Community Practice

The American Pharmacists Association Foundation is building on the successful Asheville Project model by challenging employers in 10 cities to improve care and rein in costs by teaming community pharmacists with diabetes patients.

There's some good news for pharmacists adrift in a sea of Medicare Part D confusion: They will be able to electronically determine whether a patient has prescription coverage, and they don't have to keep track of how much beneficiaries have spent out of pocket.

Shaking off the effects of Hurricane Katrina on its New Orleans facility, Xavier University of Louisiana's College of Pharmacy is working to reopen its doors in mid-January.

While American pharmacies are bracing for the onslaught of Medicare Part D, Canadian mail-order operators are worrying that their first and best customers may be lured away by the siren song of the new prescription drug benefit.

Pharmacists participating in the Community CareRx (CCRx) Medicare prescription drug plan will be paid not only for their clinical expertise but also for their financial advice that helps beneficiaries select the most economical medications that are right for them.

Patients with myelodysplastic syndrome (MDS) should be tested frequently for iron overload, a common, toxic side effect of repeated red blood cell transfusions. Patients with serum ferritin levels of 1,000 ng/ml to 2,000 ng/ml should be treated with iron chelation therapy, according to a new consensus statement, developed following a conference in Japan earlier this year. The new guidelines, published in a July 2005 supplement to Hematology-Oncology Clinics of North America, offer the first recommendations on the treatment of iron overload in these patients.

New study results published in the Lancet in September found that the use of drug-eluting stents (DESs) may be less cost-effective than bare-metal stents when used in all angioplasty patients. The results indicate that use of DESs should be limited to elderly patients in high-risk groups.

Patients with myelodysplastic syndrome (MDS) should be tested frequently for iron overload, a common, toxic side effect of repeated red blood cell transfusions. Patients with serum ferritin levels of 1,000 ng/ml to 2,000 ng/ml should be treated with iron chelation therapy, according to a new consensus statement, developed following a conference in Japan earlier this year. The new guidelines, published in a July 2005 supplement to Hematology-Oncology Clinics of North America, offer the first recommendations on the treatment of iron overload in these patients.

A recent study examining the relationship between diabetes, depression, and death demonstrates a need for diabetes patients and pharmacists to be familiar with the symptoms of depression. "We know that people with diabetes who have depression are at a much greater risk of mortality than similar people without diabetes," said Xuanping Zhang, Ph.D., a researcher with the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control & Prevention in Atlanta. "Pharmacists and physicians have a professional obligation to let patients suffering from diabetes and depression know of this risk. Absence of intervention can be life-threatening."

A 60-year-old African-American male, G.H., is admitted to your hospital with shortness of breath, peripheral edema, and 10-lb. weight gain, diagnosed as New York Heart Association Class III heart failure (HF).

Central among sessions at this year's European Society of Cardiology 2005 Annual Meeting, held in Stockholm, Sweden, were those focused on the pharmacological treatment of myocardial infarction (MI). Noteworthy among those were two meetings looking specifically at the risks of such therapy, one at timing, and a fourth at an attempt to combine therapies already proven to be successful separately.

The latest science on the diagnosis and treatment of osteoporosis was the focus of many reports from the annual meeting of the American Society for Bone & Mineral Research (ASBMR), held in Nashville late last month. Here are some of the highlights.

Stroke, which results from decreased blood flow to a portion of the brain, remains a leading cause of disability and mortality in America. According to the American Stroke Association, many patients do not recognize acute stroke symptoms and most institutions lack the necessary structure to promptly and efficiently manage stroke patients.

Even though the law was adopted two years ago, many pharmacists are just now waking up to the fact that there's a Medicare prescription drug benefit heading straight for their pharmacy counters, according to the president of the American Pharmacists Association.

The West Virginia Public Employees Insurance Agency (PEIA) is so impressed with its six-county pilot program to have pharmacists provide diabetes education that it's rolling the effort out statewide, said Betsy Elswick, Pharm.D., who trains pharmacists for the program.

The Food & Drug Administration has the legal power to inspect a compounding pharmacy's facilities, drug products, and labeling, according to a federal appeals court ruling that upheld a lower court decision.

Ten states have the lowest level of pharmacist shortage in this country. At the top of the heap is Hawaii, followed by Rhode Island, South Dakota, North Dakota, Delaware, Nebraska, New Jersey, Vermont, Idaho, and Montana. Most of these states, with the exception of New Jersey, have fairly small populations.

With only three months to D-Day, as in Medicare Part D, many unanswered questions about how the prescription drug program will be implemented and how it will impact pharmacy are causing a lot of unease, according to members of the Drug Topics Editorial Advisory Board.

Hospitals often take a financial beating when they do not get adequately reimbursed for certain high-priced, lifesaving drugs. But thanks to a new diagnostic code for stroke patients, which goes into effect on Oct. 1, 2005, reimbursement for critical clot-busting drugs (thrombolytics) will be more equitable.

A 35-year-old patient, C.A., with a mechanical heart valve, has had an INR of 2.5 to 3.5 for several years while on warfarin therapy. Today, at her visit to your anticoagulation clinic, she confides that she is six weeks' pregnant.

Heart failure (HF) is a major health problem and a leading cause of hospitalizations among the elderly. Keeping pace with the new treatment approaches, the American College of Cardiology (ACC) and the American Heart Association (AHA) task force recently released updated Guidelines for the Diagnosis and the Management of Chronic Heart Failure in the Adult.

Beginning Oct. 13, Medicare beneficiaries and pharmacists trying to help them can go to a Web site to compare the devilish details in the prescription drug plans that will be offered in their area.

Pharmacists and potential plan sponsors finally got the ground rules from Uncle Sam on how they can market prescription drug plans (PDPs) to Medicare beneficiaries, who can begin enrolling in Part D on Nov. 15.

When an Ohio pharmacist recently called Medco Health Solutions to sign up to provide medication therapy management (MTM) services to Medicare beneficiaries, the giant pharmacy benefit manager basically told him to get lost.

It's going to be up to 10 Connecticut pharmacists chosen for a pilot program to prove to legislators that collaborative practice agreements can deliver patient care in the community pharmacy.