Darcie L. Keller

Kansas City VA Medical Center, Kansas City, Missouri, United States

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Publications (5)5.23 Total impact

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    ABSTRACT: Purpose: Describe the membership, activities, and achievements of the Adult Medicine Practice and Research Network (PRN). Methods: not applicable Results: Over the past 10 years, the Adult Medicine PRN has grown into a thriving group of over 750 clinical pharmacists practicing in a variety of inpatient and outpatient settings. A 2008 survey (20% response rate) demonstrated that 61% of respondents had completed a PGY1 residency, 70% were board certified in pharmacotherapy, and 10% held other certifications. Forty percent had academic appointments and 47% served as preceptors. Also, 96% devoted time to research. Communication, collaboration and leadership are the PRN’s primary objectives. These goals are achieved through PRN focus sessions and other educational presentations at ACCP meetings, PRN business meetings, and the PRN listserv which provides opportunities for networking, sharing clinical experience, and providing support for all levels of clinical pharmacy practice. Additionally, a document repository was designed to archive information shared among members to allow efficient retrieval. Eight committees have been established to provide members opportunities to become actively involved in PRN endeavors. In addition, our members have participated in many facets of ACCP leadership, such as conducting board certification review courses and serving on editorial boards, committees and task forces. Members have also demonstrated leadership through authorship on 5 white papers and one position paper. Member accomplishments have been recognized with ACCP Fellowship status and awards. Conclusion: Throughout the years, our PRN has maintained a commitment to the practice of evidence-based medicine and fostered leadership within the PRN and ACCP by promoting active involvement in scholarly activities, development and presentation of research and innovative pharmacy practice, and education. As the PRN and its members look to the future, we have developed initiatives aimed toward advancing the practice of clinical pharmacy and encompassing the core focuses of ACCP: Education, Service and Research.
    2009 American College of Clinical Pharmacy Annual Meeting; 10/2009
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    ABSTRACT: Consistent with the American College of Clinical Pharmacy's vision that future clinical pharmacy practitioners who provide direct patient care should be board-certified specialists, a new framework for pharmacist specialty board certification is proposed. This White Paper describes the current and projected needs of the pharmacy profession regarding board certification, provides a rationale for the new framework, and discusses the potential ramifications of changes in the current board-certification process.
    Pharmacotherapy 05/2009; 29(4):3e-13e. · 2.31 Impact Factor
  • Jill S. Wallace, Darcie L. Keller, Julie M. Wright
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    ABSTRACT: Purpose: Health literacy (HL) is a person’s ability to read and understand information necessary to make decisions about their health. Patients with low HL are at risk for worse health outcomes and increased utilization of the healthcare system. Asking patients about their level of HL is a sensitive topic and little is known about how patients feel about being asked such questions. The purpose of this study was to determine if patients are uncomfortable with having their HL skills assessed. Methods: A 6-item survey utilizing a 5-point Likert scale was used to assess patients’ comfort with being asked about their HL skills in an urban primary care clinic. Age, sex, race, education, insurance, and employment status were also collected. A standardized test was used to determine their level of HL. Demographic and HL data were summarized. Spearman’s correlation was used to evaluate the relationship between these characteristics and survey scores. Results: Among 227 subjects, the mean age was 52, 69% were women, 73% were African American, 25% had completed < 12th grade, 93% had no or government insurance, and 67% were unemployed. Most (77%) had adequate HL. The mean comfort scale score was 11 (range 6-28); possible score range 6-30, >18 indicated feeling not comfortable with at least one aspect of communicating about HL. The comfort scale score was not correlated with HL status or demographic factors (rho < 0.1 for all). Only ten subjects selected any response indicating not being comfortable; no demographic characteristics were associated with that group. (Fisher’s exact, p > 0.10 for all). Conclusions: This study showed that even in a diverse population, most (95.5%) patients are comfortable being asked about their health literacy skills. Primary care providers should be encouraged to inquire about this important topic to optimize patient care.
    2008 American College of Clinical Pharmacy Annual Meeting; 10/2008
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    ABSTRACT: Purpose: Low health literacy (HL) has been associated with shame and embarrassment. As a result clinicians are reluctant to inquire about patients’ level of HL. However, studies have shown that HL status may be associated with health outcomes. The objective of this study was to test the reliability of and validate a survey tool that was developed to measure patients’ comfort with communicating with health care providers about their HL status. Methods: A 13 item survey with a 5-point Likert response scale was utilized to: assess patient comfort with provider evaluation of their ability to read, understand health information, and assess their confidence in their own HL. The survey was completed by 227 subjects as part of a HL-related study in an urban internal medicine clinic. Factor analysis was used to extract the best combination of survey items to compose a reliable scale. Chronbach’s alpha was computed to assess the consistency of the selected items. A score was created to represent patients’ degree of comfort with assessment. Results: Six of the 13 items were found to make up a common factor reflecting patients’ comfort with communicating about their level of HL. Cronbach’s alpha for this 6-item scale was 0.78. The resulting scale score range is 6 – 30; higher scores indicate being uncomfortable with communicating about HL. The comfort scale score did not correlate with demographic factors such as age, race, educational level, sex, or insurance status (rho < 0.20 for all). Conclusions: We were able to validate a reliable 6-item survey tool that can be used to evaluate patients’ comfort with communication about their ability to read and to understand health information, and to assess patients’ confidence in their own health literacy. The scale provides patient-related HL data that should be integrated into health literacy research.
    2008 American College of Clinical Pharmacy Annual Meeting; 10/2008
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    Darcie L Keller, Julie Wright, Heather A Pace
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    ABSTRACT: To examine the relationship between low health literacy and disease state control and between low health literacy medication adherence in the primary care setting. The following databases were searched for relevant articles from date of inception to April 2008: The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing & Allied Health Literature, EMBASE, Education Resources Information Center, PsycINFO, International Pharmaceutical Abstracts, and Iowa Drug Information Service. MEDLINE was searched from 1966 to April 2008. Key words included literacy, health literacy, health education, educational status, disease outcomes, health outcomes, adherence, medication adherence, and patient compliance. Additional articles were identified by reviewing reference sections of retrieved articles. Studies using a validated measure of health literacy and performing statistical analysis to evaluate the relationship between health literacy and disease state control or medication adherence were evaluated. Eleven evaluations, including 10 discrete studies, met eligibility criteria. Six studies evaluated the relationship between health literacy and disease state control, 3 evaluated health literacy and medication adherence, and 1 study evaluated health literacy and both outcomes. A quality rating of poor, fair, or good was assigned to each study based on the study question, population, outcome measures, statistical analysis, and results. Eight studies had good quality, 1 was fair, and 2 were poor. Two high-quality studies demonstrated statistically significant relationships with health literacy, 1 with disease state control and 1 with medication adherence. Limitations of the other studies included inadequate sample size, underrepresentation of patients with low health literacy, use of less objective outcome measures, and insufficient statistical analysis. There may be a relationship between health literacy and disease state control and health literacy and medication adherence. Future research, with adequate representation of patients with low health literacy, is needed to further define this relationship and explore interventions to overcome the impact that low health literacy may have on patient outcomes.
    Annals of Pharmacotherapy 09/2008; 42(9):1272-81. · 2.92 Impact Factor