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ASK THE PHARMACIST 1
Ask the Pharmacist- an Innovative Program Advancing Access, Awareness,
Wellness, and Prevention
Creighton University Master of Public Health Capstone Project MPH 612 August, 2016 Steven Banjoff
Ask the Pharmacist 1
Ask the Pharmacist- an Innovative Program Advancing Access, Awareness, Wellness, and
Prevention
Steven C. Banjoff
Creighton University Master of Public Health Capstone Project
MPH 612 07/25/2016
Author Note
This report would not be possible without the generous support and contributions of the
Ease@Work and The Centers for Families and Children staff whose vision and dedication
created an innovative and empowering Wellness Program. I was proud to play a role in planning
and advancing such an innovative strategy to improve health. Ease@Work is the profit earning
arm and represent 5% of the non-profit Centers for Families and Children income, or as they are
affectionately known, “The Centers”. My work on the Ask the Pharmacist booth, online, and
telephonic project was as an unpaid intern with no prior affiliation with either entity and as a
practicum requirement of Creighton University. My involvement with the project is designed to
give “real-world” experience as a health practitioner and no conflict of interest or financial
incentive exists.
Abstract
Ask the Pharmacist 2
Employee Assistance Programs (EAP’s) are often overlooked opportunities to reduce
stress, increase awareness, and improve wellness. The Ask the Pharmacist booth and
online/telephonic wellness program developed with The Centers for Families and Children
pharmacist team and The Centers subsidiary, Ease@Work Wellness division as an innovative
approach to increasing access, awareness, and empowerment. Building upon a successful
Ease@Work health fair program, the use of a focus group of wellness division staff from various
clients indicated a desire for additional expertise at their health fairs. Adding opportunity for
participants to consult with a health expert like a Pharmacist to improve the health fair
experience was the result of several brainstorming sessions. It provides the platform to unite the
broad range of patient centered services that represent Medication Therapy Management (MTM)
practiced by the Center’s pharmacy and Ease@Work’s holistic philosophy of wellness into a
powerful new tool for addressing health strategies, awareness, screening, and outcomes.
The goal, to improve employee’s awareness of their health risks, ameliorate medication
error, promote prevention, and empower employees to take control of their own wellness
program. This is accomplished by providing expert guidance on a wide range of topics initiated
by the employee’s concerns, issues, or questions through collaboration with one of the more
accessible, yet overlooked members of a healthcare team, the Pharmacist. Allowing the
employee to direct the conversation not only allows for individual and relevant advice, it also
allows for the better understanding of issues, wants, and needs facing the employees served by
the EAP.
Increasing assessment abilities of existing programs as well as provide motivations for
new programs are an additional benefit. Detailed and sanitized information gathered from past
and ongoing Ask the Pharmacist booth events provide the justification program expansion, as
Ask the Pharmacist 3
well as areas in which it can help to improve the wellness of the workforce. While, it may be too
early to tell what impact this program may have on wellness, initial data indicate possibilities for
lower healthcare costs, raising access to preventative measures, and empowering individuals
with control of their wellness needs and approaches.
Who are the Centers and Ease@Work?
The Centers for Families and Children (the Centers) is the fourteenth largest nonprofit in
Northeast Ohio, while also being one of the oldest and largest non-profit human services
organizations in the area (the Centers, 2016). It is the result of three well-respected human
service agencies; Center for Families and Children, West Side Ecumenical Ministry and El
Barrio joining forces in 2011 to provide a greater community impact. Their mission is the belief
“lasting, positive change begins with access to opportunity” (Berger & Smith, 2016, p. 3).
Currently, The Centers serve more than 25,000 people a year, connecting them with the right
opportunities, relationships, and resources to build better futures by making a difference in
someone’s life today (the Centers, 2016). The core offerings include Early Learning, Health and
Wellness, Workforce Development, Family Services, and an Employee Assistance Program
(EAP) Ease@Work. The Board of Directors is comprised of 48 community leaders from private,
public and nonprofit organizations, with an Associate Board containing emerging leaders
committed to building a brighter future with various community partners and volunteers (Berger
& Smith, 2016).
Overall, the Centers has a budget of approximately $54 million and employs 550
employees of which 50% work in Health and Wellness, 32% work in Early Learning, 13%
Administrative Support, 1% in family services, and 3% are with Ease@Work (Berger & Smith,
2016). The vast majority of the Centers revenue is generated from governmental reimbursement
Ask the Pharmacist 4
for services (61%), government grants (16%) Lead Agency Funding for Head Start (9%), and
Charitable Contributions (7%), while Ease@Work, the only direct income generator at the
Centers, currently contributes 5% to the agency revenue. Ease@Work embodies the Centers’
mission of making a difference by providing opportunities, and is one of the first Employee
Assistance Programs in Northeast Ohio, first serving clients in 1979, and has continually evolved
to fit ever-changing needs of their clients. Ease@Work takes pride in providing solution based
behavioral health services that benefit both the employee and employer and their comprehensive
menu of services is impressive (Ease, 2012).
Ease@Work has grown from its humble beginnings as a substance abuse and workplace
compliance resource to assisting in a broad range of issues from anxiety, depression, smoking
cessation, and nutritional/ fitness coaching to workplace stress, parenting concerns, legal
difficulties, financial issues, and eldercare issues. The diverse blend of offerings available to
employees and their dependents completely shattered my illusion Employee Assistance
Programs were the equivalent of being sent to “the principal’s office”, and were, in reality, an
underutilized, overlooked resource that represents a cost-effective investment into wellbeing.
Wellness Manager (and boss/mentor through the duration of the internship), Stephanie Patek,
assured me my preconceived notion regarding EAPs was not unique and was a regular
misconception they were confronted with. Remarkably, even employees of the Centers were
unclear of the diverse array of assistance to a healthier, more balanced life available to them and
their dependents.
The recommendation to contact Stephanie and investigate a possible internship within the
Wellness division of Ease@Work came from a good friend and fellow Master of Public Health
student who previously interned for her. Initially hesitant due to my ill-conceived assumptions
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concerning EPAs, Stephanie’s infectious “can-do” attitude, energy, and dedication to promoting
wellness through diverse cultural/belief sensitive approaches quickly put my concerns to rest.
Having the opportunity to take part in developing and launching a new participant-centered
wellness program as a respected and valued team member was a prospect that I couldn’t refuse.
The Ask the Pharmacist Program- Origins, Intent, and Justification
The Ask the Pharmacist project was initiated as a response from various Wellness
Managers using Ease@Work as their company’s Employment Assistance Program (EAP) desire
to improve the impact of Health Fairs. These events normally included informational booths
such as services the EAP offered, nutritional, physical activity information, and at times could
also include healthy cooking demonstrations, stress management techniques, and massage.
These managers were seeking strategies that would raise awareness, encourage prevention, and
add additional expertise to the health fair events they were hosting for their employees. Through
several brainstorming sessions between Ease’s Wellness Manager Stephanie Patek, the Center’s
Resident Pharmacists Ryan Bender, Lauren Miller, as well as other members of the Ease@Work
and pharmacy staff, Ask the Pharmacist was born. The program reflected the Medication
Therapy Management (MTM) training of the Center’s pharmacists with the Ease@Work mission
of improving health by increasing capability and access. MTM is much more than managing
medications, its philosophy aims to bring a group of services that optimize therapeutic outcomes
for individual patients (American Pharmacists Association, 2016). The MTM philosophy was
then captured in the mold of other Ease@Work Ask programs that utilize trained experts offering
a personalized approach to wellness that takes the time to understand the culture of the
organization, as well as the individual, to provide a sustainable wellness plan that strengthens
both.
Ask the Pharmacist 6
The Ask the Pharmacist program attempts to fulfill the added proficiency and greater
awareness needs revealed by focus groups conducted amongst current clients. It brings access to
the expertise of respected and trusted healthcare professionals (Simone, 2013) through physical
and remote formats. The first format is in person, at the health fair event, which includes an
available consultation with two pharmacists to provide information on specific and general
topics. These topics could be detailed and as a result of health conditions and number of
medications individuals are on, or merely general inquiry or safe cost saving strategies through
the use of over-the-counter or generic medications. It provides an avenue for detailed
discussions of medications being taken, drug interaction, proper storage, and optimal conditions
for when and how to take the medications. This is extremely important when one considers
approximately 80% of all medical treatments involve medication and medication error represents
a possible $100 to as high as $289-billion-dollar expense to the U.S. healthcare system and
optimal medication adherence is essential to chronic disease management (CDC, 2014).
The in-person option also includes flu-shot immunizations and Biometric Screening
stations that provide; BMI or body fat measurement, blood pressure measurement, blood glucose
level, fasting and non-fasting total cholesterol, high density lipoprotein, and triglycerides screens
(both finger stick blood tests). Screenings increase access to health risk assessments that can
play a significant role in various stages of prevention (American College of Occupational and
Environmental Medicine, 2013), while immunizations assist in ameliorating the spread of
contagious disease, hospitalization, and death (Centers for Disease Control and Prevention,
2016). The presence of the pharmacists, (usually placed in an out of the way area as possible),
allows the employee semi-private access to have answers to any questions the screening may
have brought about. Engaging the employees in this fashion provides the potential to catch
Ask the Pharmacist 7
health threatening conditions such as high blood pressure, risk for diabetes, heart disease, or
other chronic ailment at a much earlier stage. The pharmacists also serve as a reminder that the
screening does not represent a diagnosis but only an assessment of risk factors. Though on a few
occasions individuals were advised to go to the emergency room or to contact their primary care
physician as soon as possible as a result of the screenings or consultation with the pharmacist.
Providing influencers and motivators in the form of pharmacists who adhere to a MTM
philosophical approach furnishes individuals the access to tools and relevant information to assist
in the battle to change behavioral conditioning. Offering an opportunity to broaden the sense of
wellness beyond the physical and into the psychological, emotional, and social wellbeing needed
to understand the underlying causes that impact physical health. On more than one occasion
during my time observing these events the sense of relief felt by individuals was quite apparent.
They left the booth with a greater sense of awareness and empowerment, while feeling
appreciative a professional caregiver took the time to explain things in a manner in which they
could understand and accomplish.
Whether it was confirming that side-effects were a result of medication, elimination of
dangerous drug interaction possibilities, alternative treatment methods, confirmation they were
on a proven treatment method, simply having a better understanding of the purpose of the
medication they were on, or a simple inquiry on the effectiveness and safety of supplements,
they were able to take away information and strategies on something that was important to them.
The Ask the Pharmacist Program introduces individuals to the concept pharmacists can play a
role beyond that of a prescription filler. The pharmacist can provide access to preventative
services, optimize disease state management, provide greater access to care for those individuals
coping with chronic disease, and improve medication adherence (CDC, 2014). Additionally,
Ask the Pharmacist 8
there is a growing recognition that supplements are loosely regulated (Richter, 2015) despite the
fact dietary supplements have grown into a $30 billion plus industry in which over half the adult
population uses, at times with fatal results (Docherty, 2016). Poor regulation has left little
control on the supplemental industry’s capacity to market their product without proof of
effectiveness or safety (Skerret, 2012). The ability to consult with an expert in medicinal
chemical compounds, their uses and effects could be an invaluable resource when one is
determining the safety, efficacy, legitimacy, possible dangerous side-effects and drug
interactions one could encounter, or simply not wasting valuable resources for a product that
lacks effectiveness.
The importance of privacy with health information can never be overlooked (Nass, Levit,
& Gostin, 2009) not only is it an ethical imperative but encompasses personal autonomy,
individuality, respect, and dignity that encompass ethical treatment. While data from screenings
and information gathered through the discussions with the pharmacists are treated carefully,
securely, and with the utmost consideration for HIPAA, providing a more private access to the
pharmacist was still a need that needed to be addressed. It was thought that those who may feel
hesitant about approaching the booth due to privacy, self-consciousness, feelings of intimidation
or other factor could be tackled by adding an internet and telephonic component to Ask the
Pharmacist. This would allow the individual the freedom and to have their questions or concerns
addressed at their convenience and with an additional layer of privacy not available at the health
fair event. The question is first initiated over a secure server with a twenty-four-hour response
time window.
Upon receipt, the question is evaluated for type of response warranted within the 24hr
window. Basic requests will be answered via email communication, and there will be no limit to
Ask the Pharmacist 9
these types of consultations. A request is considered advanced if the individual is on three or
more medications, are experiencing at least one active disease state, or is on an active return to
work plan. Advanced requests will trigger an up to forty-five-minute telephonic consultation
that includes a comprehensive medication review. Advanced requests will also include a twenty-
minute follow-up consultation for adherence monitoring with an allowance of three sessions per
issue per year. Data entry and reporting will be completed within days of the initial request to
allow for aggregate reporting for employer, and internally to capture a picture of needs, wants,
and issues facing employees. The program has the necessary appeals process, participatory, and
contingent design that complies with ACA health promotion guidelines for qualifying financial
incentives (Pollitz & Rae, 2016).
ACA incentives are not the only potential cost savings the program provides. While
there is scant information on EAP’s offering a comprehensive MTM philosophy based program,
there have been clinical studies. A study from Minnesota using data from a six clinical settings
revealed MTM lowered healthcare costs from $11,965 to $8,197 per person, 637 drug
intervention problems were resolved among the 285 intervention patients, and biometric
screening numbers were improved in the intervention group as well (Issets, et al., 2008). A
Walgreen’s study also showed that patients do a better job with medical adherence and overall
healthcare costs decrease when a pharmacist is used as an intervention technique (Lowery,
2015).
Methods
As previously stated, the need for this program first originated through focus groups, and
has continued to rely upon them throughout its development. Development occurred with the
use of Social Cognitive Theory to behavioral change as a guiding principle. This principle
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operates on three main factors that affect the likelihood of changing behavior self-efficacy, goals,
and outcome expectancy (U. S. Department of Health and Human Services, National Cancer
Institute, 2005). The program is rooted in the patient centered care coordination approach. Care
coordination is the key strategy to potentially improve effectiveness, safety, and efficiency that if
delivered to the right people can improve outcomes for individuals, providers, and payers (U.S.
Dept. of Health and Human Services, 2016). The use of a multi-level ecological approach helps
to identify intervention points and levels of influence for health related conditions and behaviors
(USDHHS, 2005). This patient-centered philosophy had already created successful Ask the
Expert programs that served as a template.
The ability to build upon already successful initiatives led the direction of this project,
and proved to be an invaluable starting point for how the program was envisioned. It was also
critical that the program met and exceeded ACA guidelines for workplace Wellness Programs
and continue the tradition of offering a comprehensive wellness program, a distinction only 13%
of programs can claim (Pollitz & Rae, 2016). The collaborate effort between all relevant
stakeholders closely mirrors the principles of the Community Based Participatory Research
(CBPR). It strives to recognize the community it serves as a unit of identity, that is built on
strengths and resources within that community (Minkler & Wallerstein, 2008). It is designed to
promote co-learning and capacity building and integrates and achieves a balance research and
action for the mutual benefit of all partners and is developed through a cyclical and iterative
process (Minkler & Wallerstein, 2008).
While information is shared among all stakeholders, it does not reach the level required
for a true CBPR, though the program is assessed and designed with issues and input that are a
primary concern of our clients. This is quite likely due to the nature of this service being offered
Ask the Pharmacist 11
as a paid for service meant to not only improve health outcomes and lower costs for employers
who participate, but also as a means to generate a profit for Ease@Work (and ultimately the
Centers). While all legal disclaimers and privacy rights are rigidly adhered to there is a missing
acknowledgement and information sharing (it is prohibited for Ease to contact individuals of the
employers directly) that could have the potential to make this project even more effective.
Despite this fact, this project would not be possible without the collaborative effort of multiple
stakeholders with a focus of mutual respect and dignity that embodies a CBPR program.
Data gathered from Ask the Pharmacist events is analyzed through an observational,
cross sectional spreadsheet of qualitative and quantitative variables. This spreadsheet was a
compilation of information initially gathered to generate individual aggregate reports for the
client that procured the service. This report has been generated since the beginning of the phase
one in person portion of the program, and each occurring event is entered into the spreadsheet in
a timely manner. Because this spreadsheet was designed to capture as much data as possible,
different pivot tables can be used to examine relationships between different data points. Before
the compilation of this spreadsheet took place, the data for the project was spread over several
different individualized reports that made it difficult to understand what exactly was taking place
within the project.
The information on the spreadsheet includes type of issue being experienced by the
individual, number of medications they took, expected results, and recommendations made by
the pharmacist. While this method is not the best for making inferences, it is an excellent
method for descriptive purposes, and developing problem statements (Gordis, 2014). Research
through internet Pub-Med and other databases revealed this program was unique and the only
research available involved outpatient/inpatient MTM programs, with little indication that other
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EAPs were attempting to integrate these principles within the wellness programs they offered.
Creating a descriptive tool was my attempt to help clarify the issues being presented and the
solutions that were being offered, and may have been the largest contribution I made to the
project. It is hoped this spreadsheet will serve as a tool to improve the focus of the program,
inform other programs, and inspire more rigid studies such as a Case Control or Cohort that
could provide a greater insight into the benefits, relationships, and efficacy a program like Ask
the Pharmacist offers.
Work Plan, Application, and Final Product
The unique position Ease@Work has within the Centers is perhaps the most crucial
element of the project. The collaborative effort between Ease and the pharmacy most likely
would not have been possible without this unifying connection. The project also benefitted from
the existing infrastructure, programs, and expertise present within the organization. While
funding and time are always an issue with any program, the Ask the Pharmacist program is in a
position where it has stable resources and personnel to ensure continuity of the program. The
needed legal, technical, marketing, and administrative hierarchy were already in place, from its
inception, drastically improving development time and start up expenses. While staffing is far
from optimal, the use of interns and volunteers along with a pharmacy residency program help to
overcome this personnel shortfall. Ease@Work’s long history of being a trusted partner in a
wellness program with dedication to bringing innovative solutions have provided solid footing
for this program, as well as serving as a benchmark to expected standards.
As of now, the only active portion of the project is in the form of the in person Ask the
Pharmacy booth, biometric screening, and flu shot (seasonal) option. This service has been
operational for nearly a year and has been building data for further analysis during this time.
Ask the Pharmacist 13
Pricing for this option, mirrors those of other Ask the Expert programs, and thus far has been
well received by the clients that have taken advantage of the service. Several focus groups and
the Q&A session following a presentation to the North East Ohio Healthy Business Council have
left positive feedback on the potential of this program to benefit all stakeholders that employ its
use. At this time final adjustments of the online and telephonic version of the program. Pricing
and need of the internet/telephone option remains a sticking point between entities within
Ease@Work. The solution may be to create tiers such as “gold” “silver” and “bronze” packages
to enable clients to choose the most suitable program for their company’s budget. At this time
the overall internet/telephone protocol is set and only small details remain to be ironed out. This
is being accomplished with additional field research, and finalizing pricing for each package, and
launch date of this portion of the program is set for early Fall.
Resulting information from this project can be used in a variety of ways. The
information can assist employers in understanding the issues that are facing their most valuable
resource, their employees. The information also assists Ease@Work by directing their focus on
issues that are most pressing to their clients which enables them to develop programs and
strategies to meet these issues in a holistic manner. The research has already revealed that 76%
of the clients who used this service were on at least one medication, and 27% were on three or
more medications. The amelioration of medication error, improve medication adherence, and
assist in optimizing medication use are just a few examples this program has already begun to
accomplish its goal of improving health. The program represents access to preventative
strategies and screenings that may not normally take place if not for the convenience in accessing
these services Ask the Pharmacist provides. The dissemination of results in the form of client
reports as well as the observational compilation of this data will be pivotal for the development,
Ask the Pharmacist 14
growth, and effectiveness of this program. The descriptive picture this data provides can serve
as inspiration for new programs and studies that have the potential to better understand the
efficacy, approach, and role EAPs play in improving health and controlling health care costs.
Conclusion
Bringing one of the more accessible and visible but overlooked members of a healthcare
team out of the stereotype of merely the person who fills medication needs and directly involves
them with a wellness strategy has the potential to positively influence health on a number of
levels. Having an additional expert to help raise awareness, model, encourage, and partner in
strategy has the capability to benefit the individual, the company, and the health provider. It is
no secret health costs and negative outcomes are still a concern even after the passage of the
ACA. Preventative measures are a key strategy in reigning in control of these costs, both
monetarily and impact on quality of life. Instilling commitment to health, and behavioral change
requires access to influencers, motivators, and trusted information. This program attempts to
broaden the focus of a wellness strategy through a patient centered program that views wellness
as a result of the interaction between the physical, emotional, and social environment.
The difficulty of this program is the inability for Ease@Work to directly market the
program to the employees. The promotion for the program (excluding the promotion to sell the
program to the Wellness Manager) is the responsibility to whomever is administering the
company’s Wellness Program. This hard truth was ironically bore out by a situation I
experienced with an associate. My associate was having difficulty at work with other personnel
to the point she was mentally distressed. I asked if she knew if her company had an EAP, and
informed her if they did there was a good chance she would have access to the brief counseling
she desired. It turned out that indeed they used to have an EAP, and ironically it was
Ask the Pharmacist 15
Ease@Work, but the company had just discontinued their service due to lack of use. The
problem was, neither my associate, or others at her place of employment were not aware they
had access to comprehensive resources that provided assistance to an extensive variety of needs.
Proving, you can have the most effective program based on the best current evidence available
and if people are not aware of its existence it helps no one.
It is my hope the program continues to grow, and the descriptive information being
gained continues to be recorded and serve as a launching pad for further more rigidly controlled
studies, as well as raise awareness of the greatest concerns facing the employees that it serves. I
would like to see an improvement to the method that the information is initially gathered. The
largest concern being additional informed consent is not given at the information booth where
the data is gathered. While, disclosure is made within the paperwork of the event, and all legal
requirements and protection of the data is met, an additional disclosure is needed in my opinion.
The booth participant is not told verbally the information he/she are giving is being used as a
research tool. While I was successful including additional disclosure for the internet/telephonic
portion of the program explaining how this information may be used, it was determined no
additional disclosure beyond those included on procurement of the service is given was needed
for the live events. The information is also recorded after the participant leaves, which lends an
“air of secrecy” and provides the possibility for recording errors to occur. While for-profit
endeavors are more hesitant of sharing information and being completely transparent, changing
this method of information gathering may have the potential for strengthening the reliability of
the data gathered.
Ask the Pharmacist 16
References
American College of Occupational and Environmental Medicine. (2013). Biometric Health Screening for Employers Consensus Statement of the Health Enhancement Research Organization,. Journal of Environmental Medicine, Volume 55, No 10., 1244-51 DOI: 10.1097/JOM.0b013e3182a7e975.
American Pharmacists Association. (2016). What is Medication Therapy Management. Retrieved from APhA web site : http://www.pharmacist.com/mtm
Berger, J., & Smith, A. (2016). Welcome, the Centers for Families and Children Orientation. The Centers for Families and Children Employee Orientation May 9 2016 (pp. 1-6). Cleveland: The Centers.
CDC. (2014, October 21). CDC Public Health Grand Rounds How Pharmacists Can Improve Our Nations' Health pdf. Retrieved from CDC.gov: https://www.cdc.gov/cdcgrandrounds/pdf/gr-pharmacists-10-21-2014.pdf
Centers for Disease Control and Prevention. (2016, May 25). Key Facts About Seasonal Flu Vaccine. Retrieved from CDC web site, date accessed 7/30/16: http://www.cdc.gov/flu/protect/keyfacts.htm
Docherty, N. (Director). (2016). Frontline: Supplements and Safety [Motion Picture].
Ease. (2012). Ease@Work Organizational Development and Training Catalog. Retrieved from Ease@Work, date accessed July 18, 2016: https://www.easeatwork.com/Portals/0/Images/PDF/ease@work%20Organizational%20Development%20&%20Training%20Catalog.pdf
Gordis, L. (2014). Epidemiology 5th edition. Philadelphia, PA: Elsevier Saunders.
Issets, B. J., Schodelmeyer, S. W., Artz, M., Lenarz, L. A., Heaton, A., Wadd, W., . . . Cipolle, R. (2008). Clinical and economic outcomes of medication therapy management services: the
Ask the Pharmacist 17
Minnesota experience. Journal of American Pharmacy Association Volume 48 (2), 203-211 DOI: 10.1331/JAPhA.2008.07108.
Lowery, M. (2015, November 3). Walgreens study: Pharmacist interventions improve med adherence, lower healthcare costs . Drug Topics Voice of the Pharmacist, pp. 1-2.
Minkler, M., & Wallerstein, N. (2008). Community Based Participatory Research: from Process to Outcomes. San Francisco, CA: Jossey-Bass.
Nass, S., Levit, L., & Gostin, L. (2009). Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research. Washington D.C.: National Academies Press.
Pollitz, K., & Rae, M. (2016, May 19). Workplace Wellness Programs Characteristics and Requirements. Retrieved from Henry J Kaiser Family Foundation: http://kff.org/private-insurance/issue-brief/workplace-wellness-programs-characteristics-and-requirements/
Richter, A. (2015, June). Gerald Kessler, Reflections on the life of a natural health Industry icon. Retrieved from Energy Times enhancing your vitality through nutrition, health, and harmony: http://www.energytimes.com/pages/features/0615/mrk.html
Simone, A. (2013, December 18). Pharmacy Times. Retrieved from Pharmacists Among Most Widely Trusted Professionals, Gallup Poll Finds, date accessed 7/21/16: http://www.pharmacytimes.com/resource-centers/pharmacy-management/pharmacists-among-most-widely-trusted-professionals-gallup-poll-finds
Skerret, P. (2012, February 2). FDA needs stronger rules to ensure the safety of dietary supplements. Retrieved from Harvard Health Publications, Harard Medical School: http://www.health.harvard.edu/blog/fda-needs-stronger-rules-to-ensure-the-safety-of-dietary-supplements-201202024182
the Centers. (2016, July 25). The Centers for Families and Children information page. Retrieved from thecentersohio.org: http://www.thecentersohio.org/
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Ask the Pharmacist 18
8/1/2016: http://www.ahrq.gov/professionals/prevention-chronic-care/improve/coordination/index.html
Appendix A
The size of the file makes it impossible to include the spreadsheet within this report,
please double click on the icon to review the spreadsheet created for Ask the Pharmacist.