YAKHAK HOEJI (약학회지)

The Pharmaceutical Society of Korea (대한약학회)
권호 표지

A Systematic Review on the Certified Geriatric Pharmacist Program of the U.S.: Certification, Education and Outcomes

미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과

  • Nam, Hye Yeon (College of Pharmacy, Sookmyung Women's University) ;
  • Cho, Eun (College of Pharmacy, Sookmyung Women's University)
  • 남혜연 (숙명여자대학교 약학대학) ;
  • 조은 (숙명여자대학교 약학대학)
  • Received : 2014.02.24
  • Accepted : 2014.03.17
  • Published : 2014.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

Keywords

References

  1. Statistics Korea : Projected population by age (Korea) (2011).
  2. Yong, C. S., Kim, J. A., Choi, H. G. and Yoo, B. K. : Patient counseling of pharmacists to elderly patients. The Korean Journal of Clinical Pharmacy 14, 100 (2004).
  3. Health Insurance Review & Assessment Service: Statistical Indicators of Medical Benefit Expenses 2012 (2012).
  4. Odegard, P. S., Breslow, R. M., Koronkowski, M. J., Williams, B. R. and Hudgins, G. A. : Geriatric pharmacy education: a strategic plan for the future. Am. J. Pharm. Educ. 71, 47 (2007). https://doi.org/10.5688/aj710347
  5. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (2003).
  6. Tudor, C. G. : Contract Year 2014 Medication Therapy Management Program Guidance and Submission Instructions, Center for Medicare & Medicaid Service (2013).
  7. Understanding Medicare Reform : What Pharmacists Need to Know, American Pharmacists Association (2004).
  8. 황계자: 노인약학에 대한 실태조사. Journal of Korean Society of Hospital Pharmacists 18, 329 (2001).
  9. Nam, J. S., Shin, W. G. and Oh, J. M. : Pattern of medications usage and potentially inappropriate medication uasge among Korean ambulatory elderly patients based on an explicit criterion. The Korean Journal of Clinical Pharmacy 15, 149 (2005).
  10. Kang, Y. K. : Analysis of Prescriptions for Elderly at Primary Health Care Using National Health Insurance Database. Graduate School of Clinical Pharmacy, Sookmyung Women's University. 국내석사학위논문 (2006).
  11. 의료법 시행규칙 보건복지부령 제213호, 2013.10.4. 일부개정, 시행2014.4.5, 보건복지부 (2013).
  12. http://www.ccgp.org/. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/. Accessed Dec 31, 2013.
  13. https://www.ascp.com/. American Society of Consultant Pharmacist. Available at: https://www.ascp.com/. Accessed Dec 31, 2013.
  14. Pharmacy Ranked in 2012. US News. Available at: http://gradschools. usnews.rankingsandreviews.com/best-graduateschools/ top-health-schools/pharmacy-rankings?int=493b21. Accessed Dec 31, 2013.
  15. Park, H. J. and Schumock, G. T. : PSAP V BOOK 5 science and practice of pharmacotherapy, The American College of Clinical Pharmacy p. 21 (2005).
  16. CCGP History. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/aboutCCGP/ history. Accessed Dec 31, 2013.
  17. About the Certified Geriatric Pharmacist Examination. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/exam. Accessed Dec 31, 2013.
  18. Recertification Process. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/ recertification. Accessed Dec 31, 2013.
  19. Candidate Handbook of certification examination in geriatric pharmacy, Commission for Certification in Geriatric Pharmacy (2013).
  20. How to Prepare for the CGP Examination. Commission for Certification in Geriatric Pharmacy. Available at: http:// www.ccgp.org/exam/prepare. Accessed Dec 31, 2013.
  21. Purchase Self-Assessment Exam. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/ content/exam/self-assessment. Accessed Dec 31, 2013.
  22. Certified Geriatric Pharmacist Self-Assessment Examination Logic extension resources in Applied Measurement Professionals, Inc. Available at: http://store.lxr.com/dept.aspx?id=47. Accessed Dec 31, 2013.
  23. Geriatric Pharmacotherapy Practice Resource Center. American Society of Consultant Pharmacist. Available at: https:// www.ascp.com/articles/geriatric-pharmacotherapy. Accessed Dec 31, 2013.
  24. Geriatric Pharmacy Review. American Society of Consultant Pharmacists. Available at: http://education.ascp.com/gpr. Accessed Dec 31, 2013.
  25. Recertification by Professional Development Program. Commission for Certification in Geriatric Pharmacy. Available at: http://www.ccgp.org/recertification/pdp. Accessed Dec 31, 2013.
  26. Simonson, W. and Pratt, C. C. : Geriatric pharmacy curriculum in U.S. pharmacy schools: a nationwide survey. Am. J. Pharm. Educ. 46, 249 (1982).
  27. Kirschenbaum, H. L. and Rosenberg, J. M.: Geriatric training programs offered at schools and colleges of pharmacy. American Journal of Pharmaceutical Education 59, 284 (1995).
  28. Dutta, A. P., Daftary, M. N., Oke, F., Mims, B., Hailemeskel, B. and Sansgiry, S. S. : Geriatric education in US schools of pharmacy: a snapshot. Consult Pharm 20, 45 (2005). https://doi.org/10.4140/TCP.n.2005.45
  29. Jimenez, S. : Geriatric Content in U.S. Doctor of Pharmacy Degree Curricula (2011).
  30. Experiential Programs: Care And Respect for the Elderly (CARE) Program. University of Texas Austin, College of Pharmacy. Available at: http://www.utexas.edu/pharmacy/ general/experiential/. Accessed Dec 31, 2013.
  31. Experiential Education: Advanced Pharmacy Practice Experiences. Campbell University. Available at: http://www. campbell.edu/cphs/academic-programs/pharmd/experientialeducation/ rotations/advanced-practice-experience-rotations/. Accessed Jan 14, 2014.
  32. Catalog 2012-2014, University of Maryland, School of Pharmacy (2011).
  33. Doctor of Pharmacy Program Catalog 2013-2014, Texas Tech University Health Sciences Center, School of Pharmacy (2013).
  34. Professional Electives for the Doctor of Pharmacy Program. University of North Carolina-Chapel Hill, College of Pharmacy. Available at: https://pharmacy.unc.edu/programs/the-pharmd/ curriculum/electives#interdisciplinary-courses-and-nondivisional- courses. Accessed Dec 31, 2013.
  35. Student Handbook 2013-2014, University of Southern California Davis, School of Gerontology (2013).
  36. School of Pharmacy Professional Electives. University of Washington, School of Pharmacy. Available at: http:// sop.washington.edu/images/stories/school_of_pharmacy/ PharmD/asp/current_students/electivesRev12.202013.pdf. Accessed Jan 14 2014.
  37. Credential news letter, Commission for certification in geriatric pharmacy (2011).
  38. An Acute Care for Elders (ACE) project San Francisco General Hospital Foundation Available at: http://www.sfghf.net/ programs/ace_project.html. Accessed Nov 29, 2013.
  39. Nurses Improving Care for Healthsystem Elders Program. NICHE. Available at: http://www.nicheprogram.org/. Accessed Nov 29, 2013.
  40. The Hospital Elder Life Program (HELP). HELP. Available at: http://www.hospitalelderlifeprogram.org/public/public-main.php. Accessed Nov 29, 2013.
  41. Lee, J. K., Slack, M. K., Martin, J., Ehrman, C. and Chisholm- Burns, M. : Geriatric patient care by U.S. pharmacists in healthcare teams: systematic review and meta-analyses. J. Am. Geriatr. Soc. 61, 1119 (2013). https://doi.org/10.1111/jgs.12323
  42. Branham, A. R., Katz, A. J., Moose, J. S., Ferreri, S. P., Farley, J. F. and Marciniak, M. W. : Retrospective analysis of estimated cost avoidance following pharmacist-provided medication therapy management services. J. Pharm. Pract. 26, 420 (2013). https://doi.org/10.1177/0897190012465992
  43. Dodson, S. E., Ruisinger, J. F., Howard, P. A., Hare, S. E. and Barnes, B. J. : Community pharmacy-based medication therapy management services: financial impact for patients. Pharm Pract (Granada) 10, 119 (2012). https://doi.org/10.4321/S1886-36552012000300001
  44. Fox, D., Ried, L. D., Klein, G. E., Myers, W. and Foli, K. : A medication therapy management program's impact on lowdensity lipoprotein cholesterol goal attainment in Medicare Part D patients with diabetes. J. Am. Pharm. Assoc. (2003) 49, 192 (2009). https://doi.org/10.1331/JAPhA.2009.09016
  45. Michaels, N. M., Jenkins, G. F., Pruss, D. L., Heidrick, J. E. and Ferreri, S. P. : Retrospective analysis of community pharmacists' recommendations in the North Carolina Medicaid medication therapy management program. J. Am. Pharm. Assoc. (2003) 50, 347 (2010). https://doi.org/10.1331/JAPhA.2010.09021
  46. Moczygemba, L. R., Barner, J. C. and Gabrillo, E. R. : Outcomes of a Medicare Part D telephone medication therapy management program. J. Am. Pharm. Assoc. (2003) 52, e144 (2012). https://doi.org/10.1331/JAPhA.2012.11258
  47. Moczygemba, L. R., Barner, J. C., Lawson, K. A., Brown, C. M., Gabrillo, E. R., Godley, P. and Johnsrud, M. : Impact of telephone medication therapy management on medication and health-related problems, medication adherence, and Medicare Part D drug costs: a 6-month follow up. Am. J. Geriatr. Pharmacother. 9, 328 (2011). https://doi.org/10.1016/j.amjopharm.2011.08.001
  48. Pindolia, V. K., Stebelsky, L., Romain, T. M., Luoma, L., Nowak, S. N. and Gillanders, F. : Mitigation of medication mishaps via medication therapy management. Ann. Pharmacother. 43, 611 (2009). https://doi.org/10.1345/aph.1L591
  49. Brummel, A. R., Soliman, A. M., Carlson, A. M. and de Oliveira, D. R. : Optimal diabetes care outcomes following face-to-face medication therapy management services. Popul Health Manag 16, 28 (2013). https://doi.org/10.1089/pop.2012.0023
  50. Bunting, B. A. and Cranor, C. W. : The Asheville Project: longterm clinical, humanistic, and economic outcomes of a community-based medication therapy management program for asthma. J. Am. Pharm. Assoc. (2003) 46, 133 (2006). https://doi.org/10.1331/154434506776180658
  51. Bunting, B. A., Smith, B. H. and Sutherland, S. E. : The Asheville Project: clinical and economic outcomes of a community-based long-term medication therapy management program for hypertension and dyslipidemia. J. Am. Pharm. Assoc. (2003) 48, 23 (2008). https://doi.org/10.1331/JAPhA.2008.07140
  52. Chisholm, M. A., Spivey, C. A. and Mulloy, L. L. : Effects of a medication assistance program with medication therapy management on the health of renal transplant recipients. Am. J. Health Syst. Pharm. 64, 1506 (2007). https://doi.org/10.2146/ajhp060634
  53. Congdon, H. B., Dowling, T. C., Cheng, I. and Truong, H. A. : Impact of medication therapy management on underserved, primarily Hispanic patients with diabetes. Ann. Pharmacother. 47, 665 (2013). https://doi.org/10.1345/aph.1R648
  54. Hirsch, J. D., Gonzales, M., Rosenquist, A., Miller, T. A., Gilmer, T. P. and Best, B. M. : Antiretroviral therapy adherence, medication use, and health care costs during 3 years of a community pharmacy medication therapy management program for Medi-Cal beneficiaries with HIV/ AIDS. J. Manag. Care Pharm. 17, 213 (2011).
  55. Isetts, B. J., Schondelmeyer, S. W., Artz, M. B., Lenarz, L. A., Heaton, A. H., Wadd, W. B., Brown, L. M. and Cipolle, R. J. : Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J. Am. Pharm. Assoc. (2003) 4, 203 (2008).
  56. Koenigsfeld, C. F., Horning, K. K., Logemann, C. D. and Schmidt, G. A. : Medication therapy management in the primary care setting: a pharmacist-based pay-for-performance project. J. Pharm. Pract. 25, 89 (2012). https://doi.org/10.1177/0897190011416671
  57. Moczygemba, L. R., Barner, J. C., Brown, C. M., Lawson, K. A., Gabrillo, E. R., Godley, P. and Johnsrud, M. : Patient satisfaction with a pharmacist-provided telephone medication therapy management program. Res. Social Adm. Pharm. 6, 143 (2010). https://doi.org/10.1016/j.sapharm.2010.03.005
  58. Pinto, S. L., Bechtol, R. A. and Partha, G. : Evaluation of outcomes of a medication therapy management program for patients with diabetes. J. Am. Pharm. Assoc. (2003) 52, 519 (2012). https://doi.org/10.1331/JAPhA.2012.10098
  59. Pinto, S. L., Kumar, J., Partha, G. and Bechtol, R. A. : Pharmacist-Provided Medication Therapy Management (MTM) program impacts outcomes for employees with diabetes. Population Health Management 17, 21 (2013).
  60. Pinto, S. L., Kumar, J., Partha, G. and Bechtol, R. A. : Improving the economic and humanistic outcomes for diabetic patients: making a case for employer-sponsored medication therapy management. Clinicoecon Outcomes Res. 5, 153 (2013).
  61. Ramalho de Oliveira, D., Brummel, A. R. and Miller, D. B. : Medication therapy management: 10 years of experience in a large integrated health care system. J. Manag. Care Pharm. 16, 185 (2010).
  62. Schommer, J. C., Planas, L. G., Johnson, K. A. and Doucette, W. R. : Pharmacist-provided medication therapy management (part 1): provider perspectives in 2007. J. Am. Pharm. Assoc. (2003) 48, 354 (2008). https://doi.org/10.1331/JAPhA.2008.08012
  63. Scott, D. M., Dewey, M. W., Johnson, T. A., Kessler, M. L. and Friesner, D. L. : Preliminary evaluation of medication therapy management services in assisted living facilities in rural Minnesota. Consult Pharm 25, 305 (2010). https://doi.org/10.4140/TCP.n.2010.305
  64. Shimp, L. A., Kucukarslan, S. N., Elder, J., Remington, T., Wells, T., Choe, H. M., Lewis, N. J. and Kirking, D. M. : Employer based patient-centered medication therapy management program: evidence and recommendations for future programs. J. Am. Pharm. Assoc. (2003) 52, 768 (2012). https://doi.org/10.1331/JAPhA.2012.11186
  65. Smith, S. R., Catellier, D. J., Conlisk, E. A. and Upchurch, G. A. : Effect on health outcomes of a community-based medication therapy management program for seniors with limited incomes. Am. J. Health Syst. Pharm. 63, 372 (2006). https://doi.org/10.2146/ajhp050089
  66. Touchette, D. R., Masica, A. L., Dolor, R. J., Schumock, G. T., Choi, Y. K., Kim, Y. and Smith, S. R. : Safety-focused medication therapy management: a randomized controlled trial. J. Am. Pharm. Assoc. (2003) 52, 603 (2012). https://doi.org/10.1331/JAPhA.2012.12036
  67. Ward, M. A. and Xu, Y. : Pharmacist-provided telephonic medication therapy management in an MAPD plan. Am. J. Manag. Care 17, e399 (2011).
  68. Welch, E. K., Delate, T., Chester, E. A. and Stubbings, T. : Assessment of the impact of medication therapy management delivered to home-based Medicare beneficiaries. Ann. Pharmacother. 43, 603 (2009). https://doi.org/10.1345/aph.1L524
  69. Wittayanukorn, S., Westrick, S. C., Hansen, R. A., Billor, N., Braxton-Lloyd, K., Fox, B. I. and Garza, K. B. : Evaluation of medication therapy management services for patients with cardiovascular disease in a self-insured employer health plan. J. Manag. Care Pharm. 19, 385 (2013).
  70. Yeoh, T. T., Si, P. and Chew, L. : The impact of medication therapy management in older oncology patients. Support Care Cancer 21, 1287 (2013). https://doi.org/10.1007/s00520-012-1661-y
  71. Kucukarslan, S. N., Hagan, A. M., Shimp, L. A., Gaither, C. A. and Lewis, N. J. : Integrating medication therapy management in the primary care medical home: A review of randomized controlled trials. Am. J. Health Syst. Pharm. 68, 335 (2011). https://doi.org/10.2146/ajhp100405
  72. Pellegrino, A. N., Martin, M. T., Tilton, J. J. and Touchette, D. R. : Medication therapy management services: definitions and outcomes. Drugs 69, 393 (2009). https://doi.org/10.2165/00003495-200969040-00001
  73. Community Pharmacy Medicines Management Project Evaluation Team: The MEDMAN study: a randomized controlled trial of community pharmacy-led medicines management for patients with coronary heart disease. Fam Pract 24, 189 (2007). https://doi.org/10.1093/fampra/cml075
  74. Christensen, D. B., Roth, M., Trygstad, T. and Byrd, J. : Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan. J. Am. Pharm. Assoc. (2003) 47, 471 (2007). https://doi.org/10.1331/JAPhA.2007.06111
  75. Krska, J., Cromarty, J. A., Arris, F., Jamieson, D., Hansford, D., Duffus, P. R., Downie, G. and Seymour, D. G. : Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing 30, 205 (2001). https://doi.org/10.1093/ageing/30.3.205
  76. Chrischilles, E. A., Carter, B. L., Lund, B. C., Rubenstein, L. M., Chen-Hardee, S. S., Voelker, M. D., Park, T. R. and Kuehl, A. K. : Evaluation of the Iowa Medicaid pharmaceutical case management program. J. Am. Pharm. Assoc. (2003) 44, 337 (2004). https://doi.org/10.1331/154434504323063977
  77. Doucette, W. R., McDonough, R. P., Klepser, D. and McCarthy, R. : Comprehensive medication therapy management: identifying and resolving drug-related issues in a community pharmacy. Clin Ther 27, 1104 (2005). https://doi.org/10.1016/S0149-2918(05)00146-3
  78. Isetts, B. J., Brown, L. M., Schondelmeyer, S. W. and Lenarz, L. A. : Quality assessment of a collaborative approach for decreasing drug-related morbidity and achieving therapeutic goals. Arch. Intern. Med. 163, 1813 (2003). https://doi.org/10.1001/archinte.163.15.1813
  79. Olson, K. L., Delate, T., Rasmussen, J., Humphries, T. L. and Merenich, J. A. : Outcomes of patients discharged from pharmacy-managed cardiovascular disease management. Am. J. Manag. Care 15, 497 (2009).
  80. Rothman, R. L., DeWalt, D. A., Malone, R., Bryant, B., Shintani, A., Crigler, B., Weinberger, M. and Pignone, M. : Influence of patient literacy on the effectiveness of a primary care-based diabetes disease management program. JAMA 292, 1711 (2004). https://doi.org/10.1001/jama.292.14.1711
  81. Carter, B. L., Ardery, G., Dawson, J. D., James, P. A., Bergus, G. R., Doucette, W. R., Chrischilles, E. A., Franciscus, C. L. and Xu, Y. : Physician and pharmacist collaboration to improve blood pressure control. Arch. Intern. Med. 169, 1996 (2009). https://doi.org/10.1001/archinternmed.2009.358
  82. Isetts, B. J., Schondelmeyer, S. W., Heaton, A. H., Wadd, W. B., Hardie, N. A. and Artz, M. B. : Effects of collaborative drug therapy management on patients' perceptions of care and health-related quality of life. Res. Social Adm. Pharm. 2, 129 (2006). https://doi.org/10.1016/j.sapharm.2005.12.002
  83. Rothman, R. L., Malone, R., Bryant, B., Shintani, A. K., Crigler, B., Dewalt, D. A., Dittus, R. S., Weinberger, M. and Pignone, M. P. : A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes. Am. J. Med. 118, 276 (2005). https://doi.org/10.1016/j.amjmed.2004.09.017
  84. Sellors, J., Kaczorowski, J., Sellors, C., Dolovich, L., Woodward, C., Willan, A., Goeree, R., Cosby, R., Trim, K., Sebaldt, R., Howard, M., Hardcastle, L. and Poston, J. : A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients. CMAJ 169, 17 (2003).
  85. Levinson, D. R. : Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries (2010).
  86. Kim, S. Y. : Assessment of Adverse Drug Events related to Potentially Inappropriate Medications in Elderly Patients. Graduate School of Clinical Pharmacy, Sookmyung Women's University. 국내석사학위논문 (2008).
  87. Park, J. H. : Study on the recognition of training senior care pharmacists. The Graduate School of Food & Drug Administraion, Chung-Ang University. 국내석사학위논문 (2009).