***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To implement and evaluate pharmaceutical care services for patients with hyperlipidemias in the community pharmacy setting , to evaluate the results of a pharmaceutical care training process for pharmacists by using an assessment quiz , and to measure patient outcomes result ing from provision of pharmaceutical care to patients with hyperlipidemia . DESIGN : A prospect i ve study was conducted over a 1 -year period . Patients served as their own controls . SETTING : Two independent community pharmacies in Richmond , Virginia . PARTICIPANTS : Twenty-five adult patients with confirmed dyslipidemias completed the study . INTERVENTIONS : Study pharmacists assessed each patient and assisted in setting therapeutic goals ; patients also completed a visit with a registered dietitian . Drug therapy recommendations were made to physicians by the pharmacist when appropriate . Follow-up was scheduled with the pharmacist to ensure positive outcomes and reduce adverse effects . MAIN OUTCOME MEASURES : Fasting lipoprotein profiles were measured initially and at 6 and 12 months . The SF-36 survey , the MacKeigan-Larson satisfaction survey , and a patient opinion survey were administered initially and at the conclusion of the study . RESULTS : Total cholesterol and low-density lipoprotein cholesterol values were significantly decreased at 12 months compared with either the baseline or 6-month values ( p < 0.02 ) . Significant improvement was found in several domains of the surveys ; quality of life , patient satisfaction with pharmacy services , and patient opinions on the role of the pharmacist improved after the intervention . CONCLUSIONS : Pharmaceutical care may positively affect lipid values , quality of life , and patient satisfaction The impacts of two models of pharmacist consultation on patient function and health-related quality of life ( HRQOL ) relative to a control model were studied . Patients in the r and om-assignment study and the areawide study of the Kaiser Permanente/USC Patient Consultation Study were surveyed three times over a two-year period . The patients were receiving pharmaceutical services under the Kaiser Permanente model of consultation ( KP model ) , a state model of consultation , or a control model and were stratified according to prescription drug use . A global visual-analogue scale and Short Form-36 were used to assess HRQOL . In the areawide study , only 2 of 42 comparisons of the effects of the KP or state model on HRQOL were significant ; both were associated with the state model and involved only small increases . In the r and om-assignment study , 3 of 21 estimated effects of the KP model on HRQOL were positive and significant ; 2 of these were significantly different between the KP model and the state model . Although the KP and state models of consultation were associated with some changes in HRQOL , the overall influence was not consistent and not clinical ly important The impacts of three alternative models of  pharmacist consultation on the use and cost of health care services were studied . Two studies were conducted concurrently in an HMO over two years . In one , 6000 patients were r and omly assigned to one of three consultation models ; in the other , the three models were implemented in six geographic regions of California ( 4600 patients ) . The models were ( 1 ) consultation about new or changed prescriptions as m and ated by state law ( state model ) , ( 2 ) consultation focused on selected  high-risk ambulatory care patients ( Kaiser Permanente [ KP ] model ) , and ( 3 ) a control model . The patients were surveyed three times about their health status and satisfaction , and computerized data on health care use and cost were collected . The effect of the consultation models on the use and cost of health care services was examined across five risk groups that were based on drug-use profiles . An additional 37,750 patients ( 10 % of the patients residing in the areawide study sites ) were included in a supplemental analysis of the use and cost of health care services . There was no indication in the r and om-assignment study that pharmacist consultations affected either drug costs or the cost of office visits . Similar results were found in the areawide study , with the exception that the KP model was associated with lower drug costs than the control model . In the 10 % sample , the KP model appeared to be associated with lower office visit costs but higher drug costs . Both models were associated with a lower likelihood of a hospital admission and with lower total health care costs for some high-risk patients compared with the control model . Counseling patients about their medications may be unlikely to reduce medication costs or the cost of office visits but may reduce the likelihood of hospital admissions and the overall costs of health care services ; a combination of counseling patients at high risk for drug-related problems and counseling all patients about any new or changed prescription should be considered This study evaluated pharmaceutical care as an adjunct to an existing , coordinated-care program at a Regional Diabetes Center . The progress of a control group receiving the st and ard pharmacist instruction  was compared with two treatment groups receiving additional small group or individual supplementary education  for a 2-month period . Outcome evaluation included assessment of individual diabetes management through blood glucose monitoring and responses on a pretest and posttest question naire . Patients in the treatment groups demonstrated significantly lower average weekly blood glucose levels and a decreased incidence of hyperglycemic episodes compared with the control group . Question naire data for both treatment groups demonstrated a significant increase in patient underst and ing of diabetes medications and medications for associated illnesses , an increase in knowledge about blood glucose monitoring , and a positive difference in perceptions/attitudes toward diabetes and communication with the pharmacist . This approach is consistent with the concept of pharmaceutical care in which the pharmacist helps patients avoid long-term complications and thus improve their quality of life The impact of clinical pharmacists ' consultations on geriatric drug prescribing was studied in a prospect i ve r and omized controlled trial of patients 65 years of age and over discharged on 3 or more medications for chronic conditions from a 450-bed community hospital . The pharmacists provided consultation to experimental patients and their physicians at hospital discharge and at periodic intervals for 3 months postdischarge . Using a st and ardized tool , a physician-pharmacist panel , blinded to study group assignment of patients , evaluated the appropriateness of prescribing for a r and om sample of 236 patients . Eighty-eight percent had at least one or more clinical ly significant drug problems , and 22 % had at least one potentially serious and life-threatening problem . Drug-therapy problems were divided into six categories : 1 ) inappropriate choice of therapy ; 2 ) dosage ; 3 ) schedule ; 4 ) drug-drug interactions ; 5 ) therapeutic duplication ; and 6 ) allergy .  Experimental patients were less likely to have one or more prescribing problems in any of the categories ( P = 0.05 ) or in the appropriateness ( P = 0.02 ) or dosage ( P = 0.05 ) categories . A summary score , measuring the appropriateness of the patient 's total drug regimen , indicated that experimental patients ' regimens were more appropriate than those of controls ( P = 0.01 ) . Results of this trial reveal that clinical pharmacists can improve the appropriateness of geriatric drug prescribing in outpatient setting The effects of computerized drug profiles and clinical pharmacist consultation in the internal medicine clinics at a Veterans Administration hospital were studied . Population included patients ( n = 512 ) and physicians ( n = 35 ) of three internal medicine clinics during an eight-week period . The first four weeks were the preintervention period . The second four weeks were the intervention period in which a clinical pharmacist attended one clinic ( A ) and provided drug profiles on all patients . Two other clinics ( B and C ) served as controls . During the intervention , patients in clinic A experienced a significant reduction in prescribing problems as identified by the pharmacist : 49 percent of patients before the intervention versus 9.4 percent after the intervention ( p < 0.001 ) . Patients in clinic B had no significant change in prevalence in the number of problems identified ( 39 versus 40 percent ; NS ) , and patients in clinic C had a significant but less dramatic decrease ( 35 versus 22 percent ; p < 0.05 ) . The proportion of patients in clinic A with net decrease in the number of prescribed medications rose from 7.1 to 34.9 percent ( p < 0.001 ) , with a mean decrease of 0.3 medications per patient . No significant differences in number of prescribed medications were noted in clinics B or C. Accuracy of physician medication charting improved for patients in clinic A from 54 percent of charts with accurate drug lists before the intervention to 78.3 percent after the intervention ( p < 0.001 ) . No significant improvements were noted for clinics B and C. These results suggest that computerized drug profiles together with clinical pharmacist consultation can improve prescribing practice s in a hospital outpatient department . Extracto Los autores estudiaron el efecto de proveer perfiles de medicamentos computerizados y consulta por un farmaceútico clínico en las clínicas de medicina interna de un hospital de la Administración de Veteranos . La población incluyó 512 pacientes y 35 médicos de tres cl***inicas de medicina interna durante un período de ocho semanas . Las primeras cuatro semanas fue el período de pre-intervención . Las siguientes cuatro semanas fue el período de intervención en el cual un farmaceútico clínico asistió a una clínica ( A ) y proveyó perfiles de medicamentos para todos los pacientes , mientras otras dos clínicas ( B y C ) sirvieron de control . Durante la intervención los pacientes en la clínica A experimentaron una reducción significativa en los problemas de prescripción según identificados por el farmaceútico : 49 por ciento de los pacientes antes de la intervención versus 9.4 por ciento después de la intervención . Los pacientes en la clínica B no experimentaron un cambio significativo en la prevalencia del número de problemas identificados . Los pacientes en la clínica C tuvieron una disminución significativa , pero menos dramática . La proporción de pacientes en la clínica A con una disminución neta en el número de medicamentos prescritos aumentó de 7.1 por ciento a 34.9 por ciento con una disminución media de 0.3 medicamentos por paciente . No se observó una diferencia significativa en el número de medicamentos prescritos en las clínicas B y C. La precisión de las notas de medicamentos del médico mejoraron para los pacientes en la clínica A. No se observó una mejoría significativa en las clínicas B y C. Estos result ados sugieren que los perfiles de medicamentos computerizados en adición a consulta por un farmaceútico clínico pueden mejorar los patrones de prescripción en un departamento para pacientes ambulatorios de un hospital . Resume L'étude analyse l'impact de fournir le dossier-médicament des patients et de consulter avec un pharmacien clinique en médecine interne à l'hôpital Veterans Administration . Cinq cent douze sujets ont participé ainsi que les médecins ( n = 35 ) de trois cliniques en médecine interne pendant une période de huit semaines . Les quatre premières semaines constituaient la période pré-intervention . Pendant les dernières quatre semaines ( période d'intervention ) , le pharmacien clinique a participé aux activités d'une clinique ( A ) et a fourni les dossiers-médicaments pour tous les patients , alors que les deux autres cliniques ( B et C ) ont servi de contrôle . Lors de la période d'intervention , il y a eu une baisse significative pour ce qui est des problèmes de prescription pour les patients de la clinique A ( basé sur le critère modifié de King et Cheung ) : 49 pour cent des patients avant l'intervention versus 9.4 pour cent après ( p < 0.001 ) . Les patients de la clinique B n'ont eu aucun changement significatif dans la fréquence du nombre de problèmes identifiés ( 39 vs. 40 pour cent ; NS ) , et les patients de la clinique C ont vu une réduction significative mais moins dramatique ( 35 vs. 22 pour cent ; p < 0.05 ) . La proportion de patients de la clinique A avec une baisse dans le nombre de médicaments prescrits est passé de 7.1 à 34.9 pour cent ( p < 0.001 ) , avec une réduction moyenne de 0.3 médicaments par patient . Aucune différence n'a été notée pour le nombre de médicaments prescrits dans les cliniques B ou C. La précision avec laquelle le médecin a complété les dossiers s'est ameliorée pour les patients de la clinique A allant de 54 pour cent des dossiers ayant une liste correcte de médicaments avant l'intervention à 78.3 pour cent après l'intervention ( p < 0.001 ) . Aucune amélioration significative n'a été observée pour les cliniques B et C. Ces résultats démontrent que les dossiers-médicaments de patients ainsi que les consultations par le pharmacien clinique peuvent améliorer les habitudes de prescription d'un département de cliniques externes d'un hôpital OBJECTIVE : To assess the effectiveness of a pharmaceutical care model on the management of non-insulin-dependent diabetes mellitus ( NIDDM ) in urban African-American patients . DESIGN : Eligible patients were r and omized to either a pharmacist intervention or control group and followed over a 4-month period . Patients in the intervention group received diabetes education , medication counseling , instructions on dietary regulation , exercise , and home blood glucose monitoring , and evaluation and adjustment of their hypoglycemic regimen . Patients in the control group continued to receive st and ard medical care provided by their physicians . SETTING : A university-affiliated internal medicine outpat 
    Output:
    
The other studies supported the exp and ed roles of pharmacists in patient counselling and physician education .