title: Team-based approach to addressing simvastatin safety concerns.
abstract: OBJECTIVE
  To describe acceptance of systematic and organized pharmacist interventions to address simvastatin safety concerns.
  
  
  METHODS
  University of Utah Redwood Health Center and Pharmacy, June 2011 to February 2012.
  
  
  METHODS
  Redwood Health Center is an outpatient multispecialty clinic associated with University of Utah Health Care with approximately 85,000 annual visits between primary care and specialty practices. In addition to filling approximately 175,000 prescriptions per year, pharmacists provide disease management and education under collaborative practice agreements.
  
  
  METHODS
  All patients identified as being treated outside the revised simvastatin labeling were included (n = 158). After pharmacist review, recommendations were made to providers via the electronic medical record to promote adherence with the June 2011 Food and Drug Administration (FDA) safety guidelines. In addition to recommendations regarding the FDA guidelines (n = 76), additional recommendations were made to optimize treatment based on low-density lipoprotein cholesterol goal or laboratory evaluation (n = 25).
  
  
  METHODS
  Acceptance rate of recommendations and resources needed to provide pharmacist interventions.
  
  
  RESULTS
  Recommendations were accepted 92% of the time without modification and 7% of the time with modification. Total pharmacist time to conduct the interventions was 21.5 hours, and 3.9 hours of technician time were spent contacting patients.
  
  
  CONCLUSIONS
  Targeted pharmacist interventions were effective in promoting adherence with this complex medication safety alert. A standardized, comprehensive approach to patient assessment, including use of evidence to support pharmacist recommendations, resulted in a high level of acceptance by prescribers.
authors.forename: McKay
authors.initials: M
authors.lastname: Robinson
authors.forename: Karen
authors.initials: K
authors.lastname: Gunning
authors.forename: Karly
authors.initials: K
authors.lastname: Pippitt
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Jennings
mesh_terms: D000553:Ambulatory Care; D004348:Drug Labeling; D057286:Electronic Health Records; D019983:Guideline Adherence; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D010348:Patient Care Team / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D010596:Pharmacy Technicians / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D024382:Professional Role; D019821:Simvastatin / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration; D014589:Utah
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin