Journal of the American Pharmacists Association japha.org 634 JAPhA | 54:6 | NOV/DEC 2014 TOOLS FOR ADVANCING PHARMACY PRACTICE Heart failure assessment at the community pharmacy level: A feasibility pilot study Barry E. Bleske, Nicholas O. Dillman, Doug Cornelius, Jennifer K. Ward, Steve C. Burson, Heidi L. Diez, Kerry K. Pickworth, Marialice S. Bennett, John M. Nicklas, and Michael P. Dorsch Abstract Background: A key element missing in disease-management programs for heart failure (HF) is participation of the community pharmacist. The pur- pose of this study is to determine if a simple and eficient clinical tool will allow community pharmacists to identify patients at risk for worsening HF. Design: The One Minute Clinic for Heart Failure (TOM-C HF) was devel- oped as a simple six-item symptom screening tool to be used during routine patient/customer interactions. Setting: Ten community pharmacies located in the upper Midwest. Patients: Self-identiied HF patients. Results: 121 unique patients were evaluated over a 12-month period. The application of this clinical tool took between 1 and 5 minutes in over 80% of the interactions. Seventy-ive patients (62%) had one or more signs or symp- toms of worsening HF. The most common symptoms detected included edema (39%) and increased shortness of breath (17%). Self-reported weight gain of more than 5 pounds was seen in 19% of patients. Conclusion: The TOM-C HF tool was used to identify patients in a time- eficient manner in the community pharmacy setting who appear to be developing worsening HF. Inclusion of the community pharmacists as an early screen for HF decompensation may be an important link in disease- management programs to help reduce hospital readmission rates. Keywords: Disease management, clinical tool, heart failure, community pharmacy. J Am Pharm Assoc. 2014;54:634–641. doi: 10.1331/JAPhA.2014.14039 Received March 5, 2014, and in revised form May 17, 2014. Accepted for publication June 16, 2014. Barry E. Bleske, PharmD, FCCP, is Associate Professor, University of Michigan College of Pharmacy, Ann Arbor, MI. Nicholas O. Dillman, PharmD, was Student Pharmacist, University of Michigan College of Pharmacy, Ann Arbor, MI. Doug Cornelius, BS, BSPharm, is Customer First Manager, Kroger Company, Columbus, OH. Jennifer K. Ward, PharmD, was Student Pharmacist, Ohio State University College of Pharmacy, Columbus, OH. Steve C. Burson, BScPharm, is Pharmacy Sales Manager, Kroger Company, Columbus, OH. Heidi L. Diez, PharmD, BCACP, is Clinical Assistant Professor, University of Michigan College of Pharmacy, and University of Michigan Health Systems, Ann Arbor, MI. Kerry K. Pickworth, PharmD, FCCP, is Specialty Practice Pharmacist in Cardiology and Associate Clinical Professor, Richard M. Ross Heart Hospital and The Ohio State University Medical Center, Columbus, OH. Marialice S. Bennett, BSPharm, FAPhA, is Faculty Emeritus, The Ohio State University College of Pharmacy, Columbus, OH. John M. Nicklas, MD, is Associate Professor of Internal Medicine, University of Michigan Health Systems, Division of Cardiology, Ann Arbor, MI. Michael P. Dorsch, PharmD, MS, is Clinical Associate Professor, University of Michigan College of Pharmacy, Ann Arbor, MI. Correspondence: Barry E. Bleske, PharmD, FCCP, Associate Professor, University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109. Fax: 734-763-7119. E-mail: bbleske@umich.edu Acknowledgments: Dorothy Hoang, Richard Walls, and Lindsey Westerhof for their hard work and dedication in collecting the data for the project. Disclosure: The authors declare no con- flicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria. Author information continued at the end of the text on p. 640. Downloaded From: http://japha.org/ by a University of Michigan - Taubman Medical Lib User on 11/11/2014