Nicole D. Gillespie

Creighton University

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Thomas L. Lenz

Creighton University

Jessica J. Skradski

Creighton University

Michele A. Faulkner

Creighton University

Maryann Z. Skrabal

Creighton University

Yongyue Qi

Creighton University

Laura K. Viereck

Creighton University

Joni J. Pagenkemper

Creighton University

Liz Ferguson

Mater Misericordiae University Hospital

Jessica Larson

Owl Research Institute

Kathleen A. Packard

Creighton University

Cooperative Institutions

Creighton University

CHI Health Creighton University Medical Center - Bergan Mercy

University of Nebraska Medical Center

Bryan Health

Weatherford College

University of North Carolina at Chapel Hill

Loma Linda University

Mater Misericordiae University Hospital

Owl Research Institute

Tufts University

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DOAJ (DOAJ: Directory of Open Access Journals) (2012)

Yongyue Qi Jessica J. Skradski Michele A. Faulkner Maryann Z. Skrabal Nicole D. Gillespie

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Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees

Journal of Interprofessional Care (2012)

Thomas L. Lenz Nicole D. Gillespie Maryann Z. Skrabal Michele A. Faulkner Jessica J. Skradski

A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

10.3109/13561820.2012.721816

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Implementation of a Tool to Modify Behavior in a Chronic Disease Management Program

Advances in Preventive Medicine (2011)

Nicole D. Gillespie Thomas L. Lenz

Chronic diseases like diabetes, hypertension, and dyslipidemia continue to be a significant burden on the US health care system. As a result, many healthcare providers are implementing strategies to prevent the incidence of heart disease and other chronic conditions. Among these strategies are proper drug therapy and lifestyle modifications. Behavior change is often the rate-limiting step in the prevention and maintenance of lifestyle modifications. The purpose of this paper is to describe a tool used to guide the progression and assess the effectiveness of a cardiovascular risk reduction program. The tool uses the Transtheoretical Model of Behavior Change to determine the readiness and confidence to change specific lifestyle behaviors pertinent to cardiovascular health. The tool aids the practitioner in developing a patient-centered plan to implement and maintain lifestyle changes and can be tailored to use in any situation requiring a behavior change on the part of the patient.

Transtheoretical model

Dyslipidemia

Limiting

10.4061/2011/215842

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Citations (24)

Transdermal Patch Drug Delivery Interactions with Exercise

Sports Medicine (2011)

Thomas L. Lenz Nicole D. Gillespie

Transdermal patch

10.2165/11586080-000000000-00000

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Cardiovascular Disease Prevention in Women: What Not to use

U.S. pharmacist (2011)

Nicole D. Gillespie E. M. de Simone

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Development and Implementation of a Novel Lifestyle Medicine Advanced Pharmacy Practice Experience Elective

INNOVATIONS in pharmacy (2012)

Nicole D. Gillespie Thomas L. Lenz

Objective: To develop and implement an Advanced Pharmacy Practice Experience (APPE) to increase student's awareness and use of lifestyle modifications in chronic disease prevention and management. Design: A five-week APPE was developed that utilized a wide variety of activities, including direct patient care, patient education, case studies, journal clubs and reflective assessment and writing to explore various lifestyle modifications and their relation to chronic disease prevention and management. Conclusion: The novel lifestyle medicine APPE provides students a unique opportunity to advance their knowledge in therapeutic lifestyle changes and expand their understanding of the pharmacist's role in chronic disease prevention and management. Type: Idea Paper

10.24926/iip.v3i1.247

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Resveratrol

American Journal of Lifestyle Medicine (2012)

Nicole D. Gillespie Thomas L. Lenz

Resveratrol is a polyphenolic compound found in many products commonly consumed in the American diet. The reported benefits of resveratrol are broad and include antiaging effects, antioxidant effects, anticancer effects, neuroprotective effects, and an array of cardiovascular benefits such as improved cholesterol profiles, reduced atherosclerosis, improved glucose homeostasis, decreased blood pressure, and reduced ischemia– reperfusion injury. The current article discusses the literature relating the dosing, safety, and effectiveness of resveratrol for extended life span and improved cardiovascular health. Additionally, recommendations for use in clinical practice are discussed.

Clinical Practice

10.1177/1559827612448314

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Reducing Inflammation

American Journal of Lifestyle Medicine (2011)

Nicole D. Gillespie Thomas L. Lenz

An elevated C-reactive protein level is an inflammatory marker associated with an increased risk in cardiovascular disease. Regular long-term exercise, a cholesterol-lowering diet (a diet low in saturated fat and high in viscous fiber and plant sterols), and statin pharmacotherapy have all been shown to reduce C-reactive protein levels. The purpose of this article is to describe the research available regarding lowering of C-reactive protein levels and reducing incidence of cardiovascular disease. Specifically, the article will compare the use of statin therapy, regular physical activity, and a cholesterol-lowering diet. The effectiveness of each intervention will be evaluated along with the risks and benefits associated with treatment.

Pharmacotherapy

10.1177/1559827611421115

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Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

INNOVATIONS in pharmacy (2012)

Mallory C. McKenzie Thomas L. Lenz Nicole D. Gillespie Jessica J. Skradski

Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM), lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC) and the Medication Possession Ratio (MPR). Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01). The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence) for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01). The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence) pre enrollment versus post enrollment (+10%, P=0.086). The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for at least one year and was shown to be better when compared to a matched cohort of similar age, condition and region. Type: Original Research

Medication therapy management

Medication Adherence

10.24926/iip.v3i4.274

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Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program

INNOVATIONS in pharmacy (2012)

Thomas L. Lenz Nicole D. Gillespie Michele A. Faulkner Maryann Z. Skrabal Jessica J. Skradski

Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting. Type: Original Research

Consumption

10.24926/iip.v3i4.275

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