Justin Moss’s research while affiliated with Salt Lake Community College and other places

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Publications (3)


Implementation of a comprehensive pharmacy‐driven immunization care process model in a pediatric cystic fibrosis clinic
  • Article

January 2023

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8 Reads

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5 Citations

Pediatric Pulmonology

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Justin Moss

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Jenna Creelman

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[...]

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Fadi Asfour

Introduction: Members of an integrated pharmacy team (pharmacists and pharmacy technicians) have roles that have been identified in the literature as part of the multi-disciplinary cystic fibrosis (CF) care team. One role that has not specifically addressed is the administration of routine and recommended immunizations to people with CF (PwCF). According to care guidelines, PwCF of all ages should be provided all age-appropriate and recommended immunizations. Pharmacists and pharmacy technicians can administer immunizations per state laws. The Primary Children's CF Center decided to implement a comprehensive pharmacy-driven immunization care process model to impact immunization rates. Methods: A 24-month retrospective analysis was conducted with pediatric (18 years) PwCF at the Primary Children's CF Center. The primary outcome measures were the percentage (%) of PwCF who received PPSV23, and/or HPV, and/or meningococcal conjugate vaccine (MCV) immunizations 1-year post care process model implementation (October 1, 2021 to September 30, 2022) as compared to baseline values. The secondary outcome measures are the total number of immunizations, the number of each immunization provided, and the financial impact of pharmacy-driven immunization care process model 1-year post implementation. Results: During the 1-year post care process model implementation (October 1, 2021, to September 30, 2022), a total of 523 immunizations were provided to 243 pediatric PwCF. The most frequent immunizations provided were PPSV23 (160/523, 31%) and Coronavirus Disease 2019 (COVID-19) (154/523, 29%). The baseline percentages of eligible PwCF of PPSV23, HPV, and MCV were 27% (58/217), 43% (32/74), and 24% (8/34), respectively. The 1-year post-implementation percentages of PPSV23, HPV, and MCV were 99% (217/218, p<0.00001), 91% (67/74, p<0.00001), and 97% (33/34, p<0.00001), respectively. For COVID-19 immunizations, 56% of eligible PwCF (181/321) have received their first dose. Of these 181 PwCF, 70% (126/181) have received at least one dose of their primary series or booster during the 1-year post implementation period. The rate of those PwCF who have received at least one dose of a COVID-19 immunization from the age of 6 months-4 years, 5-11 years, and 12-18 years, was 37% (30/82), 60% (78/129), and 66% (73/110), respectively. For the financial impact generated during the 1-year immunization care process model post implementation period, 404 non-VFC immunizations were given for an estimated profit of $11,930. Conclusions: The implementation of a pharmacy-driven immunization care process model is a way for integrated pharmacy teams to evolve with the CF center care model and have a role expansion in the care provided to PwCF. This article is protected by copyright. All rights reserved.


Understanding the expanding role of pharmacy services in outpatient cystic fibrosis care

January 2021

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36 Reads

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13 Citations

Pediatric Pulmonology

Cystic fibrosis (CF) patients utilize an average of 10 (±5) medications per day. Given the complexity of the medication regimen, the CF Foundation (CFF) recommends pharmacists as members of the CF care team. The areas of pharmacy services have been identified in the literature. “Limited access pharmacists” are consulted to answer questions, assist in evaluating serum drug concentrations, provide medication education, and monitoring for drug‐drug interactions. Reduction in hospital length of stay has been shown through this collaboration. “Full access pharmacists” provide comprehensive medication therapy management resulting in medication adherence and access improvements, sustainability of treatments, improved provider communication, reduced medication errors and costs, expedited medication refill authorization, increased utilization of respiratory therapists, enhanced discussion of medications with CF team members, and reduction in the number of pharmacies utilized by patients to fill CF medications. An integrated CF pharmacy team are essential members of the multidisciplinary CF care team that have been shown to improvement in CF medication access, increases in body weight and body mass index, reduction in prior authorization submission times, reduction in medication delivery times, expedited medication refill authorizations, increased collaboration with respiratory therapists, augmented discussion of medication with CF team members, and reduction in the number of pharmacies utilized by CF patients. There is a need to further evaluate the impact of outpatient CF pharmacy services due to the improvements in the care on patients and families affected by CF, and as the number of CFF‐accredited care centers integrate CF pharmacy teams throughout the country increases. This article is protected by copyright. All rights reserved.


Impact of Pharmacy Technicians as part of an Integrated Health‐System Pharmacy Team on Improvement of Medication Access in the Care of Cystic Fibrosis Patients

September 2020

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43 Reads

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15 Citations

Pediatric Pulmonology

Background: Cystic Fibrosis (CF) is a genetic disease requiring patients to take multiple medications per day. Multiple barriers exist affecting access and adherence. Studies have demonstrated the positive outcomes of pharmacist involvement in CF care. The purpose of this study is to characterize the impact of pharmacy technicians on medication access in the care of CF patients. Methods: A retrospective review and analysis of patient medication profiles for patients followed by the integrated pharmacy care process model was performed. Two electronic prescription pathways with pharmacy technician involvement were analyzed. One pathway using a specialty pharmacy CF pharmacy technician (SP technician) examined CF specialty medication delivery times. The other pathway examined the impact of the clinic-based CF pharmacy technician (CB technician) on the number of filling pharmacies for patients. Results: One-hundred and fifty-three patients met inclusion criteria in the CF specialty medication delivery analysis, and 56 patients met inclusion criteria filling pharmacy analysis. The median delivery time for dornase alfa decreased from 8 days to 3 days, p<0.00001. The number of patients utilizing 1 filling pharmacy increased from 8 (14%) to 21 (38%), (p=0.005); and utilizing 3 filling pharmacies decreased from 14 (25%) to 1 (2%), (p=0.003). Conclusion: The study demonstrated that pharmacy technicians as part of an integrated health-system pharmacy care process model improve medication access in the care of CF patients. This article is protected by copyright. All rights reserved.

Citations (2)


... Multiple studies have shown that involvement of a pharmacist in inpatient and outpatient settings results in improved outcomes for the treatment of infections, decreased length of hospitalizations, decrease in medication errors, and improved safety for PwCF. [63][64][65][66] Given that many medications and supplements are metabolized through the liver, PwCF with elevated liver enzymes, CFHBI, aCFLD, and post-transplant are at risk for complicated drug-drug interactions. Preventative measures, such as avoiding herbal supplements, minimizing or abstaining from alcohol, and obtaining hepatitis A and B vaccinations, should be discussed. ...

Reference:

Cystic fibrosis screening, evaluation and management of hepatobiliary disease consensus recommendations
Understanding the expanding role of pharmacy services in outpatient cystic fibrosis care
  • Citing Article
  • January 2021

Pediatric Pulmonology

... The IHSSP model has been shown to improve medication access in a short turnaround time in several disease states [22,[37][38][39][40][41][42][43][44][45]. Pharmacists and pharmacy technicians integrated into specialty clinics evaluate new IBD treatment referrals for patient safety and appropriateness. ...

Impact of Pharmacy Technicians as part of an Integrated Health‐System Pharmacy Team on Improvement of Medication Access in the Care of Cystic Fibrosis Patients
  • Citing Article
  • September 2020

Pediatric Pulmonology