methods: Patients in the studied health system that are diagnosed with low‐risk VTE in the emergency department are often discharged without hospital admission. These patients are treated with a non‐vitamin K oral anticoagulant and follow‐up either in a pharmacist‐managed VTE clinic or with their PCP. Pharmacists in the VTE clinic work independently under a collaborative practice agreement (CPA). An evaluation of 34 patients, 17 in each treatment arm, was conducted to compare the differences in treatment‐related outcomes of rivaroxaban when managed by a pharmacist versus a PCP. Results: The primary endpoint was a 6‐month composite of anticoagulation treatment‐related complications that included a diagnosis of major bleeding, recurrent thromboembolism, or fatality due to either major bleeding or recurrent thromboembolism. Secondary endpoints included number of hospitalizations, adverse events, and medication adherence. There was no difference in the primary endpoint between groups with one occurrence of the composite endpoint in each treatment arm (p = 1.000), both of which were recurrent thromboembolic events. Medication adherence assessment was formally performed in eight patients in the pharmacist group versus no patients in the control group. No differences were seen among other secondary endpoints. Conclusions: The pharmacist‐managed clinic is a novel expansion of clinical pharmacy services that treats patients with low‐risk VTEs with rivaroxaban in the outpatient setting. The evaluation of outcomes provides support that pharmacist‐managed care utilizing standardized protocols under a CPA may be as safe as care by a PCP. [ABSTRACT FROM AUTHOR]

Published
2018
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