Sample records for arkansas pharmacists perceptions

  1. Pharmacist perception and use of UpToDate®*


    Wallace, Katie L.; Beckett, Robert D.; Sheehan, Amy Heck


    A cross-sectional survey of a convenience sample of 1,199 pharmacists was conducted to describe pharmacists' use and perception of UpToDate®. Of 472 (39%) respondents, 217 (46%) reported using UpToDate. Most respondents who used or had heard of UpToDate indicated willingness to change a treatment plan based on UpToDate recommendations (77%). Many believed that UpToDate is updated weekly (31%) or monthly (49%) and that all articles undergo external peer review (51%). In conclusion, the majorit...

  2. Pharmacist perception and use of UpToDate®. (United States)

    Wallace, Katie L; Beckett, Robert D; Sheehan, Amy Heck


    A cross-sectional survey of a convenience sample of 1,199 pharmacists was conducted to describe pharmacists' use and perception of UpToDate®. Of 472 (39%) respondents, 217 (46%) reported using UpToDate. Most respondents who used or had heard of UpToDate indicated willingness to change a treatment plan based on UpToDate recommendations (77%). Many believed that UpToDate is updated weekly (31%) or monthly (49%) and that all articles undergo external peer review (51%). In conclusion, the majority of respondents reported that they would adjust drug therapy based on UpToDate recommendations; however, many pharmacists may hold misconceptions regarding the updating and peer-review processes.

  3. Survey of community pharmacists' perception of electronic cigarettes in London (United States)

    Marques Gomes, Ana C N; Nabhani-Gebara, Shereen; Kayyali, Reem; Buonocore, Federico; Calabrese, Gianpiero


    Objectives To seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation. Setting A survey of a sample of 154 community pharmacies across London, UK. Context E-cigarettes have exclusively established themselves in the market through consumers-led demand. To date, e-cigarettes still remain unregulated and can be easily purchased in shops, over the internet, but more controversially also in pharmacies in the UK. Pharmacists find themselves with a shortage of information on their safety and efficacy, and may experience an ethical dilemma when consulted by patients/customers. Key findings Response rate: 60% (n=92). Independent pharmacies accounted for 90% of the sample. The majority of participants (73%) sell e-cigarettes. A minority of participants (20%) have been presented with adverse effects such as cough and dry mouth. As possible reasons for their use, pharmacists ranked ‘aid in stop smoking’ as the most important (56%), with ‘cheaper alternative’ (43%) and ‘social/recreational use’ (31%) being the least important ones. Safety issues were raised as statements such as ‘e-liquid in cartridges may be toxic’ were agreed by 52% of respondents. The majority of pharmacists (97%) were supportive of e-cigarettes being regulated, expressing current concerns regarding excipients (42%) and nicotine content (34%). Participants indicated that they would require training in the form of information packs (88%), online tutorials (67%), continuous professional development (CPD) workshops (43%) to cover safety, counselling, dosage instructions, adverse effects and role in the smoking cessation care pathway in the future. Conclusions Pharmacists expressed concerns about the safety of e-cigarettes, especially regarding the amounts of excipients and nicotine as these still remain unregulated. Currently, there are no guidelines for pharmacists regarding e-cigarettes. Community

  4. Pharmacists (United States)

    ... about their medications. Employment of pharmacists in traditional retail settings is projected to decline slightly as mail order and online pharmacy sales increase. Job Prospects The number of ...

  5. The Great Boundary Crossing: Perceptions on Training Pharmacists as Supplementary Prescribers in the UK (United States)

    Tann, Jennifer; Blenkinsopp, Alison; Grime, Janet; Evans, Amanda


    Objective: To explore the perceptions of General Medical Practitioners and pharmacist supplementary prescribers of the training provided for qualification as a pharmacist supplementary prescriber, and the experience of pharmacist supplementary prescribers of subsequent continuing professional development in practice. Design: A qualitative study of…

  6. A qualitative study exploring public perceptions on the role of community pharmacists in Dubai


    Rayes IK; Hassali MA; AR, Abduelkarem


    Background: The role of community pharmacists is very important due to their access to primary care patients and expertise. For this reason, the interaction level between pharmacists and patients should be optimized to ensure enhanced delivery of pharmacy services. Objective: To gauge perceptions and expectations of the public on the role of community pharmacists in Dubai, United Arab Emirates (UAE). Methods: Twenty five individuals were invited to participate in 4 separate focus group ...

  7. Identification of the Discrepancies between Pharmacist and Patient Perception of the Pharmacist's Role as an Advisor on Drug Therapy Based on Social Science Theory. (United States)

    Oshima, Shinji; Senoo, Kazuhiko; Negishi, Akio; Akimoto, Hayato; Ohara, Kousuke; Inoue, Naoko; Ohshima, Shigeru; Kutsuma, Nobuaki; Juni, Kazuhiko; Kobayashi, Daisuke


    Article 25-2 of the Japanese Pharmacists' Act was revised in June 2014, establishing the position of pharmacists as "advisors on the use of pharmaceuticals." Prior to the Act's revision, we investigated the perceptions of patients and pharmacists about pharmacists' roles using a social science methodology. We also examined current opinions and necessary factors for the future growth and development of pharmacists. This questionnaire survey was conducted using an internet method. Patients and pharmacists answered 12 questions. Responses from 529 patients and 338 pharmacists were analyzed. For all items, pharmacists' awareness of their roles exceeded patients' awareness of the roles. In this study, the difference between pharmacist and patient awareness was larger than in similar research conducted in the United States. The greatest difference was observed in three items: "Understanding the effects of the drugs the patients are taking" (rate of high ratings: pharmacists 80.2%, patients 37.8%), "Understanding the health changes caused by the drugs dispensed to the patients" (pharmacists 80.2%, patients 28.4%), and "Consciously protecting patients from the adverse effects of drugs" (pharmacists 82.8%, patients 42.2%), indicating role discrepancy. Partition analysis indicated the three factors for a pharmacist to be regarded as a drug therapy or medication specialist: "The patient regards the pharmacist as his/her family or regular pharmacist," "The pharmacist is making it easy for a patient to talk with him/her" and "The pharmacist is aware of a patient's use of products other than prescribed drugs, such as over the counter (OTC) medications or health foods and nutritional supplements." Future efforts are necessary to resolve role discrepancy and implement ongoing monitoring.

  8. Knowledge, perception and practice of pharmacovigilance among community pharmacists in South India

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    Prakasam A


    Full Text Available Pharmacovigilance has not progressed well in India and the concept is still in its infancy. India rates below 1% in pharmacovigilance as against the world rate of 5%. Objectives: The aim of our study was to evaluate the knowledge, perception and practice of pharmacovigilance among registered community pharmacists in Hyderabad, India. Methods: This was a prospective study to find out the knowledge, perception and practice of adverse drug reaction reporting among community pharmacists. It was conducted by a face to face questionnaire and the convenience factor of the pharmacist was taken into consideration. Results: From the 650 questionnaire administered to community pharmacists, 347 (53.3% were returned completely filled questionnaires. A number of 120 (34.6% pharmacists could define the term ‘pharmacovigilance’ to an acceptable extent and 119 (34.3% knew about the National Pharmacovigilance Programme in India. 96 (27.7% had good knowledge, 36(10.4% had fair knowledge and 215(61.9% had poor knowledge about pharmacovigilance. We have found that 196 (56.5% had good perception, 94(27.1% had fair perception and 57(16.4% had poor perception. Only 41(11.8% pharmacists ever reported an ADR and the other never reported ADR. The majority of pharmacists 223(64.3% felt that the AE is very simple and non-serious and hence did not report. Pharmacists have poor knowledge, good perception and negligibly low reporting rates. Conclusions: Incorporation of ADR reporting concepts in education curriculum, training of pharmacists and voluntary participation of pharmacists in ADR reporting is very crucial in achieving the safety goals and safeguarding public health.

  9. A qualitative study exploring public perceptions on the role of community pharmacists in Dubai

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    Rayes IK


    Full Text Available Background: The role of community pharmacists is very important due to their access to primary care patients and expertise. For this reason, the interaction level between pharmacists and patients should be optimized to ensure enhanced delivery of pharmacy services. Objective: To gauge perceptions and expectations of the public on the role of community pharmacists in Dubai, United Arab Emirates (UAE. Methods: Twenty five individuals were invited to participate in 4 separate focus group discussions. Individuals came from different racial groups and socio-economic backgrounds. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers coded all transcripts to identify emerging themes. Appropriate measures were taken to ensure study rigor and validity. Results: All facilitators and barriers that were identified were grouped into 5 distinct themes. The pharmacist as a healthcare professional in the public mind was the most prominent theme that was discussed in all 4 focus groups. Other themes identified were, in decreasing order of prevalence, psychological perceptions towards pharmacists, important determinants of a pharmacist, the pharmacy as a unique healthcare provider, and control over pharmacies by health authorities. Conclusions: This study provided insight into the way that the public looks at the role of community pharmacists in Dubai. Determinants that influence their perception are the media, health authorities, pharmacist’s knowledge level, attire, nationality, age, and pharmacy location.

  10. Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia (United States)

    Khan, Muhammad Umair; Hassali, Mohamed Azmi Ahmad; Ahmad, Akram; Elkalmi, Ramadan Mohamed; Zaidi, Syed Tabish Razi; Dhingra, Sameer


    Background Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship. Methods A cross-sectional study was conducted among community pharmacists between March–April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data. Results A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05). Conclusion The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and

  11. Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach


    Rayes IK; Hassali MA; AR, Abduelkarem


    Background: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. Objective: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. Methods: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire...

  12. Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates


    Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelmula R Abduelkarem


    The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories ...

  13. Quantitative study evaluating perception of general public towards role of pharmacist in health care system of Pakistan. (United States)

    Jin, Xianglan; Azhar, Saira; Murtaza, Ghulam; Xue, Feiran; Mumtaz, Amara; Niu, Huanmin; Taha, Asia; Zhang, Yunling


    To investigate general public perception towards the role of pharmacist in developing countries' healthcare system was the main aim of this study, which would be the basic foundation for researching the treatment pattern of cognitive disorder after stroke in communities. The study population (sample size = 385) consisted of general public from Islamabad, Faisalabad and Lahore, Pakistan. Main sections of the questionnaire comprised of series of statements pertaining to consumer's perception and experience with the pharmacists. The response rate of study was 77.1%. A majority (80.1%) of the consumers knows who is pharmacist; 49.8% (n = 148) of the respondents found the pharmacist working in the pharmacies; 74.1% (n = 220) believed that pharmacist can guide them regarding their medicine. With respect to government efforts to improve services provided by community pharmacies, less percentage (31.0%) of the consumers were satisfied. Half of the respondents (59.9%) were expecting from the pharmacists to be knowledgeable drug therapy experts, whereas 61.3% (n = 182) expect from the pharmacists to educate them regarding safe and appropriate use of medication. The findings of this study conclude that the quality of pharmaceutical services provided is very low in Pakistan. There is a gap between the public and the pharmacist, which can only be filled by creating awareness among public regarding the pharmacist's role in healthcare system and by focusing on how services provided by the pharmacists can add improvement to general public health.

  14. Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates. (United States)

    Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelkarem, Abduelmula R


    The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.

  15. General practitioners′ perceptions about the extended roles of the community pharmacists in the state of Karnataka: A study

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    Adepu R


    Full Text Available In developed countries, professional relationships between the prescribers and pharmacists are good due to the professional services offered by the pharmacists. Many researchers have found that, prescribers are in favour of the new extended roles of practising pharmacists as patient counsellors and drug information providers. In India, professional relationships between the prescribers and pharmacists require becoming strong in the interest of profession and patient care. The present study is aimed at analysing the general practitioners′ perception and expectations from practising community pharmacists in four district headquarters of Karnataka. The study was conducted through convenient sampling method using a well-designed 14-item questionnaire to collect the opinions from the respondents. Likert scale was employed to assess the responses. One hundred and fifteen general practitioners have participated in the study. The respondents opined that only qualified pharmacists should run the pharmacies (4.73. Although the present D. Pharm qualification is sufficient to run the pharmacies (3.55, to meet the present health care demands, B. Pharm or M. Pharm is a must (3.86. Pharmacists are considered as a part of health care team (3.43 and should be located within the medical practice (3.82 and accepted as professional partner (3.30. Coming to the question of extended roles, some respondents have mentioned that pharmacists should check the legality and drug interactions in the prescriptions (3.20 and provide the necessary drug information. However, the respondents were against the pharmacist-run diabetic and anticoagulant clinics and against pharmacists prescribing cost-effective suggestions. Age has shown significant influence only on few opinions, whereas experience of the respondents has shown significant influence on majority of the opinions. Many respondents expressed positive opinion about the extended roles of the pharmacists but said the

  16. Pharmacists' perception of pharmaceutical care in community pharmacy: a questionnaire survey in Northwest China. (United States)

    Fang, Yu; Yang, Shimin; Feng, Bianling; Ni, Yufei; Zhang, Kanghuai


    The aim of this study was to explore the perceptions of community pharmacists towards the concept of pharmaceutical care, implementing frequencies of pharmaceutical care, and barriers to implementation of pharmaceutical care in China. A 38-item self-completion pre-tested questionnaire was administered to a quota sample of 130 pharmacists in community pharmacies in Xi'an, Shaanxi Province, northwest China in April 2008. Main outcome measures included understanding of pharmaceutical care; perceived frequency of pharmaceutical care activities; attitude towards pharmaceutical care; barriers to implementation of pharmaceutical care. A response rate of 77.7% (101/130) was achieved. The data were analysed descriptively. Factor analysis was used to explore potential barriers to the provision of pharmaceutical care. Respondents' understanding of the definition of pharmaceutical care was not entirely satisfactory: it was widely but incorrectly seen as a medication counselling service and many pharmacists appeared to misunderstand their role in the process. Respondents spent most of their work time performing prescription checks and providing patients with directions for drug administration, dosage, and precautions, but they tended to ignore health promotion within and outside of pharmacy settings. Factor analysis suggested four factors influencing the implementation of pharmaceutical care in the surveyed community pharmacies: lack of external conditions for developing or providing pharmaceutical care, lack of time and skills, absence of information and economic incentive, and lack of full support from other health professionals, with a cumulative variance of 64.7%. Cronbach's alpha for the four factors was 0.71, 0.72, 0.69 and 0.74, respectively. Although the respondent pharmacists had a certain degree of understanding of the definition, aim, function and use of pharmaceutical care, and carried out some activities currently, a range of barriers need to be overcome before

  17. Patient perceptions of pharmacist roles in guiding self-medication of over-the-counter therapy in Qatar

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    Kerry Wilbur


    Full Text Available Kerry Wilbur1, Samah El Salam1, Ebrahim Mohammadi21Qatar University College of Pharmacy, Doha, Qatar; 2Qatar Petroleum Medical Services, Doha, QatarBackground: Self-care, including self-medication with over-the-counter (OTC drugs, facilitates the public’s increased willingness to assume greater responsibility for their own health. Direct consultation with pharmacists provides efficient professional guidance for safe and appropriate OTC use.Objective: The purpose of this study was to characterize patient perceptions of pharmacists and use of nonprescription therapy in an ambulatory care population in Qatar. Methods: Patients having prescriptions filled at one organization’s private medical clinics during two distinct two-week periods were invited to participate in a short verbal questionnaire. Awareness of pharmacist roles in guiding OTC drug selection was assessed, as were patient preferences for OTC indications. Attitudes towards pharmacist and nurse drug knowledge and comfort with direct dispensing were also evaluated.Results: Five hundred seventy patients participated representing 29 countries. Most respondents were men (92.1% with mean age of 38.3 years. Almost 1 in 7 did not know medical complaints could be assessed by a pharmacist (15.3% and 1 in 5 (21.9% were unaware pharmacists could directly supply OTC therapy. The majority (85.3% would be interested in this service. In general, respondents were more comfortable with medication and related advice supplied by pharmacists as opposed to nursing professionals.Conclusion: Patients were familiar with the roles of pharmacists as they pertain to selfmedication with OTC therapy and described the desire to use such a service within this Qatar ambulatory health care setting.Keywords: patient, self-medication, over-the-counter, pharmacist, Qatar

  18. Identification of the Discrepancies between Pharmacist and Patient Perception of the Pharmacist’s Role as an Advisor on Drug Therapy Based on Social Science Theory


    大島, 新司; Senoo, Kazuhiko; 根岸, 彰生; 秋元, 勇人; 大原, 厚祐; 井上, 直子; 大嶋, 繁; 久津間, 信明; 從二, 和彦; 小林, 大介


    Article 25-2 of the Japanese Pharmacists’ Act was revised in June 2014, establishing the position of pharmacists as “advisors on the use of Pharmaceuticals.” Prior to the Act’s revision, we investigated the perceptions of patients and pharmacists about pharmacists’ roles using a social science methodology. We also examined current opinions and necessary factors for the future growth and development of pharmacists. This questionnaire survey was conducted using an internet method. Patients and ...

  19. Improvement of knowledge, attitude and perception of healthcare workers about ADR, a pre- and post-clinical pharmacists' interventional study (United States)

    Mohebbi, Niayesh; Hendoiee, Narjes; Keshtkar, Abbas-Ali; Dashti-Khavidaki, Simin


    Purpose Healthcare workers have a main role in detection, assessment and spontaneous reporting of adverse drug reactions (ADRs), and improvement of their related knowledge, attitude and perception is essential. The goal of this study was evaluation of clinical pharmacists' interventions in improvement of knowledge, attitude and perception of healthcare workers about ADRs in a teaching referral hospital, Tehran, Iran. Method Changes in knowledge, attitude and perception of healthcare workers of Imam teaching hospital about ADRs were evaluated before and after clinical pharmacists' interventions including workshops, meetings and presentations. Results From the 100 participated subjects, 82 of them completed the study. 51% of the health workers have been aware of the Iranian Pharmacovigilance Center at the ministry of health before intervention and after that all the participants knew this centre. About awareness and detection of ADRs in patients, 69 (84.1%) healthcare workers recognised at least one, and following interventions, it was improved to 73 (89%). Only seven (8.5%) subjects have reported ADRs in before intervention phase that were increased significantly to 18 (22%) after intervention. Conclusion Clinical pharmacists' interventions were successful in improvement of healthcare workers' knowledge, attitude and perception about ADRs and spontaneous reporting in our hospital. PMID:22246555

  20. [The pharmacist's perceptions about their job at communitarian pharmacies of the state of Rio de Janeiro]. (United States)

    Bastos, Cláudia Regina Garcia; Caetano, Rosângela


    The aim of this study was to understand the pharmacist's perceptions that work at communitarian pharmacies from Rio de Janeiro about their professional practices and how this vision can be related to the practice implementation of Pharmaceutical Attention. A qualitative research was developed with the execution of semi-structured interviews; subsequently discourse was submitted to content analysis, through the thematic analysis. This research have been made with 15 pharmaceuticals of Rio de Janeiro state pharmacies with proportional distribution corresponding to the following typology: state pharmacy network; local network; and familiar, without branches. The speech classification which was made here has shown at least three convergences: the continue difficulties of the population about the use of medicines, certain migration of the pharmaceutical practice, in the meaning of (re)valuing the patient and the superficial knowledge about the Attention Pharmaceutical conception. It is necessary to intensify a reflection on this issue to lead us to identify elements that can guarantee that this pharmaceutical practice can be implemented as a complementary health service.

  1. Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach

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    Rayes IK


    Full Text Available Background: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. Objective: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. Methods: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists’ current professional role, and barriers to enhanced pharmacy services. Results: About half of the respondents (45.4%, n=90 agreed that pharmacy clients under-estimate them and 52.5% (n=104 felt the same by physicians. About 47.5% (n=94 of the respondents felt that they are legally unprotected against profession’s malpractice. Moreover, 64.7% (n=128 stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252 found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124 disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134 gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not. Conclusions: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost.

  2. The perceptions of pharmacists in Victoria, Australia on pharmacogenetics and its implications

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    McMahon T


    Full Text Available Objectives: This study aimed to explore how well Victorian pharmacists perceived they understood pharmacogenetics, their perceived capacity to counsel a patient about such testing, how they believed pharmacogenetics would impact upon their profession, and to investigate the ways in which Victorian pharmacists would like to be educated about pharmacogenetics.Methods: A cross-sectional survey was dispatched to 800 Victorian pharmacists. The participants were randomly selected and the survey was anonymous. The survey contained questions about where the pharmacists worked, the pharmacists’ perceived knowledge of pharmacogenetics, how well they believed they would be able to counsel patients about pharmacogenetic testing, how they thought pharmacists should be educated on the topic and how they believed pharmacogenetics would impact upon their profession.Results: 291 surveys were returned (36% response rate. Results suggest that Victorian pharmacists generally perceived they had a poor understanding of pharmacogenetics and that those who have more recently graduated from tertiary education had a better perceived understanding than those who have been in the workforce for longer. Most pharmacists indicated that they did not believe that they could counsel a patient adequately about the results of a pharmacogenetic test. Regarding education about pharmacogenetics, participants suggested that this would be best delivered during tertiary studies, and as seminars and workshops forming part of their continuing professional development. Although some pharmacists were unsure how pharmacogenetics would affect their profession, many believed it would have a major impact upon their role as a pharmacist and lead to improved patient care. Some concerns about the implementation of pharmacogenetics were noted, including economic and ethical issues.Conclusion: This study highlights the need for further research across the pharmacy profession in Australia on the

  3. Pharmacist characteristics, medication use perceptions, and professional satisfaction: a first national survey in the state of Qatar

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    Maguy Saffouh El Hajj


    Full Text Available Maguy Saffouh El Hajj1, Nadir Kheir1, Manal Zaidan2, Peter J Jewesson11College of Pharmacy, Qatar University, Doha, Qatar; 2Pharmacy Department, Al Amal Cancer Centre, Doha, QatarPurpose: To characterize the professional demographics, opinions about the medication use process, perceived public satisfaction with pharmacy services, and professional satisfaction of pharmacists practicing in the state of Qatar.Materials and methods: The study was designed as a hypothesis-generating, online, anonymous, opinion survey of practicing pharmacists in Qatar.Results: Two hundred and sixty-four survey accesses were recorded during the 6-week study period, and 250 surveys containing responses to one or more questions were included in the analysis. Eighty-four percent of respondents reported graduating at least 5 years prior to the survey, and 86% held a baccalaureate degree in pharmacy as their highest degree. The most common source of the highest degree was one of five countries (Egypt, Jordan, India, Sudan, or Pakistan. Forty-five percent of respondents were working in a hospital setting, and 33% were in a community pharmacy. The lowest incidence of agreement across the 10 drug procurement and distribution process statements was observed for the adequacy of medication supplies statements (33% of all respondents. The highest incidence of agreement across the eight medication use process statements was for the statement pertaining to infrequent dispensing errors (68%, and the lowest incidence of agreement was observed for the statement pertaining to the adequacy of patient monitoring (30%. The pharmacist was chosen as the best candidate to resolve perceived unmet medication needs for four of eight statements, whereas physicians were most frequently chosen for three of the four remaining statements. Respondents' perceptions regarding patient satisfaction with the different elements of the medication use process revealed that the lowest incidence of agreement

  4. Antibiotic use and resistance: perceptions and ethical challenges among doctors, pharmacists and the public in Vellore, South India. (United States)

    Chandy, Sujith J; Mathai, Elizabeth; Thomas, Kurien; Faruqui, Atiya Rehman; Holloway, Kathleen; Lundborg, Cecilia Stalsby


    Inappropriate antibiotic use and resistance are major public health challenges. Interventional strategies require ascertaining the perceptions of major stakeholders and documenting the challenges to changing practice. Towards this aim, a qualitative study was conducted in Vellore, South India, using focus group discussions among doctors, pharmacists and public. There were eight groups with six to eight participants each. The themes explored were: understanding of infections, antibiotics and resistance; practices and pressure driving antibiotic use; and strategies for appropriate use. Data were transcribed, analysed, verified and a summary prepared with salient features and quotations. It was found that the public had minimal awareness of resistance, antibiotics and infections. They wanted symptomatic relief. Doctors reported prescribing antibiotics for perceived patient expectations and quick recovery. Business concerns contributed to antibiotics sales among pharmacists. Pharmaceutical industry incentives and healthcare provider competition were the main ethical challenges. Suggested interventional strategies by the participants included creating public awareness, better healthcare provider communication, improved diagnostic support, strict implementation of guidelines, continuing education, and strengthening of regulations. Perceived patient benefit, unrestricted autonomy and business-cum-industry pressures are promoting inappropriate use of antibiotics. Strategies improving responsible use will help preserve their effectiveness, and provide distributive justice and benefit for future generations.

  5. Evaluating the impact of pharmacist health education on the perceptions of the pharmacist’s role among women living in a homeless shelter

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    Tsu L


    Full Text Available Objectives: To determine the impact of pharmacist-provided educational seminars on the participant’s perception of the pharmacist’s role in providing women’s health education. Secondary objectives include the participant’s level of perceived benefit from the information provided during each presentation, as well as determining characteristics of participants who are interested in attending seminars. Methods: This is a prospective study conducted within a homeless women’s shelter in Phoenix, Arizona. Pharmacists and pharmacy students provided 10 monthly educational seminars on topics related to women’s health. Participants completed a pre- and post-seminar survey regarding their perceptions of the presentations and pharmacists. Results: Fifty-six participants attended at least one of 10 seminars from January to November 2014. The average age was 46 years old, taking approximately 3 medications, and 66% completed a high school degree or lower. Prior to the presentations, 30% of participants agreed or strongly agreed that they would seek advice from a pharmacist on the topic presented, which increased significantly to 82% of participants after the presentation (p<0.001. Similarly, 55% of participants rated themselves as agreeing or strongly agreeing with being knowledgeable on the topic presented prior to the presentation, and this increased significantly to 77% after the presentation (p=0.001. After attending the educational session, 70% of participants agreed or strongly agreed that they would make changes to their health, and that they would attend an additional session. The participants noted their increased learning about the topic, the clarity of visual aids and presentation, and knowledge of the presenters as the best parts of the presentation. Conclusion: Pharmacist’s participation in providing educational seminars in the homeless women’s population increases the participant’s knowledge and perception of the pharmacist

  6. Assessment of Pharmacists' Perception of Patient Care Competence and Need for Training in Rural and Urban Areas in North Dakota (United States)

    Scott, David M.


    Context: Few studies have examined pharmacists' level of patient care competence and need for continuous professional development in rural areas. Purpose: To assess North Dakota pharmacists' practice setting, perceived level of patient care competencies, and the need for professional development in urban and rural areas. Methods: A survey was…

  7. Exploration of the perceptions, barriers and drivers of pharmacogenomics practice among hospital pharmacists in Adelaide, South Australia. (United States)

    Dias, M M; Ward, H M; Sorich, M J; McKinnon, R A


    There is little literature regarding the barriers to the uptake of pharmacogenomics (PG) in pharmacy practice, especially with respect to Australia. To date, pharmacists have seldom been engaged in discussions of these issues. This study aimed to obtain an in-depth understanding of these barriers by interviewing pharmacists in Adelaide, South Australia. Ethics approved semistructured interviews were carried out with 21 public hospital pharmacists. Analysis of the data identified themes including: confidence to engage in PG, clinician acceptance of a pharmacist PG role, and the importance of timely and relevant PG education. Interviewees thought that pharmacists could have a greater participation in PG in the future, but they questioned whether this would be possible at the moment given, among other factors, existing time and work constraints.

  8. Motivating pharmacists. (United States)

    Donehew, G R


    Although pharmacists are developing interest in many types of pharmacy practice, they are still spending the bulk of their time in the prescription dispensing process. Any effort to provide motivation must consider the prescription dispensing process. The pharmacy literature includes only a few studies that dealt with pharmacists as people. The studies usually showed that pharmacists basically were unhappy with their jobs. In developing a motivational climate for pharmacists, pharmacy supervisors have several concepts to consider: the hierarchy of needs by Maslow; the expectancy theory by Hampton; the gygiene-motivator theory by Herzberg; and the Theory Y management approach by McGregor. Because pharmacists must be induced to enter and remain in an organization, supervisors should be aware of the need to use any technique available in developing a motivational climate.

  9. Knowledge and Perceptions of Visual Communications Curriculum in Arkansas Secondary Agricultural Classrooms: A Closer Look at Experiential Learning Integrations (United States)

    Pennington, Kristin; Calico, Carley; Edgar, Leslie D.; Edgar, Don W.; Johnson, Donald M.


    The University of Arkansas developed and integrated visual communications curriculum related to agricultural communications into secondary agricultural programs throughout the state. The curriculum was developed, pilot tested, revised, and implemented by selected secondary agriculture teachers. The primary purpose of this study was to evaluate…

  10. The Power Behind the Controversy: Understanding Local Policy Elites' Perceptions on the Benefits and Risks Associated with High Voltage Power Line Installation in the State of Arkansas (United States)

    Moyer, Rachael M.

    Following a proposal for the installation of high voltage power lines in northwest Arkansas, a controversial policy debate emerged. Proponents of the transmission line argue that such an installation is inevitable and necessary to efficiently and reliably support the identified electric load in the region. Opponents claim that the lines will degrade the natural environment and hamper the tourism-based local economy in affected regions, notably in Ozark Mountain areas. This study seeks to understand how local policy elites perceive the benefits and risks associated with proposed transmission lines, which is a critical step in comprehending the formation and changes of related government policies. First, based upon the dual process theory of judgment, this study systematically investigates the triadic relationships between (a) more profound personal value predispositions, (b) affects and feelings, and (c) perceived benefits and risks related to the proposed installation of high voltage power lines among local policy elites in the state of Arkansas. Next, this study focuses more specifically on the role of value predispositions, specific emotional dimensions of affect heuristics, and perceptions pertaining to high voltage power line risks and benefits. Using original data collected from a statewide Internet survey of 420 local leaders and key policymakers about their opinions on the related issues, other factors claimed by previous literature, including trust, knowledge level, and demographic characteristics are considered. Analytical results suggest that grid-group cultural predispositions, as deeply held core values within local policy elites' individual belief systems, both directly and indirectly -- through affective feelings -- shape perceived utility associated with the installation of high voltage power lines. Recognizing that risk perceptions factor into policy decisions, some practical considerations for better designing policy addressing controversial issues

  11. Proposing Chinese Pharmacists Month

    Institute of Scientific and Technical Information of China (English)


    @@ Dear Pharmacists: Today I would like to share with you about the American Pharmacists Month which is celebrated in October every year.This month-long observance is promoted by American Pharmacist Association.

  12. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies

    Directory of Open Access Journals (Sweden)

    Kennie-Kaulbach Natalie


    Full Text Available Abstract Background Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services. Methods Using a modified Delphi process including assessing perception of the frequency and criticality of performing tasks, we validated competencies important to primary health care pharmacists practising across Canada. Results Ten key informants contributed to competency drafting; thirty-three expert pharmacists replied to a second round survey. The final primary health care pharmacist competencies consisted of 34 elements and 153 sub-elements organized in seven CanMeds-based domains. Highest importance rankings were allocated to the domains of care provider and professional, followed by communicator and collaborator, with the lower importance rankings relatively equally distributed across the manager, advocate and scholar domains. Conclusions Expert pharmacists working in primary health care estimated their most important responsibilities to be related to direct patient care. Competencies that underlie and are required for successful fulfillment of these patient care responsibilities, such as those related to communication, collaboration and professionalism were also highly ranked. These ranked competencies can be used to help pharmacists understand their potential roles in these evolving practices, to help other health care professionals learn about pharmacists' contributions to primary health care, to establish standards and performance indicators, and to prioritize supports and education to maximize effectiveness in this role.

  13. Slamming Arkansas Schools! (United States)

    Scott, W. Clayton


    In this article, the author, a poet and teaching artist, shares how he successfully brought slam poetry to College Hill Middle School in Texarkana, Arkansas. In 2001 he discovered slam poetry--a poetry-reading format in which poets compete in dramatic readings of their works--and went to Slam Nationals in Seattle on the Arkansas slam team. He…

  14. Exploring consumer and pharmacist views on the professional role of the pharmacist with respect to natural health products: a study of focus groups

    Directory of Open Access Journals (Sweden)

    Heschuk Shirley


    Full Text Available Abstract Background Natural health products (NHPs such as herbs, vitamins and homeopathic medicines, are currently available for sale in most Canadian pharmacies. However, most pharmacists report that they have limited knowledge about these products which have been regulated in Canada as a specific sub-category of drugs. In this paper, consumers' and practicing pharmacists' perceptions of pharmacists' professional responsibilities with respect to NHPs are examined. Methods A total of 16 focus groups were conducted with consumers (n = 50 and pharmacists (n = 47 from four different cities across Canada (Vancouver, Edmonton, Toronto, and Halifax. Results In this paper, we illustrate the ways in which pharmacists' professional responsibilities are impacted by changing consumer needs. Many consumers in the study utilized a wide range of information resources that may or may not have included pharmacists. Nevertheless, the majority of consumers and pharmacists agreed that pharmacists should be knowledgeable about NHPs and felt that pharmacists should be able to manage drug-NHPs interactions as well as identify and evaluate the variety of information available to help consumers make informed decisions. Conclusion This paper demonstrates that consumers' expectations and behaviour significantly impact pharmacists' perceptions of their professional responsibilities with respect to NHPs.

  15. Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study. (United States)

    Auta, Asa; Strickland-Hodge, Barry; Maz, Julia


    Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients' access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders' views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders' perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients' access to medicines, reduce doctors' workload and promote the utilisation of pharmacists' skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists' inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all

  16. Talking to the Pharmacist (For Parents) (United States)

    ... 1- to 2-Year-Old Talking to the Pharmacist KidsHealth > For Parents > Talking to the Pharmacist Print ... and families privately. Reasons to Talk to the Pharmacist Pharmacists cannot diagnose medical conditions but can answer ...

  17. Phytotherapic compounds: the consumer-pharmacist relationship. (United States)

    Bacchini, Marco; Cuzzolin, Laura; Camerlengo, Thomas; Velo, Giampaolo; Benoni, Giuseppina


    Pharmacists play an important role in providing information about natural products and in preventing risks related to these substances, particularly with respect to interactions with conventional drugs. For these reasons, a survey was specifically designed to investigate the quality of self-care counselling by pharmacists on phytotherapy. Twenty-three pharmacy stores took part in the project. Face-to-face interviews, using a pre-structured questionnaire, were undertaken by trained pharmacists to consumers buying a herbal product. The questionnaire included socio-demographic data and 17 items designed to elicit information regarding the reason of consumption, product knowledge, relationship/communication with healthcare providers, level of satisfaction, concurrent drug use and adverse reactions. The collection of interviews started in November 2006 until April 2007. From the analysis of 1420 questionnaires, it is evident that herbal use is increasing in Italy: 12% of our interviewees were buying a herbal product for the first time. The present survey highlights the favourable perception of efficacy of phytotherapic compounds by the pharmacy's consumers, who consider this healthcare modality to be an important and effective way to promote health/wellness and disease management as well as being safer overall than conventional drugs. Moreover, findings from this study demonstrate that pharmacists are more likely to answer correctly about the uses of herbal medicines than about drug interactions, adverse drug effects and cautions about these products.

  18. Multidisciplinary members’ perspectives on a pharmacist joining a rheumatology practice team


    Wilbur, Kerry; Kur, Jason


    Background: Pharmacist participation in chronic disease management benefits patients in many ambulatory settings. We explored the attitudes and perceptions among multidisciplinary members of a rheumatology team towards the skills and responsibilities of a pharmacist joining their practice. Methods: The physicians, nurse, physiotherapist and staff of a rheumatology clinic were invited to participate in focus group and semistructured interviews. Practice members also completed an in...

  19. Perception of the Professional Knowledge of and Education on the Medical Technology Products among the Pharmacists in the Baltic and Nordic Countries—A Cross-Sectional Exploratory Study

    Directory of Open Access Journals (Sweden)

    Daisy Volmer


    Full Text Available With increased development of medical technology (MT, new challenges emerge related to education and training of pharmacists and other healthcare specialists. Currently, only a few universities in the EU promote MT education and research. Objectives: The aim of this study was to evaluate the current status, views on, and need for the education on MT for the pharmacy students and practicing pharmacists in the Baltic and Nordic countries. Methods: The representatives of higher education institutions and community/hospital pharmacists from six Baltic and Nordic countries participated in a qualitative cross-sectional exploratory internet-based study from May to October 2014. Results: Approximately two-third of the respondents considered professional knowledge about MT products important for pharmacists, but half of them had never participated in any MT courses. More practicing pharmacists than representatives of academia underlined the need for increased MT education for pharmacy students in the future. Conclusions: The pharmacists in the Baltic and Nordic countries consider the professional knowledge about MT as pertinent in their education and work. The limited number and status of MT courses available today, however, is a major concern among both pharmacy students and practicing pharmacists in these countries. In the future, increasing education combining theory and practice about MT products would be one possible solution to overcome this challenge.

  20. Multidisciplinary members’ perspectives on a pharmacist joining a rheumatology practice team (United States)

    Wilbur, Kerry; Kur, Jason


    Background: Pharmacist participation in chronic disease management benefits patients in many ambulatory settings. We explored the attitudes and perceptions among multidisciplinary members of a rheumatology team towards the skills and responsibilities of a pharmacist joining their practice. Methods: The physicians, nurse, physiotherapist and staff of a rheumatology clinic were invited to participate in focus group and semistructured interviews. Practice members also completed an inventory of perceived health professional roles in the medication use process. Results: Discussions with 2 physicians, a nurse, physiotherapist and 1 office administrator were conducted. Concepts related to 3 key themes included positively viewed pharmacist roles broadly related to activities that encompass provision of medication-related services for the patients, the providers and the practice. Examples of such care included educational tasks related to therapies (rheumatological and otherwise) and maintenance of accurate drug histories. These findings were reflected in high scores for perceived pharmacist roles in education and medication review responsibilities using the Medication Use Processes Matrix instrument. Most members were not comfortable with pharmacists conducting physical assessments and emphasized the need for a team member who could adapt to variations in workflow preferences across rheumatologists in the practice. Interpretation: Perceived pharmacist roles expressed by existing rheumatology team members were largely consistent with the scope of pharmacist knowledge, skills and responsibilities in primary care. Conclusion: Overall, existing multidisciplinary staff exhibited favourable attitudes towards a pharmacist joining their practice setting. Data from this job analysis exercise were used to inform the development of a job description for a rheumatology clinical pharmacist. PMID:26862335

  1. 27 CFR 9.112 - Arkansas Mountain. (United States)


    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Arkansas Mountain. 9.112... Arkansas Mountain. (a) Name. The name of the viticultural area described in this section is “Arkansas Mountain.” (b) Approved maps. The appropriate maps for determining the boundary of the Arkansas...

  2. What is a Pharmacist: Opinions of Pharmacy Department Academics and Community Pharmacists on Competences Required for Pharmacy Practice

    Directory of Open Access Journals (Sweden)

    Jeffrey Atkinson


    Full Text Available This paper looks at the opinions of 241 European academics (who provide pharmacy education, and of 258 European community pharmacists (who apply it, on competences for pharmacy practice. A proposal for competences was generated by a panel of experts using Delphi methodology. Once finalized, the proposal was then submitted to a large, European-wide community of academics and practicing pharmacists in an additional Delphi round. Academics and community pharmacy practitioners recognized the importance of the notion of patient care competences, underlining the nature of the pharmacist as a specialist of medicines. The survey revealed certain discrepancies. Academics placed substantial emphasis on research, pharmaceutical technology, regulatory aspects of quality, etc., but these were ranked much lower by community pharmacists who concentrated more on patient care competences. In a sub-analysis of the data, we evaluated how perceptions may have changed since the 1980s and the introduction of the notions of competence and pharmaceutical care. This was done by splitting both groups into respondents < 40 and > 40 years old. Results for the subgroups were essentially statistically the same but with some different qualitative tendencies. The results are discussed in the light of the different conceptions of the professional identity of the pharmacist.

  3. A Survey for Assessment of Role of Pharmacist in Community

    Directory of Open Access Journals (Sweden)

    P Kapur


    Full Text Available

    Objective: To assess the role of pharmacist in community setting & consumer’s perception in National Capital
    Setting: The study was conducted in National Capital Region of India during the year 2003-04.
    Method: Four pharmacy shops were selected for this study which were not attached to any hospital or clinic. Seventy
    seven consumers, who visited these pharmacies during the study period, were selected for this study and
    interviewed just after they visited the pharmacy.
    Key findings: A total of 77 consumers in the age group of 11 to 72 years were included in the present study, of
    which 66.2% were males and 33.8% were females. It is observed that 46.7% consumers came for prescription
    medicines, 23.4% for over the counter medicines. Close to general physicians’ clinics and proximity to home
    were most important reasons given for visiting particular pharmacy. Majority of the consumers (n=56, 72.7%
    rated the advice given by the pharmacist as very useful, only 1(1.3% rated it as not useful at all and 2 (2.6%
    consumers did not respond. Among consumer groups 31 (40.3% thought that pharmacist has a good balance
    between health and business matter and 35.7% were in opinion that pharmacist is more concerned with making
    money, while 5.2% supported that the pharmacist is also interested in the health of his/her customers. The pharmacists
    were ranked at the top with 28(36.4% by the consumers and favoured pharmacy as the most convenient
    place to get advice about staying healthy.
    Conclusion: Most of the consumers in the present study were of the opinion that pharmacist is concerned with the
    health of the consumers, though he/she is also interested in making money. Many respondents were unaware
    about the difference between pharmacist and doctor, most of them consider

  4. Arkansas River Water Needs Assessment (United States)

    US Fish and Wildlife Service, Department of the Interior — This report is on the legal elements, hydrologic analysis, objectives, and water levels related to the Arkansas River and the management of it.

  5. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England (United States)

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet


    Background Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Conclusion Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a

  6. Libraries in Arkansas: MedlinePlus (United States)

    ... this page: Libraries in Arkansas To use the sharing features on ... Center Northwest - U Ark Med Sci AHEC - Northwest Library 1125 N College Ave Fayetteville, AR 72703 479- ...

  7. Talking to the Pharmacist (For Parents) (United States)

    ... young child. Some medicines can be mixed with chocolate or maple syrup to encourage kids to take ... pharmacy so that your pharmacist has a complete history of your family's prescribed medications. A pharmacist is ...

  8. Pharmacist-Patient Interaction and Patient Expectations (United States)

    DeSimone, Edward M.; And Others


    The nature of the professional interaction between the pharmacist and the patient was explored, with data collected from 3,743 questions asked of 16 pharmacists during an 8-week period. Factors that might affect the nature of the pharmacist-patient interaction are identified along with a cognitive-based profile of patient wants. (LBH)

  9. 75 FR 11195 - Central Arkansas National Wildlife Refuge Complex, Arkansas (United States)


    ... obtain a copy of the CCP by writing to: Mr. William R. Smith, Planning Team Leader, Central Arkansas... International Importance.'' Cache River NWR is noted as part of the most important wintering habitats for..., Including the Preferred Alternative A planning team comprised of Service personnel, State...

  10. Care of the stroke patient-communication between the community pharmacist and prescribers in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine


    OBJECTIVE: This study sought to examine the perceptions that community pharmacists have of communication with prescribers in both primary and secondary care in Ireland, with respect to care of stroke patients. SETTING: Community pharmacies across Ireland, stratified into the four representative administrative regions. METHOD: Survey using a structured postal questionnaire. MAIN OUTCOME MEASURE: Perceptions of communication with prescribers based in primary and secondary care; pharmacy and pharmacy premises demographics. RESULTS: A response rate of 52% (n = 314) was achieved. Community pharmacists\\' perceptions of information provision from secondary care were low, the majority (83%) never received any information from the hospital, although they would welcome it. Communication with hospital based prescribers was considered by most (93%) to be poor. The majority (greater than 75%) of respondents expressed a desire for greater information provision concerning a stroke patient\\'s medication and diagnostic information. Pharmacists\\' perceptions of interaction with general practitioners were generally regarded as good (63%) although information provision in both directions between pharmacist and general practitioner could be improved. CONCLUSION: The findings of this study indicated that community pharmacists perceive that there is room for improvement in the communication between themselves and prescribers in the primary and secondary care settings, concerning the care of the stroke patient. This highlights the need for the development of formal communication channels between community pharmacists and other members of the healthcare team involved in the care of the stroke patient. However, the challenges of communicating patient information across healthcare sectors are recognized.

  11. Abortion applicants in Arkansas. (United States)

    Henker, F O


    The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life.

  12. General practitioners' views of pharmacists' current and potential contributions to medication review and prescribing in New Zealand

    Directory of Open Access Journals (Sweden)

    Hatah E


    Full Text Available INTRODUCTION: Internationally, non-medical practitioners are increasingly involved in tasks traditionally undertaken by general practitioners (GPs, such as medication review and prescribing. This study aims to evaluate GPs' perceptions of pharmacists' contributions to those services. METHODS: Semi-structured interviews were carried out in two localities with GPs whose patients had and had not undergone a pharmacist-led adherence support Medication Use Review (MUR. GPs were asked their opinions of pharmacists' provision of MUR, clinical medication review and prescribing. Data were analysed thematically using NVivo 8 and grouped by strengths, weaknesses, opportunities and threats (SWOT category. FINDINGS: Eighteen GPs were interviewed. GPs mentioned their own skills, training and knowledge of clinical conditions. These were considered GPs' major strengths. GPs' perceived weaknesses were their time constraints and heavy workloads. GPs thought pharmacists' strengths were their knowledge of pharmacology and having more time for in-depth medication review than GPs. Nevertheless, GPs felt pharmacist-led medication reviews might confuse patients, and increase GP workloads. GPs were concerned that pharmacist prescribing might include pharmacists making a diagnosis. This is not the proposed model for New Zealand. In general, GPs were more accepting of pharmacists providing medication reviews than of pharmacist prescribing, unless appropriate controls, close collaboration and co-location of services took place. CONCLUSION: GPs perceived their own skills were well suited to reviewing medication and prescribing, but thought pharmacists might also have strengths and skills in these areas. In future, GPs thought that working together with pharmacists in these services might be possible in a collaborative setting.

  13. Plant Nematodes Occurring in Arkansas


    Wehunt, E. J.; Golden, A. M.; Robbins, R. T.


    A total of 110 species of plant nematodes were found in various habitats in Arkansas. Thirty species from 19 genera are reported here for the first time. Included in the new reports are the known plant pathogens Criconemella onoense, Hirshmanniella oryzae, Longidorus elongatus, and Pratylenchus pratensis.

  14. Pharmacist's Role in Diabetes Care

    Centers for Disease Control (CDC) Podcasts


    This podcast is for a professional audience and discusses the role pharmacists can play on the diabetes care team, through collaborative practice agreements and medication therapy management.  Created: 5/19/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT), National Diabetes Education Program (NDEP).   Date Released: 6/4/2008.

  15. Impact of Pharmacist Facilitated Discharge Medication Reconciliation

    Directory of Open Access Journals (Sweden)

    Todd M. Super


    Full Text Available Preventable adverse drug events occur frequently at transitions in care and are a problem for many patients following hospital discharge. Many of these problems can be attributed to poor medication reconciliation. The purpose of this study was to assess the impact that direct pharmacist involvement in the discharge medication reconciliation process had on medication discrepancies, patient outcomes, and satisfaction. A cohort study of 70 patients was designed to assess the impact of pharmacist facilitated discharge medication reconciliation at a 204-bed community hospital in Battle Creek, Michigan, USA. Discharge summaries were analyzed to compare patients who received standard discharge without pharmacist involvement to those having pharmacist involvement. The total number of discrepancies in the group without pharmacist involvement was significantly higher than that of the pharmacist facilitated group.

  16. Involving staff pharmacists in management decisions. (United States)

    Robinson, L A; Vanderveen, T W


    Various administrative techniques used to bring staff pharmacists in a decentralized, satellite pharmacy system into the managerial decision-making process are discussed. These techniques include a staff pharmacist on-call procedure to discourage absenteeism, and the concept of a head pharmacist to serve as a link with departmental administration. The head pharmacist works in the satelite pharmacy, is responsible for its daily operation and is the spokesman for the satellite. Active roles for the head pharmacist in the selection and evaluation of technicians are outlines. Management skills are developed in head pharmacists through a program of special classes and discussion groups. It is concluded that this program has improved the credibility of administrative decisions and has tapped an underused source of ideas and talent.

  17. Minnesota Pharmacists and Medical Cannabis: A Survey of Knowledge, Concerns, and Interest Prior to Program Launch (United States)

    Hwang, Joy; Arneson, Tom; St. Peter, Wendy


    Objectives To assess Minnesota pharmacists’ preparedness for the state’s medical cannabis program in terms of professional competency in policies and regulations and in pharmacotherapy, as well as their concerns and perceptions about the impact on their practice. The secondary objective was to identify pharmacists’ perceptions about ways to reduce potential gaps in knowledge. Methods A Web-based 14-item questionnaire was distributed to all pharmacists whose email addresses were registered with the Minnesota Board of Pharmacy. Results Pharmacists reported limited knowledge of Minnesota state-level cannabis policies and regulations and felt that they were inadequately trained in cannabis pharmacotherapy. Most pharmacists were unprepared to counsel patients on medical cannabis and had many concerns regarding its availability and usage. Only a small proportion felt that the medical cannabis program would impact their practice. Pharmacists’ leading topics of interest for more education included Minnesota’s regulations on the medical cannabis program, cannabis pharmacotherapy, and the types and forms of cannabis products available for commercialization. Preferred modes of receiving information were electronic-based, including email and online continuing education credit. Since the survey’s completion, educational presentations have been provided to pharmacists and health professionals in Minnesota. Conclusion Pharmacists need more training and education on the regulatory and clinical aspects of cannabis in preparation for their work with patients in the medical cannabis program. PMID:27904305

  18. Pharmacovigilance in Qatar: a survey of pharmacists. (United States)

    Wilbur, K


    Active national pharmacovigilance programmes are needed to monitor adverse drug reaction (ADR) data in local populations. The objective of this study was to describe the knowledge, experiences, attitudes and perceived barriers to reporting of suspected ADRs by pharmacists in Qatar. A 27-item web-based survey was answered by 116 pharmacists (25% response rate). Knowledge of ADR terminology and reporting purpose was high, but only 29.3% had ever made a suspected ADR report in Qatar. Most respondents expressed positive attitudes towards the pharmacist's role in pharmacovigilance. Inability to recognize a potential ADR or access a reporting form were perceived as barriers. Enhanced training and efficiency in report submissions were identified as facilitators to future participation. Hospital pharmacists were 7 times more likely to have reported a suspected ADR in Qatar. Pharmacists in Qatar are willing to engage in pharmacovigilance activities if supported by increased training and transparency in the reporting process.

  19. Why hospital pharmacists have failed to manage antimalarial drugs stock-outs in pakistan? A qualitative insight. (United States)

    Malik, Madeeha; Hassali, Mohamed Azmi Ahmad; Shafie, Asrul Akmal; Hussain, Azhar


    Purpose. This study aimed to explore the perceptions of hospital pharmacists towards drug management and reasons underlying stock-outs of antimalarial drugs in Pakistan. Methods. A qualitative study was designed to explore the perceptions of hospital pharmacists regarding drug management and irrational use of antimalarial drugs in two major cities of Pakistan, namely, Islamabad (national capital) and Rawalpindi (twin city). Semistructured interviews were conducted with 16 hospital pharmacists using indepth interview guides at a place and time convenient for the respondents. Interviews, which were audiotaped and transcribed verbatim, were evaluated by thematic content analysis and by other authors' analysis. Results. Most of the respondents were of the view that financial constraints, inappropriate drug management, and inadequate funding were the factors contributing toward the problem of antimalarial drug stock-outs in healthcare facilities of Pakistan. The pharmacists anticipated that prescribing by nonproprietary names, training of health professionals, accepted role of hospital pharmacist in drug management, implementation of essential drug list and standard treatment guidelines for malaria in the healthcare system can minimize the problem of drug stock outs in healthcare system of Pakistan. Conclusion. The current study showed that all the respondents in the two cities agreed that hospital pharmacist has failed to play an effective role in efficient management of anti-malarial drugs stock-outs.

  20. Why Hospital Pharmacists Have Failed to Manage Antimalarial Drugs Stock-Outs in Pakistan? A Qualitative Insight

    Directory of Open Access Journals (Sweden)

    Madeeha Malik


    Full Text Available Purpose. This study aimed to explore the perceptions of hospital pharmacists towards drug management and reasons underlying stock-outs of antimalarial drugs in Pakistan. Methods. A qualitative study was designed to explore the perceptions of hospital pharmacists regarding drug management and irrational use of antimalarial drugs in two major cities of Pakistan, namely, Islamabad (national capital and Rawalpindi (twin city. Semistructured interviews were conducted with 16 hospital pharmacists using indepth interview guides at a place and time convenient for the respondents. Interviews, which were audiotaped and transcribed verbatim, were evaluated by thematic content analysis and by other authors’ analysis. Results. Most of the respondents were of the view that financial constraints, inappropriate drug management, and inadequate funding were the factors contributing toward the problem of antimalarial drug stock-outs in healthcare facilities of Pakistan. The pharmacists anticipated that prescribing by nonproprietary names, training of health professionals, accepted role of hospital pharmacist in drug management, implementation of essential drug list and standard treatment guidelines for malaria in the healthcare system can minimize the problem of drug stock outs in healthcare system of Pakistan. Conclusion. The current study showed that all the respondents in the two cities agreed that hospital pharmacist has failed to play an effective role in efficient management of anti-malarial drugs stock-outs.

  1. The evaluation of pharmacist-technician teams applied to a satellite pharmacy. (United States)

    Kershaw, B P; Zarowitz, B J; Solomon, D K; Mouzakis, M M


    The team work group design has been suggested as a mechanism to integrate clinical and distributive pharmacy services, expand clinical roles, enhance staff satisfaction, and promote resource efficiency. A pharmacist-technician team was created at Henry Ford Hospital, Detroit, and the effects of the team were assessed via pre and post data collection of attitudinal, behavioral and pharmacy service aspects. Each of three satellite teams were responsible for all pharmacy services to a target group of patients. The results of the team design include a significant decrease in pharmacist and technician perceptions of role stress, especially in the categories of role overload, role isolation, and role ambiguity, and less total hours of work lost by pharmacists (54% improved) and technicians (29% improved). The nurses perceived slightly better pharmacy services upon survey, although not statistically significant, and IV solution wastage decreased 5.6%. Clinical pharmacist compliance to standards of practice was unchanged in spite of increased supervisional responsibilities. We were able to show that the pharmacist-technician team design decreased stress and created more efficient pharmacy services.

  2. Methods Used by Colleges and Schools of Pharmacy to Prepare Student Pharmacists for Careers in Academia (United States)

    Dy-Boarman, Eliza A.; Clifford, Kalin M.; Summa, Maria A.; Willson, Megan N.; Boyle, Jaclyn A.; Peeters, Michael J.


    Objective. To identify the methods used by US colleges and schools of pharmacy to prepare student pharmacists for academic careers. Method. An 18-item survey instrument was developed and distributed to US colleges and schools of pharmacy. Representatives were asked about faculty responsibilities, experiences in academia currently offered to student pharmacists, and representatives’ perception of their student pharmacists’ preparedness for careers in academia, including barriers in current programming. Results. Representatives from 96 colleges/schools responded. The vast majority (96%) provided academia-focused advanced pharmacy practice experiences (APPEs), 40% provided didactic coursework in academia, 28% offered a longitudinal research track, and 42% offered academia-focused independent studies. Teaching methods and creating learning objectives were the most common pedagogical content, while assessment activities were diverse. Time was the most prevalent barrier to providing training for academic careers; however, degree of student pharmacist interest, faculty inexperience, and lack of leadership support were also commonly reported. Conclusions: Colleges and schools of pharmacy vary in the extent to which they prepare student pharmacists for careers in academia. Advanced pharmacy practice experiences were the most common method of training offered. Standardization of training for academia may better promote this career path to student pharmacists. PMID:28289296

  3. Understanding of definition and safety of oral health products among patients, physicians and pharmacists. (United States)

    Asahina, Yasuko; Hori, Satoko; Sawada, Yasufumi


    Our objective was to clarify the current understanding of the definition and safety of oral health products among patients and health professionals, and patients' perception about their communication with physicians and pharmacists regarding those products. Self-administered questionnaires were completed by patients at 17 community pharmacies in 14 prefectures of Japan. For health professionals, we sent a questionnaire to pharmacists and physicians who were registered as members of the Internet-based Medical Doctor's and Pharmacist's Information-Sharing System. The respondents were 242 patients, 158 physicians and 407 pharmacists. Some patients did not categorize dietary supplements as health products, while they did so categorize conventional foods (e.g., fermented soybeans, yogurt). Their understanding of the definition of health products was different from that of health professionals. Less than half of the patients considered that health products might potentiate or attenuate the effects of concomitant drugs, and this view was especially common among the elderly. The percentage of patients who reported that they rarely or never asked for advice from a pharmacist about their use of health products was significantly higher among those who had an incorrect understanding about health products. In conclusion, some patients' recognition of oral health products was different from that of health professionals, and most patients do not discuss their use of such products unless they are asked. Therefore, it is important for health professionals to check a patient's use of health products and be sure what he or she means when using the term 'health product'.

  4. Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives

    Directory of Open Access Journals (Sweden)

    Wong Eliza LY


    Full Text Available Abstract Background Patient self-management is a key approach to manage non-communicable diseases. A pharmacist-led approach in patient self-management means collaborative care between pharmacists and patients. However, the development of both patient self-management and role of pharmacists is limited in Hong Kong. The objectives of this study are to understand the perspectives of physicians, pharmacists, traditional Chinese medicine (TCM practitioners, and dispensers on self-management of patients with chronic conditions, in addition to exploring the possibilities of developing pharmacist-led patient self-management in Hong Kong. Methods Participants were invited through the University as well as professional networks. Fifty-one participants comprised of physicians, pharmacists, TCM practitioners and dispensers participated in homogenous focus group discussions. Perspectives in patient self-management and pharmacist-led patient self-management were discussed. The discussions were audio recorded, transcribed and analysed accordingly. Results The majority of the participants were in support of patients with stable chronic diseases engaging in self-management. Medication compliance, monitoring of disease parameters and complications, lifestyle modification and identifying situations to seek help from health professionals were generally agreed to be covered in patient self-management. All pharmacists believed that they had extended roles in addition to drug management but the other three professionals believed that pharmacists were drug experts only and could only play an assisting role. Physicians, TCM practitioners, and dispensers were concerned that pharmacist-led patient self-management could be hindered, due to unfamiliarity with the pharmacy profession, the perception of insufficient training in disease management, and lack of trust of patients. Conclusions An effective chronic disease management model should involve patients in stable

  5. Benefits and risks of benzodiazepines and Z-drugs: comparison of perceptions of GPs and community pharmacists in Germany [Wie schätzen deutsche Hausärzte und Apotheker Nutzen und Schaden von Benzodiazepinen und Z-Drugs ein?

    Directory of Open Access Journals (Sweden)

    Hoffmann, Falk


    Full Text Available [english] Objective: Newer non-benzodiazepines zolpidem and zopiclone are often prescribed instead of benzodiazepine hypnotics, although there is no evidence of differences in effectiveness and safety. Aim was to compare perceptions on benefits and harms of benzodiazepines and Z-drugs between general practitioners (GPs and community pharmacists (CPs.Methods: A questionnaire was mailed to a random sample of 1,350 GPs and 600 CPs in 2012. They were asked to rate perceptions on a five-point Likert scale used for both benzodiazepines and Z-drugs. Wilcoxon signed rank test was performed for the comparison of perceptions between GPs and CPs. Due to multiple testing, only p-values ≤0.01 were considered statistically significant.Results: 458 GPs and 202 CPs returned questionnaires (response 33.9% and 33.7%. Mean age of GPs was 53.3 years (40.6% female and 48.8 years for CPs (59.2% females. Perceptions on benefits of benzodiazepines (and Z-drugs between GPs and CPs were not different for 3 (and 2 of 5 items. Concerning side effects of benzodiazepines, there were no statistically significant differences for 3 of 5 comparisons. CPs perceived that 4 of 5 studied side effects of Z-drugs occur significantly more often than GPs (p=0.003 or less. For instance, whereas 45.2% of CPs answered that withdrawal effects on stopping happen often or very often/always on Z-drugs, these were only 28.3% of the GPs. Conclusions: Although it is difficult to draw unambiguous conclusions from these findings, pharmacists might have a somewhat more critical view on Z-drugs, especially concerning side effects.[german] Hintergrund und Fragestellung: Die neueren Benzodiazepinrezeptor-Agonisten Zolpidem und Zopiclon (“Z-Drugs” werden in letzter Zeit häufiger als Hypnotika vom Benzodiazepintyp verschrieben, obwohl keine Belege für Unterschiede bezüglich des Nutzens und Schaden existieren. Ziel dieser Studie war es zu vergleichen, wie Hausärzte und Apotheker erwünschte und

  6. A survey for assessment of the role of pharmacist in community pharmacy services

    Directory of Open Access Journals (Sweden)

    H Sharma


    Full Text Available Objective : To assess the role of a pharmacist in a community setting and the consumer′s perception in the National Capital Region. Setting : The study was conducted in the National Capital Region of India during the year 2003 - 2004. Materials and Methods : Four pharmacies were selected for this study, which were not attached to any hospital or clinic. Seventy-seven consumers, who visited these pharmacies during the study period, were selected for this study and interviewed just after they visited the pharmacy. Results : A total of 77 consumers in the age group of 11 to 72 years were included in the present study, of which 66.2% were males and 33.8% were females. It was observed that 46.7% of the consumers came for prescription medicines and 23.4% for over-the-counter medicines. Close to the general physicians′ clinics and proximity to home were the most important reasons given for visiting a particular pharmacy. A majority of the consumers (n = 56, 72.7% rated the advice given by the pharmacist as very useful, only one (1.3% rated it as not useful at all and two (2.6% consumers did not respond. Among the consumer groups 31 (40.3% thought that the pharmacist had a good balance between health and business matters, 35.7% were of the opinion that the pharmacist was more concerned with making money, while 5.2% supported that the pharmacist was also interested in the health of his / her customers. The pharmacists were ranked at the top by 28 (36.4% consumers, and favored pharmacy as the most convenient place to get advice about staying healthy. Conclusion : Most of the consumers in the present study were of the opinion that a pharmacist is concerned with the health of the consumers, although he / she was also interested in making money. Many respondents were unaware about the difference between a pharmacist and a doctor, most of them considered the pharmacist to be a doctor and this was the main problem in concluding that the pharmacy was the

  7. Arkansas State University Beebe Branch Faculty Handbook. (United States)

    Arkansas State Univ., Beebe.

    Arkansas State University Beebe Branch provides a liberal arts oriented program for traditional and nontraditional students. Its faculty handbook contains institutional goals, description of responsibilities of administrative officers and faculty committees, faculty employment policies, and administrative and instructional policies. The…

  8. Community pharmacists' involvement in smoking cessation: familiarity and implementation of the National smoking cessation guideline in Finland

    Directory of Open Access Journals (Sweden)

    Sandström Patrick


    Full Text Available Abstract Background Guidelines on smoking cessation (SC emphasize healthcare cooperation and community pharmacists' involvement. This study explored the familiarity and implementation of the National SC Guideline in Finnish community pharmacies, factors relating to Guideline familiarity, implementation and provision of SC services. Methods A nationwide mail survey was sent to a systematic, sample of community pharmacy owners and staff pharmacists (total n = 2291. Response rate was 54% (n = 1190. Factors related to the SC Guideline familiarity were assessed by bivariate and multivariate analysis. Results Almost half (47% of the respondents (n = 1190 were familiar with the SC Guideline and familiarity enhanced Guideline implementation. The familiarity was associated with the respondents' perceptions of their personal SC skills and knowledge (OR 3.8; of customers' value of counseling on nicotine replacement therapy (NRT (OR 3.3; and regular use of a pocket card supporting SC counseling (OR 3.0. Pharmacists' workplaces' characteristics, such as size and geographical location were not associated with familiarity. In addition to recommending NRT, the pharmacists familiar with the Guideline used more frequently other Guideline-based SC methods, such as recommended non-pharmacological SC aids, compared to unfamiliar respondents. Conclusions SC Guideline familiarity and implementation is crucial for community pharmacists' involvement in SC actions in addition to selling NRT products. Pharmacists can constitute a potential public health resource in SC easily accessible throughout the country.

  9. Physician-Pharmacist Collaborative Care for Dyslipidemia Patients: Knowledge and Skills of Community Pharmacists (United States)

    Villeneuve, Julie; Lamarre, Diane; Lussier, Marie-Therese; Vanier, Marie-Claude; Genest, Jacques; Blais, Lucie; Hudon, Eveline; Perreault, Sylvie; Berbiche, Djamal; Lalonde, Lyne


    Introduction: In a physician-pharmacist collaborative-care (PPCC) intervention, community pharmacists were responsible for initiating lipid-lowering pharmacotherapy and adjusting the medication dosage. They attended a 1-day interactive workshop supported by a treatment protocol and clinical and communication tools. Afterwards, changes in…

  10. The attitudes of pharmacists and physicians in Bosnia and Herzegovina towards adverse drug reaction reporting

    Directory of Open Access Journals (Sweden)

    Tarik Catic


    Full Text Available Introduction: Adverse drug reactions (ADRs are threat to the patient’s safety and the quality of life, and they increase the cost of health care. Spontaneous ADR reporting system mainly relies on physicians, but also pharmacists, nurses, and even patients. The aim of this study was to explore attitudes, barriers, and possible improvements to ADR reporting practices in Bosnia and Herzegovina.Methods: A self-reported questionnaire was developed to collect data on the perception of pharmacovigilance practice and ADR reporting. The survey was conducted in the period between September, 2014 and October, 2014.Results: The response rate was 73% (44 of 60 and 93% (148 of 160 among the pharmacist and family medicine physician groups, respectively. Regarding the attitudes to pharmacovigilance practice and reporting, both the pharmacists and physicians found the practices important. The majority of pharmacists and physicians in year 2014 did not report any ADR, while 18% of the pharmacists and 12% of the physicians, who participated in this study, reported one ADR. Reporting procedure, uncertainty, and their exposure were the main barriers to reporting ADRs for the pharmacists. The physicians claimed lack of knowledge to whom to report an ADR as the main barrier. A significant number of the respondents thought that additional education in ADR reporting would have a positive impact, and would increase the ADR reporting rate.Conclusions: Despite the overall positive attitude towards ADR reporting, the reporting rate in Bosnia and Herzegovina is still low. Different barriers to the ADR reporting have been identified, and there is also the need for improvements in the traditional education in this field.

  11. Evaluation of patient safety culture among Malaysian retail pharmacists: results of a self-reported survey

    Directory of Open Access Journals (Sweden)

    Sivanandy P


    Full Text Available Palanisamy Sivanandy,1 Mari Kannan Maharajan,1 Kingston Rajiah,1 Tan Tyng Wei,2 Tan Wee Loon,2 Lim Chong Yee2 1Department of Pharmacy Practice, School of Pharmacy, 2School of Pharmacy, International Medical University, Wilayah Persekutuan Kuala Lumpur, Malaysia Background: Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use.Objective: To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia.Methods: A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted.Results: The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup.Conclusion: The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety. Keywords

  12. The pharmacist's role in promoting optimal antimicrobial use. (United States)

    Dickerson, L M; Mainous, A G; Carek, P J


    Optimal use of antimicrobials is essential in the face of escalating antibiotic resistance, and requires cooperation from all sectors of the health care system. Although antibiotic-restriction policies in the hospital setting are important in altering microbial susceptibility patterns, an overall reduction in antibiotic prescriptions in the outpatient setting is more likely to significantly impact antibiotic resistance. Education of providers, application of clinical practice guidelines, audit and feedback activities, and multifaceted interventions all have had an effect in altering antibiotic prescribing in a research setting. Clinicians must alter antibiotic prescribing for the treatment of infectious diseases, and patients must change their perception of the need for these drugs. Pharmacists can play a major role through clinician education and focused clinical services. With cooperation of health care teams, the effectiveness of available antibiotics may be sustained and the threat of resistance minimized.

  13. The pharmacy supervisor and the employee pharmacist's job satisfaction. (United States)

    North, M A; Kirk, K W


    It seems obvious that satisfaction with one's immediate supervisor would have a significant impact on one's general job satisfaction. However, this relationship has received little attention in the pharmacy literature. This study was designed to determine 1) whether there are differences in job-related satisfaction between pharmacists whose immediate supervisors are pharmacists and those whose supervisors are not pharmacists, and 2) whether the occurrence of conflict between a pharmacist and his or her immediate supervisor is related to the employee pharmacist's job and career satisfaction. The most pronounced finding was the importance of supervisors being pharmacists: satisfaction on five of six satisfaction subscales was related to whether one's supervisor was a pharmacist. Moreover, pharmacists who had the fewest conflicts and disagreements with their supervisors were more satisfied with their choice of pharmacy as a career, their employers, their supervisors, and their jobs.

  14. Sports pharmacy: Pharmacists role in doping in sport


    Ivanović, Darko; Stojanović, Biljana


    In this paper, the role and importance of pharmacists in prevention of doping in sports is presented. Integrating all the competencies of a pharmacist into Sports pharmacy all the segments that emphasize the position and significance of pharmacists are presented. Regarding this discipline pharmacists assume the following responsibilities: advisory and education in doping prevention, work in laboratories for doping control, designing of a dietary regimen, drug application, drug supply and the ...

  15. Pharmacy ethics: evaluation pharmacists' ethical attitude. (United States)

    Sharif, Pooneh Salari; Javadi, Mohammadreza; Asghari, Fariba


    Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making. Pharmacists' knowledge as well as ethical reasoning affects their clinical decision-making. Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance. The study was designed to evaluate pharmacists' attitude toward some principles of bioethics. A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010. Based on the pharmacists' attitude toward common ethical problems, 9 Likert-type scale scenarios were designed. A thousand pharmacists were surveyed and 505 questionnaires were filled. For the whole questionnaire the strongly disagree answer was the most ethical answer. On a scale from 1-5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57. For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers. The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme. The older participants (> 40 years) significantly had lower total score (Pethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations. Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended.

  16. Redefining the Role of the Pharmacist: Medication Therapy Management (United States)

    Hilsenrath, Peter; Woelfel, Joseph; Shek, Allen; Ordanza, Katrina


    Purpose: The purpose of this paper is to explore better use of pharmacists in rural communities as a partial solution to scarcity of physicians and other health care providers. It discusses expected reduction in public subsidies for rural health care and the changing market for pharmacists. The paper emphasizes the use of pharmacists as a backdrop…

  17. Pharmacist-Led Medication Review: Supports for New Role of Pharmacists

    Directory of Open Access Journals (Sweden)

    Kourosh Sadeghi


    Full Text Available In recent decades, by increasing complexity of drug therapy, pharmacists considered as health- care members who can help optimizing drug therapy. We know that medicines do not have the anticipated effects all the times and a vast variability may exist in their behaviors in the body. So, it is very crucial to individualize treatment for every single patient. Nowadays, optimizing drug therapy in patients needs a collaborative interdisciplinary approach to patients care and treatment. Specifically when drug therapy is considered for a condition, pharmacists can enroll as a valuable professional to help for modification of therapy along with other clinicians. Abundant number of studies and reports exist in the literatures which address usefulness of pharmacist engagement in patient care. In this review we have presented some valuable evidences supporting pharmacist role in different clinical settings.

  18. Fifty reasons to love your palliative care pharmacist. (United States)

    Walker, Kathryn A; Scarpaci, Laura; McPherson, Mary Lynn


    Pharmacists have much to offer in caring for patients with an advanced illness. To celebrate the role of pharmacists in palliative care, we wanted to share 50 excellent reasons to love your pharmacist. This list was compiled by 3 pharmacists specializing in end-of-life care spanning from inpatient palliative care to home-based hospice. Our goal is to increase awareness among other hospice and palliative care practitioners by recognizing the skills pharmacists contribute in caring for patients at the end of life. We divided the list into categories: provision of pharmaceuticals, optimizing medication regimens, education and drug information, patient safety, and administration/formulary management.

  19. Antibiotics: Pharmacists Can Make the Difference

    Centers for Disease Control (CDC) Podcasts


    In this podcast, a pharmacist counsels a frustrated father about appropriate antibiotic use and symptomatic relief options for his son's cold.  Created: 4/16/2015 by Division of Bacterial Diseases (DBD), National Center for Immunization and Respiratory Disease (NCIRD), Get Smart: Know When Antibiotics Work Program.   Date Released: 4/16/2015.

  20. Quasi experimental designs in pharmacist intervention research. (United States)

    Krass, Ines


    Background In the field of pharmacist intervention research it is often difficult to conform to the rigorous requirements of the "true experimental" models, especially the requirement of randomization. When randomization is not feasible, a practice based researcher can choose from a range of "quasi-experimental designs" i.e., non-randomised and at time non controlled. Objective The aim of this article was to provide an overview of quasi-experimental designs, discuss their strengths and weaknesses and to investigate their application in pharmacist intervention research over the previous decade. Results In the literature quasi experimental studies may be classified into five broad categories: quasi-experimental design without control groups; quasi-experimental design that use control groups with no pre-test; quasi-experimental design that use control groups and pre-tests; interrupted time series and stepped wedge designs. Quasi-experimental study design has consistently featured in the evolution of pharmacist intervention research. The most commonly applied of all quasi experimental designs in the practice based research literature are the one group pre-post-test design and the non-equivalent control group design i.e., (untreated control group with dependent pre-tests and post-tests) and have been used to test the impact of pharmacist interventions in general medications management as well as in specific disease states. Conclusion Quasi experimental studies have a role to play as proof of concept, in the pilot phases of interventions when testing different intervention components, especially in complex interventions. They serve to develop an understanding of possible intervention effects: while in isolation they yield weak evidence of clinical efficacy, taken collectively, they help build a body of evidence in support of the value of pharmacist interventions across different practice settings and countries. However, when a traditional RCT is not feasible for

  1. Role of the Pharmacist within the Heart Failure Team. (United States)

    Terasaki, Nobuyuki


    Hyogo Prefectural Amagasaki General Medical Center has formed a heart failure team. Here, I report on the role of the pharmacist in this heart failure team at this hospital. Patient education is one of the roles of the pharmacist. It is the pharmacist's responsibility to improve medication adherence among patients. For this purpose, the pharmacist uses a brochure created by the heart failure team. The brochure outlines drug information in an easy-to-understand manner. The roles of a pharmacist were addressed in a lecture presented to the heart failure team. These lectures helped improve the pharmaceutical knowledge of the team, allowing the team to prescribe medicines more safely and appropriately. Maintaining co-operation between hospital and community pharmacies is another important role of a hospital pharmacist. This allows patients to be properly educated by pharmacists even after discharge from the hospital.

  2. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study (United States)

    He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin


    Objectives Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Design Cross-sectional questionnaire study. Setting The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. Participants 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Primary and secondary outcome measures Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. Results The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. Conclusions The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. PMID:27707835

  3. 2015 Fact Book: Arkansas Public Higher Education (United States)

    Arkansas Department of Higher Education, 2015


    This publication provides governmental and higher education decision-makers a statewide perspective of Arkansas public higher education finance for the 2015-17 biennium, as well as trends for the past several years. It also contains a detailed financial profile of each institution and presents a basis for comparative assessments of revenue sources…

  4. 78 FR 9448 - Arkansas Disaster #AR-00061 (United States)


    ... ADMINISTRATION Arkansas Disaster AR-00061 AGENCY: U.S. Small Business Administration. ACTION: Notice SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the... Disaster Assistance, U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Washington,...

  5. Battle Brewing Over Arkansas Creationism Law. (United States)

    Baum, Rudy


    Reports recent proceedings regarding a new law enacted in early 1981 in Arkansas which requires schools that teach evolution to teach what the law calls "creation-science." Opposition to the law by the American Civil Liberties Union is discussed. (CS)

  6. Violence among persons diagnosed with schizophrenia: how pharmacists can help. (United States)

    Stilwell, Emily N; Yates, Sarah E; Brahm, Nancy C


    Violence among those diagnosed with schizophrenia has been reported but is not a diagnostic component of the disorder. The position of the courts regarding fulfillment of the requisite intent to commit violent acts has not been extensively reported. This article discusses the impact of a diagnosis of schizophrenia in an individual and how the pharmacist can help integrate information into the health care system. The recent Supreme Court case of Clark versus Arizona and the older case of Patterson versus Cockrell are discussed with respect to the concept of intent (to commit the act) and the implications this has on an individual in the midst of a psychotic episode. Quality of life, the perception of the stigma associated with a diagnosis of schizophrenia, and pharmacotherapy are briefly discussed. The origin of schizophrenia is multifactorial. Persons with schizophrenia are not innately violent, but alteration in perception may precipitate aggressive acts. Given the complex and diverse nature of schizophrenia and the fact that even with successful pharmacological treatment residual symptoms may still be present, there is a need to provide information to health care practitioners and the court.

  7. 78 FR 5202 - Notice of Inventory Completion: Arkansas State University Museum, Jonesboro, AR (United States)


    ... National Park Service Notice of Inventory Completion: Arkansas State University Museum, Jonesboro, AR AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Arkansas State University Museum... culturally affiliated with the human remains may contact the Arkansas State University Museum....

  8. 78 FR 5199 - Notice of Inventory Completion: Arkansas State University Museum, Jonesboro, AR (United States)


    ... National Park Service Notice of Inventory Completion: Arkansas State University Museum, Jonesboro, AR AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Arkansas State University Museum... associated funerary objects may contact the Arkansas State University Museum. Repatriation of the...

  9. Identifying sites for elk restoration in Arkansas (United States)

    Telesco, R.L.; Van Manen, F.T.; Clark, J.D.; Cartwright, Michael E.


    We used spatial data to identify potential areas for elk (Cervus elaphus) restoration in Arkansas. To assess habitat, we used locations of 239 elk groups collected from helicopter surveys in the Buffalo National River area of northwestern Arkansas, USA, from 1992 to 2002. We calculated the Mahalanobis distance (D2) statistic based on the relationship between those elk-group locations and a suite of 9 landscape variables to evaluate winter habitat in Arkansas. We tested model performance in the Buffalo National River area by comparing the D2 values of pixels representing areas with and without elk pellets along 19 fixed-width transects surveyed in March 2002. Pixels with elk scat had lower D2 values than pixels in which we found no pellets (logistic regression: Wald χ2 = 24.37, P cover, gently sloping ridge tops and valleys, low human population density, and low road densities. To assess the potential for elk–human conflicts in Arkansas, we used the analytical hierarchy process to rank the importance of 8 criteria based on expert opinion from biologists involved in elk management. The biologists ranked availability of forage on public lands as having the strongest influence on the potential for elk–human conflict (33%), followed by human population growth rate (22%) and the amount of private land in row crops (18%). We then applied those rankings in a weighted linear summation to map the relative potential for elk–human conflict. Finally, we used white-tailed deer (Odocoileus virginianus) densities to identify areas where success of elk restoration may be hampered due to meningeal worm (Parelaphostrongylus tenuis) transmission. By combining results of the 3 spatial data layers (i.e., habitat model, elk–human conflict model, deer density), our model indicated that restoration sites located in west-central and north-central Arkansas were most favorable for reintroduction.

  10. As percepções dos farmacêuticos sobre seu trabalho nas farmácias comunitárias em uma região do estado do Rio de Janeiro The pharmacist's perceptions about their job at communitarian pharmacies of the state of Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Cláudia Regina Garcia Bastos


    Full Text Available Este trabalho teve por objetivo compreender as percepções de farmacêuticos de farmácias comunitárias do estado do Rio de Janeiro sobre suas práticas profissionais e como estas poderiam estar relacionadas com a implantação da Atenção Farmacêutica. Foi desenvolvido um estudo qualitativo, com a realização de entrevistas semiestruturadas, posteriormente submetidas à análise de conteúdo baseada na análise temática das falas. A população de estudo foi composta por quinze farmacêuticos responsáveis técnicos de farmácias comunitárias do estado, com distribuição equânime segundo a seguinte tipologia: farmácias de rede estadual, de rede local e farmácias consideradas familiares, sem filiais. A categorização do discurso dos farmacêuticos mostrou, pelo menos, três convergências: as contínuas dificuldades da população quanto ao uso de medicamentos, certo deslocamento da prática, no sentido de (revalorizar o paciente, e um conhecimento bastante superficial do conceito de Atenção Farmacêutica. Faz-se necessário ampliar as reflexões sobre esse tema, de modo a identificar elementos que possam vir a garantir que a práxis farmacêutica se insira com complementaridade nos serviços de saúde.The aim of this study was to understand the pharmacist's perceptions that work at communitarian pharmacies from Rio de Janeiro about their professional practices and how this vision can be related to the practice implementation of Pharmaceutical Attention. A qualitative research was developed with the execution of semi-structured interviews; subsequently discourse was submitted to content analysis, through the thematic analysis. This research have been made with 15 pharmaceuticals of Rio de Janeiro state pharmacies with proportional distribution corresponding to the following typology: state pharmacy network; local network; and familiar, without branches. The speech classification which was made here has shown at least three

  11. Electronic prescriptions and disruptions to the jurisdiction of community pharmacists. (United States)

    Motulsky, Aude; Sicotte, Claude; Lamothe, Lise; Winslade, Nancy; Tamblyn, Robyn


    The practice of community pharmacists is being challenged by the appearance of electronic prescription (e-Rx) technology. This article examines the disruptions caused by e-Rx technology to the jurisdiction of community pharmacists based on a model developed from work by Abbott (1988). The main disruptions to professional activities were investigated by qualitative methods in a series of interviews with pharmacists and physicians separated in two groups: practitioners who tested a typical e-Rx technology and stakeholders involved in the implementation of this large-scale e-Rx project in Quebec, Canada. The findings suggest that the technology may disrupt the jurisdiction of community pharmacists, mainly by changing the distribution of information among physicians and community pharmacists. More specifically, the technology represents both a threat to community pharmacists - by supporting the dominant position held by physicians if it gives them access to information held exclusively by pharmacists - and an opportunity - by redistributing information to the pharmacists' benefit, allowing them to improve the quality of their inferences about medication. However, it would appear that the opportunities offered by the technology generate concerns and tensions, both between physicians and pharmacists and between the pharmacists themselves. This phenomenon may well work against the implementation and use of available tools.

  12. International trends in lifelong learning for pharmacists. (United States)

    Driesen, Annelies; Verbeke, Koen; Simoens, Steven; Laekeman, Gert


    Lifelong learning for community pharmacists is shifting from continuing education (CE) towards continuing professional development (CPD) in some countries. The objectives of this report were to compare lifelong learning frameworks for community pharmacists in different countries, and determine to what extent the concept of CPD has been implemented. A literature search was conducted as well as an Internet search on the web sites of professional pharmacy associations and authorities in 8 countries. The results of this review show that the concept of CPD has been implemented primarily in countries that have a long tradition in lifelong learning, such as Great Britain. However, most countries have opted for the CE approach, eg, France, or for a combination of CE and CPD, eg, New Zealand. This approach combines the controllability by regulatory organizations that CE requires with the advantage of sustained behavior change seen in successful CPD programs.

  13. Clinical skill development for community pharmacists. (United States)

    Barnette, D J; Murphy, C M; Carter, B L


    The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

  14. Role of the pharmacist in parenteral nutrition therapy: challenges and opportunities to implement pharmaceutical care in Kuwait

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    Katoue MG


    Full Text Available Background: Pharmacists can provide beneficial pharmaceutical care services to patients receiving Parenteral Nutrition (PN therapy by working within Nutrition Support Teams (NSTs. Objective: This study was designed to explore pharmacists’ role in PN therapy in hospitals of Kuwait, sources of PN-related information, opinions on NSTs, perceptions about the barriers to pharmaceutical care implementation and views on how to enhance their practices. Methods: Data were collected via face-to-face semi-structured interviews with the senior Total Parenteral Nutrition (TPN pharmacists at all the hospitals which provide TPN preparation services (six governmental hospitals and one private hospital in Kuwait. Descriptive statistics were used to describe pharmacists’ demographic details and practice site characteristics. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: The pharmacists mainly performed technical tasks such as TPN compounding with minimal role in providing direct patient care. They used multiple different sources of TPN-related information to guide their practice. They reported positive and negative experiences with physicians depending on their practice environment. None of the hospitals had a functional NST. However, pharmacists expressed preference to work within NSTs due to the potential benefits of enhanced communication and knowledge exchange among practitioners and to improve service. Pharmacists perceived several barriers to providing pharmaceutical care including lack of reliable sources of TPN-related information, lack of a standard operating procedure for TPN across hospitals, insufficient staff, time constraints and poor communication between TPN pharmacists. To overcome these barriers, they recommended fostering pharmacists’ education on TPN, establishing national standards for TPN practices, provision of pharmacy staff, development of NSTs, enhancing TPN pharmacists

  15. Virtual Pharmacist: A Platform for Pharmacogenomics.

    Directory of Open Access Journals (Sweden)

    Ronghai Cheng

    Full Text Available We present Virtual Pharmacist, a web-based platform that takes common types of high-throughput data, namely microarray SNP genotyping data, FASTQ and Variant Call Format (VCF files as inputs, and reports potential drug responses in terms of efficacy, dosage and toxicity at one glance. Batch submission facilitates multivariate analysis or data mining of targeted groups. Individual analysis consists of a report that is readily comprehensible to patients and practioners who have basic knowledge in pharmacology, a table that summarizes variants and potential affected drug response according to the US Food and Drug Administration pharmacogenomic biomarker labeled drug list and PharmGKB, and visualization of a gene-drug-target network. Group analysis provides the distribution of the variants and potential affected drug response of a target group, a sample-gene variant count table, and a sample-drug count table. Our analysis of genomes from the 1000 Genome Project underlines the potentially differential drug responses among different human populations. Even within the same population, the findings from Watson's genome highlight the importance of personalized medicine. Virtual Pharmacist can be accessed freely at or installed as a local web server. The codes and documentation are available at the GitHub repository ( Administrators can download the source codes to customize access settings for further development.

  16. Family Commitment and Work Characteristics among Pharmacists

    Directory of Open Access Journals (Sweden)

    Paul O. Gubbins


    Full Text Available Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74% participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse’s family commitment, work-related characteristics (work challenge, stress, workload, flexibility of work schedule, and job and career satisfaction. Married participants’ mean age was 48 (SD = 18 years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74% completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02 but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01, when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

  17. Pine Mountain Revisited: An Archeological Study in the Arkansas Ozarks. (United States)


    that Winbcst :ound on the wall of Shelter 2. These tlree red -:iarks on the wall were indistinct as to shape or what they rcpreo-ented. Herbest notd...the Arkansas Ozarks, compiled by L. Mark Raab. Arkansas Archeological Survey Research ,eport 7:31-39. Flenniken, J. Jeffrey and Robert A. Taylor 1977...J. Jeffrey Flennikcen and Robert A. Taylor. 1977. 103 pages. $4.00 No. 12 Contract Archeology in the Lower Mississippi Valley of Arkansas

  18. Development and evaluation of a pharmacogenomics educational program for pharmacists. (United States)

    Formea, Christine M; Nicholson, Wayne T; McCullough, Kristen B; Berg, Kevin D; Berg, Melody L; Cunningham, Julie L; Merten, Julianna A; Ou, Narith N; Stollings, Joanna L


    Objectives. To evaluate hospital and outpatient pharmacists' pharmacogenomics knowledge before and 2 months after participating in a targeted, case-based pharmacogenomics continuing education program.Design. As part of a continuing education program accredited by the Accreditation Council for Pharmacy Education (ACPE), pharmacists were provided with a fundamental pharmacogenomics education program.Evaluation. An 11-question, multiple-choice, electronic survey instrument was distributed to 272 eligible pharmacists at a single campus of a large, academic healthcare system. Pharmacists improved their pharmacogenomics test scores by 0.7 questions (pretest average 46%; posttest average 53%, p=0.0003).Conclusions. Although pharmacists demonstrated improvement, overall retention of educational goals and objectives was marginal. These results suggest that the complex topic of pharmacogenomics requires a large educational effort in order to increase pharmacists' knowledge and comfort level with this emerging therapeutic opportunity.

  19. Pharmacist educators in family medicine residency programs: A qualitative analysis

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    Jorgenson Derek


    Full Text Available Abstract Background 25-29% of North American family medicine residency programs utilize a pharmacist to teach residents. Little is known about the impact that these pharmacist educators have on residency training. The purpose of this study was to examine the experiences of residents, residency directors and pharmacists within Canadian family medicine residency programs that employ a pharmacist educator to better understand the impact of the role. Methods Recruitment from three cohorts (residents, residency directors, pharmacists within family medicine residency programs across Canada for one-on-one semi-structured interviews followed by thematic analysis of anonymized transcript data. Results 11 residents, 6 residency directors and 17 pharmacist educators participated in interviews. Data themes were: (1 strong value of the teaching with respect to improved resident knowledge, confidence and patient care delivery; (2 lack of a formal pharmacotherapy curriculum; (3 desire for expansion of pharmacist teaching; (4 impact of teaching on collaboration; (5 impact of teaching on residency program faculty; and (6 lack of criticism of the role. Conclusions The pharmacist educator role is valued within residency programs across Canada and the role has a positive impact on several important aspects of family medicine resident training. Suggestions for improvement focused on expanding the teaching role and on implementing a formal curriculum for pharmacist educators to follow.

  20. Pharmacist independent prescribing in secondary care: opportunities and challenges. (United States)

    Bourne, Richard S; Baqir, Wasim; Onatade, Raliat


    In recent years a number of countries have extended prescribing rights to pharmacists in a variety of formats. The latter includes independent prescribing, which is a developing area of practice for pharmacists in secondary care. Potential opportunities presented by wide scale implementation of pharmacist prescribing in secondary care include improved prescribing safety, more efficient pharmacist medication reviews, increased scope of practice with greater pharmacist integration into acute patient care pathways and enhanced professional or job satisfaction. However, notable challenges remain and these need to be acknowledged and addressed if a pharmacist prescribing is to develop sufficiently within developing healthcare systems. These barriers can be broadly categorised as lack of support (financial and time resources), medical staff acceptance and the pharmacy profession itself (adoption, implementation strategy, research resources, second pharmacist clinical check). Larger multicentre studies that investigate the contribution of hospital-based pharmacist prescribers to medicines optimisation and patient-related outcomes are still needed. Furthermore, a strategic approach from the pharmacy profession and leadership is required to ensure that pharmacist prescribers are fully integrated into future healthcare service and workforce strategies.

  1. Doctor and pharmacist - back to the apothecary! (United States)

    Liaw, Siaw-Teng; Peterson, Gregory


    The Australian National Medicines Policy embodies four tenets: availability, quality, safety and efficacy of medicines; timely access to affordable medicines; quality use of medicines (QUM); and a responsible and viable medicines industry. The promotion of QUM requires a multidisciplinary approach, including contributions from government, the pharmaceutical industry, health professionals, consumers and academia. However, there are significant tensions and unintended effects associated with the multidisciplinary approach, especially with the relationships between prescribers and dispensers of medicines. The general practitioner and the pharmacist share a common ancestor - the apothecary. The separation of dispensing from prescribing, which began in medieval Europe and 19th century England, reframed and confined the patient-doctor relationship to one of diagnosis, prescription and non-drug management. The role of pharmacists was limited to dispensing, though the present trend is for their responsibilities to be widened. Historical antecedents, the contribution of an increasing number of actors to the costs of health care, universal health insurance and an evolving regulatory framework, are among the factors influencing doctor-pharmacist relations. The prescribing and dispensing of medicines must be guided by an ethical clinical governance structure encompassing health professionals, regulators, the pharmaceutical industry and consumers. There must be close monitoring of safety and effectiveness, and promotion of quality use of medicines and improved patient outcomes. Ongoing training and professional development, within and across professional boundaries, is essential to support harmonious and cost-effective inter-professional practice. The approach must be "apothecarial" with complementary roles and responsibilities for the prescriber and dispenser within the patient-clinician therapeutic relationship, and not adversarial.

  2. Do community pharmacists have the attitudes and knowledge to support evidence based self-management of low back pain?

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    Waddell Gordon


    Full Text Available Abstract Background In many countries, community pharmacists can be consulted without appointment in a large number of convenient locations. They are in an ideal position to give advice to patients at the onset of low back pain and also reinforce advice given by other healthcare professionals. There is little specific information about the quality of care provided in the pharmacy for people with back pain. The main objectives of this survey were to determine the attitudes, knowledge and reported practice of English pharmacists advising people who present with acute or chronic low back pain. Methods A questionnaire was designed for anonymous self-completion by pharmacists attending continuing education sessions. Demographic questions were designed to allow comparison with a national pharmacy workforce survey. Attitudes were measured with the Back Beliefs Questionnaire (BBQ and questions based on the Working Backs Scotland campaign. Questions about the treatment of back pain in the community pharmacy were written (or adapted to reflect and characterise the nature of practice. In response to two clinical vignettes, respondents were asked to select proposals that they would recommend in practice. Results 335 responses from community pharmacists were analysed. Middle aged pharmacists, women, pharmacy managers and locums were over-represented compared to registration and workforce data. The mean (SD BBQ score for the pharmacists was 31.37 (5.75, which was slightly more positive than in similar surveys of other groups. Those who had suffered from back pain seem to demonstrate more confidence (fewer negative feelings, more advice opportunities and better advice provision in their perception of advice given in the pharmacy. Awareness of written information that could help to support practice was low. Reponses to the clinical vignettes were generally in line with the evidence base. Pharmacists expressed some caution about recommending activity. Most

  3. A Feasibility Study of Youth Apprenticeship in Arkansas. (United States)

    Jobs for the Future, Inc., West Somerville, MA.

    A study assessed the feasibility and attractiveness of youth apprenticeship in Arkansas in over 80 interviews with employers in 5 key Arkansas industries and occupations. They were allied health, food processing (equipment repair and maintenance and lab technician/quality control), information services, metalworking, and self-employment and…

  4. 78 FR 61251 - Radio Broadcasting Services; Heber Springs, Arkansas. (United States)


    ... COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Heber Springs, Arkansas. AGENCY: Federal... Making filed by Sydney Allison Sugg, proposing the allotment of Channel 270C3 at Heber Springs, Arkansas, as the community's third local service. Channel 270C3 can be allotted to Heber Springs...

  5. Pharmacist or Physician: Age Differences in Satisfaction with Medical Advice (United States)

    Gould, Odette N.; Wasylkiw, Louise; Rogers, Erin E.; MacPherson, Miranda


    Two studies examined predictors of medical care satisfaction in communities in Eastern Canada. Both studies focused on how the roles of pharmacists and physicians are perceived by adults of different ages. Using a survey methodology, Study 1 demonstrated that middle-aged adults, older adults, and community pharmacists differ in the extent to which…

  6. Community Pharmacists' Preferences for Continuing Education Delivery in Australia (United States)

    Mc Namara, Kevin P.; Duncan, Gregory J.; McDowell, Jenny; Marriott, Jennifer L.


    Introduction: New technologies such as the Internet offer an increasing number of options for the delivery of continuing education (CE) to community pharmacists. Many of these options are being utilized to overcome access- and cost-related problems. This paper identifies learning preferences of Australian community pharmacists for CE and…

  7. Pharmacists belong in accountable care organizations and integrated care teams. (United States)

    Smith, Marie; Bates, David W; Bodenheimer, Thomas S


    Effective health care workforce development requires the adoption of team-based care delivery models, in which participating professionals practice at the full extent of their training in pursuit of care quality and cost goals. The proliferation of such new models as medical homes, accountable care organizations, and community-based care teams is creating new opportunities for pharmacists to assume roles and responsibilities commensurate with their capabilities. Some challenges to including pharmacists in team-based care delivery models, including the lack of payment mechanisms that explicitly provide for pharmacist services, have yet to be fully addressed by policy makers and others. Nevertheless, evolving models and strategies reveal a variety of ways to draw on pharmacists' expertise in such critical areas as medication management for high-risk patients. As Affordable Care Act provisions are implemented, health care workforce projections need to consider the growing number of pharmacists expected to play an increasing role in delivering primary care services.

  8. Interaction between community pharmacists and community nurses in dementia care. (United States)

    Smith, Veronica M


    There has been little research that explores the interaction between community pharmacists and community nurses and how this interaction could benefit people affected by dementia. Using information taken from a larger study, this article presents the views of community pharmacists and one community nurse on how their communication, information sharing and team integration may improve care for this patient group. The community pharmacists reported positive attitudes to supporting people affected by dementia, but they highlighted barriers to integrated team working. In contrast, the community nurse conveyed the belief that the community pharmacist was an integrated member of the community health team. Community pharmacists and community nurses are keen to interact with each other to support people affected by dementia, but this interaction stops short of collaborative, integrated team working. Further research is needed to address this issue.

  9. Pharmacist credentialing in pain management and palliative care. (United States)

    Juba, Katherine M


    A credential is documented evidence of a pharmacist's qualifications; while credentialing is the method used to acquire, confirm, determine, and document a pharmacist's qualifications to practice. Voluntary credentials are important in clinical pharmacy specialties to ensure proficiency in caring for patients with complex pharmacotherapy needs. This article discusses current and future pharmacy pain management and palliative care credentialing opportunities. Pharmacists wishing to pursue voluntary pain management and palliative care credentialing may elect to take a multidisciplinary pain credentialing exam offered by the American Society of Pain Educators (ASPE) or American Academy of Pain Management (AAPM) and/or complete an American Society of Health System Pharmacists (ASHP) Postgraduate Year 2 (PGY2) pain management and palliative care pharmacy residency. A palliative care credentialing exam is not currently available to pharmacists. Efforts are underway within the pharmacy profession to standardize the board certification process, design a pain and palliative certificate program, and create a specialty pain management and palliative care board certification examination.

  10. 75 FR 44982 - Arkansas Valley Conduit (AVC) and Long-Term Excess Capacity Master Contract, Fryingpan-Arkansas... (United States)


    ..., Fryingpan-Arkansas Project (Fry-Ark Project) Colorado AGENCY: Bureau of Reclamation, Interior. ACTION... proposed feature of the Fryingpan-Arkansas (Fry-Ark) Project, and the issuance of an Excess Capacity Master...-Ark Project water in Pueblo Reservoir, a feature of the Fry-Ark Project. The water would be used...

  11. Pharmaceutical Role Expansion and Developments in Pharmacist-Physician Communication. (United States)

    Bergman, Alicia A; Jaynes, Heather A; Gonzalvo, Jasmine D; Hudmon, Karen Suchanek; Frankel, Richard M; Kobylinski, Amanda L; Zillich, Alan J


    Expanded clinical pharmacist professional roles in the team-based patient-centered medical home (PCMH) primary care environment require cooperative and collaborative relationships among pharmacists and primary care physicians (PCPs), but many PCPs have not previously worked in such a direct fashion with pharmacists. Additional roles, including formulary control, add further elements of complexity to the clinical pharmacist-PCP relationship that are not well described. Our objective was to characterize the nature of clinical pharmacist-PCP interprofessional collaboration across seven federally funded hospitals and associated primary care clinics, following pharmacist placement in primary care clinics and incorporation of expanded pharmacist roles. In-depth and semistructured interviews were conducted with 25 practicing clinical pharmacists and 17 PCPs. Qualitative thematic analysis revealed three major themes: (1) the complexities of electronic communication (particularly electronic nonformulary requests) as contributing to interprofessional tensions or misunderstandings for both groups, (2) the navigation of new roles and traditional hierarchy, with pharmacists using indirect communication to prevent PCP defensiveness to recommendations, and (3) a preference for onsite colocation for enhanced communication and professional relationships. Clinical pharmacists' indirect communication practices may hold important implications for patient safety in the context of medication use, and it is important to foster effective communication skills and an environment where all team members across hierarchies can feel comfortable speaking up to reduce error when problems are suspected. Also, the lack of institutional communication about managing drug formulary issues and related electronic nonformulary request processes was apparent in this study and merits further attention for both researchers and practitioners.

  12. Benefits of Pharmacist's Participation on Hospitalist Team. (United States)

    Mahdikhani, Simin; Dabaghzadeh, Fatemeh


    This study was performed to assess the incidence of medication errors and irrational use of human albumin in two wards of our hospital and also aimed to evaluate the ability of pharmaceutical care center and pharmacists in improving patient care. Albumin administration was evaluated for patients who received albumin during the study period, in gastroenterology and general surgery wards. The indications for Albumin administration were evaluated on the basis of reliable guidelines. The prescribing errors were simultaneously evaluated by reviewing patients' medical records. Prescribing errors were defined as selecting improper drug (based on indications, contraindications, known allergies, drug-class duplications and drug-drug interactions), dose, dosage form, and route of administration. It was found that 465 containers of human albumin solution 20 % were used for 54 patients treated in gastroenterology and general surgery wards of our hospital. A total of 306 (65.81%) vials of the albumin administrations were in concordance with the reliable protocol. The cost of irrational use of this drug (159 vials) for patients is equivalent to $ 8215. From 609 reviewed cases, 81 prescribing errors were detected in 64 patients. This study showed that the pharmacists were effective in identifying irrational drug use and medication errors.

  13. Arkansas' Anemometer Loan Program

    Energy Technology Data Exchange (ETDEWEB)

    Fernando Vego


    The measurement campaign had one year duration from 04/01/2011 to 03/31/2012 and was taken at 20m and 34m with NRG instrumentation. The data was analyzed weekly to check inconsistencies and validity and processed using Excel, Flexpro and Windographer standard Edition Version 2.04. The site analyzed is located in the Waldron, Arkansas in Scott County. It is an open site for most of the direction sectors with immediate roughness class of 1.5. It has seasonally directional winds, of which the most energetic come from the southern direction. The vertical wind profile shows moderate wind shear that varies by season as well.

  14. Knowledge and attitudes of physicians and pharmacists towards the use of generic medicines in Bosnia and Herzegovina. (United States)

    Čatić, Tarik; Avdagić, Lejla; Martinović, Igor


    Aim To investigate and assess knowledge and attitudes of pharmacists and physicians towards generic drugs prescription in order to evaluate current trends, obstacles to prescribe/dispense generics and suggest possible improvements of rational and economic prescribing having in mind scarce public budgets for drugs. Methods A cross-sectional survey among 450 primary care physicians (prescribers) and pharmacists in four major cities in Bosnia and Herzegovina (Sarajevo, Banja Luka, Tuzla and Mostar) during the period between January and March 2016 was conducted. The survey (questionnaire) was developed and physicians' and pharmacists' perception was examined using the 5-point Likert scale. Descriptive statistics was used to examine respondents' characteristics and their responses to survey questions. The respondents perception based on different characteristics was assessed using ordinal logistic regression. Results Generally, positive attitudes towards generic drugs were found. Majority of respondents, 392 (87.0%) considered generic drugs the same as originators and they could be mutually substituted. Physicians were more likely to prescribe branded drugs, 297 (66.6%), even 391 (86.8%) were aware of generic alternatives. Respondents believed that patients considered generic drugs less effective, 204 (45.4%), and 221 (49.0%) disapproved generic substitution. Conclusion Our findings suggest that further education and more information about benefits of generic drugs should be provided to key stakeholders including patients. Also, clearer generic drugs policies should be introduced in order to improve generic prescribing and potentially improve access and optimize pharmaceutical public expenditures.

  15. An expanded prescribing role for pharmacists – an Australian perspective

    Directory of Open Access Journals (Sweden)

    Kreshnik Hoti


    Full Text Available Expanded pharmacist prescribing is a new professionalpractice area for pharmacists. Currently, Australianpharmacists’ prescribing role is limited to over-the-countermedications. This review aims to identify Australian studiesinvolving the area of expanded pharmacist prescribing.Australian studies exploring the issues of pharmacistprescribing were identified and considered in the context ofits implementation internationally. Australian studies havemainly focused on the attitudes of community and hospitalpharmacists towards such an expansion. Studies evaluatingthe views of Australian consumers and pharmacy clients werealso considered. The available Australian literature indicatedsupport from pharmacists and pharmacy clients for anexpanded pharmacist prescribing role, with preference fordoctors retaining a primary role in diagnosis. Australianpharmacists and pharmacy client’s views were also inagreement in terms of other key issues surrounding expandedpharmacist prescribing. These included the nature of anexpanded prescribing model, the need for additional trainingfor pharmacists and the potential for pharmacy clients gainingimproved medication access, which could be achieved withinan expanded role that pharmacists could provide. Currentevidence from studies conducted in Australia providesvaluable insight to relevant policymakers on the issue ofpharmacist prescribing in order to move the agenda ofpharmacist prescribing forwards.


    Directory of Open Access Journals (Sweden)

    Ravi Katti Venkappa


    Full Text Available Many hospitalizations in India are due to Adverse Drug Reactions (ADR and resulting in morbidity and mortality in majority cases in addition to the huge economic burden. A survey was conducted to assess the knowledge, attitude and behavior of community pharmacists towards ADR related aspects. One hundred and twenty eight pharmacists from various Community pharmacies in two Districts of South India were consented in this survey. A questionnaire was prepared to investigate the knowledge, attitude and behavior of pharmacists regarding ADR reporting and distributed to the identified pharmacies. The data was collected and analyzed by ANOVA and t- test. Out of 342 community pharmacies approached, 128 (37.4% community pharmacists consented to be part of the survey and the questionnaire given was filled and returned by them. Out of these respondents, only 39 (30.5% pharmacists had knowledge about ADR, 15 (11.7% and 14 (10.9% were aware of National Pharmacovigilance Program (NPP and regional reporting centers respectively. Only 54 (43% agreed that ADR reporting is a professional obligation of pharmacist and none of the respondents reported ADRs. The main reason for not reporting any ADR was ‘they did not know how to report’ and ‘did not feel its beneficial’. This survey revealed that the community pharmacists were having least scores towards knowledge, attitude and behavior on ADRs in Indian Scenario.

  17. Earthquakes in Arkansas and vicinity 1699-2010 (United States)

    Dart, Richard L.; Ausbrooks, Scott M.


    This map summarizes approximately 300 years of earthquake activity in Arkansas. It is one in a series of similar State earthquake history maps. Work on the Arkansas map was done in collaboration with the Arkansas Geological Survey. The earthquake data plotted on the map are from several sources: the Arkansas Geological Survey, the Center for Earthquake Research and Information, the National Center for Earthquake Engineering Research, and the Mississippi Department of Environmental Quality. In addition to earthquake locations, other materials presented include seismic hazard and isoseismal maps and related text. Earthquakes are a legitimate concern in Arkansas and parts of adjacent states. Arkansas has undergone a number of significant felt earthquakes since 1811. At least two of these events caused property damage: a magnitude 4.7 earthquake in 1931, and a magnitude 4.3 earthquake in 1967. The map shows all historical and instrumentally located earthquakes in Arkansas and vicinity between 1811 and 2010. The largest historic earthquake in the vicinity of the State was an intensity XI event, on December 16, 1811; the first earthquake in the New Madrid sequence. This violent event and the earthquakes that followed caused considerable damage to the then sparsely settled region.

  18. Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription

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    Francisco Caamaño


    Full Text Available Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor's prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a physicians' prescribing practices; b the pharmacist's qualifications to prescribe; c the responsibility of the pharmacist regarding the dispensed drugs; d the customer' qualifications for self-medication; and e the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. Results: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. Conclusion: Our results suggest that to increase the quality of dispensing: a the importance of the pharmacist's duty in controlling drug consumption should be stressed; b pharmacies' workload should be optimized; and c perceptions of physicians' prescribing practices among pharmacists should be improved.Objetivo: Evaluar la influencia de las opiniones de los farmacéuticos que no solicitan receta médica para dispensar fármacos que la

  19. An exploration of the role of pharmacists within general practice clinics: the protocol for the pharmacists in practice study (PIPS

    Directory of Open Access Journals (Sweden)

    Tan Edwin


    Full Text Available Abstract Background Medication-related problems are a serious concern in Australian primary care. Pharmacist interventions have been shown to be effective in identifying and resolving these problems. Collaborative general practitioner-pharmacist services currently available in Australia are limited and underused. Limitations include geographical isolation of pharmacists and lack of communication and access to patient information. Co-location of pharmacists within the general practice clinics is a possible solution. There have been no studies in the Australian setting exploring the role of pharmacists within general practice clinics. The aim of this study is to develop and test a multifaceted practice pharmacist role in primary care practices to improve the quality use of medicines by patients and clinic staff. Methods/design This is a multi-centre, prospective intervention study with a pre-post design and a qualitative component. A practice pharmacist will be located in each of two clinics and provide short and long patient consultations, drug information services and quality assurance activities. Patients receiving long consultation with a pharmacist will be followed up at 3 and 6 months. Based on sample size calculations, at least 50 patients will be recruited for long patient consultations across both sites. Outcome measures include the number, type and severity of medication-related problems identified and resolved; medication adherence; and patient satisfaction. Brief structured interviews will be conducted with patients participating in the study to evaluate their experiences with the service. Staff collaboration and satisfaction with the service will be assessed. Discussion This intervention has the potential to optimise medication use in primary care clinics leading to better health outcomes. This study will provide data about the effectiveness of the proposed model for pharmacist involvement in Australian general practice clinics

  20. Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians. (United States)

    Billaux, Mathilde; Borget, Isabelle; Prognon, Patrice; Pineau, Judith; Martelli, Nicolas


    Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders' perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as 'new', 'safe' and 'effective', whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital

  1. Aquifers of Arkansas: protection, management, and hydrologic and geochemical characteristics of groundwater resources in Arkansas (United States)

    Kresse, Timothy M.; Hays, Phillip D.; Merriman, Katherine R.; Gillip, Jonathan A.; Fugitt, D. Todd; Spellman, Jane L.; Nottmeier, Anna M.; Westerman, Drew A.; Blackstock, Joshua M.; Battreal, James L.


    Sixteen aquifers in Arkansas that currently serve or have served as sources of water supply are described with respect to existing groundwater protection and management programs, geology, hydrologic characteristics, water use, water levels, deductive analysis, projections of hydrologic conditions, and water quality. State and Federal protection and management programs are described according to regulatory oversight, management strategies, and ambient groundwater-monitoring programs that currently (2013) are in place for assessing and protecting groundwater resources throughout the State.

  2. Pharmacist conscience clauses and access to oral contraceptives. (United States)

    Flynn, D P


    The introduction of conscience clauses after the 1973 US Supreme Court decision in Roe v. Wade allowed physicians and nurses to opt out of medical procedures, particularly abortions, to which they were morally opposed. In recent years pharmacists have requested the same consideration with regard to dispensing some medicines. This paper examines the pharmacists' role and their professional and moral obligations to patients in the light of recent refusals by pharmacists to dispense oral contraceptives. A review of John Rawls's concepts of the "original position" and the "veil of ignorance", along with consideration of the concept of compartmentalisation, are used to assess pharmacists' requests and the moral and legal rights of patients to have their prescriptive needs met.

  3. [The conscientious objection among pharmacists in the Slovak Republic]. (United States)

    Ambrus, Tünde; Kolář, Jozef; Krempaská, Radka


    There were two primary objectives of this study: 1. bibliographic analysis of literature on pharmacists and conscientious objection, 2. analysis of present condition and attitudes of pharmacists (n = 100) and pharmacy students (n = 100) towards conscientious objection in the Slovak Republic. Data were obtained from the survey using by questionnaire.Almost all, 191 (95.5%) respondents knew the phrase "conscientious objection". The respondents claimed this right to refuse filling prescriptions written for emergency post-coital contraception in 43.5%, and dispensing of hormonal contraception in 26.5%. Most participants, 178 (89.0%) think that pharmacists have the right to conscientious objection. 65 respondents (32.5%) implement this right in their practice.Key words: conscientious objection pharmacists pharmacy students Pro-life pharmacies.

  4. Regional assessment of nonforestry related biomass resources: Arkansas

    Energy Technology Data Exchange (ETDEWEB)


    This document consists of spreadsheets detailing in a county by county manner agricultural crop, agricultural waste, municipal waste and industrial waste in Arkansas that are potential biomass energy sources.

  5. Central Arkansas National Wildlife Refuge Complex: Comprehensive Conservation Plan (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Central Arkansas NWR Complex for the next 15 years. This plan outlines the Complex...

  6. Final Critical Habitat for the Arkansas River Shiner (Notropis girardi) (United States)

    US Fish and Wildlife Service, Department of the Interior — To provide the user with a general idea of areas where final critical habitat for Arkansas River Shiner (Notropis girardi) occur. The geographic extent includes New...

  7. Pharmacist's impact on acute pain management during trauma resuscitation. (United States)

    Montgomery, Kayla; Hall, A Brad; Keriazes, Georgia


    The timely administration of analgesics is crucial to the comprehensive management of trauma patients. When an emergency department (ED) pharmacist participates in trauma resuscitation, the pharmacist acts as a medication resource for trauma team members and facilitates the timely administration of analgesics. This study measured the impact of a pharmacist on time to first analgesic dose administered during trauma resuscitation. All adult (>18 years) patients who presented to this level II trauma center via activation of the trauma response system between January 1, 2009, and May 31, 2013, were screened for eligibility. For inclusion, patients must have received intravenous fentanyl, morphine, or hydromorphone in the trauma bay. The time to medication administration was defined as the elapsed time from ED arrival to administration of first analgesic. There were 1328 trauma response system activations during the study period; of which 340 patients were included. The most common analgesic administered was fentanyl (62% in both groups). When a pharmacist was participating, the mean time to first analgesic administered was decreased (17 vs 21 minutes; P = .03). Among the 78% of patients with documented pain scores, the overall mean reduction in pain scores from ED arrival to ED discharge was similar between the 2 groups. There was a 2.4 point reduction with a pharmacist versus 2.7 without a pharmacist, using a 0 to 10 numeric pain rating scale. The participation of a clinical pharmacist during trauma resuscitation significantly decreased the time to first analgesic administration in trauma patients. The results of this study supplement the literature supporting the integration of clinical ED pharmacists on trauma teams.

  8. Key articles and guidelines for the emergency medicine pharmacist. (United States)

    Thomas, Michael C; Acquisto, Nicole M; Patanwala, Asad E; Weant, Kyle A; Baker, Stephanie N


    Abstract Compilations of articles important to the pharmacist practicing in the emergency department have not been published. Consistent with other specialty areas of practice, a collection of important literature is valuable for both the new and experienced clinician. A diverse breadth of medical problems are represented that were felt to be the most pertinent issues facing the emergency medicine pharmacist; however, it is not intended to be a complete representation of available literature.

  9. [Pharmacy and pharmacists in the novels of Orhan Pamuk]. (United States)

    Tekiner, Halil


    The Nobel Prize 2006 recipient turkish author Orhan Pamuk is among those who give place to pharmacy settings, pharmaceutical objects, and pharmacist characters through his fictional works, more specially in novels such as Cevdet Bey and His Sons (1982), The Silent House (1983), The White Castle (1985), The New Life (1994), Snow (2002), The Museum of Innocence (2006), Parts of Landscapes (2010) provide interesting descriptions of community pharmacies and pharmacists.

  10. Archeological Investigation at Montgomery Point, Desha County, Arkansas (United States)


    listed in the same census were the voyageurs trading on the Arkansas, White and St. Francis Rivers (Vaudreull Papers, LO 200). Life at the post settled...tied to the systems of navigation and commerce on the Mississippi, Arkansas, and White Rivers. Although the Mississippi River was a highway of trade...was guaranteed that a real system of commerce developed. Beginning with flatboats and keelboats, expanding during the steamboat era, and continuing into

  11. [Specialist pharmacist training from the viewpoint of sports pharmacology]. (United States)

    Kasashi, Kumiko


    When athletes consult sports outpatient or orthopedic clinics it is possible to undergo drug treatment with the medical staff having prior knowledge of that patient being an athlete. However, if athletes seek any other diagnosis and treatment as an ordinary patient, the possibility of medical staff realizing the potential for imposing a doping issue on the athlete is extremely low. As a result, if the athlete fails to provide medical staff with information regarding anti-doping regulations when receiving clinical treatment, drug treatment administered as part of medical practices could be viewed as doping, resulting in the athlete being disciplined. In order to avoid this, pharmacist should participate in training in order to be able to provide information for anti-doping purposes. It is my personal opinion that knowledge regarding anti-doping is something that should be shared by all pharmacists, as pharmacists are educated in the fields of pharmacology and pharmacokinetics during the pharmacy education process, and sports pharmacology is a part of this. However, in order for pharmacists to understand sports pharmacology, it is necessary to provide education not only on the benefits and adverse effects of pharmaceutical products, but also on the concept of banned substances. It can be considered one of the pharmacist's duties to protect athletes who purchase drugs at a pharmacy or consult medical institutions as patients. With this, I would like to propose considering the potential for introducing sports pharmacology to pharmaceutical education, and specialist pharmacist training in the sports spectrum.

  12. The role of the pharmacist in home health care. (United States)

    McAllister, J C


    Home infusion services, a new facet of home health care (HHC) delivery, have created many new opportunities for hospital pharmacists to participate more actively in patient care. These opportunities can create new roles for the pharmacist as an educator, clinician, and administrator. Early efforts must be made to educate hospital administrators, physicians, and other allied health personnel regarding the advantages and disadvantages of providing HHC--from the perspective of both patients and institutions. The pharmacist can also collect data to assist in determining the extent to which the institution should participate in HHC delivery, and should coordinate the hospital's efforts to initiate home infusion services. Pharmacists should play an active role in screening, selecting, and training patients for HHC before discharge. The input of pharmacists in drug product selection and assistance in product compounding can ensure optimal patient outcomes and minimize costs. Clinical monitoring activities conducted by the pharmacist can include telephone interviews with patients at home and assessment of clinical progress during scheduled return visits to the clinic.

  13. Maslach Burnout Inventory: factor structures for pharmacists in health maintenance organizations and comparison with normative data for USA pharmacists. (United States)

    Gupchup, G V; Lively, B T; Holiday-Goodman, M; Siganga, W W; Black, C D


    This study compared the factor structure and burnout scores obtained on the Maslach Burnout Inventory from 84 pharmacists in Health Maintenance Organizations (HMO) with the normative data for USA pharmacists. Results provided empirical support for the reliability and validity of the inventory to measure burnout within the profession of pharmacy. Values of Cronbach coefficient alpha for subscales of Emotional Exhaustion, Depersonalization, and Personal Accomplishment were similar to those obtained with the normative sample. Factor analysis was conducted to yield the best three-factor solution. Derived factor loadings matched the three hypothesized subscales. On Personal Accomplishment the mean subscale score for HMO pharmacists was significantly higher than the normative score. Given limitations of the small sample, research is indicated to substantiate use of the inventory among HMO pharmacists.

  14. A Regional Guidebook for Conducting Functional Assessments of Forested Wetlands in the Arkansas Valley Region of Arkansas (United States)


    the Arkansas River was incising into the sedimentary rocks of the valley, and periods in the Holocene when the river was aggrading caused by changes...from the adjacent upland slopes. Slack- water deposits formed from aggradation of the Arkansas River during the Holocene, which in turn caused...tributary streambeds to aggrade , resulting in “drowning” of the tributaries and deposition of thick deposits of fine-grained sediments. This process

  15. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Arkansas

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)


    The 2015 IECC provides cost-effective savings for residential buildings in Arkansas. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Arkansas.

  16. 78 FR 72877 - Arkansas Electric Corporation v. Oklahoma Gas and Electric Company; Notice of Complaint (United States)


    ... Energy Regulatory Commission Arkansas Electric Corporation v. Oklahoma Gas and Electric Company; Notice... Procedure of the Federal Energy Regulatory Commission (Commission), 18 CFR 385.206, Arkansas Electric Corporation (Complainant) filed a formal complaint against Oklahoma Gas and Electric Company...

  17. The Role of Medicinal Cannabis in Clinical Therapy: Pharmacists' Perspectives.

    Directory of Open Access Journals (Sweden)

    Sami Isaac

    Full Text Available Medicinal cannabis has recently attracted much media attention in Australia and across the world. With the exception of a few countries, cannabinoids remain illegal-known for their adverse effects rather than their medicinal application and therapeutic benefit. However, there is mounting evidence demonstrating the therapeutic benefits of cannabis in alleviating neuropathic pain, improving multiple sclerosis spasticity, reducing chemotherapy induced nausea and vomiting, and many other chronic conditions. Many are calling for the legalisation of medicinal cannabis including consumers, physicians and politicians. Pharmacists are the gatekeepers of medicines and future administrators/dispensers of cannabis to the public, however very little has been heard about pharmacists' perspectives. Therefore the aim of this study was to explore pharmacists' views about medicinal cannabis; its legalisation and supply in pharmacy.Semi-structured interviews with 34 registered pharmacists in Australia were conducted. All interviews were audio-recorded, transcribed ad verbatim and thematically analysed using the NVivo software.Emergent themes included stigma, legislation, safety and collaboration. Overall the majority of pharmacists felt national legalisation of a standardised form of cannabis would be suitable, and indicated various factors and strategies to manage its supply. The majority of participants felt that the most suitable setting would be via a community pharmacy setting due to the importance of accessibility for patients.This study explored views of practicing pharmacists, revealing a number of previously undocumented views and barriers about medicinal cannabis from a supply perspective. There were several ethical and professional issues raised for consideration. These findings highlight the important role that pharmacists hold in the supply of medicinal cannabis. Additionally, this study identified important factors, which will help shape future

  18. Emerging roles for pharmacists in clinical implementation of pharmacogenomics. (United States)

    Owusu-Obeng, Aniwaa; Weitzel, Kristin W; Hatton, Randy C; Staley, Benjamin J; Ashton, Jennifer; Cooper-Dehoff, Rhonda M; Johnson, Julie A


    Pharmacists are uniquely qualified to play essential roles in the clinical implementation of pharmacogenomics. However, specific responsibilities and resources needed for these roles have not been defined. We describe roles for pharmacists that emerged in the clinical implementation of genotype-guided clopidogrel therapy in the University of Florida Health Personalized Medicine Program, summarize preliminary program results, and discuss education, training, and resources needed to support such programs. Planning for University of Florida Health Personalized Medicine Program began in summer 2011 under leadership of a pharmacist, with clinical launch in June 2012 of a clopidogrel-CYP2C19 pilot project aimed at tailoring antiplatelet therapies for patients undergoing percutaneous coronary intervention and stent placement. More than 1000 patients were genotyped in the pilot project in year 1. Essential pharmacist roles and responsibilities that developed and/or emerged required expertise in pharmacy informatics (development of clinical decision support in the electronic medical record), medication safety, medication-use policies and processes, development of group and individual educational strategies, literature analysis, drug information, database management, patient care in targeted areas, logistical issues in genetic testing and follow-up, research and ethical issues, and clinical precepting. In the first 2 years of the program (1 year planning and 1 year postimplementation), a total of 14 different pharmacists were directly and indirectly involved, with effort levels ranging from a few hours per month, to 25-30% effort for the director and associate director, to nearly full-time for residents. Clinical pharmacists are well positioned to implement clinical pharmacogenomics programs, with expertise in pharmacokinetics, pharmacogenomics, informatics, and patient care. Education, training, and practice-based resources are needed to support these roles and to

  19. Student pharmacist initiated medication reconciliation in the outpatient setting

    Directory of Open Access Journals (Sweden)

    Andrus MR


    Full Text Available The Joint Commission continues to emphasize the importance of medication reconciliation in all practice settings. Pharmacists and student pharmacists are uniquely trained in this aspect of patient care, and can assist with keeping accurate and complete medication records through patient interview in the outpatient setting.Objective: The objective of this study was to quantify and describe medication reconciliation efforts by student pharmacists in an outpatient family medicine center.Methods: A retrospective review was conducted of all standard medication reconciliation forms completed by student pharmacists during patient interviews from April 2010 to July 2010. The number of reviews conducted was recorded, along with the frequency of each type of discrepancy. A discrepancy was defined as any lack of agreement between the medication list in the electronic health record (EHR and the patient-reported regimen and included any differences in dose or frequency of a medication, duplication of the same medication, medication no longer taken or omission of any medication.Results: A total of 213 standard medication forms from the 4 month period were reviewed. A total of 555 discrepancies were found, including medications no longer taken, prescription medications that needed to be added to the EHR, over-the-counter(OTC and herbal medications that needed to be added to the EHR, medications taken differently than recorded in the EHR, and medication allergies which needed to be updated. An average of 2.6 discrepancies was found per patient interviewed.Conclusion: Student pharmacist-initiated medication reconciliation in an outpatient family medicine center resulted in the resolution of numerous discrepancies in the medication lists of individual patients. Pharmacists and student pharmacists are uniquely trained in medication history taking and play a vital role in medication reconciliation in the outpatient setting.

  20. Associations of gender and age groups on the knowledge and use of drug information resources by American pharmacists

    Directory of Open Access Journals (Sweden)

    Carvajal MJ


    Full Text Available Objectives: To explore knowledge and use of drug information resources by pharmacists and identify patterns influenced by gender and age-group classification. Methods: A survey questionnaire was mailed nationwide to 1,000 practitioners working in community (n = 500 and hospital (n = 500 settings who answer drug information questions as part of their expected job responsibilities. Responses pertaining to drug information resource use and knowledge of different types of drug-related queries, resource media preferences, and perceived adequacy of resources maintained in the pharmacy were analyzed by gender and age group. The t statistic was used to test for significant differences of means and percentages between genders and between age groups. Descriptive statistics were used to characterize other findings.Results: Gender and age group classification influenced patterns of knowledge and use of drug information resources by pharmacists. They also affected pharmacists’ perceptions of the most common types of questions prompting them to consult a drug information reference, as well as the resources consulted. Micromedex, exclusively available in electronic format, was the most commonly consulted resource overall by pharmacists. Lexi-Comp Online was the leading choice by women, preferred over Micromedex, but was not one of the top two resources selected by men. Conclusion: This study successfully identified the influence of gender and age-group classification in assessing drug information resource knowledge and use of general and specific types of drug-related queries.

  1. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination. (United States)

    Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P


    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

  2. Identification of major factors in Australian primary care pharmacists. (United States)

    Jackson, John K; Hussainy, Safeera Y; Kirkpatrick, Carl M J


    Objective The aim of the present study was to describe an environmental framework for pharmacists in primary care in Australia and determine the major factors within that environment that have the greatest bearing on their capacity to implement patient-focused models of professional practice.Methods A draft framework for pharmacists' practice was developed by allocating structures, systems and related factors known to the researchers or identified from the literature as existing within pharmacists' internal, operational and external environments to one of five domains: Social, Technological, Economic, Environmental or Political [STEEP]. Focus groups of pharmacists used an adapted nominal group technique to assess the draft and add factors where necessary. Where applicable, factors were consolidated into groups to establish a revised framework. The three major factors or groups in each domain were identified. The results were compared with the enabling factors described in the profession's vision statement.Results Seventy-eight individual factors were ultimately identified, with 86% able to be grouped. The three dominant groups in each of the five domains that had a bearing on the implementation of professional models of practice were as follows: (1) Social: the education of pharmacists, their beliefs and the capacity of the pharmacist workforce; (2) Technological: current and future practice models, technology and workplace structures; (3) Economic: funding of services, the viability of practice and operation of the Pharmaceutical Benefits Scheme; (4) Environmental: attitudes and expectations of stakeholders, including consumers, health system reform and external competition; and (5) Political: regulation of practice, representation of the profession and policies affecting practice.Conclusions The three dominant groups of factors in each of the five STEEP environmental domains, which have a bearing on pharmacists' capacity to implement patient-focused models of

  3. 40 CFR 81.139 - Northeast Arkansas Intrastate Air Quality Control Region. (United States)


    ... Air Quality Control Regions § 81.139 Northeast Arkansas Intrastate Air Quality Control Region. The Northeast Arkansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Arkansas Intrastate...

  4. 40 CFR 81.140 - Northwest Arkansas Intrastate Air Quality Control Region. (United States)


    ... Air Quality Control Regions § 81.140 Northwest Arkansas Intrastate Air Quality Control Region. The Northwest Arkansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northwest Arkansas Intrastate...

  5. 40 CFR 81.138 - Central Arkansas Intrastate Air Quality Control Region. (United States)


    ... Air Quality Control Regions § 81.138 Central Arkansas Intrastate Air Quality Control Region. The Central Arkansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central Arkansas Intrastate...

  6. 75 FR 66306 - Drawbridge Operation Regulation; Arkansas Waterway, Little Rock, AR (United States)


    ..., Little Rock, AR AGENCY: Coast Guard, DHS. ACTION: Final rule. SUMMARY: Drawbridge operations for the Baring Cross Railroad Drawbridge across the Arkansas Waterway at Mile 119.6 at Little Rock, Arkansas... (NPRM) entitled Drawbridge Operation Regulation; Arkansas Waterway, Little ] Rock, AR in the...

  7. Biography of Dr. Eugene W. Smith Arkansas State University President 1984 to 1992 (United States)

    Newsom, Glenda


    A president of a university in the state of Arkansas would benefit from researching the roots of the educational system within the state. Even though the state now has a number of universities that have evolved and are on the cutting-edge of advanced technology, Arkansas was slow in growth and development. Since Arkansas was slow to expand public…

  8. The palliative care interdisciplinary team: where is the community pharmacist? (United States)

    O'Connor, Moira; Pugh, Judith; Jiwa, Moyez; Hughes, Jeff; Fisher, Colleen


    Palliative care emphasizes an interdisciplinary approach to care to improve quality of life and relieve symptoms. Palliative care is provided in many ways; in hospices, hospital units, and the community. However, the greatest proportion of palliative care is in the community. In hospice and palliative care units in hospitals, clinical pharmacists are part of the interdisciplinary team and work closely with other health care professionals. Their expertise in the therapeutic use of medications is highly regarded, particularly as many palliative care patients have complex medication regimens, involving off-label or off-license prescribing that increases their risk for drug-related problems. However, this active involvement in the palliative care team is not reflected in the community setting, despite the community pharmacist being one of the most accessible professionals in the community, and visiting a community pharmacist is convenient for most people, even those who have limited access to private or public transport. This may be due to a general lack of understanding of skills and knowledge that particular health professionals bring to the interdisciplinary team, a lack of rigorous research supporting the necessity for the community pharmacist's involvement in the team, or it could be due to professional tensions. If these barriers can be overcome, community pharmacists are well positioned to become active members of the community palliative care interdisciplinary team and respond to the palliative care needs of patients with whom they often have a primary relationship.

  9. Impact of Self Efficacy on Innovative Behaviour Pharmacist in Hospital

    Directory of Open Access Journals (Sweden)

    Sri M. Wahyuningrum


    Full Text Available Hospitals are always required in order to improve the quality of service in accordance with professional standards in accordance with their code of ethics. Therefore, health workers in hospitals, especially pharmacists, are required to continuously improve its service to the community. To improve health services to the community, then the pharmacist must interact and be accepted by other professional health personnel in hospitals. The purpose of this study was to determine the effect of self-efficacy pharmacist in a hospital organization that became an impact on innovative behavior. This study used an obsevational quantitative measurement using questionnaire instrument. The results measured by number consist of value, rank, and frequencies were analyzed using statistics software smartPLS to answer the research question or hypothesis to predict a particular variable affects another variable. The results showed that effect between self-efficacy of behavioral innovations in the hospital pharmacist significantly different. A pharmacist who has high self-efficacy will obviously have the higher innovation behavior in hospitals.

  10. Internationally trained pharmacists in Great Britain: what do registration data tell us about their recruitment?

    Directory of Open Access Journals (Sweden)

    Hassell Karen


    Full Text Available Abstract Background Internationally trained health professionals are an important part of the domestic workforce, but little is known about pharmacists who come to work in Great Britain. Recent changes in the registration routes onto the Register of Pharmacists of the Royal Pharmaceutical Society of Great Britain may have affected entries from overseas: reciprocal arrangements for pharmacists from Australia and New Zealand ended in June 2006; 10 new states joined the European Union in 2004 and a further two in 2007, allowing straightforward registration. Aims The aims of the paper are to extend our knowledge about the extent to which Great Britain is relying on the contribution of internationally trained pharmacists and to explore their routes of entry and demographic characteristics and compare them to those of pharmacists trained in Great Britain. Methods The August 2007 Register of Pharmacists provided the main data for analysis. Register extracts between 2002 and 2005 were also explored, allowing longitudinal comparison, and work pattern data from the 2005 Pharmacist Workforce Census were included. Results In 2007, internationally trained pharmacists represented 8.8% of the 43 262 registered pharmacists domiciled in Great Britain. The majority (40.6% had joined the Register from Europe; 33.6% and 25.8% joined via adjudication and reciprocal arrangements. Until this entry route ended for pharmacists from Australia and New Zealand in 2006, annual numbers of reciprocal pharmacists increased. European pharmacists are younger (mean age 31.7 than reciprocal (40.0 or adjudication pharmacists (43.0, and the percentage of women among European-trained pharmacists is much higher (68% when compared with British-trained pharmacists (56%. While only 7.1% of pharmacists registered in Great Britain have a London address, this proportion is much higher for European (13.9%, adjudication (19.5% and reciprocal pharmacists (28.9%. The latter are more likely to

  11. The importance of pharmacist providing patient education in oncology. (United States)

    Avery, Mia; Williams, Felecia


    The world's increasing diversity requires health care professionals to adjust delivery methods of teaching to accommodate different cultural values and beliefs. The ability to communicate effectively across languages and various cultural practices directly affects patient education outcomes. Pharmacist should be aware of varying modalities and considerations when counseling a patient diagnosed with cancer and undergoing chemotherapy. In more recent years, the medical profession has seen an increase in patient outcomes due to using the multidisciplinary team approach and has benefited by implementing Medication Therapy Management (MTM) programs at various institutions. For the clinical pharmacist, this would mean documentation for these services should be precise and accurate based on the specific patients needs. There are several factors involved in the care and therapy of the patient with cancer. Clinical oncology pharmacist should be aware of the ever-changing role in oncology and be able to implement new practices at their facility for better patient outcomes.

  12. Clinical pharmacist interventions to support adherence to thrombopreventive therapy

    DEFF Research Database (Denmark)

    Hedegaard, Ulla

    individualised interventions and team-based care, e.g. integrating a clinical pharmacist with particular focus on patients’ drug-related problems. One approach with growing evidence of improving medication adherence is motivational interviewing (MI). So far, no clinical pharmacist intervention using MI has...... to the different results in the two trials is that the stroke patients - compared to the hypertension patients - may have been more motivated for taking their medication as they just experienced a serious event. Another factor is that a secondary prevention clinic was established during the stroke study, which may...... by the clinical pharmacists and the patients.  Sensitivity and specificity for the two scales of the adherence questionnaire demonstrating the best agreement with prescription-based measures were about 90% and 30%, and the agreement with refill data was fairly low with kappa values below 0.3, suggesting...

  13. [Fraud and pharmacist: an old companionship from Antiquity to nowadays]. (United States)

    Bonnemain, Bruno


    Fraudulent trading often deals with pharmacist, from several viewpoints. Pharmacist had often suffered from it, but he was also sometimes the source of falsification which initiated the need for inspection of pharmacy shops. The scientific knowledge of pharmacists, and particularly his analytical skills, explains their role to detect falsifications for products outside drugs, especially for food and also for drug use in competitive sport. Drug falsification goes back to time immemorial and goes on today very actively with Internet expansion. States and WHO try to fight against this plague with more and more complex tools such as Datamatrix progressively implemented worldwide. Pharmacy and falsifications, two words that will be unfortunately associated during the whole human history.

  14. Revised Subjects of the Current Korean Oriental Pharmacists' Licensing Examination

    Directory of Open Access Journals (Sweden)

    Jong-Pil Lim


    Full Text Available This study is designed to draw out new integrated subjects of the Korean Oriental Pharmacists??Licensing Examination (KOPLE. In 2004, for the revision of subjects, we have analyzed the curriculums of the Oriental Pharmacy department, the oriental pharmacist?占퐏 (OP?占퐏 job description book, and the elementary items of KOPLE. We also examined the system of the Chinese Herb Pharmacists??Examination and other health personnel licensing examinations and studied the data of items and compared them with KOPLE. We heard the public opinion on the present KOPLE. We developed a subfield of 18 subjects, a middle category of 188 items, and a small category of 1,026 items. We proposed a new KOPLE that consists of three subjects: basic oriental pharmacy, applied oriental pharmacy, and laws and regulations.

  15. Role of the pharmacist in reducing healthcare costs: current insights

    Directory of Open Access Journals (Sweden)

    Dalton K


    Full Text Available Kieran Dalton, Stephen Byrne Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland Abstract: Global healthcare expenditure is escalating at an unsustainable rate. Money spent on medicines and managing medication-related problems continues to grow. The high prevalence of medication errors and inappropriate prescribing is a major issue within healthcare systems, and can often contribute to adverse drug events, many of which are preventable. As a result, there is a huge opportunity for pharmacists to have a significant impact on reducing healthcare costs, as they have the expertise to detect, resolve, and prevent medication errors and medication-related problems. The development of clinical pharmacy practice in recent decades has resulted in an increased number of pharmacists working in clinically advanced roles worldwide. Pharmacist-provided services and clinical interventions have been shown to reduce the risk of potential adverse drug events and improve patient outcomes, and the majority of published studies show that these pharmacist activities are cost-effective or have a good cost:benefit ratio. This review demonstrates that pharmacists can contribute to substantial healthcare savings across a variety of settings. However, there is a paucity of evidence in the literature highlighting the specific aspects of pharmacists’ work which are the most effective and cost-effective. Future high-quality economic evaluations with robust methodologies and study design are required to investigate what pharmacist services have significant clinical benefits to patients and substantiate the greatest cost savings for healthcare budgets. Keywords: pharmacoeconomics, pharmaceutical care, clinical pharmacy, cost-effectiveness, economic evaluation

  16. Attitudes of Iraqi society towards the role of community pharmacists

    Directory of Open Access Journals (Sweden)

    Abdulrasoul Wayyes


    Full Text Available Objectives: The main aims of this study were to assess society’s use of community pharmacies; evaluate attitudes towards the role of the community pharmacist; and describe required pharmacist characteristics and future services.Study design: A cross-sectional survey with a stratified sampling technique.Methods: A self-administered, validated, questionnaire was distributed to 500 consumers in attendance at 50 community pharmacies in Baghdad, Iraq. Data were gathered from January to April 2012. Mann-Whitney and Kruskal-Wallis tests were performed to test for statistical differences among the study variables. Further analysis through the Chi-square test and logistic regression was completed to assess the predictors of society’s attitudes.Results: Twenty-six percent of respondents visited their community pharmacies at least once per week and an additional 65% reported visiting their pharmacy at least once per month. Fifty-five percent of respondents listed the community pharmacist as the first person they would contact in case of any drug-related problem. However, the pharmacist’s role was under-appreciated by the majority of respondents (79.8%. These attitudes varied significantly with regard to the demographic characteristics of respondents. Logistic regression analysis showed that gender and age were the influential predictors of favourable versus non-favourable attitudes towards the role of pharmacist.Conclusions: The use of community pharmacies in Iraq was characterized by frequent visits to purchase medicines. Selection of the pharmacy primarily depended on its location. Overall, an under-appreciation of the professional performance of pharmacists was predominant. Raising public awareness towards the important role of community pharmacists in providing public health is warranted.

  17. Do pharmacists use social media for patient care? (United States)

    Benetoli, Arcelio; Chen, Timothy F; Schaefer, Marion; Chaar, Betty; Aslani, Parisa


    Background Social media are frequently used by consumers and healthcare professionals. However, it is not clear how pharmacists use social media as part of their daily professional practice. Objective This study investigated the role social media play in pharmacy practice, particularly in patient care and how pharmacists interact online with patients and laypeople. Setting Face-to-face, telephone, or Skype interviews with practising pharmacists (n = 31) from nine countries. Method In-depth semi-structured interviews; audio-recorded, transcribed verbatim, and thematically analysed. Main outcome measure Two themes related to the use of social media for patient care: social media and pharmacy practice, and pharmacists' online interactions with customers and the public. Results Most participants were community pharmacists. They did not provide individualized services to consumers via social media, despite most of them working in a pharmacy with a Facebook page. No participant "friended" consumers on Facebook as it was perceived to blur the boundary between professional and personal relationships. However, they occasionally provided advice and general health information on social media to friends and followers, and more commonly corrected misleading health information spread on Facebook. Short YouTube videos were used to support patient counselling in community pharmacy. Conclusions Participants recognized the potential social media has for health. However, its use to support patient care and deliver pharmacy services was very incipient. Pharmacists as medicine experts are well equipped to contribute to improvements in social media medicines-related information, learn from consumers' online activities, and design new ways of delivering care to communities and individuals.

  18. Improving care transitions: current practice and future opportunities for pharmacists. (United States)

    Hume, Anne L; Kirwin, Jennifer; Bieber, Heather L; Couchenour, Rachel L; Hall, Deanne L; Kennedy, Amy K; LaPointe, Nancy M Allen; Burkhardt, Crystal D O; Schilli, Kathleen; Seaton, Terry; Trujillo, Jennifer; Wiggins, Barbara


    During the past decade, patient safety issues during care transitions have gained greater attention at both the local and national level. Readmission rates to U.S. hospitals are high, often because of poor care transitions. Serious adverse drug events (ADEs) caused by an incomplete understanding of changes in complex drug regimens can be an important factor contributing to readmission rates. This paper describes the roles and responsibilities of pharmacists in ensuring optimal outcomes from drug therapy during care transitions. Barriers to effective care transitions, including inadequate communication, poor care coordination, and the lack of one clinician ultimately responsible for these transitions, are discussed. This paper also identifies specific patient populations at high risk of ADEs during care transitions. Several national initiatives and newer care transition models are discussed, including multi- and interdisciplinary programs with pharmacists as key members. Among their potential roles, pharmacists should participate on medical rounds where available, perform medication reconciliation and admission drug histories, apply their knowledge of drug therapy to anticipate and resolve problems during transitions, communicate changes in drug regimens between providers and care settings, assess the appropriateness and patient understanding of drug regimens, promote adherence, and assess health literacy. In addition, this paper identifies barriers and ongoing challenges limiting greater involvement of pharmacists from different practice settings during care transitions. Professional degree programs and residency training programs should increase their emphasis on pharmacists' roles, especially as part of interdisciplinary teams, in improving patient safety during care transitions in diverse practice settings. This paper also recommends that Accreditation Council for Pharmacy Education (ACPE) standards include specific language regarding the exposure of students to

  19. The pharmacist as a drug information supplier in hospitals : A view from services marketing

    NARCIS (Netherlands)

    Boerkamp, EJC; Reuijl, JC; Haaijer-Ruskamp, FM


    The aim of this study is to gain insight into how the information supply services of the pharmacist and his or her-potential competitors ave seen by physicians. In the context of the upcoming professionalization trend of the pharmacist we are interested in determining how the hospital pharmacist can

  20. Pharmacist advice is accepted more for medical than for surgical patients in an emergency department

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Olsen, Inger; Thisted, Anette Rehn


    Pharmacists' advice may reduce medication errors in the emergency department (ED). However, pharmacists' recommendations are of little value if not acknowledged by physicians. The aim of the present study was to analyze how often and which categories of pharmacist recommendations were taken...... into account by the physicians in a Danish ED. Special attention is paid to problems of significant or vital importance....

  1. Peak streamflow on selected streams in Arkansas, December 2015 (United States)

    Breaker, Brian K.


    Heavy rainfall during December 2015 resulted in flooding across parts of Arkansas; rainfall amounts were as high as 12 inches over a period from December 27, 2015, to December 29, 2015. Although precipitation accumulations were highest in northwestern Arkansas, significant flooding occurred in other parts of the State. Flood damage occurred in several counties as water levels rose in streams, and disaster declarations were declared in 32 of the 75 counties in Arkansas.Given the severity of the December 2015 flooding, the U.S. Geological Survey (USGS), in cooperation with the Federal Emergency Management Agency (FEMA), conducted a study to document the meteorological and hydrological conditions prior to and during the flood; compiled flood-peak gage heights, streamflows, and flood probabilities at USGS streamflow-gaging stations; and estimated streamflows and flood probabilities at selected ungaged locations.

  2. Emerging Developments in Pharmacists' Scope of Practice to Address Unmet Health Care Needs. (United States)

    Burns, Anne L


    Pharmacists' comprehensive training is being leveraged in emerging patient care service opportunities that include prescriptive authority under collaborative practice agreements (CPAs) with prescribers or through state-based protocols. CPAs and state-based protocols expand pharmacists' scope of practice to allow the pharmacist to perform designated functions under the terms of the agreement or protocol. For patient-specific CPAs, this often includes initiating, modifying, or discontinuing therapy and ordering laboratory tests. For population-based CPAs and state-based protocols, pharmacists are often authorized to initiate medications to address a public health need. CPAs and state-based protocols are mechanisms to optimally use pharmacists' education and training.

  3. Effects on Deaf Patients of Medication Education by Pharmacists (United States)

    Hyoguchi, Naomi; Kobayashi, Daisuke; Kubota, Toshio; Shimazoe, Takao


    Deaf people often experience difficulty in understanding medication information provided by pharmacists due to communication barriers. We held medication education lectures for deaf and hard of hearing (HH) individuals and examined the extent to which deaf participants understood medication-related information as well as their attitude about…

  4. [Development of skill scale for communication skill measurement of pharmacist]. (United States)

    Teramachi, Hitomi; Komada, Natsuki; Tanizawa, Katsuya; Kuzuya, Yumi; Tsuchiya, Teruo


    To purpose of this study was to develop a pharmacist communication skill scale. A 38 items scale was made and 283 pharmacists responded. The original questionnaire consisted of 38 items, with 1-5 graded Likert scale. Completed responses of 228 pharmacists data were used for testing the reliability and the validity of this scale. The first group of items from the original questionnaire were 38, and finally 38 original items were chosen for investigation of content validity, correlation coefficient and commonality. From factor analysis, four factors were chosen among the 31 items as follows: patient respect reception skill, problem discovery and solution skill, positive approach skill, feelings processing skill. The correlation coefficient between this original scale and the KiSS-18 (Social Skill) received high score (r=0.694). The reliability of this scale showed high internal consistency (Cronbach α coefficient=0.951), so the result of test for the validity of this scale supports high content validity. Thus we propose adoption of pharmacist communication skill scale to carry a brief eponymous name as TePSS-31. The above findings indicate that this developed scale possess adequate validity and reliability for practical use.

  5. Pharmacists and medical doctors in nineteenth‐century Belgium

    NARCIS (Netherlands)

    Schepers, R.


    textabstractAbstract In this article the main areas of conflict between the medical and the pharmaceutical professions in Belgium in the 19th century are outlined. The medical profession was dominant in the division of labour and the pharmacists were not allowed to threaten its position. However, ph

  6. Translators vs pharmacists as successful interlingual knowledge mediators?

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth

    : Studies in Translatology 10 (1): 15-29. EU Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001. Nisbeth Jensen, Matilde. Forthcoming. “Patient Information Leaflet translators in the EU: Mapping the hypothetical competences of professional translators and pharmacists...

  7. Regulation of pharmacists: a comparative law and economics analysis

    NARCIS (Netherlands)

    Philipsen, N.J.


    This paper discusses the regulation of pharmacists from an economic perspective, focusing on licensing, price and fee regulation, advertising restrictions and rules on exercise of the profession, and restrictions on business structure. A comparative overview is presented of the most common forms of

  8. Evaluation of pharmacist clinical interventions in a Dutch hospital setting

    NARCIS (Netherlands)

    Bosma, Liesbeth; Jansman, Frank G. A.; Franken, Anton M.; Harting, Johannes W.; Van den Bemt, Patricia M. L. A.


    Objective Assessing the relevance of a clinically active pharmacist method compared to the traditional working method. Method The study was carried out in a general internal/gastro-enterology unit during two 8-weeks periods in 2004. It was an observational, non-randomized prospective study. Outcome

  9. The Role of a Psychiatric Pharmacist in College Health (United States)

    Caley, Charles F.; Webber, Donna; Kurland, Michael; Holmes, Paula


    Published evidence indicates there is a growing prevalence of psychiatric illnesses on college campuses, and that approximately one quarter of students may be taking psychotropic medications. But attracting and retaining experienced mental health care professionals to college health settings is a challenging task. The psychiatric pharmacist is one…

  10. [Christ as a pharmacist, according to Martin Luther]. (United States)

    Steiger, Johann Anselm


    This condition has been stimulated by the latest study written by Fitz Krafft concerning the motif "Jesus Christ as a pharmacist", which was frequently used in Christian art. It is shown that this motif, fully developed in the first third of the 17th century, originated in the theology of Martin Luther.

  11. Medical Oncology Pharmacy: A New Role for the Clinical Pharmacist (United States)

    Morris, Carl R.; Hickman, Mary Johne


    The University of Tennessee has established a training program for clinical pharmacists dealing with cancer chemotherapy patients. Health-care settings are described in which these individuals can contribute as unique health-care team members in oncology. (Author/LBH)

  12. Do pharmacists' reports of adverse drug reactions reflect patients' concerns?

    NARCIS (Netherlands)

    van Grootheest, A.C.; van Puijenbroek, E.P.; de Jong-van den Berg, Lolkje Theodora Wilhelmina


    Aim: The aim of the present study was to investigate whether the concerns patients express to a Drug Information Line about possible adverse drug reactions (ADRs) they have experienced, are sufficiently reflected by the ADR reports submitted by pharmacists to the Netherlands Pharmacovigilance Centre

  13. Contribution of pharmacists to the reporting of adverse drug reactions

    NARCIS (Netherlands)

    van Grootheest, AC; van Puijenbroek, EP; de Jong-van den Berg, LTW


    Purpose The aim of the study is to get a better view about the possible contribution of pharmacists' reports to the quantity and the quality of reports and in this way to the quality of a voluntary reporting system of adverse drug reactions. Methods A total of 15 293 reports, sent to the Netherlands

  14. [Lavoisier and the Parisian pharmacists of his time]. (United States)

    Flahaut, J


    In the 17th and 18th centuries, pharmacists were highly competent in experimentation and well-versed in chemical manipulations. Of necessity, Lavoisier had extensive rapport with them. Presented here are the attitudes regarding him by pharmacists who had their own shops during the twenty years preceding the Revolution. There were his adversaries (one implacable: Baumé; the other lightly mocking: Demachy), his defenders (one timorous: Bronigniart; the other enthusiastic: Cadet de Vaux), and finally and above all those who remained indifferent, although for the most part they had worked for brief periods with Lavoisier (Cadet de Gassicourt, Déyeux, Mitouard and Quinquet). And yet, Baumé and Cadet de Vaux, who were in opposition when faced with the ideas of the new chemistry, joined in their efforts to attempt to get Lavoisier out of prison, at the risk of being guillotined. Finally, the greatest hommage rendered to the pharmacists came from Lavoisier himself, who believing that he would be released from prison denied all of his assets, envisaged himself becoming a pharmacist.

  15. Evaluation of pharmacist utilization of a poison center as a resource for patient care. (United States)

    Armahizer, Michael J; Johnson, David; Deusenberry, Christina M; Foley, John J; Krenzelok, Edward P; Pummer, Tara L


    The objective of this study was to evaluate pharmacist use of a Regional Poison Information Center (RPIC), identify potential barriers to utilization, and provide strategies to overcome these barriers. All calls placed to a RPIC by a pharmacist, physician, or nurse over a 5-year period were retrieved. These data were analyzed to assess the pharmacist utilization of the RPIC and the variation of call types. Additionally, a survey, designed to assess the past and future use of the RPIC by pharmacists, was distributed to pharmacists in the region. Of the 37,799 calls made to the RPIC, 26,367 (69.8%) were from nurses, 8096 (21.4%) were from physicians, and 3336 (8.8%) were from pharmacists. Among calls initiated by pharmacists, the majority involved medication identification (n = 2391, 71.7%). The survey had a 38.9% response rate (n = 715) and revealed a trend toward less RPIC utilization by pharmacists with more formal training but less practice experience. The utilization of the RPIC was lowest among pharmacists as compared to other health care professionals. This may be due to pharmacists' unfamiliarity with the poison center's scope of services and resources. Therefore, it is important that pharmacists are educated on the benefit of utilizing poison centers in clinical situations.

  16. Medication management during pregnancy: role of the pharmacist. (United States)

    Samuel, Nardin; Einarson, Adrienne


    A community pharmacist is frequently the first healthcare professional who is asked to give advice regarding medication use during pregnancy. As 50% of pregnancies are unplanned, a woman often discovers she is pregnant while already taking a medication and visits a pharmacy which is easily accessible, to enquire if she has harmed her baby by this action. Following a review of the literature, of which there is a paucity on this topic, we found that pharmacists often do not feel equipped to dispense teratology information and frequently refer the woman to her attending physician, without giving any information. In addition, it was clear that even when they did give information, it was not necessarily evidence-based and at times, inaccurate and based on their own opinions. In this article, we have attempted to make pharmacists aware of all the sources that are available, to enable them to perform this important role as a member of the health care team. These include websites, texts, evidence-based literature, teratogen information services and more. With the knowledge extracted from various resources, following critical appraisal of the data, they should be more comfortable and feel better equipped to transfer this information to a pregnant woman. In conclusion, while there may be a lack of adequate information regarding use of certain medications during pregnancy, pharmacists should be able to integrate available information with their medication expertise, to make appropriate individual risk/benefit decisions. This requires active engagement with pregnant women, rather than automatically referring them to their physician, thus establishing the pharmacist role as an essential member of the health care team.

  17. Avoiding Treatment Interruptions: What Role Do Australian Community Pharmacists Play?

    Directory of Open Access Journals (Sweden)

    Salem Hasn Abukres

    Full Text Available To explore the reported practice of Australian community pharmacists when dealing with medication supply requests in absence of a valid prescription.Self-administered questionnaire was posted to 1490 randomly selected community pharmacies across all Australian states and territories. This sample was estimated to be a 20% of all Australian community pharmacies.Three hundred eighty five pharmacists participated in the study (response rate achieved was 27.9% (there were 111 undelivered questionnaires. Respondents indicated that they were more likely to provide medications to regular customers without a valid prescription compared to non-regular customers (p<0.0001. However, supply was also influenced by the type of prescription and the medication requested. In the case of type of prescription (Standard, Authority or Private this relates to the complexity/probability of obtaining a valid prescription from the prescriber at a later date (i.e. supply with an anticipated prescription. Decisions to supply and/or not supply related to medication type were more complex. For some cases, including medication with potential for abuse, the practice and/or the method of supply varied significantly according to age and gender of the pharmacist, and pharmacy location (p<0.05.Although being a regular customer does not guarantee a supply, results of this study reinforce the importance for patients having a regular pharmacy, where pharmacists were more likely to continue medication supply in cases of patients presenting without a valid prescription. We would suggest, more flexible legislation should be implemented to allow pharmacists to continue supplying of medication when obtaining a prescription is not practical.

  18. Black bears in Arkansas: Characteristics of a successful translocation (United States)

    Smith, Kimberly G.; Clark, Joseph D.


    In 1958, the Arkansas Game and Fish Commission began translocating black bears (Ursus americanus) from Minnesota to the Interior Highlands (Ozark and Ouachita mountains) of Arkansas where bears had been extirpated early in this century. This project continued for 11 years with little public imput, during which time an estimated 254 bears were released. We estimate there are now >2,500 bears in the Interior Highlands of Arkansas, Missouri, and Oklahoma, making it one of the most successful translocations of a Carnivora. Factors that contributed to the success include use of wild-captured animals, elimination of major factors associated with extirpation, release into prime habitats within the former range, multiple release sites, release of 20–40 animals/year for eight years, and release of mostly males prior to release of mostly females. Studies on two allopatric populations demonstrate that they are now diverging in some demographic characteristics, including litter size, cub survivorship, and adult sex-ratio. Translocation of black bears to the Interior Highlands is successful in terms of numbers of animals, but it will not be truly successful until people accept black bears as part of the regional fauna. To that end, those associated with management and research of bears in Arkansas are now focussing on public education and control of nuisance bears.

  19. State Minimum Core Curricula: Arkansas Institutions of Higher Education. (United States)

    Arkansas State Dept. of Higher Education, Little Rock.

    State minimum core curricula for two-year and four-year colleges and universities have been approved by the Arkansas Board of Higher Education. Within the framework of the State Minimum Core, each state institution is required to propose 35 semester/credit hours from its institutional general education core to be recognized for purposes of the…

  20. State Minimum Core Curricula: Arkansas Institutions of Higher Education, 2000. (United States)

    Arkansas State Dept. of Higher Education, Little Rock.

    This document provides state minimum core curricula for each two- and four-year institution of higher education in Arkansas, determined by the Department of Higher Education. Courses within this core are to apply toward the general education core curriculum requirements for baccalaureate degrees at state-supported institutions and should be fully…

  1. State Minimum Core Curricula: Arkansas Institutions of Higher Education, 2003. (United States)

    Arkansas State Dept. of Higher Education, Little Rock.

    In 1990 the Arkansas State Board of Higher Education adopted guidelines for the development of state minimum core curriculum response to state legislation. This legislation provides that courses within the core shall apply to the general education core curriculum requirements for baccalaureate degrees at state-supported institutions and shall be…

  2. Risks, Assets, and Negative Health Behaviors among Arkansas' Hispanic Adolescents (United States)

    Fitzpatrick, Kevin M.; Choudary, Wendie; Kearney, Anne; Piko, Bettina F.


    This study examined the relationship between risk, assets, and negative health behaviors among a large sample of Hispanic adolescents. Data were collected from over 1,000 Hispanic youth in grades 6, 8, 10, and 12 attending school in a moderate size school district in Northwest Arkansas. Logistic regression models examined the variation in the odds…

  3. Project CAP. Boston Mountains Educational Cooperative, Greenland, Arkansas. (United States)

    Hamilton, Jack A.; Leffler, Jeanne

    This description of career education activities in Greenland, Arkansas, was prepared as part of a study conducted to identify evaluated, exemplary career education activities which represent the best of the current career education programs and practices referred to in Public Law 93-380. (See CE 018 212 for the final report of this study.) This…

  4. Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study (United States)

    Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S


    Objectives This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Design Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Setting Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Participants Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Main outcome measures Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. Results 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. Conclusions This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist

  5. Pharmacist-based health coaching: A new model of pharmacist-patient care. (United States)

    Lonie, John M; Austin, Zubin; Nguyen, Rosalie; Gill, Imninder; Tsingos-Lucas, Cherie


    This paper describes a provider-patient communication process, which although not new to health care in general, is new to the pharmacy profession. Health coaching is a technique that empowers patients to make lasting health behavior changes that improve overall well-being. It provides patients with health care implementation options that better suit their lifestyle and abilities. Health coaching programs have the potential to foster better health outcomes, especially with patients who are chronically ill or represent an at risk population for medication non-adherence (e.g. elderly, patients on psychotropic medications). Other health professions (e.g. nursing and medicine) have had success with the implementation of health coaching models. For example, nurse coaching is recognized by the American Nurse Association and recent statistics show 3.1 million nurses in the U.S.A are also trained in nurse coaching. The pharmacy profession has yet to tap the patient-related benefits of health coaching. This commentary will discuss (i) The theoretical foundations of health coaching (ii) Distinctions between health coaching, motivational interviewing and traditional medication therapy counseling (iii) Training necessary for health coaching; and (iv) How pharmacists can use health coaching in practice.


    Directory of Open Access Journals (Sweden)

    Max Joseph Herman


    Full Text Available ABSTRACT Background: Up to now there are more than 60 schools of pharmacy with a variety of accreditation level in lndonesia. Previous study found that the standard of pharmaceutical services at various service facilities (hospitals, primary health care and community pharmacy can not be fully implemented because of the limited competency of pharmacist. This study was conducted to identify the qualification of pharmacist who delivers services in community pharmacy in compliance with the Indonesian Health Law No. 36 of 2009. As mandated in the Health Law No. 36 of 2009, the government is obliged to establish minimum requirements that must be possessed. Methods: This cross sectional study was conducted in 2010 at 2 community pharmacies in each of 3 cities, i.e. Bandung, DI Yogyakarta and Surabaya. Other than ten pharmacists delivering services in community pharmacies, there were pharmacists as informants from 4 institutions in each city selected, i.e. six pharmacists from two Schools of Pharmacy, three pharmacists from three Regional Indonesian Pharmacists Association,six pharmacists from three District Health Offices and three Provincial Health Offices. Primary data collection through in-depth interviews and observation as well as secondary data collection concerning standard operating procedures, monitoring documentation and academic curricula has been used. Descriptive data were analysed qualitatively Results: The findings indicate that pharmacists' qualification to deliver services in a community pharmacy in accordance with the Government Regulation No. 51 of 2009, Standards of Pharmacy Services in Community Pharmacy and Good Pharmaceutical Practices (GPP was varied. Most pharmacists have already understood their roles in pharmacy service, but to practice it in accordance with the standards or guidelines they are still having problems. It is also acknowledged by pharmacists in other institutions, including School of Pharmacy, Regional

  7. Lithology, hydrologic characteristics, and water quality of the Arkansas River Valley alluvial aquifer in the vicinity of Van Buren, Arkansas (United States)

    Kresse, Timothy M.; Westerman, Drew A.; Hart, Rheannon M.


    A study to assess the potential of the Arkansas River Valley alluvial aquifer in the vicinity of Van Buren, Arkansas, as a viable source of public-supply water was conducted by the U.S. Geological Survey in cooperation with the Little Rock, District, U.S. Army Corps of Engineers. An important study component was to identify possible changes in hydrologic conditions following installation of James W. Trimble Lock and Dam 13 (December 1969) on the Arkansas River near the study area. Data were gathered for the study in regard to the lithology, hydrologic characteristics, and water quality of the aquifer. Lithologic information was obtained from drillers’ logs of wells drilled from 1957 through 1959. Water-quality samples were collected from 10 irrigation wells and analyzed for inorganic constituents and pesticides. To evaluate the potential viability of the alluvial aquifer in the Van Buren area, these data were compared to similar stratigraphic, lithologic, and groundwater-quality data from the Arkansas River Valley alluvial aquifer at Dardanelle, Ark., where the aquifer provides a proven, productive, sole-source of public-supply water.

  8. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists (United States)

    Frick, Amber; Benton, Cristina S.; Scolaro, Kelly L.; McLaughlin, Jacqueline E.; Bradley, Courtney L.; Suzuki, Oscar T.; Wang, Nan; Wiltshire, Tim


    Pharmacogenomics, once hailed as a futuristic approach to pharmacotherapy, has transitioned to clinical implementation. Although logistic and economic limitations to clinical pharmacogenomics are being superseded by external measures such as preemptive genotyping, implementation by clinicians has met resistance, partly due to a lack of education. Pharmacists, with extensive training in pharmacology and pharmacotherapy and accessibility to patients, are ideally suited to champion clinical pharmacogenomics. This study aimed to analyze the outcomes of an innovative pharmacogenomic teaching approach. Second-year student pharmacists enrolled in a required, 15-week pharmaceutical care lab course in 2015 completed educational activities including lectures and small group work focusing on practical pharmacogenomics. Reflecting the current landscape of direct-to-consumer (DTC) genomic testing, students were offered 23andMe genotyping. Students completed surveys regarding their attitudes and confidence on pharmacogenomics prior to and following the educational intervention. Paired pre- and post-intervention responses were analyzed with McNemar's test for binary comparisons and the Wilcoxon signed-rank test for Likert items. Responses between genotyped and non-genotyped students were analyzed with Fisher's exact test for binary comparisons and the Mann-Whitney U-test for Likert items. Responses were analyzed for all student pharmacists who voluntarily completed the pre-intervention survey (N = 121, 83% response) and for student pharmacists who completed both pre- and post-intervention surveys (N = 39, 27% response). Of those who completed both pre- and post-intervention surveys, 59% obtained genotyping. Student pharmacists demonstrated a significant increase in their knowledge of pharmacogenomic resources (17.9 vs. 56.4%, p < 0.0001) and confidence in applying pharmacogenomic information to manage patients' drug therapy (28.2 vs. 48.7%, p = 0.01), particularly if the student

  9. [Consideration of the Work Content of the Clinic Pharmacist and Its Usefulness]. (United States)

    Imajo, Hirofumi; Imai, Kazutaka; Hisajima, Kazuhiro; Kishimoto, Masato; Sekiya, Kyosuke; Kagawa, Yoshihiko; Talman-Teramoto, Honami; Soga, Yukihiro; Yasukawa, Keigo; Hirohara, Masayoshi; Kushida, Kazuki


    "Medical teams"have been promoted in the home care setting. For the pharmacist, it is possible to maintain the safety and improve the quality of medical care by working with a multidisciplinary team. The arrangement of the pharmacist with the clinic is specified in Article 18 of the Medical Care Law, but there is no medical treatment fee for the clinic pharmacist. We examined the work content and usefulness of the clinic pharmacist. The work content was to participate in visiting consultation, introduce pharmacotherapy management based on the clinic pharmacist's working protocol, propose prescriptions, provide drug information service, and cooperate with insurance pharmacy pharmacists. Because the pharmacist was working in the clinic, he or she was able to actively intervene in drug treatment. Intervention in medication requires organizing and gathering information, which is difficult in the position of the insurance pharmacy pharmacist. The fact that the clinic pharmacist assumes this role and works with insurance pharmacy pharmacists makes it possible to maintain the safety and improve the quality of medical care.

  10. Multi-site Management Plan Ecoregional Conservation for the Ouachita Ecoregion Arkansas and Oklahoma (United States)


    Ecological Studies: Analysis of vertebrates in the Inyo-white Mountains, California . In Proc: Management of Amphibians, Reptiles, and Small Mammals...Forests in the Interior Highlands of Arkansas and Oklahoma, Winrock International; 1992. Duncan, Wilbur H. and Leonard E. Foote. Wildflowers of the...Trees, Shrubs and Vines of Arkansas. Ozark Soc. Found.; 1989. Hunter, Carl G. Wildflowers of Arkansas (3rd. ed.). Ozark Soc. Found.; 1992 Hyatt

  11. Food Shopping Perceptions, Behaviors And Ability To Purchase Healthy Food Items In The Lower Mississippi Delta (United States)

    Purpose: To examine the agreement between perceptions, behaviors and ability to purchase healthy foods in the Lower Mississippi Delta (LMD). Methods: FOODS 2000, a nutritional survey conducted in 18 counties in Arkansas, Louisiana, and Mississippi, provided information about dietary intake. A food ...

  12. Perceptions of Factors Influencing Healthful Food Consumption Behavior in the Lower Mississippi Delta: Focus Group Findings (United States)

    McGee, Bernestine B.; Richardson, Valerie; Johnson, Glenda S.; Thornton, Alma; Johnson, Crystal; Yadrick, Kathleen; Ndirangu, Murugi; Goolsby, Susan; Watkins, Debra; Simpson, Pippa M.; Hyman, Edith; Stigger, Flavelia; Bogle, Margaret L.; Kramer, Tim R.; Strickland, Earline; McCabe-Sellers, Beverly


    Objective: To identify perceptions of Lower Mississippi Delta (LMD) residents regarding factors that influence a change in healthful food consumption behavior to assist in planning sustainable nutrition interventions in the LMD. Design: Nine focus groups were conducted with LMD residents in 9 counties in Arkansas, Louisiana, and Mississippi. One…

  13. Application of STOPP and START criteria: interrater reliability among pharmacists.

    LENUS (Irish Health Repository)

    Ryan, Cristin


    Inappropriate prescribing is a well-documented problem in older people. The new screening tools, STOPP (Screening Tool of Older Peoples\\' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) have been formulated to identify potentially inappropriate medications (PIMs) and potential errors of omissions (PEOs) in older patients. Consistent, reliable application of STOPP and START is essential for the screening tools to be used effectively by pharmacists.

  14. Polypharmacy in pediatric patients and opportunities for pharmacists' involvement

    Directory of Open Access Journals (Sweden)

    Horace AE


    Full Text Available Alexis E Horace, Fahamina Ahmed School of Pharmacy, College of Health and Pharmaceutical Sciences, University of Louisiana at Monroe, Monroe, LA, USA Abstract: Rates of chronic conditions among pediatrics have been steadily increasing and medications used to treat these conditions have also shown a proportional increase. Most clinical trials focus on the safety of solitary medications in adult patients. However, data from these trials are often times extrapolated for use in pediatric patients who have different pharmacokinetic processes and physical profiles. As research increases and more drugs become available for pediatric use, the issue of polypharmacy becomes more of a concern. Polypharmacy is defined as the practice of administering or using multiple medications concurrently for the treatment of one to several medical disorders. With the increased rates of diagnosed complex disease states as prescribed mediations in pediatric patients, the prevalence and effect of polypharmacy in this patient population is largely a mystery. Polypharmacy falls within the realm of expertise of specialized pharmacists who can undertake medication therapy management services, medical chart reviews, and other services in pediatrics. Pharmacists have the time and knowledge to undertake pertinent interventions when managing polypharmacy and can play a major positive role in preventing adverse events. The aim of this paper is to review the literature on pediatric polypharmacy and provide insight into opportunities for pharmacists to help with management of polypharmacy. Information on adverse events, efficacy, and long-term outcomes with regard to growth and development of children subject to polypharmacy has yet to be published, leaving this realm of patient safety ripe for research. Keywords: polypharmacy, pediatrics, pharmacists, involvement

  15. The modern pharmacist: Is the future in the past?

    Directory of Open Access Journals (Sweden)

    Roberto Frontini


    Full Text Available In conclusion between a medicine with its active ingredient and the outcome of the patient there are a lot of barriers like e.g. drug formulation, patient attitude, social context, medication errors, patient’s genomic, biased information. The pharmacist has to help patients in overcoming such barriers but this is only possible if he or she is part of a cure team working in collaborative way without hierarchy barriers.

  16. Professional Use of Social Media by Pharmacists: A Qualitative Study (United States)

    Benetoli, Arcelio; Chen, Timothy Frank; Schaefer, Marion; Chaar, Betty B


    Background Social media is frequently used by consumers and health care professionals; however, our knowledge about its use in a professional capacity by pharmacists is limited. Objective Our aim was to investigate the professional use of social media by pharmacists. Methods In-depth semistructured interviews were conducted with practicing pharmacists (N=31) from nine countries. Interviews were recorded, transcribed verbatim, and thematically analyzed. Results Wikipedia, YouTube, and Facebook were the main social media platforms used. Professional use of social media included networking with peers, discussion of health and professional topics, accessing and sharing health and professional information, job searching, and professional promotion. Wikipedia was the participants’ first choice when seeking information about unfamiliar topics, or topics that were difficult to search for. Very few pharmacy-related contributions to Wikipedia were reported. YouTube, a video-sharing platform, was used for self-education. University lectures, “how-to” footage, and professionally made videos were commonly watched. No professional contribution was made to YouTube. Facebook, a general social networking site, was used for professional networking, promotion of achievements, and job advertisements. It also afforded engagement in professional discussions and information sharing among peers. Conclusions Participants used social media in a professional capacity, specifically for accessing and sharing health and professional information among peers. Pharmacists, as medicines experts, should take a leading role in contributing to health information dissemination in these user-friendly virtual environments, to reach not only other health care professionals but also health consumers. PMID:27663570

  17. Middle Claiborne Aquifer: Alabama, Arkansas, Illinois, Kentucky, Louisiana, Missouri, Mississippi, Tennessee 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Outcrop and subcrop extent of the Middle Claiborne Aquifer in Alabama, Arkansas, Illinois, Kentucky, Louisiana, Missouri, Mississippi, Tennessee.

  18. Pharmacist's role in an interdisciplinary cardiac rehabilitation team. (United States)

    Packard, Kathleen; Herink, Megan; Kuhlman, Paulette


    The purpose of this study was to determine the impact of pharmacist and pharmacy student involvement with an interdisciplinary cardiac rehabilitation program in the outpatient setting. The study included 192 patients who were seen following discharge from an acute care hospital between June 2008 and September 2010. The pharmacy team educated patients on their medications, conducted medication reconciliation, and made patient and provider interventions when appropriate. The pharmacist met with the cardiac rehabilitation team before these sessions to identify areas of focus and concern. The team met again after the sessions to reconcile medication lists and identify areas for follow-up. Of the 192 patients seen, an intervention was initiated in 157 (81.8%), for a total of 467 interventions (mean 2.43 interventions/patient). Medication reconciliation interventions not requiring a physician response comprised 79.9% of total interventions, most commonly involving an over-the-counter medication not initially reported (18%). Seventy-six patient interventions and 18 provider interventions were also made; of these, 92% of the patient interventions were accepted, and 72% of the provider interventions were accepted. The most common patient intervention was changing the administration time of a medication (36.8%), and the most common provider intervention was avoidance of a significant drug interaction (33.3%). Pharmacists can play a vital role as part of an interdisciplinary cardiac rehabilitation team to ensure proper adherence to cardiac medications and patient safety through patient education and interventions.

  19. The influence of job characteristics on job outcomes of pharmacists in hospital, clinic, and community pharmacies. (United States)

    Lin, Blossom Yen-Ju; Yeh, Ying-Chen; Lin, Wen-Hung


    This study examines the relationship between job characteristics and job outcomes of pharmacists in hospital, clinic, and community pharmacies in Taiwan. The structured questionnaires covered the items of job characteristics, job outcomes, and demographics of pharmacists, and were distributed between Feb 2004 and April 2004. Two hundred and ninety-eight pharmacists responded. Data were analyzed descriptively, and univariate analyses, factor analysis, and multiple regression analyses were used. It found the more enriched the job, the greater the job satisfaction and less intention to leave. And community pharmacists reported greater job enrichment and job satisfaction and less intention to leave than did hospital and clinic pharmacists. It suggests pharmacy managers could recognize the needs of pharmacists to redesign and enrich their work arrangements.

  20. Factors affecting collaboration between general practitioners and community pharmacists: a qualitative study

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    Rubio-Valera Maria


    Full Text Available Abstract Background Although general practitioners (GPs and community pharmacists (CPs are encouraged to collaborate, a true collaborative relationship does not exist between them. Our objective was to identify and analyze factors affecting GP-CP collaboration. Methods This was a descriptive-exploratory qualitative study carried out in two Spanish regions: Catalonia (Barcelona and Balearic Islands (Mallorca. Face-to-face semi-structured interviews were conducted with GPs and CPs from Barcelona and Mallorca (January 2010-February 2011. Analysis was conducted using Colaizzi’s method. Results Thirty-seven interviews were conducted. The factors affecting the relationship were different depending on timing: 1 Before collaboration had started (prior to collaboration and 2 Once the collaboration had been initiated (during collaboration. Prior to collaboration, four key factors were found to affect it: the perception of usefulness; the Primary Care Health Center (PCHC manager’s interest; the professionals’ attitude; and geography and legislation. These factors were affected by economic and organizational aspects (i.e. resources or PCHC management styles and by professionals’ opinions and beliefs (i.e. perception of the existence of a public-private conflict. During collaboration, the achievement of objectives and the changes in the PCHC management were the key factors influencing continued collaboration. The most relevant differences between regions were due to the existence of privately-managed PCHCs in Barcelona that facilitated the implementation of collaboration. In comparison with the group with experience in collaboration, some professionals without experience reported a skeptical attitude towards it, reporting that it might not be necessary. Conclusions Factors related to economic issues, management and practitioners’ attitudes and perceptions might be crucial for triggering collaboration. Interventions and strategies derived from these

  1. Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients (United States)

    Foroutan, Nazanin; Dabaghzadeh, Fatemeh


    Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. Objective: The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Methods: Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Results: Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists’ gender and detection of possible interaction (p value= 0.048). Conclusion: The quality of the pharmacists’ consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement. PMID:28042350

  2. Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription


    Francisco Caamaño; Manuel Tomé-Otero; Bahi Takkouche; Juan Jesús Gestal-Otero


    Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor's prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the ...

  3. The practice of OTC counseling by community pharmacists in Parana, Brazil

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    Halila GC


    Full Text Available Background: In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. Objective: To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. Method: A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey® platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidence-based practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS® (version 22.0 for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05. Results: Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product's efficacy (97% and adverse effects (62.3% were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. Conclusion: Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence

  4. Utility of pharmacists on clinical outcomes of patients in palliative care: A short review


    Brkić, Jovana; Tasić, Ljiljana; id_orcid 0000-0001-9584-0341; Krajnović, Dušanka


    Pharmacists as the most accessible health care professionals in outpatient settings can improve palliative patient care. The aim of this review was to assess utility of pharmacists (the effectiveness of pharmacists' interventions) on clinical outcomes of patients in palliative care at all levels of health care and in home care. Two electronic databases were searched: PubMed and SCOPUS (last searched August 2014). Primary studies, of any type of research design, in English, related to clinical...

  5. Evaluation of Croatian Community Pharmacists' Patient Care Competencies Using the General Level Framework


    Mestrovic, A.; Stanicic, Z.; Hadziabdic, M. O.; Mucalo, I.; Bates, I.; Duggan, C; Carter, S; Bruno, A.


    Objectives. To assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF). Methods. The competencies of 100 community pharmacists working in 38 community pharmacies were evaluated using an adapted version of the GLF. Results. Pharmacists demonstrated the best performance in the competency areas drug specific issues and provision of drug products; the poorest performance was in the competency areas evaluation of outcomes and monitoring drug therapy...


    Directory of Open Access Journals (Sweden)

    Tetyana Reva


    Full Text Available Purpose: In the article there has been substantiated the practicality of analysing trends emerging in the contemporary vocational training system of pharmacists-to-be in higher medical education in Ukraine, which resulted from the requirements of the state to train competitive specialists in pharmacy in the labor market and from the demands of society in ensuring efficient and effective pharmacotherapy along with prevention of the population from the diseases. Methods: In the article there have been used theoretical methods – the method of theoretical and comparative analysis to do the review of the works of scientists on the development of pharmaceutical education in Ukraine for the period of formation and development of its sovereignty; the synthesis method for grouping trends occurring in the modern pharmaceutical industry of Ukraine, which, at present, are the reflection in modelling educational process of vocational training of pharmacists in the domestic higher educational institutions. Results: While doing the synthesis of information sources on the development of pharmaceutical education in Ukraine for the period of establishment and development of its sovereignty, there have been specified, substantiated and characterised the leading trends in the development of modern pharmaceutical industry of Ukraine, which, at present, are the reflected in modelling the educational process of vocational training of pharmacists in the domestic higher educational institutions. In the opinion of the author of the article those trends are as follows: 1 strengthening the moral principles of training for the pharmaceutical industry of Ukraine, which are based on ethics to follow in a pharmacist profession, in a communicative interaction with people needing advice of specialists-pharmacists; 2 orientation to European standards of pharmacy, which are based on high standards of customer service, an increase of social responsibility to society for the

  7. Histoplasmosis associated with a bamboo bonfire--Arkansas, October 2011. (United States)

    Haselow, Dirk T; Safi, Haytham; Holcomb, David; Smith, Nathaniel; Wagner, Kendall D; Bolden, Branson B; Harik, Nada S


    On October 27, 2011, the Arkansas Department of Health (ADH) was notified by a northeast Arkansas primary care provider of a cluster of three histoplasmosis cases. On November 4, ADH was notified by a pediatric infectious diseases specialist regarding seven potential cases of pulmonary histoplasmosis associated with a family gathering that included a bonfire that burned bamboo from a grove that had been a red-winged blackbird roost. These reports prompted an outbreak investigation to ensure that the persons involved received appropriate medical care, to identify whether any novel exposures were associated with illness, and to determine whether any factors were associated with hospitalization. The investigation found that, among the 19 attendees at the family gathering, seven were confirmed with histoplasmosis, 11 were probable, and one did not have histoplasmosis.

  8. Floods of Selected Streams in Arkansas, Spring 2008 (United States)

    Funkhouser, Jaysson E.; Eng, Ken


    Floods can cause loss of life and extensive destruction to property. Monitoring floods and understanding the reasons for their occurrence are the responsibility of many Federal agencies. The National Weather Service, the U.S. Army Corps of Engineers, and the U.S. Geological Survey are among the most visible of these agencies. Together, these three agencies collect and analyze floodflow information to better understand the variety of mechanisms that cause floods, and how the characteristics and frequencies of floods vary with time and location. The U.S. Geological Survey (USGS) has monitored and assessed the quantity of streamflow in our Nation's streams since the agency's inception in 1879. Because of ongoing collection and assessment of streamflow data, the USGS can provide information about a range of surface-water issues including the suitability of water for public supply and irrigation and the effects of agriculture and urbanization on streamflow. As part of its streamflow-data collection activities, the USGS measured streamflow in multiple streams during extreme flood events in Arkansas in the spring of 2008. The analysis of streamflow information collected during flood events such as these provides a scientific basis for decision making related to resource management and restoration. Additionally, this information can be used by water-resource managers to better define flood-hazard areas and to design bridges, culverts, dams, levees, and other structures. Water levels (stage) and streamflow (discharge) currently are being monitored in near real-time at approximately 150 locations in Arkansas. The streamflow-gaging stations measure and record hydrologic data at 15-minute or hourly intervals; the data then are transmitted through satellites to the USGS database and displayed on the internet every 1 to 4 hours. Streamflow-gaging stations in Arkansas are part of a network of over 7,500 active streamflow-gaging stations operated by the USGS throughout the United

  9. Environmental Impact Assessment. Overall Training Mission, Fort Chaffee, Arkansas, (United States)


    Lindane for fleas, and Warfarin for mice. (f) Fire protection and prevention. Fort Chaffee maintains its own fire protection service. At present...Sebastian County have inadequate diets , according to statistics acquired by the Cooperative Extension Service of~ the University of Arkansas, Division...adequate diet or lack knowledge of the basic four food groups. Homemakers lack the knowledge of principles of food cookery. Homemakers lack knowledge

  10. Evolution of the role of the transplant pharmacist on the multidisciplinary transplant team. (United States)

    Alloway, R R; Dupuis, R; Gabardi, S; Kaiser, T E; Taber, D J; Tichy, E M; Weimert-Pilch, N A


    Transplant pharmacists have been recognized as an essential part of the transplant team by their colleagues along with several governing and professional organizations. The specific education, training and responsibilities of the transplant pharmacist have not been clearly delineated in the literature. Various pharmacists across the country have been called upon to serve on the transplant team necessitating standardization of their fundamental and desirable activities. Therefore, the purpose of this manuscript is to describe the training and role of a transplant pharmacist on the patient care team and provide a roadmap to implementation of novel transplant pharmacy services.

  11. Development of an expert professional curriculum for antimicrobial pharmacists in the UK. (United States)

    Sneddon, Jacqueline; Gilchrist, Mark; Wickens, Hayley


    The role of antimicrobial pharmacists has changed considerably over the past 15 years. We describe here the development and ratification of a new expert professional curriculum to guide the training and development of antimicrobial specialist pharmacists. The curriculum has been developed by the UK Clinical Pharmacy Association Pharmacy Infection Network and endorsed by the Royal Pharmaceutical Society as a tool to support pharmacists in meeting the requirements for joining the Royal Pharmaceutical Society Faculty. This new resource has also been endorsed by PHE, the Scottish Antimicrobial Prescribing Group and the BSAC, and will support antimicrobial pharmacists in delivery of antimicrobial stewardship, which will in turn help the fight against antimicrobial resistance.

  12. [The gift of pharmacopoeias made by Mésaize to the Society of Pharmacists of Rouen]. (United States)

    Lafont, Olivier; Vettes, Jules


    Pierre-Grégoire Mésaize, a pharmacist of Rouen made an important gift to the Society of pharmacists of Rouen in 1831. 21 Books, mainly foreign pharmacopoeias, constituted this gift. Six were from Germany; five came from United Kingdom, three from Nederland, only two from France, and one from Belgium, one from Switzerland, one from Austria and one from Russia. This diversity of origins was quite informative about the quality of the content of pharmacists' libraries in Rouen at the beginning of the 19th century. Unfortunately these books could not be found nowadays in the Library of the Union of pharmacists of Seine-Maritime.

  13. A Retrospective Evaluation of Remote Pharmacist Interventions in a Telepharmacy Service Model Using a Conceptual Framework (United States)

    Murante, Lori J.; Moffett, Lisa M.


    Abstract Objectives: This retrospective cross-sectional study evaluated a telepharmacy service model using a conceptual framework to compare documented remote pharmacist interventions by year, hospital, and remote pharmacist and across rural hospitals with or without an on-site rural hospital pharmacist. Materials and Methods: Documented remote pharmacist interventions for patients at eight rural hospitals in the Midwestern United States during prospective prescription order review/entry from 2008 to 2011 were extracted from RxFusion® database (a home-grown system, i.e., internally developed program at The Nebraska Medical Center (TNMC) for capturing remote pharmacist-documented intervention data). The study authors conceptualized an analytical framework, mapping the 37 classes of remote pharmacist interventions to three broader-level definitions: (a) intervention, eight categories (interaction/potential interaction, contraindication, adverse effects, anticoagulation monitoring, drug product selection, drug regimen, summary, and recommendation), (b) patient medication management, two categories (therapy review and action), and (c) health system-centered medication use process, four categories (prescribing, transcribing and documenting, administering, and monitoring). Frequencies of intervention levels were compared by year, hospital, remote pharmacist, and hospital pharmacy status (with a remote pharmacist and on-site pharmacist or with a remote pharmacist only) using chi-squared test and univariate logistic regression analyses, as appropriate. Results: For 450,000 prescription orders 19,222 remote pharmacist interventions were documented. Frequency of interventions significantly increased each year (36% in 2009, 55% in 2010, and 7% in 2011) versus the baseline year (2008, 3%) when service started. The frequency of interventions also differed significantly across the eight hospitals and 16 remote pharmacists for the three defined intervention levels and categories

  14. [Attitude survey of medical staff on the participation of community pharmacists in palliative home care]. (United States)

    Akai, Namika; Fujita-Hamabe, Wakako; Tokuyama, Shogo


    The treatment of cancer pain requires an individually-targeted multidimensional team approach. Further, the basic act for the Anti-Cancer Measures describes that medical staff including pharmacists should participate in the palliative care. Thus it is obvious that community pharmacists should also participate in palliative home care. In addition, a misunderstanding about opioids remains strong in Japan, which could be one of the barriers to palliative home care. In our previous report, we clarified for local residents the importance of educational activity using opioids as a new role for community pharmacists, and it was recognized of great significance by these pharmacists. In this study, we conducted a questionnaire survey among medical doctors, nurses, care managers and home helpers about the need and meaning of the educational activity performed by pharmacists in palliative home care. 86.4% of respondents felt pharmacists' participation in home care was required. Furthermore, most respondents thought that misunderstanding remained about opioids in palliative home care, and believed that pharmacists could play an important role in educational activity about opioids as experts in medicine. This study clarified that other medical team members need the participation of community pharmacists in palliative home care. Therefore, it seems important for these pharmacists to be proactive in participating in such care in the future.

  15. Spanish-speaking patients' satisfaction with clinical pharmacists' communication skills and demonstration of cultural sensitivity. (United States)

    Kim-Romo, Dawn N; Barner, Jamie C; Brown, Carolyn M; Rivera, José O; Garza, Aida A; Klein-Bradham, Kristina; Jokerst, Jason R; Janiga, Xan; Brown, Bob


    OBJECTIVE To assess Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity, while controlling for patients' sociodemographic, clinical, and communication factors, as well as pharmacist factors, and to identify clinical pharmacists' cultural factors that are important to Spanish-speaking patients. DESIGN Cross-sectional study. SETTING Central Texas during August 2011 to May 2012. PARTICIPANTS Spanish-speaking patients of federally qualified health centers (FQHCs). MAIN OUTCOME MEASURE(S) A Spanish-translated survey assessed Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity. RESULTS Spanish-speaking patients (N = 101) reported overall satisfaction with their clinical pharmacists' communication skills and cultural sensitivity. Patients also indicated that pharmacists' cultural rapport (e.g., ability to speak Spanish, respectfulness) was generally important to Spanish speakers. Multiple linear regression analyses showed that cultural rapport was significantly related to satisfaction with pharmacists' communication skills and demonstration of cultural sensitivity. CONCLUSION Overall, patients were satisfied with pharmacists' communication skills and cultural sensitivity. Patient satisfaction initiatives that include cultural rapport should be developed for pharmacists who provide care to Spanish-speaking patients with limited English proficiency.

  16. Potentiometric surfaces and water-level trends in the Cockfield (upper Claiborne) aquifer in southern Arkansas and the Wilcox (lower Wilcox) aquifer of northeastern and southern Arkansas, 2012 (United States)

    Rodgers, Kirk D.


    The Cockfield aquifer, located in southern Arkansas, is composed of Eocene-age sand beds found near the base of the Cockfield Formation of Claiborne Group. The Wilcox aquifer, located in northeastern and southern Arkansas, is composed of Paleocene-age sand beds found in the middle to lower part of the Wilcox Group. The Cockfield and Wilcox aquifers are primary sources of groundwater. In 2010, withdrawals from the Cockfield aquifer in Arkansas totaled 19.2 million gallons per day (Mgal/d), and withdrawals from the Wilcox aquifer totaled 36.5 Mgal/d.

  17. What is the role of the pharmacist?: physicians' and nurses' perspectives in community and hospital settings of Santiago de Cuba

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    Niurka María Dupotey Varela


    Full Text Available This study was carried out to understand the perceptions and expectations of the other health care professionals about pharmacists' role in primary health care centers and hospitals in Santiago de Cuba (Cuba. A cross-sectional descriptive study was conducted, applying a self-administered questionnaire to health care professionals. The sample included 763 professionals (40.9% physicians and 59.1 % nurses from hospitals and primary health care clinics, chosen by random stratified sampling,. The most common activity performed by pharmacists was the distribution of medications or the drug supply management (51.5% and adverse drug reactions reporting (29.4%, activities performed daily by pharmacists. Pharmaceutical care practice was considered as poor by the professionals, and only 15.6% of them have collaborated in these programs in the past. For nurses and physicians, interprofessional communication occurs sometimes (56.9% and never (25.8%. Pharmacists' integration into the health team was considered as fair (50.7%. A total of 70.1% perceived the pharmacist as a drug expert and 60.1% as a professional who provides medication counseling. The main expectations these health care professionals expressed were that pharmacists provide more education about medication (97.4% and improve their interprofessional communication techniques in order to communicate more effectively with the other members of the health care team (96.6%.O presente trabalho analisa o papel do farmacêutico na atenção primária de saúde e em hospitais, na percepção de profissionais da saúde na província de Santiago de Cuba. Um estudo descritivo transversal foi conduzido, através da aplicação de um questionário autoadministrado a uma amostra de 763 profissionais de atenção primária e hospitalar, 40,9% de médicos e 59,1% de enfermeiros. As funções farmacêuticas mais reconhecidas pelos profissionais desta amostra foram o fornecimento e distribuição de medicamentos

  18. Use of Pharmacist Consultations for Nonprescription Laxatives in Japan: An Online Survey. (United States)

    Shibata, Keita; Matsumoto, Arisa; Nakagawa, Ayumi; Akagawa, Keiko; Nakamura, Akihiro; Yamamoto, Toshinori; Kurata, Naomi


    Community pharmacies in Japan have long been advocated as effective sources of nonprescription medicines and health-related advice. Consumers sometimes self-treat symptoms of minor illnesses without consulting a pharmacist because the benefits of such consultations are not adequately recognized. The aim of this study was to investigate the use and impact of pharmacist consultations before purchase of nonprescription laxatives. An online survey was conducted July 14-22, 2012 with 500 respondents (250 men, 250 women), ranging 20-60 years old. All participants had purchased nonprescription laxatives for constipation within the past year. Stratified analysis was used to compare responses in groups that had and had not consulted a pharmacist before purchase. Consulting a pharmacist appears to improve consumers' awareness and makes them more likely to use appropriate medication. Those who consulted a pharmacist were better able to identify side effects and take appropriate action than the group that did not consult the pharmacist. Those who consulted a pharmacist were also significantly more likely to say that they would consult a pharmacist in the future. These results indicate that it is important for consumers to be able to consult with pharmacists, to improve consumers' awareness of side effects and to self-medicate appropriately, and hence improve their quality of life. Pharmacists in community pharmacy could be more active in health promotion campaigns, such as drug safety, campaigns, to raise their public profile. Increased public awareness of what pharmacists in community pharmacy do will make it easier for patients to consult with them.

  19. Transport and transformation of nutrients and sediment in two agricultural watersheds in northeast Arkansas (United States)

    Agriculture is vital to Arkansas economy as it contributes $20 billion annually, double the average national contribution to the state GDP. Arkansas is ranked in the top 5 in rice, cotton seed and sorghum, and top 20 in soybean, corn for grain, and wheat production nationally. Despite the importance...

  20. 78 FR 27306 - Radio Broadcasting Services; Dermott, Arkansas, and Cleveland, Mississippi (United States)


    ... COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Dermott, Arkansas, and Cleveland, Mississippi AGENCY... CFR part 73 Radio, Radio broadcasting. Federal Communications Commission. Nazifa Sawez, Assistant... Delta Radio Network, LLC, substitutes FM Channel 224A for 289A at Dermott, Arkansas, and substitutes...

  1. Association of School-Based Influenza Vaccination Clinics and School Absenteeism--Arkansas, 2012-2013 (United States)

    Gicquelais, Rachel E.; Safi, Haytham; Butler, Sandra; Smith, Nathaniel; Haselow, Dirk T.


    Background: Influenza is a major cause of seasonal viral respiratory illness among school-aged children. Accordingly, the Arkansas Department of Health (ADH) coordinates >800 school-based influenza immunization clinics before each influenza season. We quantified the relationship between student influenza vaccination in Arkansas public schools…

  2. 78 FR 14319 - Arkansas; Amendment No. 1 to Notice of a Major Disaster Declaration (United States)


    ... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to... SECURITY Federal Emergency Management Agency Arkansas; Amendment No. 1 to Notice of a Major Disaster... notice of a major disaster declaration for the State of Arkansas (FEMA-4100-DR), dated January 29,...

  3. 76 FR 36142 - Arkansas; Amendment No. 6 to Notice of a Major Disaster Declaration (United States)


    ... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to... SECURITY Federal Emergency Management Agency Arkansas; Amendment No. 6 to Notice of a Major Disaster... notice of a major disaster declaration for the State of Arkansas (FEMA-1975-DR), dated May 2, 2011,...

  4. [Alzheimer's disease and pharmacists in contact with the public]. (United States)

    Dreux, C


    All healthcare professionals are concerned by Alzheimer's disease, which in France will affect, in just a few years, over one million persons, mainly women. Pharmacists have shown particular interest, irrespective of their sector of activity. Here, we wanted to better define the role of colleagues who are constantly in contact with the public, i.e. in France in drug dispensaries and biology laboratories. Within the framework of the French pharmacy committee for health and social education, Cespharm, the Ethics and Communications working group of the 2008-2012 Alzheimer Disease Committee headed by Professor Joël Menard proposed a project worksheet which can be used by French pharmacists in their action to help Alzheimer patients and their caregivers. This project, prepared by Fabienne Blanchet, the Cespharm director and Christine Curty, mission head, was approved by the Menard commission and is inscribed in the National Alzheimer Plan 2008-2012 presented by this commission in November 2007. Here, our objective is to motivate pharmacists to participate in a structured initial and continuing training program proposed by specialists from the School of Pharmacy and other organizations duly approved by the High Committee for Continuing Education in Pharmacy. In keeping with the general operative procedures of Cespharm, information tools should be developed for colleagues and the public. Available interventions, in terms of prevention, diagnosis and treatment should be updated permanently and transmitted to professionals. Information which can be delivered to patients, and most importantly to their caregivers, concerning local assistance programs should be collected and transmitted to the local professionals. The role of the pharmacist can be summarized with four verbs: listen, reassure, orient, support. It is important to identify all available means enabling a confidential relationship with the persons needing help. Of particular interest are the relationship guides

  5. Job characteristics, well-being and risky behaviour amongst pharmacists. (United States)

    Phipps, Denham L; Walshe, Kieran; Parker, Dianne; Noyce, Peter R; Ashcroft, Darren M


    Healthcare practitioners' fitness to practise has often been linked to their personal and demographic characteristics. It is possible that situational factors, such as the work environment and physical or psychological well-being, also have an influence on an individual's fitness to practise. However, it is unclear how these factors might be linked to behaviours that risk compromising fitness to practise. The aim of this study was to examine the association between job characteristics, well-being and behaviour reflecting risky practice amongst a sample of registered pharmacists in a region of the United Kingdom. Data were obtained from a cross-sectional self-report survey of 517 pharmacists. These data were subjected to principal component analysis and path analysis, with job characteristics (demand, autonomy and feedback) and well-being (distress and perceived competence) as the predictors and behaviour as the outcome variable. Two aspects of behaviour were found: Overloading (taking on more work than one can comfortably manage) and risk taking (working at or beyond boundaries of safe practice). Separate path models including either job characteristics or well-being as independent variables provided a good fit to the data-set. Of the job characteristics, demand had the strongest association with behaviour, while the association between well-being and risky behaviour differed according to the aspect of behaviour being assessed. The findings suggest that, in general terms, situational factors should be considered alongside personal factors when assessing, judging or remediating fitness to practise. They also suggest the presence of different facets to the relationship between job characteristics, well-being and risky behaviour amongst pharmacists.

  6. British community pharmacists' views of physician-assisted suicide (PAS) (United States)

    Hanlon, T.; Weiss, M.; Rees, J.


    Objectives— To explore British community pharmacists' views on PAS , including professional responsibility, personal beliefs, changes in law and ethical guidance. Design— Postal questionnaire Setting— Great Britain Subjects— A random sample of 320 registered full-time community pharmacists Results— The survey yielded a response rate of 56%. The results showed that 70% of pharmacists agreed that it was a patient's right to choose to die, with 57% and 45% agreeing that it was the patient's right to involve his/her doctor in the process and to use prescription medicines, respectively. Forty-nine per cent said that they would knowingly dispense a prescription for use in PAS were it to be legalised and 54% believed it correct to refuse to dispense such a prescription. Although 53% believed it to be their right to know when they were being involved in PAS, 28% did not. Most pharmacists (90%) said that they would wish to see the inclusion of a practice protocol for PAS in the code of ethics of the Royal Pharmaceutical Society of Great Britain (CE-RPSGB) in the event of a change in the law on PAS. In addition, 89% would wish to see PAS included in the Conscience Clause of the CE-RPSGB. Males were found to be significantly less likely to favour PAS than females (pphysician's, in having to provide the means for PAS. It is worrying that a proportion of the respondents prefer to remain in ignorance of the true purpose of a prescription for PAS; a finding at odds with current developments within the pharmaceutical profession. A practice protocol for PAS and an extension of the conscience clause should be considered in the event of PAS becoming legal. Such measures would allow the efficient provision of the pharmaceutical service whilst at the same respecting the personal beliefs of those who object to cooperating in the ending of a life. Key Words: Professional ethics • pharmacy ethics • community pharmacy • bioethics • physician-assisted suicide

  7. Description of Survey Data Regarding the Chemical Repackaging Plant Accident West Helena, Arkansas

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, J.H.; Vogt, B.M.


    Shortly after 1:00 p.m. on Thursday, May 8, 1997, clouds of foul-smelling smoke began pouring from an herbicide and pesticide packaging plant in West Helena, Arkansas. An alert was sounded, employees evacuated, and the West Helena fire department was called. As three firefighters prepared to enter the plant, the chemical compounds exploded, collapsing a solid concrete block wall, and killing all three firefighters. As the odorous smoky cloud drifted away from the plant, authorities ordered residents in a 2-mile area downwind of the plant to evacuate and those in the 2- to 3-mile zone to shelter in place. This study examines and compares the responses to a mail survey of those ordered to evacuate and those told to shelter in place. Among the variables examined are compliance with official orders and perceived warnings, threat perception, time and source of first warning, response times, and behavior characteristics for both populations. The findings indicate that 90% of those that were told to evacuate did so but only 27% of those told to shelter-in-place did so, with 68% opting to evacuate instead. The implications of these findings for emergency managers is that people will likely choose to evacuate when both warnings to evacuate and warnings to shelter are issued to residents in close proximity to each other. The findings on warning times closely resemble other findings from evacuations when chemical accidents occur and route notification is used for warning residents.

  8. Survey on Disaster Relief Activities to the Pharmacists Belonging to Kobe-city Pharmaceutical Organization. (United States)

    Yasuhara, Tomohisa; Kondo, Hiroki; Nagata, Misa; Iwata, Kana; Kushihata, Taro; Katsuragi, Satoko; Ikeuchi, Junko; Sone, Tomomichi


     In 2014, there were about 160 thousands community pharmacists in Japan. Community pharmacists are health care workers who help victims in a disaster and are potential resources who can provide disaster relief. However, currently the disaster relief activities of community pharmacists are merely a resourceful and flexible demonstration of their professional abilities and not a specifically organized activity. Therefore, disaster relief education programs for community pharmacists are being explored and studies are still in the nascent stage. In this study, pharmacists of a pharmaceutical organization in Kobe City were asked to reply to a questionnaire survey so that their hopes and ideas about the disaster relief activities that they carry out can help build effective educational programs to enhance relief activities. Finally, 8 factors (cumulative contribution rate: 90.9%) were extracted by factor analysis (maximum likelihood method, the diagonal elements: squared multiple correlation, quartimin rotation) of the 25 questions. In addition, a hierarchical cluster analysis (Ward method) by the factor scores of the extracted 8 factors resulted in 7 groups. The findings revealed the groups into which the community pharmacists were divided and their hopes and ideas about disaster relief. We expect that these results could bring awareness about the disaster relief activities suitable for each community pharmacist, provide appropriate training opportunities for those who volunteer, and motivate daily studies and preparations for disaster relief activities among community pharmacists.

  9. The quality of the professional practice of community pharmacists : What can still be improved in Europe?

    NARCIS (Netherlands)

    Cancrinus-Matthijsse, A.M; Lindenberg, S.M.; Bakker, A; Groenewegen, P.P.


    This article describes a research project concerning the professional practice of community pharmacists in Western Europe. In 1990 interviews were held with key figures and practising pharmacists in the Netherlands, Belgium, Great Britain Sweden and Portugal. In 1991 a questionnaire was sent which w

  10. Student and Teacher Reflections on Indirectness as a Pragmatic Feature of Pharmacist-Patient Simulations (United States)

    Hussin, Virginia


    This article reports on a research process where focussed reflection on pharmacist-patient simulations led to meta-pragmatic awareness and directions for pedagogical practice. The research participants were third-year EAL pharmacy students, who were practising being pharmacists, and pharmacy staff members, who played the part of patients. Analysis…

  11. Controversy and consensus on a clinical pharmacist in primary care in the Netherlands

    NARCIS (Netherlands)

    Hazen, A.C.M.; van der Wal, Aletta W.; Sloeserwij, Vivianne M.; Zwart, Dorien L M; de Gier, Johan J; De Wit, Niek J.; Leendertse, A.J.; Bouvy, M.L.; De Bont, Antoinette A.


    Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and co

  12. Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

    NARCIS (Netherlands)

    R.J. Zaal (Rianne); M.M.P.M. Jansen (Mark M. P.); M. Duisenberg-Van Essenberg (Marjolijn); C.C. Tijssen (Cees); J.A. Roukema; P.M.L.A. van den Bemt (Patricia)


    textabstractBackground Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective st

  13. Tobacco Cessation through Community Pharmacies: Knowledge, Attitudes, Practices and Perceived Barriers among Pharmacists in Penang (United States)

    Taha, Nur Akmar; Tee, Ooi Guat


    Objectives: Tobacco cessation is the primary goal of tobacco control measures. Community pharmacists are possible providers of tobacco cessation counselling due to their close contact with the public and the availability of non-prescription nicotine replacement therapies in pharmacies. However, community pharmacists often do not provide tobacco…

  14. Optimizing identification and management of COPD patients - reviewing the role of the community pharmacist

    NARCIS (Netherlands)

    van der Molen, Thys; van Boven, Job F M; Maguire, Terence; Goyal, Pankaj; Altman, Pablo


    AIM: To propose key steps for community pharmacist integration into a patient care pathway for COPD management. METHODS: A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. RESULTS: The literature searc

  15. Controversy and consensus on a clinical pharmacist in primary care in the Netherlands

    NARCIS (Netherlands)

    A.C.M. Hazen (Ankie); Wal, A.W.V.D. (Aletta W. Van Der); V.M. Sloeserwij (Vivianne); D.L.M. Zwart (Dorien Lyd Marieke); Gier, J.J.D. (Johan J. De); Wit, N.J.D. (Niek J. De); A.J. Leendertse (Anne); M.L. Bouvy (Marcel); A.A. de Bont (Antoinette)


    textabstractBackground Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the contro

  16. 10 CFR 35.55 - Training for an authorized nuclear pharmacist. (United States)


    ... Pharmaceutical Education (ACPE) or have passed the Foreign Pharmacy Graduate Examination Committee (FPGEC... 10 Energy 1 2010-01-01 2010-01-01 false Training for an authorized nuclear pharmacist. 35.55... Administrative Requirements § 35.55 Training for an authorized nuclear pharmacist. Except as provided in §...

  17. Development, Implementation and Evaluation of a Modular Approach to a Pharmacist-Oriented Course in Oncology. (United States)

    Abate, Marie A.; And Others


    A project to develop, implement, and evaluate a slide/text modular oncology course teaching disease state and pharmacist-oriented information to pharmacy students, with potential adaptation for pharmacist continuing education, is described. Module effectiveness was evaluated using a pretest, posttest design, with group mean comparisons across both…

  18. Factors Associated With Health-Related Quality of Life of Student Pharmacists



    Objective. To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university.

  19. [Research on the forecasting of trends in demand for pharmacists 2011-2035]. (United States)

    Hasegawa, Yoichi; Sakamaki, Hiroyuki; Yamazaki, Manabu; Iwatsuki, Susumu; Oide, Sentaro; Kitada, Mitsukazu; Ohashi, Yoshiaki; Suda, Kohji; Mochizuki, Masataka


    The first crop of pharmacists graduating from 6-year programs in pharmaceutical l education arrived in April 2012, and it will be important to incorporate new factors when predicting future trends in supply and demand for pharmacists. If we project supply given an exam pass rate of 75%, the supply of pharmacists will increase for the next 10 years or so if the number of exam takers is about 10000, and no decrease in the total number of pharmacists is expected until 2035. At pharmacies, a high degree of demand for the services of pharmacists can be expected to result from increases in the number of elderly patients and the number of patients receiving prescriptions, together with expanded accommodation of home health care, if the proportion of prescriptions that are actually filled up to 70%. At hospitals, demand has been projected to increase over the short term, owing to such factors as the trend toward having a resident pharmacist in each ward, advances in team medicine, and the spread of outpatient chemotherapy. Given the rising enrollment quotas for schools of pharmacy, and if the current supply and demand for pharmacists are maintained, we cannot rule out the possibility that pharmacists will come to be in excess supply within a 10-year horizon if the number of unemployed continues to decrease and the employment rate continues to improve along with changes in economic conditions and the consciousness of graduates of the 6-year programs.

  20. Physician-assisted death: attitudes and practices of community pharmacists in East Flanders, Belgium

    NARCIS (Netherlands)

    Bilsen, J.J.; Bauwens, M.; Bernheim, J.L.; Stichele, R.V.; Deliens, L.H.J.


    This study investigates attitudes and practices of community pharmacists with respect to physician-assisted death. Between 15 February and 15 April 2002, we sent anonymous mail questionnaires to 660 community pharmacists in the eastern province of Flanders, Belgium. The response rate was 54% (n = 35

  1. Dentist/pharmacist relations: professional responsibility, scope of practice, and rational prescription writing. Interview by Debra Belt. (United States)

    Jacobsen, Peter L; Lofholm, Paul W


    Earlier this year, CDA engaged the California Pharmacists Association in discussion about the relationship between dentists and pharmacists and the most efficient ways to handle prescriptions. Professionals agree that the situation where a pharmacist fails to fill a dentist-written prescription does not occur frequently. However, when it does occur, all parties--the dentist, the pharmacist and the patient--are challenged. This discussion led to the following interview.

  2. The roles of community pharmacists in cardiovascular disease prevention and management

    Directory of Open Access Journals (Sweden)

    George J


    Full Text Available There is ample evidence in the international literature forpharmacist involvement in the prevention and managementof cardiovascular disease (CVD conditions in primary care.Systematic reviews and meta-analyses have confirmed thesignificant clinical benefits of pharmacist interventions for arange of CVD conditions and risk factors. Evidence generatedin research studies of Australian community pharmacistinvolvement in CVD prevention and management issummarised in this article.Commonwealth funding through the Community PharmacyAgreements has facilitated research to establish the feasibilityand effectiveness of new models of primary care involvingcommunity pharmacists. Australian community pharmacistshave been shown to effect positive clinical, humanistic andeconomic outcomes in patients with CVD conditions.Improvements in blood pressure, lipid levels, medicationadherence and CVD risk have been demonstrated usingdifferent study designs. Satisfaction for GPs, pharmacists andconsumers has also been reported. Perceived ‘turf’encroachment, expertise of the pharmacist, space, time andremuneration are challenges to the implementation of diseasemanagement services involving community pharmacists.

  3. The use of opioids at the end of life: knowledge level of pharmacists and cooperation with physicians


    Borgsteede, S.D.; Rhodius, C.A.; Smet, P.A.G.M. de; Pasman, H.R.W.; Onwuteaka-Philipsen, B. D.; Rurup, M.L.


    Abstract Purpose What is the level of knowledge of pharmacists concerning pain management and the use of opioids at the end of life, and how do they cooperate with physicians? Methods A written questionnaire was sent to a sample of community and hospital pharmacists in the Netherlands. The questionnaire was completed by 182 pharmacists (response rate 45%). Results ...

  4. Work-related well-being of South African hospital pharmacists

    Directory of Open Access Journals (Sweden)

    Sebastiaan Rothmann


    Full Text Available Orientation: Hospital pharmacists in South Africa are experiencing increased stress because of the high demand for their services, a lack of resources in hospital pharmacies, and the shortage of pharmacists in South Africa.Research purpose: The objective of this study was to investigate whether job stress and coping strategies could predict the work-related well-being (burnout and work engagement of hospital pharmacists in South Africa.Motivation for the study: Information about the work-related well-being and coping strategies of hospital pharmacists could be used to plan individual and organisational interventions which can be used to retain them and to manage their well-being and performance.Research design, approach and method: A survey design was used. A stratified random sample (N = 187 of pharmacists in South African hospitals was studied. The Maslach Burnout Inventory – Human Services Survey, Utrecht Work Engagement Scale, Pharmacist Stress Inventory and the COPE questionnaire were administered.Main findings: The results showed that job related stress and three coping strategies (approach coping, avoidant coping, and turning to religion predicted burnout and work engagement of South African hospital pharmacists.Practical implications: Job stressors that are in the main responsible for the unfavourable work environment and that lead to the development of burnout amongst hospital pharmacists should be addressed. It is also important to enhance the coping capabilities of the hospital pharmacists.Contribution/value-add: The findings of this study provide insight into the factors impacting on the work-related well-being of hospital pharmacists in South Africa.

  5. A web-based training program to support chronic kidney disease screening by community pharmacists. (United States)

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Bereznicki, Luke; Jose, Matthew D; Castelino, Ronald L


    Background Community pharmacists' role in screening of several chronic diseases has been widely explored. The global health burden of chronic kidney disease is high; however, the progression and adverse outcomes can be prevented or delayed by detecting and treating the disease in its initial stages 1-3. Therefore, a web-based training program was developed to enhance pharmacists' knowledge and skills required to perform a chronic kidney disease screening service in a community setting. Objective The aim of this study was to evaluate the impact of a web-based training program on community pharmacists' knowledge and skills associated with chronic kidney disease screening. As secondary aim, pharmacists' satisfaction with the training program was assessed. Setting Community pharmacy practice. Method A web-based training program was developed by four pharmacists and a nephrologist. Quantitative data was collected by employing a self-administered, web-based questionnaire, which comprised a set of five multiple-choice knowledge questions and one clinical vignette to assess skills. A nine-item Likert scale was used to determine pharmacists' satisfaction with the training program. Main outcome measure Pharmacists' knowledge and skills scores at pre and post-training, reliability of the Likert scale, and the proportion of responses to the individual nine items of the satisfaction survey. Results Fifty pharmacists participated in the pre-questionnaire and 38 pharmacists completed the web-based training and post-questionnaire. Significant differences were observed in the knowledge scores (p web-based training program positively enhanced pharmacists' knowledge and skills associated with chronic kidney disease screening. These findings support further development and widespread implementation of the training program to facilitate health promotion and early identification of chronic kidney disease in a community setting.

  6. Assessment of pharmacist-led patient counseling in randomized controlled trials: a systematic review. (United States)

    Okumura, Lucas Miyake; Rotta, Inajara; Correr, Cassyano Januário


    Background Pharmacists' counseling has improved health-related outcomes in many acute and chronic conditions. Several studies have shown how pharmacists have been contributing to reduce morbidity and mortality related to drug-therapy (MMRDT). However, there still is a lack of reviews that assemble evidence-based clinical pharmacists' counseling. Equally, there is also a need to understand structure characteristics, processes and technical contents of these clinical services. Aim of the review To review the structure, processes and technical contents of pharmacist counseling or education reported in randomized controlled trials (RCT) that had positive health-related outcomes. Methods We performed a systematic search in specialized databases to identify RCT published between 1990 and 2013 that have evaluated pharmacists' counseling or educational interventions to patients. Methodological quality of the trials was assessed using the Jadad scale. Pharmacists' interventions with positive clinical outcomes (p Pharmacists were more likely to provide counseling at ambulatories (60 %) and hospital discharge (25 %); on the other hand pharmacists intervention were less likely to happen when dispensing a medication. Teaching back and explanations about the drug therapy purposes and precautions related to its use were often reported in RCT, whereas few studies used reminder charts, diaries, group or electronic counseling. Most of studies reported the provision of a printed material (letter, leaflet or medication record card), regarding accessible contents and cultural-concerned informations about drug therapy and disease. Conclusion Pharmacist counseling is an intervention directed to patients' health-related needs that improve inter-professional and inter-institutional communication, by collaborating to integrate health services. In spite of reducing MMRDT, we found that pharmacists' counseling reported in RCT should be better explored and described in details, hence

  7. Improving population management through pharmacist-primary care integration: a pilot study. (United States)

    Kennedy, Amanda G; Chen, Harry; Corriveau, Michele; MacLean, Charles D


    Pharmacists have unique skills that may benefit primary care practices. The objective of this demonstration project was to determine the impact of integrating pharmacists into patient-centered medical homes, with a focus on population management. Pharmacists were partnered into 5 primary care practices in Vermont 1 day per week to provide direct patient care, population-based medication management, and prescriber education. The main measures included a description of drug therapy problems identified and cost avoidance models. The pharmacists identified 708 drug therapy problems through direct patient care (336/708; 47.5%), population-based strategies (276/708; 38.9%), and education (96/708; 13.6%). Common population-based strategies included adjusting doses and discontinuing unnecessary medications. Pharmacists' recommendations to correct drug therapy problems were accepted by prescribers 86% of the time, when data about acceptance were known. Of the 49 recommendations not accepted, 47/49 (96%) were population-based and 2/49 (4%) were related to direct patient care. The cost avoidance model suggests $2.11 in cost was avoided for every $1.00 spent on a pharmacist ($373,092/$176,690). There was clear value in integrating pharmacists into primary care teams. Their inclusion prevented adverse drug events, avoided costs, and improved patient outcomes. Primary care providers should consider pharmacists well suited to offer direct patient care, population-based management, and prescriber education to their practices. To be successful, pharmacists must have full permission to document findings in the primary care practices' electronic health records. Given that many pharmacist services do not involve billable activities, sustainability requires identifying alternative funding mechanisms that do not rely on a traditional fee-for-service approach.

  8. New roles for pharmacists in community mental health care: a narrative review. (United States)

    Rubio-Valera, Maria; Chen, Timothy F; O'Reilly, Claire L


    Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists' role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists' attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.


    Directory of Open Access Journals (Sweden)

    Naveed Muhammad


    Full Text Available A cross sectional study was conducted in the Medical ward of Hayath Abad Medical Complex (HMC, Peshawar, Pakistan from 1st June 2009 to 31st December 2009. HMC is one of the teaching hospital in KPK, Pakistan, it consist of 800 beds. The data were collected through prescribed history form and questionnaire designed from the general medical ward. The results indicates that the hepatotoxic drug prescribed in hepatic impaired patients were 5.6% of the study and about 31% drugs were found with improper dose or the frequency of dose was not mentioned. About 12.56% drugs were prescribed without mentioning the duration of therapy while, untreated conditions were found about 15.70% of our study. In the present study 21.46% drug interactions was found. The prescription containing unnecessary drugs without any indication were 7.85%. All these mentioned irrationality were due to the lack of clinical pharmacist in the whole hospital. It is concluded that the presence or involvement of a competent and qualified clinical pharmacist is very essential for the rationalization of the prescription in any hospital or health institution.

  10. [Role of pharmacists in disaster medicine: required knowledge and skills]. (United States)

    Nakura, Hironori


    Immediately after the Great East Japan Earthquake of March 2011, Okayama University dispatched a medical assistance team based on the request of Iwate Prefecture. The first team was followed by 12 medical teams. I was one of the members of the fourth and fifth medical teams sent to Rikuzen-takata and Ofunato for a week beginning March 16th to support medical relief operations as a pharmacist during the sub-acute phase of the disaster. As a member of the team at the temporary clinic in Rikuzen-takata, pharmacists such as myself required physical assessment skills to perform related tasks, along with expertise in drug dispensing and consultation. In my next medical team, which headed the pneumonia unit at Oofunato Hospital, I played a critical role in the effective use of medicine reserved/provided for disasters, including antibiotics. Throughout the relief operations, strong clinical reasoning and decision making, as well as good teamwork, proved vital, especially in emergency situations. For future community medical systems, emergency/disaster medicine should be included in pharmacy education. The School of Pharmacy at Okayama University will establish emergency medicine program in the next school year, in cooperation with the Medical, Dental and Health Care Departments.

  11. Water-quality investigation of the Tyronza River watershed, Arkansas (United States)

    Lamb, T.E.


    The results of a 1-year study of surface-water quality in the Tyronza River Watershed, Arkansas, are presented to document conditions before implementation of Soil Conservation Service Programs. The report includes a general description of the watershed 's topography, geology, and aquifers, and the results of monthly measurements of discharge at five sites, and several physical and chemical parameters, plus quarterly analyses for several ions and semiannual analyses of bottom material for various pesticides. The results indicate that the quality of the water in the streams and ditches samples is normal for an intensely farmed area such as this watershed. (Woodard-USGS)

  12. A Study on How Industrial Pharmacists Rank Competences for Pharmacy Practice: A Case for Industrial Pharmacy Specialization

    Directory of Open Access Journals (Sweden)

    Jeffrey Atkinson


    Full Text Available This paper looks at the way in which industrial pharmacists rank the fundamental competences for pharmacy practice. European industrial pharmacists (n = 135 ranked 68 competences for practice, arranged into 13 clusters of two types (personal and patient care. Results show that, compared to community pharmacists (n = 258, industrial pharmacists rank competences centering on research, development and production of drugs higher, and those centering on patient care lower. Competences centering on values, communication skills, etc. were ranked similarly by the two groups of pharmacists. These results are discussed in the light of the existence or not of an “industrial pharmacy” specialization.

  13. A newly developed assessment tool on collaborative role of doctor–pharmacist in patient medication management

    Directory of Open Access Journals (Sweden)

    Mayur Porwal


    Full Text Available Background Poor communication is one of the most important common factor contributing to medication errors. Despite their common history, there are many intellectual and practical differences between the professions of medicine and pharmacy that eventually affects patient care and health outcomes. Objectives. The main objective of the study is to evaluate the coordination and teamwork between pharmacist and doctor to provide betterment in the care of the patient health. Material and methods . A questionnaire of 10 questions was developed each for the patient, pharmacist and doctor posted on District Hospital, Moradabad (U.P., India and data collected from the patient and medical professionals through questionnaire were analyzed for collaborative role of doctor-pharmacist with respect to patient care. The results were analyzed using Graph Pad Prism 5. Results. The data obtained from the questionnaire highlights a significant effort between pharmacist and doctors. However, some patients often doubt in the skills of pharmacist for treatment outcome, but the majority of people responds positive to doctor-pharmacist role as they prove to be fruitful in removing medication errors. Conclusions . To facilitate the patient care, doctor-pharmacist alliance is necessary, desired and should be motivated as professed by the respondents. Collaboration is an important element of effective patient-focused health care delivery.

  14. Pharmacists' perspective on providing care when patients engage in unhealthy behaviors. (United States)

    Lee, Christine; Segal, Richard; Kimberlin, Carole; Smith, W Thomas; Weiler, Robert M


    OBJECTIVE To assess the association between unhealthy lifestyle-related behaviors in patients and the pharmacist's professional obligation for providing care. DESIGN Repeated measures ANOVA was used to examine the effect of severity of lifestyle disease on professional obligation. SETTING Four live continuing education programs on law and management conducted in the state of Florida. PARTICIPANTS 488 Florida pharmacists were surveyed with 65% completing the survey. MAIN OUTCOME MEASURES Pharmacists' opinions based on lifestyle-related diseases classified as follows: low lifestyle-related disease (low LD): nonsmoker with asthma who is adherent with asthma medications; moderate (mod) LD: nonsmoker with asthma who is nonadherent with asthma medications; high LD: smoker with asthma who is adherent with asthma medications. RESULTS The difference between the scales for measuring professional obligation for low and mod LD was significant, with pharmacists reporting greater professional obligation for low versus mod LD. The difference between professional obligation for low and high LD was significant, with pharmacists reporting greater professional obligation for low than high LD. The difference between professional obligation for mod and high LD was significant, with pharmacists reporting a higher professional obligation for mod than high LD. CONCLUSION The differences in professional obligation between the three patient scenarios were small but statistically significant. The findings suggest that certain patient behaviors, such as smoking or medication nonadherence, can have a negative effect on pharmacists' sense of professional obligation to the patient.

  15. Pharmacists implementing transitions of care in inpatient, ambulatory and community practice settings

    Directory of Open Access Journals (Sweden)

    Sen S


    Full Text Available Objective: To introduce pharmacists to the process, challenges, and opportunities of creating transitions of care (TOC models in the inpatient, ambulatory, and community practice settings. Methods: TOC literature and resources were obtained through searching PubMed, Ovid, and GoogleScholar. The pharmacist clinicians, who are the authors in this manuscript are reporting their experiences in the development, implementation of, and practice within the TOC models. Results: Pharmacists are an essential part of the multidisciplinary team and play a key role in providing care to patients as they move between health care settings or from a health care setting to home. Pharmacists can participate in many aspects of the inpatient, ambulatory care, and community pharmacy practice settings to implement and ensure optimal TOC processes. This article describes establishing the pharmacist’s TOC role and practicing within multiple health care settings. In these models, pharmacists focus on medication reconciliation, discharge counseling, and optimization of medications. Additionally, a checklist has been created to assist other pharmacists in developing the pharmacist’s TOC roles in a practice environment or incorporating more TOC elements in their practice setting. Conclusion: Optimizing the TOC process, reducing medication errors, and preventing adverse events are important focus areas in the current health care system, as emphasized by The Joint Commission and other health care organizations. Pharmacists have the unique opportunity and skillset to develop and participate in TOC processes that will enhance medication safety and improve patient care.

  16. [The Pharmacist as Gatekeeper of Prescription Drug Abuse: Return to "Community Scientists"]. (United States)

    Shimane, Takuya


      The non-medical use or abuse of prescription drugs, including benzodiazepines, is a growing health problem in Japan. An association between prescription drug overdose and suicide risk has also been reported. The Japanese Ministry of Health, Labour and Welfare has expected pharmacists to act as "gatekeepers", facilitating early identification of individuals at high risk of prescription drug abuse including overdose, supplying medication counseling to patients, and helping to introduce these patients to appropriate medical care. Prescription drugs such as benzodiazepines are widely used in psychiatry. However, these drugs are prescribed not only by psychiatrists but also by other healthcare professionals including primary care physicians. Moreover, in recent years, the dispensing of prescriptions has moved rapidly from inside to outside hospitals, with prescription drugs being dispensed mainly at community pharmacies. Although all healthcare professionals including hospital pharmacists can play a role in preventing prescription drug abuse, the role of the community pharmacist is vital in addressing this problem. Formerly, community pharmacists were recognized as "community scientists", low-threshold accessible healthcare advisors. Now, community pharmacists should return to the role of community scientists to prevent prescription drug abuse. This article begins by reviewing the current situation of prescription drug abuse and dependence in Japan. The role of pharmacists as gatekeepers in preventing prescription drug abuse is then examined. Finally, this article discusses the effect of intervention in the form of gatekeeper training for community pharmacists.

  17. The role of a clinical pharmacist in a multidisciplinary amyotrophic lateral sclerosis clinic. (United States)

    Jefferies, Kristen A; Bromberg, Mark B


    Patients with ALS have complicated medication regimens and many questions about medications. Our multidisciplinary ALS clinic includes a clinical pharmacist, and the purpose of this study was to assess the types and outcomes of consultative interactions. This was a prospective, data collection study of patients seen by the pharmacist at a single ALS clinic visit. The following data were obtained: 1) current medications; 2) number and types of pharmacy interventions; 3) amount of time spent by the pharmacist with each patient. Thirty-seven patients were included. The average number of prescriptions used per patient was 3.59 (0-10) with 1.75 (0-9) used for ALS related indications. The average number of pharmacist interventions was two per patient, with the majority related to medication monitoring and optimizing drug therapy for ALS symptoms. The pharmacist provided education on an average of 2.5 topics per patient. The pharmacist spent an average of 21 (5-50) min with each patient. In conclusion, a clinical pharmacist contributes to the team by: 1) optimizing drug therapy for ALS symptoms; 2) providing medication-related education to patients; 3) allowing more time for the neurologist to attend to neurologic issues; and 4) discussing general medicine issues.

  18. An analysis of the design and implementation of elementary science methods class instruction in colleges and universities in Arkansas (United States)

    Lee, Carole K.

    This study aims to understand the design and implementation of elementary methods classes focused in science instruction by teacher educators in the colleges and universities in the state of Arkansas. All 18 institutions with an Early Childhood Education program approved by the Arkansas Department of Education were reviewed with interviews, site visits and data analysis. The research questions are: (1) What goals do teacher educators express with respect to the preparation of preservice elementary teachers for the teaching of science? (2) What components of methods classes for teaching of elementary science examined relate to each of Feiman-Nemser's conceptual orientations in teacher education? (3) What challenges do teacher educators state that they encounter when they plan and teach the methods classes for teaching elementary science? (4) What specific scientific knowledge or skills are emphasized in the methods classes? Enrollment data of the Early Childhood Education program of the 18 institutions were sought. Data collected from the interviews of 16 teacher educators were transcribed according to Feiman-Nemser's five conceptual orientations in teacher education. The findings reveal the complexities and diverse nature of the science-focused method classes as they are affected by the perceptions and academic backgrounds of the teacher educators, the field experiences that preservice teachers have to teach science in the elementary schools, and the science teaching pedagogy and content knowledge provided by the teacher educators. Results show that not all methods classes are focused mainly in science teaching methods and science knowledge; some are an integration of mathematics and science or a blended curriculum with several disciplines. Most institutions do not provide science-related field experiences for preservice teachers. One common theme that emerges in the lesson observations is that all teacher educators use hands-on activities to illustrate the

  19. Tectonic origin of Crowley's Ridge, northeastern Arkansas

    Energy Technology Data Exchange (ETDEWEB)

    VanArsdale, R.B. (Univ. of Arkansas, Fayetteville, AR (United States). Geology Dept.); Williams, R.A.; Shedlock, K.M.; King, K.W.; Odum, J.K. (Geological survey, Denver, CO (United States). Denver Federal Center); Schweig, E.S. III; Kanter, L.R. (Memphis State Univ., TN (United States))


    Crowley's Ridge is a 320 km long topographic ridge that extends from Thebes, Illinois to Helena, Arkansas. The ridge has been interpreted as an erosional remnant formed during Quaternary incision of the ancestral Mississippi and Ohio rivers; however, the Reelfoot Rift COCORP line identified a down-to-the-west fault bounding the western margin of Crowley's Ridge south of Jonesboro, Arkansas. Subsequent Mini-Sosie seismic reflection profiles confirmed the COCORP data and identified additional faults beneath other margins of the ridge. In each case the faults lie beneath the base of the ridge scarp. The Mini-Sosie data did not resolve the uppermost 150 m and so it was not possible to determine if the faults displace the near-surface Claiborne Group (middle Eocene). A shotgun source seismic reflection survey was subsequently conducted to image the uppermost 250 m across the faulted margins. The shotgun survey across the western margin of the ridge south of Jonesboro reveals displaced reflectors as shallow as 30 m depth. Claiborne Group strata are displaced approximately 6 m and it appears that some of the topographic relief of Crowley's Ridge at this location is due to post middle Eocene fault displacement. Based on the reflection data, the authors suggest that Crowley's Ridge is tectonic in origin.

  20. Woodpecker densities in the big woods of Arkansas (United States)

    Luscier, J.D.; Krementz, David G.


    Sightings of the now-feared-extinct ivory-billed woodpecker Campephilus principalis in 2004 in the Big Woods of Arkansas initiated a series of studies on how to best manage habitat for this endangered species as well as all woodpeckers in the area. Previous work suggested that densities of other woodpeckers, particularly pileated Dryocopus pileatus and red-bellied Melanerpes carolinus woodpeckers, might be useful in characterizing habitat use by the ivory-billed woodpecker. We estimated densities of six woodpecker species in the Big Woods during the breeding seasons of 2006 and 2007 and also during the winter season of 2007. Our estimated densities were as high as or higher than previously published woodpecker density estimates for the Southeastern United States. Density estimates ranged from 9.1 to 161.3 individuals/km2 across six woodpecker species. Our data suggest that the Big Woods of Arkansas is attractive to all woodpeckers using the region, including ivory-billed woodpeckers.

  1. Effect of critical care pharmacist's intervention on medication errors: A systematic review and meta-analysis of observational studies. (United States)

    Wang, Tiansheng; Benedict, Neal; Olsen, Keith M; Luan, Rong; Zhu, Xi; Zhou, Ningning; Tang, Huilin; Yan, Yingying; Peng, Yao; Shi, Luwen


    Pharmacists are integral members of the multidisciplinary team for critically ill patients. Multiple nonrandomized controlled studies have evaluated the outcomes of pharmacist interventions in the intensive care unit (ICU). This systematic review focuses on controlled clinical trials evaluating the effect of pharmacist intervention on medication errors (MEs) in ICU settings. Two independent reviewers searched Medline, Embase, and Cochrane databases. The inclusion criteria were nonrandomized controlled studies that evaluated the effect of pharmacist services vs no intervention on ME rates in ICU settings. Four studies were included in the meta-analysis. Results suggest that pharmacist intervention has no significant contribution to reducing general MEs, although pharmacist intervention may significantly reduce preventable adverse drug events and prescribing errors. This meta-analysis highlights the need for high-quality studies to examine the effect of the critical care pharmacist.

  2. Knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city

    Directory of Open Access Journals (Sweden)

    Priya Shanmuga


    Full Text Available Objectives : This study was done to find out the knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city. Materials and Methods : A cross-sectional survey among a sample of the pharmacists in Chennai city was done and data regarding their knowledge and attitudes towards oral health care and oral hygiene products were obtained using a closed-ended questionnaire. Results: Among the 60 pharmacies approached, 50 pharmacists participated in the study and completed the questionnaire. Though 48% of the participants gave a positive answer when asked whether they had met the dentist practicing close to their pharmacies, the frequency with which they met the dentist ranged from once a week (24% to once a month (28%. Most of the pharmacists stocked oral health-related products, which comprised 15-25% of their total stock. Of these products toothpaste was the most common (62%, followed by mouth rinses (12%. Toothache or painful teeth was the most common dental problem (78% for which patients approached the pharmacists for advice. With regard to the advice given, 38.5% of the pharmacists asked the patient to consult a nearby dentist after dispensing medications, while 22.4% of the pharmacists dispensed antibiotics and painkillers without any referral. Seventy percent of the pharmacists expressed interest in giving oral health care advice to patients. However, many of them (38% felt that lack of proper knowledge is a barrier to providing oral health care advice. Conclusion : It is clear from the present study that pharmacists are presently an underutilized resource, and there is a definitive need to improve their training and access to information on available dental services.

  3. An exploration of clinical interventions provided by pharmacists within a complex asthma service

    Directory of Open Access Journals (Sweden)

    LeMay KS


    Full Text Available Background: Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions they choose to deliver. Objective: To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service. Methods: Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient’s asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically. Results: Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service. The most frequently delivered interventions were in the themes ‘Education on asthma’, ‘Addressing trigger factors’, ‘Medications – safe and effective use’ and ‘Explore patient perspectives’. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions. Conclusion: Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were

  4. Public health in community pharmacy: A systematic review of pharmacist and consumer views

    Directory of Open Access Journals (Sweden)

    Ferguson Jill S


    Full Text Available Abstract Background The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. Methods Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. Results From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health Conclusions There has been little change in customer and pharmacist attitudes since reviews

  5. 78 FR 56170 - Radio Broadcasting Services; Magnolia, Arkansas; and Oil City, Louisiana (United States)


    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Magnolia, Arkansas; and Oil City, Louisiana AGENCY: Federal Communications Commission. ACTION: Final rule; denial of application for review. SUMMARY: In...

  6. Mississippi River Valley Alluvial Aquifer, Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Tennessee; 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Outcrop and subcrop extent of the Mississippi River Valley Alluvial Aquifer in Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, and Tennessee.

  7. Middle Claiborne Confining Unit: Alabama, Arkansas, Kentucky, Louisiana, Missouri, Mississippi, Tennessee 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Digital hydrogeologic surface of the Middle Claiborne Confining Unit in Alabama, Arkansas, Kentucky, Louisiana, Missouri, Mississippi, Tennessee. The hydrogeologic...

  8. Vicksburg-Jackson Confining Unit: Alabama, Arkansas, Louisiana, Missouri, Mississippi, Tennessee 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Digital hydrogeologic surface of the Vicksburg-Jackson Confining Unit in Arkansas, Alabama, Louisiana, Missouri, Mississippi, and Tennessee. The hydrogeologic unit...

  9. Middle Wilcox Aquifer: Alabama, Arkansas, Illinois, Kentucky, Louisiana, Missouri, Mississippi, Tennessee 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Digital hydrogeologic surface of the Middle Wolcox Aquifer in Alabama, Arkansas, Illinois, Kentucky, Louisiana, Missouri, Mississippi, Tennessee. The hydrogeologic...

  10. Lower Wilcox Aquifer: Alabama, Arkansas, Illinois, Kentucky, Missouri, Mississippi 2006-2008 (United States)

    U.S. Geological Survey, Department of the Interior — Digital hydrogeologic surface of the in Alabama, Arkansas, Illinois, Kentucky, Missouri, Mississippi. The hydrogeologic unit dataset contains 414 rows and 394...

  11. 78 FR 48716 - Notice of Availability of the Final Environmental Impact Statement for the Arkansas Valley... (United States)


    ... Arkansas River Basin, groundwater, climate change, recreation biological resources, human environment, socioeconomics, environmental justice, and historic properties. A Notice of Availability of the Draft EIS was... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE...

  12. An Evaluation of Ecosystem Restoration Options for Grand Prairie Region of Arkansas (United States)

    US Fish and Wildlife Service, Department of the Interior — This Evaluation of Ecosystem Restoration and Management Options covers the hydrogeomorphic analysis (HGM) for Grand Prairie Region of Arkansas. This three step...

  13. The fishes of Pea Ridge National Military Park, Arkansas, 2003 (United States)

    Justus, B.G.; Petersen, James C.


    A fish inventory was conducted at Pea Ridge National Military Park, Arkansas, during base-flow conditions in September 2003. Six sites including four streams and two ponds were sampled using conventional electrofishing equipment (a seine also was used at one site). There were 653 individuals collected comprising 18 species (plus 1 hybrid) and 15 genera. The number of species collected at the four stream sites ranged from 1 16. Most fish species collected generally are associated with small streams in the Ozark Plateaus. The two most common species were the banded sculpin and the southern redbelly dace. Three species and a sunfish hybrid were collected from the quarry pond. No fish were collected from the unnamed pond. A preliminary expected species list incorrectly listed 42 species because of incorrect species range or habitat requirements. One species not on the original list was added to the revised list. Upon revising this list, the inventory yielded 18 the 40 species (45 percent) and 1 hybrid. No previous fish inventories have been completed for park but some observations can be made relative to species distributions. There were only five fish species collected in three headwater streams, and it is unlikely that many other species would occur in these three streams because of constraints imposed on the fish community by stream size. Little Sugar Creek, a medium-sized stream, had the most species collected, and it is likely that additional species would be collected from this stream if additional sampling were to occur. Distribution records indicate that all 18 species occur in the general area. Although no species collected in this study are federallylisted threatened or endangered species, three species collected at Pea Ridge National Military Park may be of some special interest to National Park Service managers and others. Two the species collected (cardinal shiner and stippled darter) are endemic to the Ozark Plateaus; both are rather common in certain

  14. Certification of sterile equipment and facilities: what pharmacists need to know. (United States)

    Lanze, Amanda; Rudner, Shara


    Although it is common knowledge that all sterile compounding pharmacies must have their equipment and facilities certified and calibrated every six months, it is not as clear what is expected of pharmacists. There is currently a disconnect between the certification companies and the pharmacists. As pharmacists, we look to the certification companies as the experts and rely upon them accordingly. The certification companies look upon the pharmacy to know which testing is required. It is the role of the pharmacist to know which tests are necessary and how they are to be interpreted correctly. The end goal of certification testing is to prove that the standards listed in United States Pharmacopeia Chapter are met. Testing requirements can vary from state to state. A few of the most commonly required sterile certification and calibration tests will be discussed in this article.

  15. The role of the clinical pharmacist in the care of patients with cardiovascular disease. (United States)

    Dunn, Steven P; Birtcher, Kim K; Beavers, Craig J; Baker, William L; Brouse, Sara D; Page, Robert L; Bittner, Vera; Walsh, Mary Norine


    Team-based cardiovascular care, including the use of clinical pharmacists, can efficiently deliver high-quality care. This Joint Council Perspectives paper from the Cardiovascular Team and Prevention Councils of the American College of Cardiology provides background information on the clinical pharmacist's role, training, certification, and potential utilization in a variety of practice models. Selected systematic reviews and meta-analyses, highlighting the benefit of clinical pharmacy services, are summarized. Clinical pharmacists have a substantial effect in a wide variety of roles in inpatient and ambulatory settings, largely through optimization of drug use, avoidance of adverse drug events, and transitional care activities focusing on medication reconciliation and patient education. Expansion of clinical pharmacy services is often impeded by policy, legislation, and compensation barriers. Multidisciplinary organizations, including the American College of Cardiology, should support efforts to overcome these barriers, allowing pharmacists to deliver high-quality patient care to the full extent of their education and training.

  16. What practicing pharmacists think about their role in healthcare: Preliminary findings from Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Shazia Qasim Jamshed


    Conclusion: The pharmacists expressed dissatisfaction about their perceived status in the healthcare system of Pakistan. In order to intensify the feel of professionalism, reconceptualization of education and training system is advocated.

  17. Technicians or patient advocates?--still a valid question (results of focus group discussions with pharmacists)

    DEFF Research Database (Denmark)

    Almarsdóttir, A B; Morgall, J M


    New legislation went into effect in Iceland in March 1996 making it the first Nordic country to liberate their drug distribution system. The term liberalization implies the abolishment of the professional monopoly in that ownership was not tied to the pharmacy profession anymore. Focus group...... and the self-image of the pharmacist has changed in the short time since the legislative change. The pharmacists generally said that their patient contact is deteriorating due to the discount wars, the rural pharmacists being more optimistic, and believing in a future competition based on quality. Secondly...... technical skills. This account of the changes in the drug distribution system in Iceland highlights some of the implications for pharmacists internationally....

  18. Bridging the gap between hospital and primary care: the pharmacist home visit. (United States)

    Ensing, Hendrik T; Koster, Ellen S; Stuijt, Clementine C M; van Dooren, Ad A; Bouvy, Marcel L


    Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied, albeit with variable effects. Therefore, in this manuscript we propose a three phase approach to structurally address post-discharge drug-related problems. First, hospitals need to transfer up-todate medication information to community pharmacists. Second, the key phase of this approach consists of adequate follow-up at the patients' home. Pharmacists need to apply their clinical and communication skills to identify and analyze drug-related problems. Finally, to prevent and solve identified drug related problems a close collaboration within the primary care setting between pharmacists and general practitioners is of utmost importance. It is expected that such an approach results in improved quality of care and improved patient safety.

  19. The raison d'etre for the community pharmacy and the community pharmacist in Sweden

    DEFF Research Database (Denmark)

    Wisell, Kristin; Kälvemark Sporrong, Sofia


    Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim...... of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who...... are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks...

  20. Evaluation of a Danish pharmacist student-physician medication review collaboration model

    DEFF Research Database (Denmark)

    Kaae, Susanne; Sørensen, Ellen Westh; Nørgaard, Lotte Stig


    Background Interprofessional collaboration between pharmacists and physicians to conduct joint home medication reviews (HMR) is important for optimizing the medical treatment of patients suffering from chronic illnesses. However, collaboration has proved difficult to achieve. The HMR programme...

  1. Piloting the role of a pharmacist in a community palliative care multidisciplinary team: an Australian experience

    Directory of Open Access Journals (Sweden)

    Box Margaret


    Full Text Available Abstract Background While the home is the most common setting for the provision of palliative care in Australia, a common problem encountered here is the inability of patient/carers to manage medications, which can lead to misadventure and hospitalisation. This can be averted through detection and resolution of drug related problems (DRPs by a pharmacist; however, they are rarely included as members of the palliative care team. The aim of this study was to pilot a model of care that supports the role of a pharmacist in a community palliative care team. A component of the study was to develop a cost-effective model for continuing the inclusion of a pharmacist within a community palliative care service. Methods The study was undertaken (February March 2009-June 2010 in three phases. Development (Phase 1 involved a literature review; scoping the pharmacist's role; creating tools for recording DRPs and interventions, a communication and education strategy, a care pathway and evidence based patient information. These were then implemented in Phase 2. Evaluation (Phase 3 of the impact of the pharmacist's role from the perspectives of team members was undertaken using an online survey and focus group. Impact on clinical outcomes was determined by the number of patients screened to assess their risk of medication misadventure, as well as the number of medication reviews and interventions performed to resolve DRPs. Results The pharmacist screened most patients (88.4%, 373/422 referred to the palliative care service to assess their risk of medication misadventure, and undertook 52 home visits. Medication reviews were commonly conducted at the majority of home visits (88%, 46/52, and a variety of DRPs (113 were detected at this point, the most common being "patient requests drug information" (25%, 28/113 and "condition not adequately treated" (22%, 25/113. The pharmacist made 120 recommendations in relation to her interventions. Fifty percent of online

  2. Exploring the nature of power distance on general practitioner and community pharmacist relations in a chronic disease management context. (United States)

    Rieck, Allison Margaret


    To improve collaboration in Australian primary health care, there is a need to understand aspects of the general practitioner (GP)/community pharmacist relationship, its influence on collaborative chronic disease management (CDM) and if this influence can be explained by a pre-existing theory or concept. Adopting a grounded theory approach, 22 GP and 22 community pharmacist semi-structured interviews were undertaken. Analysis of the transcripts identified common themes regarding the GP/community pharmacist relationship. Trustworthiness of the themes identified was tested through negative case analysis and member checking. Hofstede's (in 1980) phenomenon of power distance was employed to illuminate the nature of GP/community pharmacist relations. The majority of GPs and community pharmacists described the characteristics of this phenomenon. The power distance was based on knowledge and expertise and was shown to be a barrier to collaboration between GPs and community pharmacists because GPs perceived that community pharmacists did not have the required expertise to improve CDM above what the GP could deliver alone. Power distance exists within the GP/community pharmacist relationship and has a negative influence on GP/community pharmacist collaborative CDM. Understanding and improving GP awareness of community pharmacist expertise has important implications for the future success of collaborative CDM.

  3. How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?

    DEFF Research Database (Denmark)

    Rubak, Sune; Andersen, Marie-Louise Elkjær; Mainz, Jan;


    Aim/Objectives: Evaluation of how the substitution system has been implemented, how it was assessed by the general practitioners (GPs), pharmacists (PHs) and patients, and clarification of benefits and problems related to the system. Methods: The study was based on specific question-naires to GPs....... How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?. Available from:

  4. Responding to patient demand: community pharmacists and herbal and nutritional products for children



    Abstract The attitudes and behaviour of pharmacists working in a multi-ethnic community regarding herbal and nutritional products (HNPs) for children, were explored in depth. Qualitative interviews with four pharmacists were analysed using Framework Analysis. Quantitative diary recording of all HNP-related events for child customers in four pharmacies was carried out over 2 separate week periods between March - June 2008. Of 29 events recorded, most involved parents buying product...

  5. Knowledge and attitudes about emergency contraception among pharmacist and physician preceptors in South Carolina

    Directory of Open Access Journals (Sweden)

    Sarah Shrader


    Full Text Available Sarah Shrader1,2, Ann M Rodden1, Lisa Carroll3, Lars E Peterson11Medical University of South Carolina, Department of Family Medicine, Charleston, SC, USA; 2South Carolina College of Pharmacy, Department of Clinical Pharmacy and Outcomes Sciences, Charleston, SC, USA; 3Spartanburg Regional Family Medicine Residency Program, Department of Family Medicine, Spartanburg, SC, USABackground: Emergency contraception (EC may reduce unintended pregnancies if patients are informed and have access. A great deal of medical education occurs during medical and pharmacy training community clerkships. This study concurrently assesses knowledge and attitudes about EC between community physician and pharmacist preceptors who prescribe/dispense EC.Study design: Electronic survey of demographic information, knowledge-based, and attitude questions related to EC was completed by 182 (36.6% response rate South Carolina ­community physicians and pharmacists who precept students. Comparisons were performed using chi-square or Fischer’s exact test.Results: In the study population, approximately 62% of pharmacists dispense EC while only 28% of physicians prescribe it. More physicians than pharmacists believe repetitive use is not harmful (48.3% vs 28.0%, P = 0.010, while more pharmacists believe it causes birth defects (22.6% vs 7.9%, P = 0.008.Conclusion: Overall, both physicians and pharmacists have poor knowledge about EC. ­Further education for both groups may be needed so future physicians and pharmacists are not taught incorrectly during their training and so patient access is not hampered by prescriber misunderstanding.Keywords: emergency contraception, levonorgestrel, pharmacist, physician

  6. Pharmaceutical Care and the Role of a Pharmacist in Space Medicine (United States)

    Bayuse, Tina


    Space medicine is primarily preventative medicine Outcomes of space medicine pharmaceutical care are: a) Elimination or reduction of a patient's symptomatology; b) Arresting or slowing of long term effects from microgravity; and c) Preventing long term effects or symptomatology as a result of microgravity. Space medicine pharmaceutical care is about both the patient and the mission. Pharmaceutical care in the area of space medicine is evolving. A pharmacist serves a critical role in this care. Commercial space travel will require pharmacist involvement.

  7. A feasibility study of a combined nurse/pharmacist-led chronic pain clinic in primary care. (United States)

    Briggs, Michelle; Closs, S José; Marczewski, Kath; Barratt, Joanne


    Chronic pain is common and management hampered by lack of resources in primary and secondary care. Nurse- or pharmacist-led clinics have been shown to lead to improvements in care for patients with chronic pain. This study showed that a combined nurse/pharmacist-led clinic for managing chronic pain in primary care can lead to improvements in management of pain, reduction in use of secondary care resources and high rates of satisfaction.

  8. New Roles for Pharmacists in Community Mental Health Care: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Maria Rubio-Valera


    Full Text Available Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1 the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2 the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3 barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.

  9. Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moran Lazaryan


    Full Text Available Background: One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available.Objective: To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU. Methods: A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded.Results: The review time for one medical record was 8.9 (95% CI, 6.9-10.9 minutes. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11 minutes. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8 and 12 (9-15 minutes, respectively, for patients with psychiatric-neurologic disorders compared to those without (p=0.032. Usually, a daily workload of 240 minutes was needed for the pharmacist accompanying the round in contrast to 108 minutes per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9% and made no comment on 36.9% of the recommendations. Conclusion: Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

  10. The Arkansas AHEC model of community-oriented primary care. (United States)

    Hartwig, M S; Landis, B J


    This article explicates the Arkansas Area Health Education Center (AHEC) model of community-oriented primary care (COPC) and the role of the family nurse practitioner (FNP) in its implementation. The AHECs collaborate with local agencies to provide comprehensive, accessible, quality health care to specific patient populations, and offer learning opportunities to a wide variety of health professions students. The FNP demonstrates organizational and role competencies that include directing patient care, providing professional leadership, and developing the advanced practice nursing role. Two case studies are used to illustrate the FNPs' approach to COPC: (1) selection of interdisciplinary, multidisciplinary, and transdisciplinary approaches to management of a patient with chronic illnesses, and (2) the Sexual Assault Nurse Examiners Training Project.

  11. Pharmacist's management of drug-related problems: a tool for teaching and providing pharmaceutical care. (United States)

    Winslade, N E; Bajcar, J M; Bombassaro, A M; Caravaggio, C D; Strong, D K; Yamashita, S K


    During the development of education and practice models based on the philosophy of pharmaceutical care (PC), six pharmacists worked with the University of Toronto Faculty of Pharmacy to implement the PC model in their practice sites. These pharmacists found it necessary to modify existing tools to create one that explicitly guided them through the PC process, including the phase of monitoring patients for desired outcomes. This resulted in the development of the Pharmacist's Management of Drug Related Problems. This tool requires pharmacists to collect patient drug and medical data and write responses to specific questions about the data to interpret their significance. As proficiency in providing PC is attained, the questions and space for written responses can be eliminated, leaving a comprehensive documentation system of patient outcomes and the data collected, recommendations made, and monitoring completed by the pharmacist. This tool has been adopted by the University of Toronto Faculty of Pharmacy and is being used in various continuing education programs and by practicing pharmacists across Canada.

  12. Strategic initiatives to maintain pharmaceutical care and clinical pharmacists sufficiency in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulkareem M Albekairy


    Full Text Available Objectives: The shortage of clinical pharmacists in Saudi Arabia has limited the full implementation of pharmaceutical care in most of its hospitals. The National Guard Health Affairs hospitals. This work discussed the Department of Pharmaceutical Care, and the King Saud Bin Abdulaziz University for Health Sciences College of Pharmacy four initiatives that were planned in 2009–2010 to develop and recruit clinical pharmacists, practitioners, or faculty. Methods: The combined initiatives were aimed at (1 instituting a 4-year clinical skills development career ladder, (2 expanding the National Guard Health Affairs postgraduate residency program, (3 offering scholarships to qualified pharmacy graduates to pursue the PharmD degree and a PGY-1 residency training in the United States, and (4 recruiting non-Saudi clinical pharmacists educated and trained in the United States to ameliorate the current shortage of practitioner. Results: The current number of clinical pharmacists practicing at the National Guard Health Affairs at central region is 24, most of whom are Board Certified by the American Pharmacists Association Board of Pharmacy Specialties. Conclusions: The four initiatives, based on current trends, suggest that 60–65 positions will be added by 2017–2018, barring attrition. Saudi Arabia and many developing countries will continue to experience a shortage in clinical pharmacists due to the high demand for clinical pharmacy services. A multifaceted approach is recommended to address the problem.

  13. Contribution of a liaison clinical pharmacist to an inpatient palliative care unit. (United States)

    Lucas, C; Glare, P A; Sykes, J V


    The impact on patient care of interventions made by a liaison clinical pharmacist visiting a busy inpatient palliative care unit were evaluated using a validated six-point scoring system. Interventions made in 13% of patients could improve patient care, save money or both, but rarely involved the drugs that are commonly used for symptom control in patients with terminal cancer. Advice to rationalize inappropriate drug regimens (53%) was the commonest intervention, followed by warnings about drug interactions (24%) and advice about therapeutic drug monitoring (8%). The interventions were evaluated by the pharmacist, a palliative medicine registrar and two independent doctors, confirming that the pharmacist was valid and accurate in assessing her own work. Although more than 60% of interventions could significantly improve patient care, compliance by medical and nursing staff with advice was only 55%, reflecting possible tensions between palliative and general hospital medicine. This survey emphasizes the role of liaison clinical pharmacists in palliative care, the need for much more critical appraisal of prescribing practices and the utility of ranking pharmacist interventions as a quality assurance and educational tool. In particular, providing palliative care for patients with advanced acquired immunodeficiency syndrome (AIDS) is enhanced when a pharmacist with a specialist knowledge of AIDS therapeutics is available.

  14. Pharmacist Collaborative Drug Therapy Management in U.S. Hospitals


    Mishra, Pragya


    The objectives for this study were to 1) assess the current extent, scope and perceptions of CDTM in U.S. hospitals, 2) determine the associations between hospital characteristics, pharmacy director characteristics, and perceptions of CDTM, 3) investigate hospitals' short-term and long-term plans regarding CDTM, and 4) identify pharmacy directors' views about the major facilitators and barriers for CDTM in hospitals. A self-administered written survey was mailed to a national random sample...

  15. Folic acid and the decline in neural tube defects in Arkansas. (United States)

    Mosley, Bridget S; Hobbs, Charlotte A; Flowers, Bettye S; Smith, Veronica; Robbins, James M


    Folic acid has been shown to reduce the risk of pregnancies affected by neural tube defects (NTDs) by as much as 70%. Cereal grains sold in the U.S. have been fortified with folic acid since 1998. The Arkansas Reproductive Health Monitoring System and the Arkansas Folic Acid Coalition have encouraged use of folic acid and monitored the impact of increased consumption of folic acid among Arkansans. NTDs in Arkansas have declined 40% since intervention programs were implemented. The greatest decline has been observed among white and Hispanic women. Efforts to encourage folic acid consumption should continue to target Arkansas women. NTDs include anencephaly and spina bifida. These birth defects result from incomplete closure of the fetal neural tube during the first month of pregnancy. Infants with anencephaly are born without all or most of their brain and die within a few days of life. Infants with spina bifida have varying degrees of impairment ranging from little noticeable disability to severe, lifelong disability. Folic acid, when taken in supplement form has been shown to reduce the risk of a pregnancy affected by a neural tube defect by as much as 70%. As a result of this finding, the U.S. Federal Drug Administration mandated that cereal grains sold in this country be fortified with at least 140 mcg of folic acid per 100 grams of grain by January 1, 1998. Prior to mandatory fortification, the March of Dimes and the U.S. Public Health Service released statements encouraging all women of reproductive age who are capable of becoming pregnant to take 400 mcg 'of synthetic folic acid daily. The Arkansas Reproductive Health Monitoring System (ARHMS) has monitored rates of NTDs in Arkansas since 1980. ARHMS is the lead agency of the Arkansas Folic Acid Coalition whose mission is to encourage folic acid use among all Arkansas women of reproductive age. In this report, we summarize efforts by ARHMS and the Arkansas Folic Acid Coalition to increase the awareness and

  16. U.S. and Canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review

    Directory of Open Access Journals (Sweden)

    Boon Heather


    Full Text Available Abstract Background Although dietary supplements (DS are widely sold in pharmacies, the legal, ethical, and practice responsibilities of pharmacists with respect to these products have not been well defined. This systematic review of pharmacists' attitudes, knowledge, and professional practice behaviours toward DS is intended to inform pharmacy regulators' and educators' decision making around this topic. Methods Eligible studies were identified through a systematic database search for all available years through to March 2006. Articles were analyzed for this review if they included survey data on U.S. or Canadian pharmacists' attitudes, knowledge, or professional practice behaviors toward DS published in 1990 or later. Results Due to the heterogeneity of the data, it was not possible to draw a conclusion with respect to pharmacists' general attitudes toward DS. Approximately equal numbers of pharmacists report positive as well as negative attitudes about the safety and efficacy of DS. There is strong agreement among pharmacists for the need to have additional training on DS, increased regulation of DS, and quality information on DS. In addition, survey data indicate that pharmacists do not perceive their knowledge of DS to be adequate and that pharmacists do not routinely document, monitor, or inquire about patients' use of DS. Despite this, a large proportion of pharmacists reported receiving questions about DS from patients and other health care practitioners. Conclusion Further research is needed to explore the factors that influence pharmacists' beliefs and attitudes about DS, to accurately evaluate pharmacists' knowledge of DS, and to uncover the reasons why pharmacists do not routinely document, monitor, or inquire about patients' use of DS.

  17. Pharmacist-led medication review in an acute admissions unit

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Bonnerup, Dorthe Krogsgaard; Kjeldsen, Lene Juel;


    Objectives Over the last decades, several papers have evaluated clinical pharmacy interventions in hospital settings with conflicting findings as results. Medication reviews are frequently a central component of these interventions. However, the term ‘medication review’ covers a plethora of princ......, not to provide or advocate a single one-size-fits-all solution, but in an attempt to inspire a debate of the practical approach on how to execute a systematic medication review in order to develop and expand clinical pharmacy and achieve better patient outcomes.......Objectives Over the last decades, several papers have evaluated clinical pharmacy interventions in hospital settings with conflicting findings as results. Medication reviews are frequently a central component of these interventions. However, the term ‘medication review’ covers a plethora...... of principles and methodologies, and the practical procedure is seldom described in detail, which makes reproducing study findings difficult. The objective of this paper is to provide a detailed description of a procedure developed and used for pharmacist-led medication review in acute admissions units...

  18. Records and record-keeping for the hospital compounding pharmacist. (United States)

    McElhiney, Linda F


    The United States Pharmacopeial Convention, Inc., is recognized by federal law and by most state boards of pharmacy as the official group for setting the standards for pharmaceuticals and pharmacy practice, including compounding. The standards of United States Pharmacopeia Chapter 795 require that a pharmacy maintain records on a compounded preparation, including the formulation record, and a Material Safety Data Sheets file. The American Society of Health-Systems Pharmacists' guidelines require that hospital pharmacy departments maintain at least four sets of records in the compounding area: (1) compounding formulas and procedures, (2) compounding logs of all compounded preparations, including batch records and sample batch labels, (3) equipment maintenance records, and (4) a record of ingredients purchased, including cerificates of analysis and Material Saftey Data Sheets. Hospital compounding records may be inspected by any of several outside organizations, including state boards of pharmacy, third-party payers, the Joint Commission on Accreditaion of Healthcare Organizations, the Drug Enforcement Agency, and attorneys. With the existing standards and guidelines in place and the importance of documentation unquestionable, a record of pharmacy activites should be maintained in a compounding pharmacy so that preparations can be replicated consistently, the history of each ingredient traced, equipment maintenance and calibration verified, and compounding procedures evaluated easily.

  19. Expanding the Scope of Practice for Pharmacists in Ontario

    Directory of Open Access Journals (Sweden)

    Glen Edward Randall


    Full Text Available On 15 December 2009 the Regulated Health Professions Statute Law Amendment Act, 2009 (Bill 179 received Royal Assent in Ontario. The resulting legislative amendments were intended to strengthen government oversight of the health regulatory colleges, promote interprofessional collaboration, and make better use of health professionals’ existing skills and training by enhancing the scope of practice for several health professions in order to improve health system efficiency. Among the most notable scope of practice enhancements were those given to pharmacists, who would be permitted to: modify and renew existing prescriptions, prescribe a limited range of drugs independent of a physician, and administer medications such as vaccinations via injection or inhalation. The reform was driven in large part by the government’s concerns related to the rising cost of health care, the public’s desire for greater access to services, and demonstrated successes of similar reforms in other jurisdictions. While the Ontario reform has had some clear success, such as expanding the public’s access to influenza vaccinations, to date, the evidence of achieving other goals remains weak. In particular, there is no clear evidence of improved health system efficiency and associated cost effectiveness. Moreover, it is possible that Ontario’s umbrella regulatory model may be making interprofessional collaboration more, rather than less, difficult to realize.

  20. Community pharmacists: a forgotten resource for palliative care. (United States)

    Tait, Paul Anthony; Gray, John; Hakendorf, Paul; Morris, Bel; Currow, David Christopher; Rowett, Debra S


    Timely access to medicines within the community is important for palliative patients where their preferred place of care is the home environment. The objective of this observational study is to establish baseline data to quantify the issue of poor access to medicines for symptom control in the last few days of life. The list of 13 medicines was generated from medicine use within a metropolitan palliative care unit. A survey was designed to determine which of these 13 medicines community pharmacies stock, the expiry date of this stock, awareness of palliative care patients by community pharmacists and basic demographic characteristics of the community pharmacies. Surveys were distributed, by post, to all community pharmacies in South Australia. The response rate was 23.7%, and was representative of all socioeconomic areas. Each pharmacy stocked a median of 3 medicines (range 0-12) with 1 in 8 pharmacies having none of the 13 medicines listed in the survey. When the data was combined to identify the range of medicines from all pharmacies within a geographical postcode region, the median number of medicines increased to 5 medicines per postcode. Just over 1 in 5 pharmacies reported learning about the palliative status of a patient through another health practitioner. Community pharmacies remain an underused resource to support timely access to medicines for community-based palliative patients. Palliative care services and government agencies can develop new strategies for better access to medicines that will benefit community patients and their carers.

  1. Does the presence of a pharmacist in primary care clinics improve diabetes medication adherence?

    Directory of Open Access Journals (Sweden)

    Kocarnik Beverly Mielke


    Full Text Available Abstract Background Although oral hypoglycemic agents (OHAs are an essential element of therapy for the management of type 2 diabetes, OHA adherence is often suboptimal. Pharmacists are increasingly being integrated into primary care as part of the move towards a patient-centered medical home and may have a positive influence on medication use. We examined whether the presence of pharmacists in primary care clinics was associated with higher OHA adherence. Methods This retrospective cohort study analyzed 280,603 diabetes patients in 196 primary care clinics within the Veterans Affairs healthcare system. Pharmacists presence, number of pharmacist full-time equivalents (FTEs, and the degree to which pharmacy services are perceived as a bottleneck in each clinic were obtained from the 2007 VA Clinical Practice Organizational Survey—Primary Care Director Module. Patient-level adherence to OHAs using medication possession ratios (MPRs were constructed using refill data from administrative pharmacy databases after adjusting for patient characteristics. Clinic-level OHA adherence was measured as the proportion of patients with MPR >= 80%. We analyzed associations between pharmacy measures and clinic-level adherence using linear regression. Results We found no significant association between pharmacist presence and clinic-level OHA adherence. However, adherence was lower in clinics where pharmacy services were perceived as a bottleneck. Conclusions Pharmacist presence, regardless of the amount of FTE, was not associated with OHA medication adherence in primary care clinics. The exact role of pharmacists in clinics needs closer examination in order to determine how to most effectively use these resources to improve patient-centered outcomes including medication adherence.

  2. The role of the pharmacist in patient-centered medical home practices: current perspectives

    Directory of Open Access Journals (Sweden)

    Lewis NJW


    Full Text Available Nancy JW Lewis,1 Leslie A Shimp,2 Stuart Rockafellow,2 Jeffrey M Tingen,2 Hae Mi Choe,3 Marie A Marcelino21Private consultancy practice, Rochester Hills, MI, USA; 2Clinical, Social and Administrative Department, University of Michigan College of Pharmacy, Ann Arbor, MI, USA; 3Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USAAbstract: Patient-centered medical homes (PCMHs are the centerpiece of primary care transformation in the US. They are intended to improve care coordination and communication, enhance health care quality and patient experiences, and lower health care costs by linking patients to a physician-led interdisciplinary health care team. PCMHs are widely supported by health care associations, payers, and employers. Health care accreditation organizations have created performance measures that promote the adoption of PCMH core attributes. Public and private payers are increasingly providing incentives and bonuses related to performance measure status. Evidence-based prescription, medication adherence, medication use coordination, and systems to support medication safety are all necessary components of PCMHs. Pharmacists have unique knowledge and skills that can complement the care provided by other PCMH team members. Their experience in drug therapy assessments, medication therapy management, and population health has documented benefits, both in terms of patient health outcomes and health care costs. Through collaborative care, pharmacists can assist physicians and other prescribers in medication management and thus improve prescriber productivity and patient access to care. Pharmacists are engaged in PCMHs through both employment and contractual arrangements. While some pharmacists serve a unique PCMH, others work within practice networks that serve practices within a geographical area. Financial support for pharmacist-provided services includes university funding, external grant funding

  3. Clinical impact of a pharmacist-led inpatient anticoagulation service: a review of the literature

    Directory of Open Access Journals (Sweden)

    Lee T


    Full Text Available Tiffany Lee, Erin Davis, Jason Kielly School of Pharmacy, Memorial University, St John's, NL, Canada Background: Anticoagulant therapies provide management options for potentially life-threatening thromboembolic conditions. They also carry significant safety risks, requiring careful consideration of medication dose, close monitoring, and follow-up. Inpatients are particularly at risk, considering the widespread use of anticoagulants in hospitals. This has prompted the introduction of safety goals for anticoagulants in Canada and the USA, which recommend increased pharmacist involvement to reduce patient harm. The goal of this review is to evaluate the efficacy and safety of pharmacist-led inpatient anticoagulation services compared to usual or physician-managed care. Methods: This narrative review includes articles identified through a literature search of PubMed, Embase, and International Pharmaceutical Abstracts databases, as well as hand searches of the references of relevant articles. Full publications of pharmacist-managed inpatient anticoagulation services were eligible if they were published in English and assessed clinical outcomes. Results: Twenty-six studies were included and further divided into two categories: 1 autonomous pharmacist-managed anticoagulation programs (PMAPs and 2 pharmacist recommendation. Pharmacist management of heparin and warfarin appears to result in improvements in some surrogate outcomes (international normalized ratio [INR] stability and time in INR goal range, while results for others are mixed (time to therapeutic INR, length of stay, and activated partial thromboplastin time [aPTT] measures. There is also some indication that PMAPs may be associated with reduced patient mortality. When direct thrombin inhibitors are managed by pharmacists, there seems to be a shorter time to therapeutic aPTT and a greater percentage of time in the therapeutic range, as well as a decrease in the frequency of medication

  4. Experiences of community pharmacists involved in the delivery of a specialist asthma service in Australia

    Directory of Open Access Journals (Sweden)

    Emmerton Lynne M


    Full Text Available Abstract Background The role of community pharmacists in disease state management has been mooted for some years. Despite a number of trials of disease state management services, there is scant literature into the engagement of, and with, pharmacists in such trials. This paper reports pharmacists’ feedback as providers of a Pharmacy Asthma Management Service (PAMS, a trial coordinated across four academic research centres in Australia in 2009. We also propose recommendations for optimal involvement of pharmacists in academic research. Methods Feedback about the pharmacists’ experiences was sought via their participation in either a focus group or telephone interview (for those unable to attend their scheduled focus group at one of three time points. A semi-structured interview guide focused discussion on the pharmacists’ training to provide the asthma service, their interactions with health professionals and patients as per the service protocol, and the future for this type of service. Focus groups were facilitated by two researchers, and the individual interviews were shared between three researchers, with data transcribed verbatim and analysed manually. Results Of 93 pharmacists who provided the PAMS, 25 were involved in a focus group and seven via telephone interview. All pharmacists approached agreed to provide feedback. In general, the pharmacists engaged with both the service and research components, and embraced their roles as innovators in the trial of a new service. Some experienced challenges in the recruitment of patients into the service and the amount of research-related documentation, and collaborative patient-centred relationships with GPs require further attention. Specific service components, such as the spirometry, were well received by the pharmacists and their patients. Professional rewards included satisfaction from their enhanced practice, and pharmacists largely envisaged a future for the service. Conclusions The


    Directory of Open Access Journals (Sweden)

    Mamta V Karani


    Full Text Available Falls are the leading cause of both fatal and nonfatal injuries in people aged 65 and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient centered team-based approach, pharmacists can collaborate with primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health care providers implement fall prevention, the Centers for Disease Control and Prevention (CDC developed the STEADI (Stopping Elderly Accidents, Death and Injuries initiative. Based on established clinical guidelines, STEADI provides members of the health care team, including pharmacists, with the tools and resources they need to manage their older patients’ fall risk. These tools are being adapted to specifically advance the roles of pharmacists in: reviewing medications, identifying those that increase fall risk, and communicating those risks with patients’ primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health care team can better meet the needs of America’s growing older adult population and reduce falls.

  6. Development of a Survey to Assess the Acceptability of an Innovative Contraception Practice among Rural Pharmacists

    Directory of Open Access Journals (Sweden)

    Michael Wong


    Full Text Available Improved access to effective contraceptive methods is needed in Canada, particularly in rural areas, where unintended pregnancy rates are high and specific sexual health services may be further away. A rural pharmacist may be the most accessible health care professional. Pharmacy practice increasingly incorporates cognitive services. In Canada many provinces allow pharmacists to independently prescribe for some indications, but not for hormonal contraception. To assess the acceptability for the implementation of this innovative practice in Canada, we developed and piloted a survey instrument. We chose questions to address the components for adoption and change described in Rogers’ “diffusion of innovations” theory. The proposed instrument was iteratively reviewed by 12 experts, then focus group tested among eight pharmacists or students to improve the instrument for face validity, readability, consistency and relevancy to community pharmacists in the Canadian context. We then pilot tested the survey among urban and rural pharmacies. 4% of urban and 35% of rural pharmacies returned pilot surveys. Internal consistency on repeated re-phrased questions was high (Cronbach’s Alpha = 0.901. We present our process for the development of a survey instrument to assess the acceptability and feasibility among Canadian community pharmacists for the innovative practice of the independent prescribing of hormonal contraception.

  7. Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study. (United States)

    Zerafa, Natalie; Scerri, Charles


    Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

  8. Implementation of a novel train-the-trainer program for pharmacists in China

    Directory of Open Access Journals (Sweden)

    Hoan Linh Banh


    Full Text Available Clinical pharmacy services in North American are well implemented both in community pharmacies and in hospital pharmacies. In 2009 the Chinese government mandated the implementation of clinical pharmacy services in all secondary and tertiary hospitals by 2020. The mandate would require adequately trained clinical pharmacists. However, most pharmacy education programs in China have not yet incorporated clinical pharmacy into their curricula. Many pharmacists have been sent to countries, including the United States and Canada, to receive clinical pharmacy training. Because of different health care systems, medical team dynamics, and language barriers, it became difficult for the returning pharmacists to apply the skills gained from this type of training. As a result, the Second Xiangya Hospital of Central South University initiated an international academic–run train-the-trainer program. The objectives are to provide adequate training for pharmacists to provide pharmaceutical care to patients, conduct clinical pharmacy–related research, and engage in scholarly activities. After evaluation of local readiness, the course commenced in 2014, and to date four trainers have received personalized one-on-one training by an advanced pharmacist with 15 years of experience of delivering similar curricula in North America. We present the initial process evaluation and learning that will contribute to the development of clinical pharmacy courses at Central South University.

  9. Outcomes assessment of a pharmacist-directed seamless care program in an ambulatory oncology clinic. (United States)

    Edwards, Scott J; Abbott, Rick; Edwards, Jonathan; LeBlanc, Michael; Dranitsaris, George; Donnan, Jennifer; Laing, Kara; Whelan, Maria A; MacKinnon, Neil J


    The primary goal of seamless care is improved patient outcomes and improved standards of care for patients with cancer. The pharmacy service of the Newfoundland Cancer Treatment and Research Foundation conducted a randomized control study that measured clinical and humanistic outcomes of a pharmacist-directed seamless care program in an ambulatory oncology clinic. This article focuses on the intervention group, particularly the identification of drug-related problems (DRPs) and utilization of health care services as well the satisfaction of 3 types of health professionals with the services provided by the pharmacist-directed seamless care program. Overall, the seamless care pharmacist (SCP) identified an average of 3.7 DRPs per intervention patient; the most common DRP reported was a patient not receiving or taking a drug therapy for which there is an indication. The SCP identified more DRPs in patients receiving adjuvant treatment compared to those receiving palliative treatment. On average, family physicians, oncology nurses, and hospital pharmacists were satisfied with the SCP intervention indicating that they agreed the information collected and distributed by the SCP was useful to them. Pharmacist-directed seamless care services in an ambulatory oncology clinic have a significant impact on clinical outcomes and processes of patient care. The presence of a SCP can help identify and resolve DRPs experienced by patients in an outpatient oncology clinic, ensuring that patients are receiving the highest standard of care.

  10. [Pharmacist's requirements for evidence-based self-medication guidelines]. (United States)

    Laven, Anna; Läer, Stephanie


    Due to the removal of many pharmaceuticals from the prescription requirement, self-medication implies an increasing responsibility for pharmacists towards their patients. The application of evidence-based guidelines could be a responsible basis for consulting in pharmacies. Evidence-based guidelines represent the systematically accumulated and evaluated facts (the evidence) of desired and undesired effects of pharmaceuticals in the population. We wanted to find out which interest pharmaceutical professionals have in evidence-based guidelines and which are the exact requirements on their content, deducted from public pharmacies everyday demands. With this purpose, three surveys were conducted between March and August 2012, in which 365, 350, and 486 pharmaceutical professionals participated respectively. The results show that pharmacy staff is very interested in evidence based guidelines. Furthermore, they suggest that the pharmacy staff feel safe with the self-diagnosis of the customer, with the consideration of limits of self-medication, as well as with the selection of the--according to own assessment--appropriate active substance. For the selection of the correct active substance, the following criteria are named: self-security in the counselling, first-hand experiences as well as the wish of the customer. At the same time, it is striking that the most frequent critique the pharmacy staff gets from pharmacy customers is the lack of effectiveness of the selected medication. With that in mind, it is possible that not the appropriate medication was selected, and the chosen criteria as selection method should be replaced by an evidence-based decision. Secondly, the results show that in up to 52% of the cases, depending on the indications, the participating consultants felt less certain to uncertain with regards to possible interactions or contraindications. Also in this context, it is desirable to prepare the existing data in such a practical way, that the

  11. "How dare you question what I use to treat this patient?": Student pharmacists' reflections on the challenges of communicating recommendations to physicians in interdisciplinary health care settings. (United States)

    Denvir, Paul; Brewer, Jeffrey


    A growing number of pharmacists practice within interdisciplinary health care teams, leading pharmacy educators to place increased emphasis on the development of interprofessional collaboration skills. In the pharmacist-physician relationship, pharmacists' medication therapy recommendations (MTRs) are a recurrent and significant interprofessional activity, one that can be challenging for both seasoned and student pharmacists. Drawing on in-depth ethnographic interviews with pharmacy preceptors and advanced student pharmacists, we identify and describe an important distinction between pharmacist-initiated MTRs and physician-initiated MTRs as contexts for interprofessional collaboration. We describe and illustrate a range of social, professional, and communication challenges that students experience in each context, as well as some strategies they use to navigate these challenges. Using the theoretical framework of dialectic tensions, we argue that the pharmacist-physician relationship is characterized by a tension between assertiveness and deference. We also offer recommendations to pharmacy preceptors, who can use this article to enhance the experiential education of pharmacists.

  12. The fishes of Hot Springs National Park, Arkansas, 2003 (United States)

    Petersen, James C.; Justus, B.G.


    Fish communities were sampled from eight sites within Hot Springs National Park. Fish were collected by seining and electrofishing during base-flow periods in July and October 2003. All individuals were identified to species. More than 1,020 individuals were collected, representing 24 species. The number of species collected at the sites ranged from 5 to 19. Central stoneroller, orangebelly darter, and longear sunfish were among the more abundant fish species at most sites. These species are typical of small streams in this area. An expected species list incorrectly listed 35 species because of incorrect species range or habitat requirements. Upon revising this list, the inventory yielded 24 of the 51 expected species (47 percent). No species collected in 2003 were federally-listed threatened or endangered species. However, two species collected at Hot Springs National Park may be of special interest to National Park Service managers and others. The Ouachita madtom is endemic to the Ouachita Mountains and is listed as a species of special concern by the Arkansas Natural Heritage Commission. The grass carp, which is a native of eastern Asia, is present in Ricks Pond; one individual was collected and no other grass carp were observed. The introduction of grass carp into the United States is a controversial issue because of possible (but undocumented) harmful effects on native species and habitats.

  13. A rare Uroglena bloom in Beaver Lake, Arkansas, spring 2015 (United States)

    Green, William R.; Hufhines, Brad


    A combination of factors triggered a Uroglena volvox bloom and taste and odor event in Beaver Lake, a water-supply reservoir in northwest Arkansas, in late April 2015. Factors contributing to the bloom included increased rainfall and runoff containing increased concentrations of dissolved organic carbon, followed by a stable pool, low nutrient concentrations, and an expansion of lake surface area and littoral zone. This was the first time U. volvox was identified in Beaver Lake and the first time it was recognized as a source of taste and odor. Routine water quality samples happened to be collected by the US Geological Survey and the Beaver Water District throughout the reservoir during the bloom—. Higher than normal rainfall in March 2015 increased the pool elevation in Beaver Lake by 2.3 m (by early April), increased the surface area by 10%, and increased the littoral zone by 1214 ha; these conditions persisted for 38 days, resulting from flood water being retained behind the dam. Monitoring programs that cover a wide range of reservoir features, including dissolved organic carbon, zooplankton, and phytoplankton, are valuable in explaining unusual events such as this Uroglena bloom.

  14. Medication reviews by clinical pharmacists at hospitals lead to improved patient outcomes

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Kjeldsen, Lene Juel


    and outcomes vary among studies. Hence, there is a need for compiling the evidence within this area. The aim of this systematic MiniReview was to identify, assess and summarize the literature investigating the effect of pharmacist-led medication reviews in hospitalized patients. Five databases (MEDLINE, EMBASE......, CINAHL, Web of Science and the Cochrane Library) were searched from their inception to 2011 in addition to citation tracking and hand search. Only original research papers published in English describing pharmacist-led medication reviews in a hospital setting including minimum 100 patients or 100......Suboptimal medication use may lead to morbidity, mortality and increased costs. To reduce unnecessary patient harm, medicines management including medication reviews can be provided by clinical pharmacists. Some recent studies have indicated a positive effect of this service, but the quality...

  15. [European paintings entitled "Jesus Christ as Pharmacist" in the Middle Ages and later]. (United States)

    Okuda, J


    Ninety-eight pictures painted in the Middle Ages and later entitled "Christ as Pharmacist" are shown in a little German book (W. H. Hein, Christus als Apotheker, Govi-Verlag, Frankfurt am Main, 1974). In the three paintings shown here, Christ appears as a pharmacist standing behind a pharmacy table used to compound medicine, and he has a medicinal balance in his left hand. The Christian terms, such as faith, love, and hope, and the drug's name are written on each of the drug vase labels. It seems that the purpose of displaying these paintings in a pharmacy was both to propagate Christianity to the poor who bought medicine at their family pharmacy and to win their respect for the pharmacist.

  16. Antimicrobial Stewardship from Policy to Practice: Experiences from UK Antimicrobial Pharmacists. (United States)

    Gilchrist, Mark; Wade, Paul; Ashiru-Oredope, Diane; Howard, Philip; Sneddon, Jacqueline; Whitney, Laura; Wickens, Hayley


    Antimicrobial stewardship in the UK has evolved dramatically in the last 15 years. Factors driving this include initial central funding for specialist pharmacists and mandatory reductions in healthcare-associated infections (particularly Clostridium difficile infection). More recently, the introduction of national stewardship guidelines, and an increased focus on stewardship as part of the UK five-year antimicrobial resistance strategy, have accelerated and embedded developments. Antimicrobial pharmacists have been instrumental in effecting changes at an organizational and national level. This article describes the evolution of the antimicrobial pharmacist role, its impact, the progress toward the actions listed in the five-year resistance strategy, and novel emerging areas in stewardship in the UK.

  17. Case Study: Hidden Complexity of Medicines Use: Information Provided by a Person with Intellectual Disability and Diabetes to a Pharmacist (United States)

    Flood, Bernadette; Henman, Martin C.


    People with intellectual disabilities may be "invisible" to pharmacists. They are a complex group of patients many of whom have diabetes. Pharmacists may have little experience of the challenges faced by this high risk group of patients who may be prescribed high risk medications. This case report details information supplied by Pat, a…

  18. Impact of pharmacist recommendations on the cost of drug therapy in ICU patients at a Malaysian hospital

    NARCIS (Netherlands)

    Zaidi, S.T.R.; Hassan, Y.; Postma, Maarten; Hain Ng, S.


    Objectives: To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions. Methods: A clinical pharmacist reviewed drug prescriptions during one month. Drug-related problems were documented

  19. The use of opioids at the end of life: knowledge level of pharmacists and cooperation with physicians

    NARCIS (Netherlands)

    Borgsteede, S.D.; Rhodius, C.A.; Smet, P.A. de; Pasman, H.R.; Onwuteaka-Philipsen, B.D.; Rurup, M.L.


    PURPOSE: What is the level of knowledge of pharmacists concerning pain management and the use of opioids at the end of life, and how do they cooperate with physicians? METHODS: A written questionnaire was sent to a sample of community and hospital pharmacists in the Netherlands. The questionnaire wa

  20. Improving the working relationship between doctors and pharmacists: is inter-professional education the answer?

    LENUS (Irish Health Repository)

    Gallagher, Ruth M


    Despite their common history, there are many cultural, attitudinal and practical differences between the professions of medicine and pharmacy that ultimately influence patient care and health outcomes. While poor communication between doctors and pharmacists is a major cause of medical errors, it is clear that effective, deliberate doctor-pharmacist collaboration within certain clinical settings significantly improves patient care. This may be particularly true for those patients with chronic illnesses and\\/or requiring regular medication reviews. Moreover, in hospitals, clinical and antibiotic pharmacists are successfully influencing prescribing and infection control policy. Under the new Irish Pharmacy Act (2007), pharmacists are legally obliged to provide pharmaceutical care to their patients, thus fulfilling a more patient-centred role than their traditional \\'dispensing\\' one. However, meeting this obligation relies on the existence of good doctor-pharmacist working relationships, such that inter-disciplinary teamwork in monitoring patients becomes the norm in all healthcare settings. As discussed here, efforts to improve these relationships must focus on the strategic introduction of agreed changes in working practices between the two professions and on educational aspects of pharmaceutical care. For example, standardized education of doctors\\/medical students such that they learn to prescribe in an optimal manner and ongoing inter-professional education of doctors and pharmacists in therapeutics, are likely to be of paramount importance. Here, insights into the types of factors that help or hinder the improvement of these working relationships and the importance of education and agreed working practices in defining the separate but inter-dependent professions of pharmacy and medicine are reviewed and discussed.

  1. Knowledge of folic acid and counseling practices among Ohio community pharmacists

    Directory of Open Access Journals (Sweden)

    Rodrigues CR


    Full Text Available Objective: To determine knowledge of folic acid use for neural tube defect (NTD prevention and counseling practices among community pharmacists registered in Ohio.Methods: A cross-sectional study was performed on a random sample (n=500 of community pharmacists registered with the Ohio Board of Pharmacy and practicing in Ohio. A survey previously used by researchers to assess folic acid knowledge and practices among samples of other healthcare provider groups in the United States was adapted with permission for this study. The final tool consisted of 28 questions evaluating the knowledge, counseling practices, and demographics of respondents. The cover letter did not reveal the emphasis on folic acid, and surveys were completed anonymously. The university institutional review board deemed the study exempt.Results: Of the 122 pharmacists who completed the survey, 116 (95.1% knew that folic acid prevents some birth defects. Twenty-eight (22.9% responded that they “always” or “usually” discuss multivitamins with women of childbearing potential, and 19 (15.6% responded that they “always” or “usually” discuss folic acid supplements. Some gaps in knowledge specific to folic acid were revealed. While 63.1% of pharmacists selected the recommended dose of folic acid intake for most women of childbearing potential, 13.1% could identify the dose recommended for women who have had a previous NTD-affected pregnancy. Respondents identified continuing education programs, pharmacy journals/magazines, and the Internet as preferred avenues to obtain additional information about folic acid and NTD.Conclusion: This study represents the first systematic evaluation of folic acid knowledge and counseling practices among a sample of pharmacists in the United States. As highly accessible healthcare professionals, community pharmacists can fulfill a vital public health role by counseling women of childbearing potential about folic acid intake. Educational

  2. Net Income of Pharmacy Faculty Compared to Community and Hospital Pharmacists (United States)

    Gatwood, Justin; Spivey, Christina A.; Dickey, Susan E.


    Objective. To compare the net cumulative income of community pharmacists, hospital pharmacists, and full-time pharmacy faculty members (residency-trained or with a PhD after obtaining a PharmD) in pharmacy practice, medicinal chemistry, pharmaceutics, pharmacology, and social and administrative sciences. Methods. Markov modeling was conducted to calculate net projected cumulative earnings of career paths by estimating the costs of education, including the costs of obtaining degrees and student loans. Results. The economic model spanned 49 years, from ages 18 to 67 years. Earning a PharmD and pursuing an academic career resulted in projected net cumulative lifetime earnings ranging from approximately $4.7 million to $6.3 million. A pharmacy practice faculty position following public pharmacy school and one year of residency resulted in higher net cumulative income than community pharmacy. Faculty members with postgraduate year 1 (PGY1) training also had higher net income than other faculty and hospital pharmacy career paths, given similar years of prepharmacy education and type of pharmacy school attended. Faculty members with either a PharmD or PhD in the pharmacology discipline may net as much as $5.9 million and outpace all other PhD graduates by at least $75 000 in lifetime earnings. Projected career earnings of postgraduate year 2 (PGY2) trained faculty and PharmD/PhD faculty members were lower than those of community pharmacists. Findings were more variable when comparing pharmacy faculty members and hospital pharmacists. Conclusion. With the exception of PGY1 trained academic pharmacists, faculty projected net cumulative incomes generally lagged behind community pharmacists, likely because of delayed entry into the job market as a result of advanced training/education. However, nonsalary benefits such as greater flexibility and autonomy may enhance the desirability of academic pharmacy as a career path. PMID:27756925

  3. Detection and management of medication errors in internal wards of a teaching hospital by clinical pharmacists.

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinazari


    Full Text Available Any suboptimum treatment in the management of patients can lead to medication errors (MEs that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each. Wrong frequency 71 (27%, forget to order 37 (14.1%, wrong selection 33 (12.5%, drug interactions 26 (9.9%, forget to discontinue 25 (9.5% and inappropriate dose adjustment in renal impairment 25 (9.5% were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6% followed by gastrointestinal agents (15.6%. Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists.

  4. Net Income of Pharmacy Faculty Compared to Community and Hospital Pharmacists. (United States)

    Chisholm-Burns, Marie A; Gatwood, Justin; Spivey, Christina A; Dickey, Susan E


    Objective. To compare the net cumulative income of community pharmacists, hospital pharmacists, and full-time pharmacy faculty members (residency-trained or with a PhD after obtaining a PharmD) in pharmacy practice, medicinal chemistry, pharmaceutics, pharmacology, and social and administrative sciences. Methods. Markov modeling was conducted to calculate net projected cumulative earnings of career paths by estimating the costs of education, including the costs of obtaining degrees and student loans. Results. The economic model spanned 49 years, from ages 18 to 67 years. Earning a PharmD and pursuing an academic career resulted in projected net cumulative lifetime earnings ranging from approximately $4.7 million to $6.3 million. A pharmacy practice faculty position following public pharmacy school and one year of residency resulted in higher net cumulative income than community pharmacy. Faculty members with postgraduate year 1 (PGY1) training also had higher net income than other faculty and hospital pharmacy career paths, given similar years of prepharmacy education and type of pharmacy school attended. Faculty members with either a PharmD or PhD in the pharmacology discipline may net as much as $5.9 million and outpace all other PhD graduates by at least $75 000 in lifetime earnings. Projected career earnings of postgraduate year 2 (PGY2) trained faculty and PharmD/PhD faculty members were lower than those of community pharmacists. Findings were more variable when comparing pharmacy faculty members and hospital pharmacists. Conclusion. With the exception of PGY1 trained academic pharmacists, faculty projected net cumulative incomes generally lagged behind community pharmacists, likely because of delayed entry into the job market as a result of advanced training/education. However, nonsalary benefits such as greater flexibility and autonomy may enhance the desirability of academic pharmacy as a career path.

  5. Medication reviews led by community pharmacists in Switzerland: a qualitative survey to evaluate barriers and facilitators

    Directory of Open Access Journals (Sweden)

    Niquille A


    Full Text Available Objective: 1 To evaluate the participation rate and identify the practical barriers to implementing a community pharmacist-led medication review service in francophone Switzerland and, 2 To assess the effectiveness of external support.Methods: A qualitative survey was undertaken to identify barriers to patient inclusion and medication review delivery in daily practice among all contactable independent pharmacists working in francophone Switzerland (n=78 who were members of a virtual chain (pharmacieplus, regardless of their participation in a simultaneous cross-sectional study. This study analyzed the dissemination of a medication review service including a prescription and drug utilization review with access to clinical data, a patient interview and a pharmaceutical report to the physicians. In addition, we observed an exploratory and external coaching for pharmacists that we launched seven months after the beginning of the cross-sectional study. Results: Poor motivation on the part of pharmacists and difficulties communicating with physicians and patients were the primary obstacles identified. Lack of time and lack of self-confidence in administering the medication review process were the most commonly perceived practical barriers to the implementation of the new service. The main facilitators to overcome these issues may be well-planned workflow organization techniques, strengthened by an adequate remuneration scheme and a comprehensive and practice-based training course that includes skill-building in pharmacotherapy and communication. External support may partially compensate for a weak organizational framework.Conclusions: To facilitate the implementation of a medication review service, a strong local networking with physicians, an effective workflow management and a practice- and communications-focused training for pharmacists and their teams seem key elements required. External support can be useful to help some pharmacists improve their

  6. Prescribers and pharmacists requests for prescription monitoring program (PMP) data: does PMP structure matter? (United States)

    Fleming, Marc L; Chandwani, Hitesh; Barner, Jamie C; Weber, Stephanie N; Okoro, Tony T


    Prescription monitoring programs (PMPs) have been purported to be an effective tool to combat prescription drug abuse. However, utilization rates of PMP data by health care providers (e.g., prescribers and pharmacists) is relatively low. The objectives of the study were to describe (1) PMP utilization (e.g., requested reports) by prescribers, pharmacists, and law enforcement for active state PMPs; (2) PMP utilization by health care providers with and without online access; (3) average annual operational costs for PMPs from 2008 to 2009; and (4) PMP requests based on PMP housing authority (law enforcement vs. non-law enforcement [e.g., board of pharmacy]). This was a cross-sectional study employing a Web-based survey. A 16-item questionnaire was e-mailed to the 33 operational state PMP administrators and responses were collected from January to March 2011. Descriptive statistics were used to describe PMP request rates and annual operating costs. The usable survey response rate was 45.5%. Among all authorized users, prescribers had higher mean (±SD) requests per 100,000 population (2198.2 ± 3218.0) compared with pharmacists' requests (268.9 ± 261.2). Online accessibility resulted in higher request rates per 100,000 population (2996.4 ± 3021.5) compared with mail/fax access (14.6 ± 2.8). On average, PMP annual costs were $12,515 ± $14,911 per 100,000 population. In law enforcement-governed PMPs, health care provider utilization was lower compared with PMPs under health or pharmacy boards. Prescriber request rates were higher than pharmacists and online access for providers (e.g., prescribers and pharmacists) resulted in higher request rates per 100,000 population. More research is needed to determine other factors that may be associated with PMP utilization by prescribers and pharmacists.

  7. Sadness, suicide, and bullying in Arkansas: results from the Youth Risk Behavior Survey -- 2011. (United States)

    Kindrick, Kristi; Castro, Juan; Messias, Erick


    Bullying is a common exposure in high school and more recently cyberbullying has become prevalent among teens. We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of school bullying and cyberbullying and to measure its association with teen suicidality. In Arkansas, 11.6% of students reported only school bullying, 6.2% only cyberbullying, and 10.2% both forms of bullying. We determined "feeling unsafe at school" was a significant risk factor for depression and all suicide questions. We also found that being a victim of school bullying, cyberbullying, or both, increased the risk for depression, suicidal ideation, and plan.

  8. Comparing the 2000 and 2005 factors affecting the selling price of feeder cattle sold at Arkansas livestock auctions. (United States)

    Troxel, T R; Barham, B L


    The objectives of the study were to determine how factors affecting the selling price of feeder calves changed from 2000 to 2005 and to examine the perception that discounts narrow or even disappear as calf supplies decrease and selling prices increase. Data from weekly Arkansas livestock auctions were collected from January 1 to December 31 in 2000 and 2005. Data included calf sex, breed type, color, muscle score, horn status, frame score, fill, condition, health, and BW. Mean selling prices for 2000 and 2005 were $92.91 +/- 15.05 and $118.32 +/- 15.13 (mean +/- SD; $/45.45 kg), respectively. Individual price observations were subtracted from the respective annual means and became the dependent variable. The selling prices for feeder calves sold in groups of 2 to 5 calves and in groups of >/= 6 calves were greater in 2005 than 2000 (P x Hereford, Angus, Angus x Charolais, and Brahman (P Brahman Cross, Charolais, Charolais x Limousin, Hereford x Limousin, Limousin, Limousin x one-fourth Brahman, Longhorn, Saler and Simmental. Yellow-white face, black-white face, black, and gray feeder calves received an increase in selling price from 2000 to 2005 (P < 0.001). Although fewer horned feeder calves were sold in 2005 (P < 0.01), they received greater discounts in 2005 than 2000 (-$2.86 +/- 0.16 and -$0.51 +/- 0.09; P < 0.001). In 2005, large-framed feeder calves did not receive the premium detected in 2000, but medium-framed feeder calves in 2005 received a greater selling price compared with 2000. Feeder calves with a muscle score of 1 received a greater premium in 2005 compared with 2000 ($2.58 +/- 0.06 and $0.02 +/- 0.09, respectively; P < 0.001). Feeder calves with a muscle score of 2 were discounted in both years, but the discount in 2005 was not as great as in 2000 (P < 0.001). Full and tanked feeder calves received greater discounts in 2005 than in 2000 (P < 0.001). Discounts for fleshy and fat feeder calves were greater in 2005 than in 2000. Most factors

  9. Detecting pre-diabetes and the role of the pharmacist

    Directory of Open Access Journals (Sweden)

    Simoens S


    Full Text Available Objective: This study aims to use a pharmacoepidemiological approach to study the drug use of patients during the year prior to diabetes diagnosis (i.e. pre-diabetic patients and control patients. Drug use might reveal cardiovascular, metabolic and/or endocrinological changes and help to identify indicators for active monitoring of Type 2 diabetes mellitus.Methods: A retrospective case-control study compared drug use of patients with a future diagnosis of diabetes (experimental patients with patients without a diabetes diagnosis (control patients based on community pharmacy records. An experimental patient had used oral hypoglycaemic drugs during 2005 or 2006. Experimental and control patients were matched in terms of age, gender and quarter of index date. Drugs were selected based on possible co-morbidities of diabetes. Drug use was expressed as a binary variable, indicating whether or not a patient took specific drugs. Drug use was compared between experimental patients during the year prior to diagnosis and control patients using the chi-squared test.Results: Our dataset covered 5,064 patients (1,688 experimental and 3,376 control patients. A higher probability of taking cardiovascular drugs was observed for specific subgroups of patients with pre-diabetes as compared to control patients: this trend was observed for men as well as for women, for various cardiovascular drug classes, and for different age groups (p<0.05, although it was not always statistically significant for the 29-38 age group. For each selected age and gender group, patients with pre-diabetes had a higher probability of taking a combination of a lipid-modifying agent and an antihypertensive drug than control patients (p<0.005.Conclusions: Using community pharmacy data, this study demonstrated that age and a characteristic drug use pattern could contribute to detecting pre-diabetes. There is a potential role for community pharmacists to follow up drug indicators of patients

  10. Pharmaceutical interventions by collaboration between staff pharmacists and clinical pharmacists and implementation of Joint Commission International Accreditation Standards on medication use may optimize pharmacotherapy in geriatric patients

    Directory of Open Access Journals (Sweden)

    Chen M


    Full Text Available Meng Chen, Quan Zhou Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaWe read with great interest the prospective study by Cortejoso et al,1 which describes the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit of a general teaching hospital. We strongly agree with their finding that shows the importance of clinical pharmacist involvement in the optimization of pharmacotherapy in elderly patients. Furthermore, we especially appreciate their new and interesting findings that the clinical pharmacist was more frequently requested by physicians and nurses for information about the pharmacotherapy of the patients on the geriatric day unit, compared with the orthogeriatric ward at admission and discharge (5.7% vs 1.2% and 1.7%, respectively, P<0.05, and that the pharmacist asked for more confirmation of the physician orders on the geriatric day unit rather than the orthogeriatric ward (19.8% vs 1.8% and 15.7% at admission and discharge, respectively, P<0.05. We are from a Joint Commission International (JCI-accredited academic medical center hospital with 3200 beds in China. Safe medication management and use are pivotal to patient safety and quality of care on which the state-of-the-art standards of the Joint Commission focus. We would like to share our perspectives in the following paragraphs.View original paper by Cortejoso and colleagues. 

  11. Geologic map of the Murray Quadrangle, Newton County, Arkansas (United States)

    Hudson, Mark R.; Turner, Kenzie J.


    This map summarizes the geology of the Murray quadrangle in the Ozark Plateaus region of northern Arkansas. Geologically, the area is on the southern flank of the Ozark dome, an uplift that has the oldest rocks exposed at its center, in Missouri. Physiographically, the Murray quadrangle is within the Boston Mountains, a high plateau region underlain by Pennsylvanian sandstones and shales. Valleys of the Buffalo River and Little Buffalo River and their tributaries expose an approximately 1,600-ft-thick (488-meter-thick) sequence of Ordovician, Mississippian, and Pennsylvanian carbonate and clastic sedimentary rocks that have been mildly deformed by a series of faults and folds. The Buffalo National River, a park that encompasses the Buffalo River and adjacent land that is administered by the National Park Service is present at the northwestern edge of the quadrangle.Mapping for this study was carried out by field inspection of numerous sites and was compiled as a 1:24,000 geographic information system (GIS) database. Locations and elevation of sites were determined with the aid of a global positioning satellite receiver and a hand-held barometric altimeter that was frequently recalibrated at points of known elevation. Hill-shade relief and slope maps derived from a U.S. Geological Survey 10-meter digital elevation model as well as orthophotographs were used to help trace ledge-forming units between field traverses within the Upper Mississippian and Pennsylvanian part of the stratigraphic sequence. Strike and dip of beds were typically measured along stream drainages or at well-exposed ledges. Structure contours, constructed on the top of the Boone Formation and the base of a prominent sandstone unit within the Bloyd Formation, were drawn based on the elevations of field sites on these contacts well as other limiting information for their minimum elevations above hilltops or their maximum elevations below valley bottoms.

  12. Impact of Participation on a Solid Organ Transplant Team on Student Pharmacists’ Perceptions of Interprofessional Roles (United States)

    Bray, Brenda S.; Woodard, Lisa J.; Barbosa-Leiker, Celestina; Hardinger, Karen L.; Wu, Vivian; Hayney, Mary S.


    Objective. To examine student pharmacists’ perceptions of interprofessional roles before and after completing an advanced pharmacy practice experience on solid organ transplantation. Methods. Student pharmacists across the United States participating in an APPE on a solid organ transplant team completed an online pre- and post-APPE survey instrument examining perceptions of interprofessional roles, communication, and teamwork. Results. Student pharmacists’ scores on interprofessionalism increased significantly on 17 of 22 items. Positive changes were seen in the interprofessional education core competency areas of roles and responsibilities, interprofessional communication, and teams and teamwork. Conclusion. Student pharmacist participation in interprofessional clinical APPEs can positively influence their professional development as they prepare to become members of multi-disciplinary teams in the healthcare workforce. PMID:23716742

  13. [The pendulum and the mortar. Some pharmacist deviners and particularly Gabriel Lesourd]. (United States)

    Lefebvre, Thierry


    At the beginning of the 1930s, many French doctors and pharmacists practised dowsing. Some adhered to the 'Association des amis de la radiesthésie'. It was in particular the case of Gabriel Lesourd (1890-1976), owner of the famous "Tisane du Curé de Deuil".

  14. Factors associated with provision of addiction treatment information by community pharmacists. (United States)

    Hagemeier, Nicholas E; Alamian, Arsham; Murawski, Matthew M; Pack, Robert P


    Community pharmacists in the United States have significant opportunity to engage in community-level prescription substance abuse prevention and treatment efforts, including dissemination of information specific to available addiction treatment options. Our cross-sectional study of Tennessee community pharmacists noted that 26% had previously provided addiction treatment facility information to one or more patients in the past. The purpose of this study was to employ multivariate modeling techniques to investigate associations between community pharmacist and community pharmacy factors and past provision of addiction treatment information to pharmacy patients. Multivariate logistic regression indicated having addiction treatment facility information in a pharmacy setting (aOR=8.19; 95% CI=4.36-15.37), having high confidence in ability to discuss treatment facility options (aOR=4.16; 95% CI=2.65-6.52), having participated in prescription opioid abuse-specific continuing education (aOR=2.90; 95% CI=1.70-4.97), being male (aOR=2.23; 95% CI=1.38-3.59), and increased hours per week in the practice setting (aOR=1.02; 95% CI=1.004-1.05) were all significantly associated with provision of information about addiction treatment. Dissemination of addiction treatment information, improvements in communicative self-efficacy beliefs, and dissemination of prescription opioid abuse-specific continuing education are modifiable factors significantly associated with increased provision of addiction treatment information by community pharmacists.

  15. [Role of pharmacists during serious natural disasters: report from Ishinomaki, the disaster-struck city]. (United States)

    Tanno, Yoshiro


    On August 31, 2011, five months after the Great East Japan Earthquake, Miyagi prefecture reported 9357 dead and 2288 missing citizens, whereas Ishinomaki reported 4753 dead and 1302 missing citizens. A total of 12 pharmacists in Miyagi prefecture had lost their lives. Many medical institutions at the time were rendered out of service due to damage. Ishinomaki Red Cross had to serve as headquarters of disaster medicine management for the area. The government of Miyagi and Miyagi Pharmacist Association signed a contract regarding the provision of medical and/or other related tasks. Nevertheless, the contract was not fully applied given the impact of the tsunami, which caused chaos in telecommunication, traffic, and even the functions of the government. Given the nature of the disaster, medical teams equipped only with emergency equipment could not offer appropriate response to the needs of patients with chronicle diseases. "Personal medicine logbook" and pharmacists were keys to relief works during the disaster. Pharmacists played a critical role not only for self-medication by distributing over the counter (OTC) drugs, but also in hygiene management of the shelter. Apart from the establishment of an adoptive management system for large-scale natural disasters, a coordinated system for disaster medical assistance team (DMAT), Japanese Red Cross (JRC), Self-Defense Force (SDF), and other relief work organizations was imperative.

  16. [A pharmacist designer and manufacturer of veterinarian patent medicines, Paul Méré, de Chantilly]. (United States)

    Devaux, Guy


    In the last quarter of the 19th century, Paul Méré, pharmacist in Chantilly (Oise), worked out and marketed a range of veterinarian medicines mainly intended for horses. He pursued his activity in Orleans (Loiret), giving her a big extension with export of his patents medicines in numerous foreign countries, this company having remained up to the Second World War.

  17. Isoniazid Completion Rates for Latent Tuberculosis Infection among College Students Managed by a Community Pharmacist (United States)

    Hess, Karl; Goad, Jeffery; Wu, Joanne; Johnson, Kathleen


    Objective: The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacist-managed LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants: Participants were university students diagnosed with…

  18. Pharmacists remuneration models in iran and selected countries: a comparative study. (United States)

    Hashemi-Meshkini, Amir; Keshavarz, Khosro; Nikfar, Shekoufeh; Vazirian, Iman; Kebriaeezadeh, Abbas


    Pharmacists are members of the healthcare teams that provide valuable services to society. Their incentive to deliver such services is influenced by remuneration methods. In this study, we aimed to review the remuneration models for pharmacists' services and the factors affecting the profitability of pharmacies in some selected countries, including France, Ireland, Canada and Turkey, and compared them to Iran. International data were collected by literature review on Google, Google scholar, PubMed and Scopus. In addition, domestic data were collected by contacting relevant organizations. There is no payment for pharmacists' cognitive services in Iran and in the countries investigated, except for some Canadian provinces. The dispensing fee system in Iran does not seem to be adequate, especially considering that most of the insurers do not cover these fees. The pricing method in Iran has resulted in a low price level, in comparison to the other countries, and this issue has dramatically affected the profitability of pharmacies in standard practice. It could be concluded that changing the current formulation for the dispensing fee to a more appropriate one, defining a remuneration system for non-owner pharmacists other than salary and implementing the new pricing method are necessary in order to improve the services provided by pharmacies.

  19. Bridging the gap between hospital and primary care : the pharmacist home visit

    NARCIS (Netherlands)

    Ensing, Hendrik T; Koster, Ellen S; Stuijt, Clementine C M; van Dooren, Ad A; Bouvy, Marcel L


    Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied,

  20. Improving the Working Relationship between Doctors and Pharmacists: Is Inter-Professional Education the Answer? (United States)

    Gallagher, Ruth M.; Gallagher, Helen C.


    Despite their common history, there are many cultural, attitudinal and practical differences between the professions of medicine and pharmacy that ultimately influence patient care and health outcomes. While poor communication between doctors and pharmacists is a major cause of medical errors, it is clear that effective, deliberate…

  1. [Marie-Victor Ernest Baudrimont, a famous pharmacist from Compiègne, France]. (United States)

    Bonté, Frédéric


    Ernest Baudrimont is a pharmacist born in Compiègne in 1821. He is the nephew of the pharmacist chemist Alexandre Baudrimont and is from a family of Compiègne pharmacists. First prize and gold medal in 1846 of the School of Pharmacy in Paris, he obtained in 1852 his Ph D in pharmacy for a dissertation on the formation and composition of mineral waters, and in 1864 is Ph D of physical sciences for a dissertation on the chlorides and bromides of phosphorus. Hospitals Chief Pharmacist in 1854, he had his first position at the Sainte Eugénie children's Hospital, today Trousseau hospital in Paris, position he held until 1875 prior to his appointment as Director of the Paris Civilian Hospitals central Pharmacy. Member of the french Botanical Society, the Society of Medical Hydrology, secretary of the Society of Pharmacy, he was also associate professor of Pharmacy at the School of Pharmacy of Paris. His scientific publications focus on the mineral chemistry i.e he described the nature of white phosphorus; mineral waters and some plants chemistry. One of the major contributions of Ernest Baudrimont was his involvment to the successive editions of the dictionary of the alterations and falsifications of foodstuffs of A. Chevallier. Member of the french Academy of Medicine in 1881, he died in Paris in September 1885.

  2. Preventing drug-related adverse events following hospital discharge: the role of the pharmacist

    Directory of Open Access Journals (Sweden)

    Nicholls J


    Full Text Available Justine Nicholls,1 Craig MacKenzie,1 Rhiannon Braund2 1Dunedin Hospital Pharmacy, 2School of Pharmacy, University of Otago, Dunedin, New Zealand Abstract: Transition of care (ToC points, and in particular hospital admission and discharge, can be associated with an increased risk of adverse drug events (ADEs and other drug-related problems (DRPs. The growing recognition of the pharmacist as an expert in medication management, patient education and communication makes them well placed to intervene. There is evidence to indicate that the inclusion of pharmacists in the health care team at ToC points reduces ADEs and DRPs and improves patient outcomes. The objectives of this paper are to outline the following using current literature: 1 the increased risk of medication-related problems at ToC points; 2 to highlight some strategies that have been successful in reducing these problems; and 3 to illustrate how the role of the pharmacist across all facets of care can contribute to the reduction of ADEs, particularly for patients at ToC points. Keywords: pharmacist, adverse drug events, drug-related problems, transitions of care, hospital discharge

  3. Empowered diabetes management: life coaching and pharmacist counseling for employed adults with diabetes. (United States)

    Nishita, Christy; Cardazone, Gina; Uehara, Denise Lea; Tom, Tammy


    The Hawai'i Demonstration to Maintain Independence and Employment was a randomized controlled trial examining the effect of a participant-driven, multicomponent intervention on 190 employed adults with diabetes, 36% of whom were Asian and 35% of whom were Native Hawaiian or Pacific Islander. A no treatment concurrent control group was used, and the treatment group was provided an intervention that paired each participant with a life coach and a pharmacist counselor with whom they worked to achieve collaboratively chosen goals. Treatment fidelity data suggest that the intervention was largely implemented as planned. Life coaches and pharmacists performed key program functions with high to moderate adherence. The quality of their adherence to the intervention model ranged from basic to above basic and below basic to above basic for life coaches and pharmacists, respectively. Results of repeated-measures analysis of covariance analyses indicate that the intervention had a significant positive effect on participants' diabetes self-efficacy, quality of life, and body mass index but not on hemoglobin A1c levels. Further analyses examining just the treatment group indicate a dosage effect, with body mass index and quality of life outcomes optimized among participants who engaged in a greater number of sessions with life coaches and pharmacists. Implications of the study findings for practice are discussed.

  4. Are pharmacists reducing COPD'S impact through smoking cessation and assessing inhaled steroid use?

    DEFF Research Database (Denmark)

    Verma, Arpana; Harrison, Annie; Torun, Perihan;


    The National Institute for Health and Clinical Excellence (NICE) COPD 2004 guidelines recommend: * COPD patients who smoke should be encouraged to stop at every opportunity; * Inhaled corticosteroid should be used only among patients with moderate to severe COPD; * Pharmacists should identify smo...

  5. Drug-related problems identified in medication reviews by Australian pharmacists

    DEFF Research Database (Denmark)

    Stafford, Andrew C; Tenni, Peter C; Peterson, Gregory M


    OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to exam......OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study...... was to examine the number and nature of the drug-related problems identified and investigate differences between each type of review. SETTING: Australian patients living at home or in residential care-facilities. METHOD: We collected a nation-wide sample of medication reviews conducted between 1998 and 2005....... These reviews had been self-selected by pharmacists and submitted as part of the reaccreditation process to the primary body responsible for accrediting Australian pharmacists to perform medication reviews. The drug-related problems identified in each review were classified by type and drugs involved. MAIN...

  6. The Relationship between Physical Fitness and Academic Achievement in Ninth-Grade Students in Arkansas (United States)

    Hanna, Shellie Lyne


    Purpose, scope, and method of study. The purpose of this study was to determine if and to what degree a relationship existed between physical fitness and the academic achievement of ninth-grade public school students in Arkansas. A sample of 152 students from four different schools participated in the study. The dependent variable was academic…

  7. Dry matter partitioning and quality of Miscanthus, Panicum, and Saccharum genotypes in Arkansas, USA. (United States)

    The partitioning and quality of aboveground biomass have important ramifications for crop management and biomass conversion. In preliminary studies, small samples of Saccharum sp. x Miscanthus sp. hybrids exhibited stubble cold tolerance in west-central Arkansas, unlike Saccharum sp. x S. spontaneum...

  8. Sadness, suicide, and sexual behavior in Arkansas: results from the youth risk behavior survey 2011. (United States)

    Kindrick, Clint; Gathright, Molly; Cisler, Josh M; Messias, Erick


    We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of risky sexual behavior and sexual assault and to measure its association with teen suicidality. In Arkansas, 50.3% of students reported ever having sexual intercourse, 26% onset at 14 or younger, 36 % having had more than one partner, and 10.2% having been physically forced to have sex. "Being forced to have sex" was a risk factor for depression and all components of the suicide continuum. Additionally, early onset of sexual activity and having more than one partner increased the risk for depression, suicidal ideation, plan, and attempt. Suicide is a grievous and preventable tragedy, sadly standing among the leading causes of death for teens.' In this series, we examine risk factors for suicidality among Arkansas high school students; in this installment, we examine sexual behavior. A previous study utilizing the Rhode Island Youth Risk Behavior Survey (YRBS) found an association between having forced sexual intercourse and suicide. Furthermore, an association between psychiatric disorders and risky sexual behaviors, including both early onset and number of partners was found in a birth cohort study revealed. We hypothesize that Arkansas' teens reporting risky sexual behavior and sexual assault are at higher risk of depression and suicidality as well.

  9. Implications of Teacher Motivation and Renewal Indicators in Arkansas toward Professional Growth and Achievement (United States)

    Whitten, Lary D.


    This qualitative study was designed to determine if the teaching population in the state of Arkansas had a more favorable attitude toward specific motivational theories and practices; and to determine if that attitude significantly affected the teacher retention rate and the quality of work produced. The literature reviewed included the role of…

  10. Characterizing irrigation water requirements for rice production from the Arkansas Rice Research Verification Program (United States)

    This study investigated rice irrigation water use in the University of Arkansas Rice Research Verification Program between the years of 2003 and 2011. Irrigation water use averaged 747 mm (29.4 inches) over the nine years. A significant 40% water savings was reported for rice grown under a zero gr...

  11. Utilizing Professional Learning Community Concepts and Social Networking for State Advocacy: The Arkansas Case (United States)

    Albritton, Shelly; Chadwick, Mona; Bangs, David; Holt, Carleton; Longing, Jeff; Duyar, Ibrihim


    This article provides an overview of National Council of Professors of Educational Administration (NCPEA) state affiliate, Arkansas Professors of Educational Administration's (ARPEA), activities, accomplishments, and advocacy efforts. Faced with numerous changes being implemented in education in the state, it became imperative for ARPEA's…

  12. Arkansas Public Higher Education Personal Services Recommendations, 2011-2013 Biennium. 7-B (United States)

    Arkansas Department of Higher Education, 2010


    This publication lists "non-classified" personal services recommendations of the Arkansas Higher Education Coordinating Board, and "classified" positions recommended by the Office of Personnel Management, Department of Finance and Administration for public institutions of higher education for the 2011-13 biennium. The Office of…

  13. Arkansas Public Higher Education Personal Services Recommendations: Fiscal Year 2010-2011 (United States)

    Arkansas Department of Higher Education, 2010


    This publication lists non-classified personal services recommendations of the Arkansas Higher Education Coordinating Board for the Fiscal Year 2010-11. Due to the implementation of the pay plan study, the Office of Personnel Management of the Department of Finance and Administration (OPM) did not make recommendations for classified positions.…

  14. 76 FR 76971 - Cross-Media Electronic Reporting: Authorized Program Revision Approval, State of Arkansas (United States)


    ... its 40 CFR Part 272--Approved State Hazardous Waste Management EPA-authorized program for electronic reporting of annual hazardous waste information submitted under 40 CFR parts 262, 264, and 265 is being... Arkansas Department of Environmental Quality (AR DEQ) submitted an application for its Hazardous...

  15. What Factors Relate to Student Performance in Arkansas College Gateway Courses? (United States)

    Jenkins, Rick; Butler, Sharon


    In higher education in the state of Arkansas, two courses are considered to be gateway courses to obtaining a college degree--College Algebra and English Composition I. While students may obtain Certificates of Proficiency and Technical Certificates without taking these courses, few, if any, can earn an Associate's or Bachelor's degree without…

  16. Ready to Lead? A Study of Arkansas and Louisiana Charter School Principals' Leadership Skills (United States)

    Price, Creshun Anjal


    The purpose of this study was to explore the relationship of Arkansas and Louisiana district conversion and open-enrollment charter school principals' background characteristics, leadership skills, and school success. A quantitative methodology was used to test the research questions prescribed in the study. Data was collected using a survey. The…

  17. Field evaluation of four spatial repellent devices against Arkansas rice-land mosquitoes (United States)

    Four commercially available spatial repellent devices were tested in a rice land habitat near Stuttgart, Arkansas after semi-field level assessments had been made at the Center for Medical, Agricultural, and Veterinary Entomology, ARS, USDA in Gainesville, FL. OFF! Clip-On® (a.i. metofluthrin, S.C....

  18. Impact of Spina Bifida on Parental Caregivers: Findings from a Survey of Arkansas Families (United States)

    Grosse, Scott D.; Flores, Alina L.; Ouyang, Lijing; Robbins, James M.; Tilford, John M.


    The well-being of caregivers of children with spina bifida and other conditions is an important topic. We interviewed the primary caregivers of 98 children aged 0-17 years with spina bifida sampled from a population-based birth defects registry in Arkansas and the caregivers of 49 unaffected children. Measures of caregiver well-being were compared…

  19. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    Directory of Open Access Journals (Sweden)

    Somers A


    Full Text Available Annemie Somers,1 Hugo Robays,1 Peter De Paepe,2 Georges Van Maele,3 Katrina Perehudoff,4 Mirko Petrovic41Department of Pharmacy, Ghent University Hospital, Ghent, Belgium; 2Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium; 3Department of Medical Statistics, Ghent University Hospital, Ghent, Belgium; 4Department of Geriatrics, Ghent University Hospital, Ghent, BelgiumObjective: To evaluate the type, acceptance rate, and clinical relevance of clinical pharmacist recommendations at the geriatric ward of the Ghent university hospital.Methods: The clinical pharmacist evaluated drug use during a weekly 2-hour visit for a period of 4 months and, if needed, made recommendations to the prescribing physician. The recommendations were classified according to type, acceptance by the physician, prescribed medication, and underlying drug-related problem. Appropriateness of prescribing was assessed using the Medication Appropriateness Index (MAI before and after the recommendations were made. Two clinical pharmacologists and two clinical pharmacists independently and retrospectively evaluated the clinical relevance of the recommendations and rated their own acceptance of them.Results: The clinical pharmacist recommended 304 drug therapy changes for 100 patients taking a total of 1137 drugs. The most common underlying drug-related problems concerned incorrect dose, drug–drug interaction, and adverse drug reaction, which appeared most frequently for cardiovascular drugs, drugs for the central nervous system, and drugs for the gastrointestinal tract. The most common type of recommendation concerned adapting the dose, and stopping or changing a drug. In total, 59.7% of the recommendations were accepted by the treating physician. The acceptance rate by the evaluators ranged between 92.4% and 97.0%. The mean clinical relevance of the recommendations was assessed as possibly important (53.4%, possibly low relevance (38.1%, and possibly

  20. Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Awad Abdelmoneim


    Full Text Available Abstract Background Obesity is a growing health concern in Kuwait. Obesity has been identified as a key risk factor for many chronic diseases including hypertension, dyslipidemia and type 2 diabetes mellitus. It has been shown that community pharmacists' involvement is associated with successful weight management in developed countries. This study was conducted to investigate the role of community pharmacists in obesity counseling, and to identify the barriers to counseling in Kuwait. Methods A descriptive cross-sectional study involved 220 community pharmacies that were selected via stratified and systematic random sampling. A pretested self-administered questionnaire collected information on frequency and comfort level with obesity counseling, and the perceived effectiveness of four aspects of obesity management (diet and exercise, prescribed antiobesity medications, diet foods, and nonprescription products and dietary supplements. Information on perceived confidence in achieving positive outcomes as a result of counseling and barriers to counseling was also collected. Descriptive and Spearman’ r analysis were conducted using SPSS version 17. Responses with Likert scale rating 1(low score to 5 (high score and binary choices (yes/no were presented as mean (SD and (95% CI, respectively. Results The response rate was 93.6%. The overall mean (SD responses indicated that pharmacists counseled obese patients sometimes to most of the time, 3.67 (1.19 and were neutral to comfortable with counseling about aspects of obesity management, 3.77 (1.19. Respondents perceived obesity management aspects to be somewhat effective, 3.80 (1.05. Of the four aspects of obesity management, diet and exercise, and diet foods were the highest ranked in terms of frequency of counseling, comfort level and perceived effectiveness. Pharmacists were neutral to confident in achieving positive outcomes as a result of obesity counseling, 3.44 (1.09. Overall mean responses of

  1. Treatment Considerations and the Role of the Clinical Pharmacist Throughout Transitions of Care for Patients With Acute Heart Failure. (United States)

    McNeely, Elizabeth B


    Heart failure is associated with increased risk of morbidity and mortality, resulting in substantial health-care costs. Clinical pharmacists have an opportunity to reduce health-care costs and improve disease management as patients transition from inpatient to outpatient care by leading interventions to develop patient care plans, educate patients and clinicians, prevent adverse drug reactions, reconcile medications, monitor drug levels, and improve medication access and adherence. Through these methods, clinical pharmacists are able to reduce rates of hospitalization, readmission, and mortality. In addition, care by clinical pharmacists can improve dosing levels and adherence to guideline-directed therapies. A greater benefit in patient management occurs when clinical pharmacists collaborate with other members of the health-care team, emphasizing the importance of heart failure treatment by a multidisciplinary health-care team. Education is a key area in which clinical pharmacists can improve care of patients with heart failure and should not be limited to patients. Clinical pharmacists should provide education to all members of the health-care team and introduce them to new therapies that may further improve the management of heart failure. The objective of this review is to detail the numerous opportunities that clinical pharmacists have to improve the management of heart failure and reduce health-care costs as part of a multidisciplinary health-care team.

  2. [Proposition and evaluation of the educational activities for effective utilization of opioids performed by pharmacists in palliative home care]. (United States)

    Akai, Namika; Hashimoto, Daisuke; Fujita, Tomoko; Miyake, Keiichi; Hamabe-Fujita, Wakako; Tokuyama, Shogo


    Recently, it is required that community pharmacists participate in palliative home care. In this study, we designed educational activities for palliative home care to local residents as a new approach performed by community pharmacists. In addition, we proposed this approach to community pharmacists and discussed its roles to promote palliative home care in the future. We designed and held an educational seminar on palliative home care focusing on safe use of opioids in local residents. After this seminar, we conducted a questionnaire survey of the participants. Then, we made a proposition of this new approach by presentation of a seminar to community pharmacists (members of "Heartfulcare INC"). After the proposition, a questionnaire survey of the seminar on palliative home care was performed. In total, 79 people participated in the educational seminar. Most (87.3%) participants thought that it was informative. Furthermore, about 40% of participants answered "misunderstanding of opioids" or "anxiety regarding side effects of opioids" were removed following the seminar. All participating pharmacists evaluated the seminar as useful. The educational activity in the present study seemed effective to local residents on their misunderstanding of opioids. Furthermore, this approach was appreciated as an important role of community pharmacists in the palliative home care not only by local residents but also by pharmacists themselves. Therefore it seems important to continue such activities so as to improve palliative home care in the future.

  3. Role of community pharmacists in asthma – Australian research highlighting pathways for future primary care models

    Directory of Open Access Journals (Sweden)

    Saini B


    Full Text Available Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade of coordinated research efforts, in various aspects of asthma care, has culminated in the implementation trial of the Pharmacy Asthma Management Service (PAMS, a comprehensive disease management model. There has been research investigating asthma medication adherence through data mining, ways in which usual asthma care can be improved. Our research has focused on self-management education, inhaler technique interventions, spirometry trials, interprofessional models of care, and regional trials addressing the particular needs of rural communities. We have determined that inhaler technique education is a necessity and should be repeated if correct technique is to be maintained. We have identified this effectiveness of health promotion and health education, conducted within and outside the confines of the pharmacy, in public for a and settings such as schools, and established that this outreach role is particularly well received and increases the opportunity for people with asthma to engage in their asthma management. Our research has identified that asthma patients have needs which pharmacists delivering specialized models of care, can address. There is a lot of evidence for the effectiveness of asthma care by pharmacists, the future must involve integration of this role into primary care.

  4. Giving “Best Advice”: Proposing a Framework of Community Pharmacist Professional Judgement Formation

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    Cicely Roche


    Full Text Available Community pharmacy is often portrayed as a marriage of professional and business roles in a commercial domain, thereby creating a need for, and value in, pursuing the development of professional competencies for use in the community pharmacy business. In context, professional judgement is the application of knowledge, skills and attitudes (competencies which, when applied to situations where there is no one or obvious right or wrong way to proceed, gives a patient a better likelihood of a favourable outcome than if a lay-person had made the decision. The challenge for community pharmacists is that professional judgement formation is influenced by professional, commercial and personal criteria with inherent interconnected challenges. In community pharmacy practice in the Republic of Ireland (ROI, this challenge is compounded by the fact that advice is normally provided in an environment where the pharmacist provides professional advice “for free” and then may offer to sell the patient a product or service based on that advice, an activity which amounts to a commercial transaction. While there is currently no evidence to confirm whether or not these professional judgement influences are resolved successfully, their very existence poses a risk that their resolution “in the wrong way” could compromise patient outcomes or professional standing following the delivery of pharmacy services. It is therefore apparent that a community pharmacist requires skills in identifying and analysing professional/commercial/personal influences in order to appreciate the criteria which may affect both parties’ (patient and pharmacist decision making. By contemplating the interaction between the pharmacist’s professional competencies and the individual influences on that pharmacist, we can consider the enhancement of professional competencies that underpin the “best” advice being offered to the patient, regardless of whether that advice is offered in

  5. Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study.

    Directory of Open Access Journals (Sweden)

    Maria Rubio-Valera

    Full Text Available Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care.Patients were recruited by general practitioners and randomized to community pharmacist intervention (87 that received an educational intervention and usual care (92. Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs, use of healthcare services and productivity losses were measured at baseline, 3 and 6 months.There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective. From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000.A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not NCT

  6. Unpublished Interim Digital Geologic Map of Hot Springs National Park and Vicinity, Arkansas (NPS, GRD, GRI, HOSP, HOSP digital map) adapted from the interim Arkansas Geological Survey DGM-HSR-003 by Johnson and Hanson (2011) (United States)

    National Park Service, Department of the Interior — The Unpublished Interim Digital Geologic Map of Hot Springs National Park and Vicinity, Arkansas is composed of GIS data layers complete with ArcMap 9.3 layer (.LYR)...

  7. [A new identity for pharmacists: the Mexican Pharmaceutical Society at the turn of the century (1890-1919)]. (United States)

    Martínez Solís, Sandra; Aceves Pastrana, Patricia; Morales Cosme, Alba


    The Mexican Pharmaceutical Society was founded in 1871. Pharmacists in this Society organized and supported activities to develop their profession, including the preparation of a Mexican pharmacopela, promotion of the interests of pharmacists and improvement of the profession, and the creation of a unified legal framework for its practice. This society played a central role in the institutionalization of pharmacy as a profession and in the expansion of pharmacists into new areas, especially in relation to the transfer of pharmacy training from the National School of Medicine to the School of Chemical Sciences in 1919. when they took on a new identity as chemists.

  8. Pharmacists’ response to anaphylaxis in the community (PRAC): a randomised, simulated patient study of pharmacist practice (United States)

    Salter, Sandra M; Delfante, Brock; de Klerk, Sarah; Sanfilippo, Frank M; Clifford, Rhonda M


    Objective To evaluate how community pharmacists manage patients with anaphylaxis. Design A randomised, cross-sectional, simulated patient study of community pharmacist practice. Setting 300 metropolitan pharmacies located in Perth Australia, randomised to three groups of 100 pharmacies. Each group corresponded to a different epinephrine autoinjector: original EpiPen, new-look EpiPen or Anapen. Participants 300 pharmacies were visited with 271 simulated patient visits included in the final analysis (88=original EpiPen, 92=new-look EpiPen, 91=Anapen). Outcome measures Primary anaphylaxis preparedness (readiness to treat acute anaphylaxis). Secondary anaphylaxis engagement (willingness to engage the patient in a discussion about their anaphylaxis). Methods Simulated patients approached pharmacists, using a standardised scenario, for assistance with epinephrine autoinjector use and advice about the use of antihistamines in anaphylaxis. Scores for each outcome were obtained based on the number of predefined statements addressed by the pharmacist during the consultation (maximum score=5 for preparedness and 8 for engagement). Results The mean anaphylaxis preparedness score was 2.39 points (SD 1.17). Scores for new-look EpiPen were significantly higher than for original EpiPen and Anapen (2.75 vs 2.38 points, p=0.027; 2.75 vs 2.03 points, pEpiPen were similar to original EpiPen and Anapen (3.11 vs 3.32 points; 3.11 vs 2.90 points, both p=0.42). Engagement was associated with preparedness. For each additional engagement point, preparedness increased by 7% (0.357 points; 95% CI 0.291 to 0.424; p<0.001). Conclusions Pharmacists demonstrated reasonable knowledge of anaphylaxis symptoms and emergency care, but had poor epinephrine autoinjector technique and rarely discussed anaphylaxis action plans. Pharmacists who had a more comprehensive discussion about anaphylaxis with patients, were more prepared for anaphylaxis emergencies. Future research should evaluate the nature and

  9. Perceptions and efficiency of short-term medical aid missions among key groups of health professionals. (United States)

    Chiu, Ya-Wen; Weng, Yi-Hao; Chen, Chih-Fu; Yang, Chun-Yuh; Lee, Ming-Liang


    This study investigated the perceptions of short-term assignments of medical services among participating health care professionals dispatched from Taiwan to underdeveloped areas. Structured questionnaires were mailed to four groups of professionals (physicians, pharmacists, nurses, and public health personnel) who had participated in any of 88 medical missions dispatched to 24 allied nations. A total of 278 returns were valid for analysis. Among them, 222 respondents reported that they had participated in just one overseas medical mission (79.9%). The majority of physicians, pharmacists, and nurses listed humanitarianism as their foremost incentive for participation. In contrast, public health personnel most frequently reported that they had been assigned to the mission abroad. Pharmacists, nurses, and public health personnel most commonly stated that their top goal was health care; but physicians said that aiding Taiwan's diplomatic relations was their main motive. While all groups generally recognized language proficiency and cultural awareness as important for conducting successful short-term medical aid missions (STMMs), many members of groups did not rate their own capabilities in those area as sufficient, especially pharmacists (p help inform efforts to integrate evidence into the deployment of STMMs.

  10. Medication monitoring and optimization : a targeted pharmacist program for effective and cost-effective improvement of chronic therapy adherence

    NARCIS (Netherlands)

    van Boven, Job F.M.; Stuurman-Bieze, Ada G.G.; Hiddink, Eric G.; Postma, Maarten J.; Vegter, Stefan


    BACKGROUND: Community pharmacies provide a promising platform for monitoring and improving therapy adherence and providing pharmaceutical care. Structured methods and appropriate software are important tools to increase pharmacist effectiveness and improve health outcomes. In 2006, the Medication Mo

  11. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Saw PS


    Full Text Available Pui San Saw,1 Lisa M Nissen,2,3 Christopher Freeman,2,4 Pei Se Wong,3 Vivienne Mak5 1School of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia; 2School of Clinical Sciences, Queensland University Technology, Brisbane, QLD, Australia; 3School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 4School of Pharmacy, University of Queensland, St Lucia, QLD, Australia; 5School of Pharmacy, Monash University Malaysia, Selangor, Malaysia Background: Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia.Methods: A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results: A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1 pharmacists’ role viewed mainly as supplying medications, 2 readiness to accept pharmacists in private GP clinics, 3 willingness to pay for pharmacy services, and 4 concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy

  12. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study

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    Osman A


    Full Text Available Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists’ ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden.Objective: To evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan.Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI (n=105, MDI with Spacer (n=83, Turbuhaler (n=61, and Diskus (n=51. Investigator (a pharmacist acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know.Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an “optimal technique”. The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus either did not know proper technique or were totally unfamiliar with the devices.Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge

  13. Effectiveness of alcohol brief intervention delivered by community pharmacists: study protocol of a two-arm randomised controlled trial

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    Dhital Ranjita


    Full Text Available Abstract Background There is strong evidence to support the effectiveness of Brief Intervention (BI in reducing alcohol consumption in primary healthcare. Methods and design This study is a two-arm randomised controlled trial to determine the effectiveness of BI delivered by community pharmacists in their pharmacies. Eligible and consenting participants (aged 18 years or older will be randomised in equal numbers to either a BI delivered by 17 community pharmacists or a non-intervention control condition. The intervention will be a brief motivational discussion to support a reduction in alcohol consumption and will take approximately 10 minutes to deliver. Participants randomised to the control arm will be given an alcohol information leaflet with no opportunity for discussion. Study pharmacists will be volunteers who respond to an invitation to participate, sent to all community pharmacists in the London borough of Hammersmith and Fulham. Participating pharmacists will receive 7 hours training on trial procedures and the delivery of BI. Pharmacy support staff will also receive training (4 hours on how to approach and inform pharmacy customers about the study, with formal trial recruitment undertaken by the pharmacist in a consultation room. At three month follow up, alcohol consumption and related problems will be assessed with the Alcohol Use Disorders Identification Test (AUDIT administered by telephone. Discussion The UK Department of Health’s stated aim is to involve community pharmacists in the delivery of BI to reduce alcohol harms. This will be the first RCT study to assess the effectiveness of BI delivered by community pharmacists. Given this policy context, it is pragmatic in design. Trial registration Current Controlled Trials ISRCTN95216873

  14. An evaluation of knowledge, attitude and practice of Indian pharmacists towards adverse drug reaction reporting: A pilot study

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    Akram Ahmad


    Full Text Available Background: Pharmacovigilance is a useful to assure the safety of medicines and protect consumers from their harmful effects. Healthcare professionals should consider Adverse Drug Reaction (ADR reporting as part of their professional obligation and participate in the existent pharmacovigilance programs in their countries. In India, the National PV Program was re-launched in July 2010. Objectives: This survey was conducted in order to assess the knowledge, attitude and practice of Indian pharmacists with the aim of exploring the pharmacists′ participation in ADR reporting system, identifying the reasons of under reporting and determining the steps that could be adopted to increase reporting rates. Materials and Methods: A cross-sectional survey was carried out among the pharmacists in India using a pretested questionnaire with 33 questions (10 questions on knowledge, 6 on attitude, 7 on practice, 7 on future of ADR reporting in India and 3 on benefits of reporting ADRs.. The study was conducted, over a period of 3 months from May 2012 to July 2012. Results: Out of the 600 participants to whom the survey was administered, a total of 400 were filled. The response rate of the survey was 67%. 95% responders were knowledgeable about ADRs. 90% participants had a positive attitude towards making ADRs reporting mandatory for practicing pharmacists. 87.5% participants were interested in participating in the National Pharmacovigilance program, in India. 47.5% respondents had observed ADRs in their practice, and 37% had reported it to the national pharmacovigilance center. 92% pharmacists believed reporting ADRs immensely helped in providing quality care to patients. Conclusion : The Indian pharmacists have poor knowledge, attitude, and practice (KAP towards ADR reporting and pharmacovigilance. Pharmacists with higher qualifications such as the pharmacists with a PharmD have better KAP. With additional training on Pharmacovigilance, the Indian Pharmacists

  15. Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF in Serbia

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    Stojkov Svetlana


    Full Text Available Background/Aim. Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF. The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. Methods. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. Results. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1 had the lowest score (average value 2.98, while the cluster Management and Organizational Competency (KK2 had the highest score (average value 3.15. The competence Recognition of the Diagnosis and Patient Counseling (K8, which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively among the all evaluated competencies. Conclusion. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

  16. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Brandstrup, Lene; Brandslund, Ivan;


    prescription practice. Prescriptions not following good practice in these intervention areas were defined as "sub-optimal prescriptions," and then discussed between a physician and a clinical pharmacist. The primary parameter was the difference in the number of days with a sub-optimal prescription (Mann...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  17. Description of a practice model for pharmacist medication review in a general practice setting

    DEFF Research Database (Denmark)

    Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk;


    BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs...... concerned the reporting of interventions and the considerations of the GPs. 208 interventions were proposed among the 50 patients. The acceptance rate among the GPs was 82%. The most common interventions were lack of clinical or laboratory data (n=57, 27%) and drugs that should be discontinued as they had...

  18. Venous thromboembolism in patients with cancer: an overview for pharmacists using a case-based approach. (United States)

    Pangilinan, Joanna Maudlin


    Clinicians must always maintain a heightened suspicion for the development of venous thromboembolism (VTE) in the cancer patient population. VTE is common in this population and often results in morbidity and mortality. The pathophysiology is complex and likely multifactorial. Risk factors for VTE include patient-associated, cancer-associated, and treatment-associated factors as well as biomarkers. Low-molecular-weight heparin (LMWH) is a cornerstone for VTE prophylaxis and treatment. Studies have shown that LMWH may decrease VTE recurrence and impart a survival benefit. Organizational guidelines are available to assist the clinician in choosing appropriate anticoagulant agents, dosing, and duration of prophylaxis and treatment. Pharmacists serve an important role for the safe and effective management of anticoagulation in this complex patient population. In addition, pharmacists can be important providers of patient education about VTE and anticoagulation.

  19. Pain attitudes and knowledge among RNs, pharmacists, and physicians on an inpatient oncology service. (United States)

    Xue, Ying; Schulman-Green, Dena; Czaplinski, Cindy; Harris, Debra; McCorkle, Ruth


    Patients with cancer often experience pain, yet studies continue to document inadequate and inappropriate assessment and management of cancer-related pain. This study aimed to evaluate the attitudes and knowledge of inpatient oncology healthcare providers toward pain management by surveying nurses, pharmacists, and physicians working on the inpatient oncology units at an academic medical center. Healthcare providers generally reported positive attitudes toward pain management but were deficient in their knowledge of pain management. The authors suggest that pharmacists become more integral members of palliative care teams and actively participate in rounds. A need exists for educational programs in pain management for healthcare providers, especially for those who do not routinely care for patients with cancer.

  20. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring. (United States)

    Omboni, Stefano; Sala, Elisa


    Randomized controlled trials have documented that a team of health care professionals which includes a physician, a nurse and a community pharmacist may improve the benefit and adherence of anti-hypertensive therapy. If such a health care model relies on blood pressure telemonitoring, it can promote a stronger relationship between health care professionals and patients, and further improve BP control of hypertension. The major benefit of this collaborative approach is to center the patient's management in a tailored way, providing comprehensive and preventive care based on health information technologies. In this review, the authors summarize recent clinical studies that evaluate the role of the community pharmacist in BP measurements, and in hypertension screening and control. The authors also describe the advantages of using blood pressure telemonitoring in home and ambulatory settings to evaluate potential alternatives to primary care in hypertension management.

  1. Changing Perceptions (United States)

    Mallett, Susanne; Wren, Steve; Dawes, Mark; Blinco, Amy; Haines, Brett; Everton, Jenny; Morgan, Ellen; Barton, Craig; Breen, Debbie; Ellison, Geraldine; Burgess, Danny; Stavrou, Jim; Carre, Catherine; Watson, Fran; Cherry, David; Hawkins, Chris; Stapenhill-Hunt, Maria; Gilderdale, Charlie; Kiddle, Alison; Piggott, Jennifer


    A group of teachers involved in embedding NRICH tasks ( into their everyday practice were keen to challenge common perceptions of mathematics, and of the teaching and learning of mathematics. In this article, the teachers share what they are doing to change these perceptions in their schools.

  2. Surface waters of Illinois River basin in Arkansas and Oklahoma (United States)

    Laine, L.L.


    The estimated runoff from the Illinois River basin of 1,660 square miles has averaged 1,160,000 acre-feet per year during the water years 1938-56, equivalent to an average annual runoff depth of 13.1 inches. About 47 percent of the streamflow is contributed from drainage in Arkansas, where an average of 550,000 acre-ft per year runs off from 755 square miles, 45.5 percent of the total drainage area. The streamflow is highly variable. Twenty-two years of record for Illinois River near Tahlequah, Okla., shows a variation in runoff for the water year 1945 in comparison with 1954 in a ratio of almost 10 to 1. Runoff in 1927 may have exceeded that of 1945, according to records for White River at Beaver, Ark., the drainage basin just east of the Illinois River basin. Variation in daily discharge is suggested by a frequency analysis of low flows at the gaging station near Tahlequah, Okla. The mean flow at that site is 901 cfs (cubic feet per second), the median daily flow is 350 cfs, and the lowest 30-day mean flow in a year probably will be less than 130 cfs half of the time and less than 20 cfs every 10 years on the average. The higher runoff tends to occur in the spring months, March to May, a 3-month period that, on the average, accounts for almost half of the annual flow. High runoff may occur during any month in the year, but in general, the streamflow is the lowest in the summer. The mean monthly flow of Illinois River near Tahlequah, Okla., for September is about 11 percent of that for May. Records show that there is flow throughout the year in Illinois River and its principal tributaries Osage Creek, Flint Creek and Barren Fork. The high variability in streamflow in this region requires the development of storage by impoundment if maximum utilization of the available water supplies is to be attained. For example, a 120-day average low flow of 22 cfs occurred in 1954 at Illinois River near Tahlequah, Okla. To have maintained the flow at 350 cfs, the median daily

  3. Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

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    Ann Lloyd, Pharm.D., BCPS


    Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.

  4. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

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    Rachel Root, PharmD, MS


    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  5. Microbial air-sampling equipment, part 2: experiences of compounding pharmacists. (United States)

    Mixon, Bill; Cabaleiro, Joe; Latta, Kenneth S


    The most recent changes to Chapter 797 of the United States Pharmacopeia-National Formulary initiated an intense controversy about the frequency of cleanroom air sampling that is required to prevent the contamination of sterile preparations. For compounders who must purchase an air sampler to use in the cleanroom, choices abound. This article summarizes discussions from compounding pharmacists and their experiences with air sampling devices.

  6. Exploration into the Clinic Pharmacists%开展药师门诊的探讨

    Institute of Scientific and Technical Information of China (English)



    Many patients in the clinic, looking at the hands of drugs, half would not know how to use, consult pharmacists in dispensing window became a common phenomenon. Outpatient pharmacists are required to carry out the requirements for pharmacists, medical services are also extended. Patient Counseling most problems have drug usage, dosage, drug interactions, adverse drug reactions, drug validity preservation and so on. Outpatient pharmacy pharmacists have a solid knowledge and understanding of al hospital drug information, and master the basic situation of the patient, for the patient's problems and provide the best solution to help patients establish medication record card, to avoid forget ing and repeated administration even the occurrence of medication errors.%很多患者在就诊后,看着手里的药品,一时半会不知道怎么使用,在发药窗口咨询药师成了常见的现象。开展药师门诊是对药师的要求,也是医疗服务延伸的要求。患者咨询最多的问题有药物的用法、用量、药物的相互作用、药物的不良反应、药物的保存与有效期等。门诊药师要有扎实的药学专业知识,了解本院所有药品信息,并掌握患者的基本情况,针对患者的问题,提供最佳的解决方法,帮助患者建立用药记录卡,可避免遗忘及重复给药甚至错误用药的发生。

  7. Technicians or patient advocates?--still a valid question (results of focus group discussions with pharmacists)

    DEFF Research Database (Denmark)

    Almarsdóttir, Anna Birna; Morgall, Janine Marie


    New legislation went into effect in Iceland in March 1996 making it the first Nordic country to liberate their drug distribution system. The term liberalization implies the abolishment of the professional monopoly in that ownership was not tied to the pharmacy profession anymore. Focus group disc...... technical skills. This account of the changes in the drug distribution system in Iceland highlights some of the implications for pharmacists internationally....

  8. Supporting the management of type 2 diabetes with pharmacist-led reviews: an observational analysis (United States)

    Langran, Tim; Nanda, Nithya; Bataveljic, Attia; Gonzalez-Durio, Javier


    Objective Describe and assess the impact of a pharmacist-led patient review programme on the management and control of type 2 diabetes (T2D). Design Uncontrolled prospective cohort study with before and after intervention data collection. Setting General practices within NHS Slough Clinical Commissioning Group (CCG). Participants 5910 patients with T2D. Interventions Pharmacists reviewed 5910 patients and worked with general practice teams to schedule any of the 9 key care processes recommended by the National Institute for Health and Care Excellence (NICE) that the patients were lacking, to optimise medication and to make other interventions such as providing lifestyle advice. Main outcome measures The proportion of patients receiving the NICE-recommended 9 key care processes and proportion of patients whose glycated haemoglobin (HbA1c), blood pressure (BP) or total cholesterol (TC) readings were over target before and after the intervention period. Results The proportion of patients receiving all of the NICE-recommended 9 key care processes increased from 46% at project outset in April 2013 to 58% on completion in April 2014 and the percentage of patients achieving HbA1c, BP and TC targets all increased (65% to 70%, 70% to 76%, 78% to 82%, respectively). Quality Outcomes Framework (QOF) data for Slough CCG showed the percentage of diabetic patients achieving target HbA1c, BP and TC readings increased from April 2013 to April 2014, but then diminished in the year after project completion. Conclusions The pharmacist-led review increased the number of key care processes administered and improved diabetic control during the year of programme delivery. The improvement abated during the year after, suggesting that such programmes should be ongoing rather than fixed term. The programme combined the strategic drive and project facilitation skills of Slough CCG, the general practice teams' knowledge of their patients and the clinical and information technology skills of

  9. [The role of pharmacists, members of the Hungarian Academy of Sciences, in the history of chemistry]. (United States)

    Majoros, Krisztina; Mazák, Károly


    In this study we present the role of Hungarian academic pharmacists in the history of chemistry and in university education since the formation of the first chemistry department until today. After a short resume we summarize the teaching activity and main research fields of each scholar. Pictures, chemical formulas, interesting and personal moments based on recollections of students and colleagues make the discussion more colorful.

  10. The First International Residency Program Accredited by the American Society of Health-System Pharmacists


    Al-Qadheeb, Nada S.; Alissa, Dema A.; Al-Jedai, Ahmed; Ajlan, Aziza; Al-Jazairi, Abdulrazaq S.


    The processes by which the pharmacy residency program at King Faisal Specialist Hospital and Research Centre-Riyadh, Saudi Arabia became the first American Society of Health-System Pharmacists (ASHP) accredited program outside the United States is described. This article provides key points for a successful program for other pharmacy residency programs around the world. Additionally, it points out the need for establishing international standards for pharmacy residency programs.

  11. Impact of pharmacist and clinician dual intervention on prescribed benzodiazepines in prisoner patients: a retrospective study. (United States)

    Lerat, Marie-Cecile; Cabelguenne, Delphine; Lassia, Jerome; Meunier, Frederic; Zimmer, Luc


    High-dose benzodiazepine (BDZs) represents an important risk factor for dependence, particularly in a prison environment. In Lyon's prison, BDZs and/or opioid maintenance treatment are often prescribed to patients with mental disorders. The aim of this retrospective study was to assess the impact of psychiatrist and pharmacist collaboration on reducing the BDZs dose prescribed to prisoner patients. Since 2001, clinicians and pharmacists have been holding monthly meetings to develop prescribing guidelines and discuss those patients receiving high-dose BDZs. All prescribed psychotropic drugs were noted for each included patient in the control (before guidelines) and intervention groups. Criteria used to define each patient profile included age, diagnosis (mental disorder), and concomitant treatment (opioids, antidepressants). To compare each group, the daily dose of prescribed BDZs was used as a quantitative variable and expressed in diazepam equivalent. Four hundred and seventy-three patients were included, 222 in the control group and 251 in the intervention group. The two groups showed no difference in terms of diagnosis. The daily dose of BDZ was higher in the control group when all patients were considered (mean(CONTROL GROUP) = 46 mg in diazepam equivalent vs. mean(INTERVENTIION GROUP) = 34 mg) and for each of the following patient categories: 'mental disorder' (48 mg vs. 30 mg), 'no opioid treatment' (44 mg vs. 31 mg), 'buprenorphin treatment' (58 mg vs. 63 mg), 'no antidepressant treatment' (41 mg vs. 29 mg), and 'antidepressant treatment' (53 mg vs. 38 mg). The results of this retrospective study show the positive impact of multidisciplinary intervention on reducing the prescribed daily dose of BDZs. This experience confirms the positive impact that pharmacist feedback on prescriptions and the development of treatment guidelines by clinician and pharmacist collaboration have on improving the prescribing practice in a prison environment.

  12. [Role of pharmacists in the medical team--attempting palliative care]. (United States)

    Ishiguro, T; Takahashi, M; Kato, H; Abe, C; Shioya, A; Ishiguro, T; Yoshizawa, T; Yoshizawa, A


    The Pharmacy Department at our hospital is attempting to develop methods for palliative care, for example of cancer pain or smelly tumors. The participation of pharmacists on the medical team for home care is necessary, because the supply of proper drugs for patients' individual conditions is indispensable in palliative care. Communication between not only patients, but also between their families and us, as well as the maintenance of close contact with the medical team, are important in home care.

  13. Evaluation of pharmacists' services for dispensing emergency contraceptive pills in Delhi, India: A mystery shopper study

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    Pikee Saxena


    Full Text Available Background: Although emergency contraceptive pills are available over the counter, the quality of consultation, including key areas of contraceptive counseling and prevention of sexually transmitted infections (STI, has not been well documented. Objective: To evaluate actual pharmacist services while dispensing emergency contraception through a mystery shopper technique. Material and Methods: This cross-sectional study was conducted in 81 pharmacies situated in Delhi by 4 trained mystery shoppers posed as customers over a period of 6 months. Results: None of the pharmacists asked about the time lapsed since last unprotected sexual intercourse or last menstrual period before deciding the eligibility of the customer. The majority were unclear about side effects associated with emergency contraception (78.57% or with anticipated changes in menstrual flow (78.57%; 85.71% did not know whether subsequent unprotected intercourse would be protected. Only 15.71% counseled shoppers regarding risk of STI on asking leading questions and 88.5% did not provide any contraceptive advice. Conclusion: There is a huge gap in the technical knowledge and mindset of the pharmacists when it comes to checking for the eligibility of the client and providing advice regarding use of regular contraception and barrier for protection from STI, which needs to be addressed in order to realize the full benefit of making emergency contraceptive pills available over the counter.

  14. Disruptive innovation in community pharmacy - Impact of automation on the pharmacist workforce. (United States)

    Spinks, Jean; Jackson, John; Kirkpatrick, Carl M; Wheeler, Amanda J

    Pharmacy workforce planning has been relatively static for many decades. However, like all industries, health care is exposed to potentially disruptive technological changes. Automated dispensing systems have been available to pharmacy for over a decade and have been applied to a range of repetitive technical processes which are at risk of error, including record keeping, item selection, labeling and dose packing. To date, most applications of this technology have been at the local level, such as hospital pharmacies or single-site community pharmacies. However, widespread implementation of a more centralized automated dispensing model, such as the 'hub and spoke' model currently being debated in the United Kingdom, could cause a 'technology shock,' delivering industry-wide efficiencies, improving medication accessibility and lowering costs to consumers and funding agencies. Some of pharmacists' historical roles may be made redundant, and new roles may be created, decoupling pharmacists to a certain extent from the dispensing and supply process. It may also create an additional opportunity for pharmacists to be acknowledged and renumerated for professional services that extend beyond the dispensary. Such a change would have significant implications for the organization and funding of community pharmacy services as well as pharmacy workforce planning. This paper discusses the prospect of centralized automated dispensing systems and how this may impact on the pharmacy workforce. It concludes that more work needs to be done in the realm of pharmacy workforce planning to ensure that the introduction of any new technology delivers optimal outcomes to consumers, insurers and the pharmacy workforce.

  15. Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists (United States)

    Fois, Romano A.; McLachlan, Andrew J.; Chen, Timothy F.


    Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns’ patient safety attitudes. However, other factors likely influenced their attitudes in the longer term. PMID:28289295

  16. [Advanced curriculum for clinical assessment and skill in new age pharmacist education]. (United States)

    Kiuchi, Yuji; Masuda, Yutaka; Kamei, Daisuke; Kogo, Mari; Nakamura, Akihiro


    In Showa University School of pharmacy, 7 competencies for outcome-based education were set up in 2011. We are now creating sequential curriculum in order to achieve these competencies. As a member of team medical treatment, pharmacist must share a patient's information with other members, assess each patient's condition, propose the best medication with evidence, and also check the effect of medication. Therefore, many active practices in a hospital and community and problem-based learning (PBL) tutorials are carried out in curriculum in School of Pharmacy. As a training for the future pharmacists who positively perform primary care with responsibility in community pharmacy, students study the method of clinical assessment (assessment of condition of disease from the patient's complain, and choice of appropriate proposal). Furthermore, the exercise and training of parenteral medication, physical assessment, and first aid, etc. are also taken in the curriculums as new clinical skill. The systematic and gradual interprofessional education curriculum for the team medical education has been carried out aiming at training of active members in medical team in a hospital and community. At this symposium, I will introduce these systematic advanced curriculums for the pharmacist of a new age, and to show the usefulness and learning effect.

  17. Exploring the Process of Conveying Information about Side Effects: A Qualitative Study among Pharmacists

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    Therése Kairuz


    Full Text Available This study explored how a sample of Australian pharmacists would convey information about the side effects of a medicine, if they were to counsel a patient. A qualitative method was selected and written responses to a case-based scenario were analysed using inductive thematic analysis. The grounded theory approach elicited a fluid and dynamic model for side effect counselling. The study identified strategies for counselling, such as encouraging adherence through emphasising the benefits of the medication, referral to the prescriber, and providing empathy and reassurance to ease anxiety and address concerns. Pharmacists acknowledged the potential for risk, although only a minority used numerical descriptors. The final themes or outcomes were that pharmacists aim to allay fears, minimise harm and promote medication use when counselling about side effects. Professional empathy, the acknowledgment of patient concerns, and the importance of providing tailored information to promote medication adherence, emerged as features of the quality use of medicines. This study contributes to existing literature by identifying the role of allaying patients’ fears when conveying side effect information. It also describes a process to convey tailored information. Implications for practice include the importance of effective use of communication strategies to encourage adherence, as the appropriate use of medication can lead to positive health outcomes.

  18. [Current situation of suicide in Japan, and what pharmacists contribute to suicide prevention]. (United States)

    Matsumoto, Toshihiko


      In Japan, a national countermeasure has been forwarded since the enactment of the Basic Act on Suicide Countermeasures in 2006 and the Comprehensive Suicide Prevention Initiative in 2007. The distinctive policy of the Japanese countermeasure is expressed as the word, "comprehensive," which means that suicide prevention may not only be carried out only by mental health measures but also by comprehensive measures including chance of administrative practices. This policy is proper, although mental health measures appear to be too simple inclining to psychiatric treatments for the classic type of "depression" by a pharmacotherapy. The authors have insisted that mental health measures including psychiatric treatments are also required to be more comprehensive. This paper describes that benzodiazepine (BZ)-abuse problems including overdosing by suicidal intents have got worse recently as psychiatric clinics have increased and most of BZ abusers obtain the abused drugs form psychiatrists. This current situation indicates that pharmacists need to monitor psychiatrists' prescribing behavior and qualities of psychiatric treatment is required to be refined, suggesting pharmacists may be one of the "Gate Keeper," as supporting resources for suicide prevention. Additionally, this paper explained that basic attitudes and responses acquired by pharmacists as a supporter for suicide prevention.

  19. Pharmacist and Physician Interpretation of Abbreviations for Acetaminophen Intended for Use in a Consumer Icon

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    Saul Shiffman


    Full Text Available Concomitant use of multiple acetaminophen medications is associated with overdose. To help patients identify acetaminophen medications and thus avoid concomitant use, an icon with an abbreviation for “acetaminophen” has been proposed for all acetaminophen medications. This study assessed pharmacists’ and physicians’ use and interpretation of abbreviations for “acetaminophen”, to identify abbreviations with other meanings that might cause confusion. Physicians (n = 150 reported use and interpretation of candidate abbreviations Ac and Acm. Pharmacists (n = 150 interpretations of prescription orders using the candidate abbreviations APAP, Ac, Ace and Acm in typed, handwritten or spoken form, were judged for critical confusions likely to cause patient harm. Critical confusion was rare, except for omission by pharmacists of the acetaminophen dose for Hydrocodone/APAP prescriptions (10%. Ac was in common use to indicate “before meals”, and was interpreted as such, but some physicians (8% said they use Ac to indicate anticoagulant drugs. Most pharmacists (54% interpreted Ace as acetaminophen, and none interpreted it as referring to ACE-inhibitors. Acm was rarely used in prescriptions, had no common interfering meanings, and was often (63% interpreted as acetaminophen, especially when prescribed in combination with an opiate (85%. The data validated concerns about abbreviations in prescribing: all abbreviations resulted in some misinterpretations. However, Acm was rarely misinterpreted, was readily associated with “acetaminophen”, and seemed appropriate for use in a graphic icon to help consumers/patients identify acetaminophen medications.

  20. Use of an Auditory Hallucination Simulation to Increase Student Pharmacist Empathy for Patients with Mental Illness (United States)

    Eukel, Heidi N.; Frenzel, Jeanne E.; Werremeyer, Amy; McDaniel, Becky


    Objective. To increase student pharmacist empathy through the use of an auditory hallucination simulation. Design. Third-year professional pharmacy students independently completed seven stations requiring skills such as communication, following directions, reading comprehension, and cognition while listening to an audio recording simulating what one experiencing auditory hallucinations may hear. Following the simulation, students participated in a faculty-led debriefing and completed a written reflection. Assessment. The Kiersma-Chen Empathy Scale was completed by each student before and after the simulation to measure changes in empathy. The written reflections were read and qualitatively analyzed. Empathy scores increased significantly after the simulation. Qualitative analysis showed students most frequently reported feeling distracted and frustrated. All student participants recommended the simulation be offered to other student pharmacists, and 99% felt the simulation would impact their future careers. Conclusions. With approximately 10 million adult Americans suffering from serious mental illness, it is important for pharmacy educators to prepare students to provide adequate patient care to this population. This auditory hallucination simulation increased student pharmacist empathy for patients with mental illness. PMID:27899838

  1. Development, validation and implementation of continuous professional development programmes for community pharmacists

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    Adepu R


    Full Text Available In India, structured continuous professional development modules are not available to update the knowledge and skills of the practicing community pharmacists. A prospective study was designed to develop, validate and implement continuous professional development modules and to assess the impact of training programme on knowledge and skills of community pharmacists. Modules were developed by referring to standard texts and data bases and were validated for the content. The impact of training programme on pharmacists′ knowledge and skills was assessed using suitably designed pre and post training knowledge attitude and practice questionnaires, pre and post training questionnaires for individual continuous professional development training sessions, pre and post training patient counseling skill assessment, blood pressure measurement skill assessment and capillary blood glucose check-up skill assessment check-lists. Data was analyzed by applying suitable statistical methods using InStat version 3.01 statistical software. Fourty eight community pharmacists were enrolled in to the study. A statistically significant (P<0.05 improvement was observed in post training knowledge attitude and practice scores and in post training scores of individual training sessions. A statistically significant (P<0.05 improvement was also observed in post training scores of professional skills such as Patient counseling, capillary blood glucose recording and blood pressure measurement skills. The study findings conclude that continuous training updates the knowledge and skills in practicing the pharmaceutical care in their pharmacies.

  2. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

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    Sarah M. Westberg, Pharm.D.


    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  3. An Investigation of Job Stress and Job Burnout in Iranian Clinical Pharmacist

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    Armaghan Eslami


    Full Text Available Background: Stress is an important element of organization ineffectiveness and since it leads to sickness, eventually it reduces quality and quantity of health care, lead to expansion of it costs and low job satisfaction. Stress comes along with consequences, one of this reactions which comes along with horrible effects is job burnout. Health care are more exposed for job burnout. We examined the relationship between job stress and job burnout in Iranian clinical pharmacist.Methods: Sample was 50 of men and women of clinical pharmacist. Parker and De cotiis  scale (1983 and Maslach Burnout Inventory (MBI, 1981 were used to asses clinical pharmacist stress and burnout. Data were analyzed by applying regression method.Results: Results indicated that there is strong relationship between stress and burnout and its three dimensions. The result also indicated that stress have the highest impact on emotional exhaustion and the least on the depersonalization.Conclusion: Burnout is a result of stress in human services career. Human service needs are vary from other professions since in these jobs in order to fulfill the clients’ needs, employees should use themselves as the required technology, and in return they do not receive gratitude or appreciation.

  4. Arkansas: a leading laboratory for health care payment and delivery system reform. (United States)

    Bachrach, Deborah; du Pont, Lammot; Lipson, Mindy


    As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make significant funds available for states seeking to transform their health care systems. In crafting their reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state's particular health care landscape.

  5. A demographic comparison of two black bear populations in the Interior Highlands of Arkansas (United States)

    Clark, Joseph D.; Smith, Kimberly G.


    The Ozark and Ouachita mountain regions of western Arkansas, collectively known as the Interior Highlands, historically supported large numbers of black bears (Ursus americanus). Indiscriminate killing of bears by early settlers and subsequent habitat reductions due to extensive logging and changes in land use resulted in their decline (Smith et al. 1991). By the late 1940's, bears had been extirpated from both regions (Holder 1951).

  6. Field Evaluation of Four Spatial Repellent Devices Against Arkansas Rice-Land Mosquitoes (United States)


    FIELD EVALUATION OF FOUR SPATIAL REPELLENT DEVICES AGAINST ARKANSAS RICE-LAND MOSQUITOES DAVID A. DAME,1 MAX V. MEISCH,2 CAROLYN N. LEWIS,2 DANIEL L... mosquitoes to locate a host. There are many commercially available spatial repellent products currently on the market. These products include...a large rice growing area where late-spring and summer agricultural irriga- tion generates dense mosquito populations. Spatial repellent devices

  7. Molecular Detection of Rickettsia Species Within Ticks (Acari: Ixodidae) Collected from Arkansas United States. (United States)

    Trout Fryxell, R T; Steelman, C D; Szalanski, A L; Billingsley, P M; Williamson, P C


    Rocky Mountain spotted fever (RMSF), caused by the etiological agent Rickettsia rickettsii, is the most severe and frequently reported rickettsial illness in the United States, and is commonly diagnosed throughout the southeast. With the discoveries of Rickettsia parkeri and other spotted fever group rickettsiae (SFGR) in ticks, it remains inconclusive if the cases reported as RMSF are truly caused by R. rickettsii or other SFGR. Arkansas reports one of the highest incidence rates of RMSF in the country; consequently, to identify the rickettsiae in Arkansas, 1,731 ticks, 250 white-tailed deer, and 189 canines were screened by polymerase chain reaction (PCR) for the rickettsial genes gltA, rompB, and ompA. None of the white-tailed deer were positive, while two of the canines (1.1%) and 502 (29.0%) of the ticks were PCR positive. Five different tick species were PCR positive: 244 (37%) Amblyomma americanum L., 130 (38%) Ixodes scapularis Say, 65 (39%) Amblyomma maculatum (Koch), 30 (9%) Rhipicephalus sanguineus Latreille, 7 (4%) Dermacentor variabilis Say, and 26 (44%) unidentified Amblyomma ticks. None of the sequenced products were homologous to R. rickettsii. The most common Rickettsia via rompB amplification was Rickettsia montanensis and nonpathogenic Candidatus Rickettsia amblyommii, whereas with ompA amplification the most common Rickettsia was Ca. R. amblyommii. Many tick specimens collected in northwest Arkansas were PCR positive and these were commonly A. americanum harboring Ca. R. amblyommii, a currently nonpathogenic Rickettsia. Data reported here indicate that pathogenic R. rickettsii was absent from these ticks and suggest by extension that other SFGR are likely the causative agents for Arkansas diagnosed RMSF cases.

  8. Distributing medical expertise: the evolution and impact of telemedicine in arkansas. (United States)

    Lowery, Curtis L; Bronstein, Janet M; Benton, Tina L; Fletcher, David A


    Arkansas's telemedicine system has evolved since 2003 from a support mechanism for high-risk pregnancy consultations to an initiative that spans medical specialties, including asthma care, pediatric cardiology, gynecology, and mental health. The system has also expanded care to diverse populations, including incarcerated women and people with HIV/AIDS. This article describes the system's evolution, organization, and diverse activities. It also shows how telemedicine can have a positive impact on a rural state and how such a state can become an engine for change regionally. The Arkansas telemedicine system faced classic challenges to uptake and function, in building and sustaining funding, in obtaining insurance reimbursement for services, and in educating patients and providers. The system's impacts on health outcomes and medical practice culture have also reached beyond patient care and provider support. The existing yet continually evolving telemedicine infrastructure and partnerships in Arkansas will respond to the state's inevitable health care reform adaptations from the Affordable Care Act and could provide direction for other states seeking to adopt or expand their telemedicine efforts.

  9. Evaluation of Community Pharmacists Performance in Management of Cough, Diarrhea and Common Cold using OTC Medication Requests in Hamadan in 2015

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    A. Rashidi


    Full Text Available Introduction & Objective: Pharmacists usually encounter requests for over the counter drugs. How a pharmacist performs in evaluating patients' signs and symptoms, treating them, and moreover his or her approach in prescribing over the counter (OTC medications were the main goals of this study. Materials & Methods: In this cross- sectional study, the scenarios of cough, diarrhea and com-mon cold were obtained from questionnaires. These scenarios were then designed by deter-mining key questions. From the overall pharmacies in Hamadan, for each of the three scenar-ios, 46 pharmacies were randomly selected and analyzed. Performance of pharmacists, includ-ing their interventions on over the counter counseling, asking key questions, explaining drugs' side effects and interactions, and their approach of prescribing medications, were measured. Moreover, the influence of pharmacists' gender and type of the pharmacy were determined. Results: In 41 out of 179 visits, pharmacists were not present in the pharmacy (22.9%, mostly in suburban pharmacies. The pharmacists' performances in explaining drug interactions were significantly better in urban pharmacies in comparison with suburban ones. Moreover, subur-ban pharmacies and male pharmacists, in comparison with urban pharmacies and female pharmacists, prescribed more drugs. Conclusion: This study shows that despite the pharmacists asking the key questions ,the major-ity of pharmacists made weak recommendations. In order to improve pharmacists perform-ances, modification of educational system for pharmacy students in addition to the continu-ous and effective supervision of authorities on pharmacists' performance in OTC drugs is suggested. (Sci J Hamadan Univ Med Sci 2016; 23 (2:164-171

  10. The impact of pharmacist certification on the quality of chemotherapy in Japan. (United States)

    Suzuki, Shinya; Sakurai, Hiroomi; Kawasumi, Kenji; Tahara, Makoto; Saito, Shinichiro; Endo, Kazushi


    Background In the Japanese healthcare system, board certification not only maintains the quality of daily practice but is also required for hospitals to receive healthcare reimbursement. To date, no data on the effects of the board certification system in Japanese hospitals have been reported. Objective We performed a survey to clarify the impact of pharmacist certification on the quality of chemotherapy. Setting A nationwide mailing survey was conducted in Japan. Method We surveyed oncology pharmacists from 388 cancer designated hospitals (DHs) and 984 randomly selected general hospitals (GHs). Main outcome measure Multivariate analysis of factors for compliance with standard cancer chemotherapy to clarify the impact of pharmacist certification on the quality of chemotherapy. Results The response rate was 70.6 % (274/388) at the DHs and 43.4 % (428/984) at the GHs. Of the 13 different regimens, 66.1 % (181/274) of DHs and 64.7 % (277/428) of GHs reported having experienced either improper doses or intervals of drug administration. The median number of improper regimens was 1 at both the DHs (range 0-15) and GHs (range 0-22). We identified two groups of hospitals, those with two or more improper regimens and those with one improper regimen or less. Univariate analysis showed significant differences in the number of DHs (p < 0.01), performance of more than 10 chemotherapies per day (p < 0.05), presence of more than 400 beds (p < 0.01) and the professional qualifications of oncology pharmacists or medical oncologists. From multivariate analysis, significant differences were observed in certifications from the Japanese Society of Pharmacy Healthcare and Sciences certified Senior Oncology Pharmacist (odds ratio 0.29, p < 0.01) and the Japanese Society of Medical Oncology certified oncologist (odds ratio 0.48, p < 0.01). Conclusion Board certification was more prevalent in the designated (cancer specialist) hospitals than general hospitals and adherence to

  11. Optimizing hepatitis C virus treatment through pharmacist interventions: Identification and management of drug-drug interactions (United States)

    Langness, Jacob A; Nguyen, Matthew; Wieland, Amanda; Everson, Gregory T; Kiser, Jennifer J


    AIM To quantify drug-drug-interactions (DDIs) encountered in patients prescribed hepatitis C virus (HCV) treatment, the interventions made, and the time spent in this process. METHODS As standard of care, a clinical pharmacist screened for DDIs in patients prescribed direct acting antiviral (DAA) HCV treatment between November 2013 and July 2015 at the University of Colorado Hepatology Clinic. HCV regimens prescribed included ledipasvir/sofosbuvir (LDV/SOF), paritaprevir/ritonavir/ombitasvir/dasabuvir (OBV/PTV/r + DSV), simeprevir/sofosbuvir (SIM/SOF), and sofosbuvir/ribavirin (SOF/RBV). This retrospective analysis reviewed the work completed by the clinical pharmacist in order to measure the aims identified for the study. The number and type of DDIs identified were summarized with descriptive statistics. RESULTS Six hundred and sixty four patients (83.4% Caucasian, 57% male, average 56.7 years old) were identified; 369 for LDV/SOF, 48 for OBV/PTV/r + DSV, 114 for SIM/SOF, and 133 for SOF/RBV. Fifty-one point five per cent of patients were cirrhotic. Overall, 5217 medications were reviewed (7.86 medications per patient) and 781 interactions identified (1.18 interactions per patient). The number of interactions were fewest for SOF/RBV (0.17 interactions per patient) and highest for OBV/PTV/r + DSV (2.48 interactions per patient). LDV/SOF and SIM/SOF had similar number of interactions (1.28 and 1.48 interactions per patient, respectively). Gastric acid modifiers and vitamin/herbal supplements commonly caused interactions with LDV/SOF. Hypertensive agents, analgesics, and psychiatric medications frequently caused interactions with OBV/PTV/r + DSV and SIM/SOF. To manage these interactions, the pharmacists most often recommended discontinuing the medication (28.9%), increasing monitoring for toxicities (24.1%), or separating administration times (18.2%). The pharmacist chart review for each patient usually took approximately 30 min, with additional time for more complex

  12. Methods and applications of electrical simulation in ground-water studies in the lower Arkansas and Verdigris River Valleys, Arkansas and Oklahoma (United States)

    Bedinger, M.S.; Reed, J.E.; Wells, C.J.; Swafford, B.F.


    The Arkansas River Multiple-Purpose Plan will provide year-round navigation on the Arkansas River from near its mouth to Muskogee, Okla., and on the Verdigris River from Muskogee to Catoosa, Okla. The altered regimen in the Arkansas and Verdigris Rivers will affect ground-water conditions in the adjacent alluvial aquifers. In 1957 the U.S. Geological Survey and U.S. Army Corps of Engineers entered into a cooperative agreement for a comprehensive ground-water study of the lower Arkansas and Verdigris River valleys. At the request of the Corps of Engineers, the Geological Survey agreed to provide (1) basic ground-water data before, during, and after construction of the Multiple-Purpose Plan and (2) interpretation and projections of postconstruction ground-water conditions. The data collected were used by the Corps of Engineers in preliminary foundation and excavation estimates and by the Geological Survey as the basis for defining the hydrologic properties of, and the ground-water conditions in, the aquifer. The projections of postconstruction ground-water conditions were used by the Corps of Engineers in the planning, design, construction, and operation of the Multiple-Purpose Plan. Analysis and projections of ground-water conditions were made by use of electrical analog models. These models use the analogy between the flow of electricity in a resistance-capacitance circuit and the flow of a liquid in a porous and permeable medium. Verification provides a test of the validity of the analog to perform as the aquifer would, within the range of historic forces. The verification process consists of simulating the action of historic forces which have acted upon the aquifer and of duplicating the aquifer response with the analog. The areal distribution of accretion can be treated as an unknown and can be determined by analog simulation of the piezometric surface in an aquifer. Comparison of accretion with depth to piezometric surface below land surface shows that

  13. A Study of the School Principal Labor Market in Arkansas: Implications for Incentive-Based Compensation Policies to Improve Principal Quality (United States)

    Holley, Marc Jacob


    Improving principal quality in Arkansas may be a partial solution to the public policy problem of low performing public schools. Just as policymakers in other states are beginning to explore incentive-based compensation policies to improve principal quality, education policymakers in Arkansas should look to these policies as a way to align goals…

  14. How organizational context affects bioethical decision-making: pharmacists' management of gatekeeping processes in retail and hospital settings. (United States)

    Chiarello, Elizabeth


    Social science studies of bioethics demonstrate that ethics are highly contextual, functioning differently across local settings as actors make daily decisions "on the ground." Sociological studies that demonstrate the key role organizations play in shaping ethical decision-making have disproportionately focused on physicians and nurses working in hospital settings where they contend with life and death issues. This study broadens our understanding of the contexts of ethical decision-making by empirically examining understudied healthcare professionals - pharmacists - working in two organizational settings, retail and hospital, where they act as gatekeepers to regulated goods and services as they contend with ethical issues ranging from the serious to the mundane. This study asks: How do organizations shape pharmacists' identification, negotiation, and resolution of ethical challenges; in other words, how do organizations shape pharmacists' gatekeeping processes? Based on 95 semi-structured interviews with U.S. pharmacists practicing in retail and hospital pharmacies conducted between September 2009 and May 2011, this research finds that organizations influence ethical decision-making by shaping how pharmacists construct four gatekeeping processes: medical, legal, fiscal, and moral. Each gatekeeping process manifests differently across organizations due to how these settings structure inter-professional power dynamics, proximity to patients, and means of accessing information. Findings suggest new directions for theorizing about ethical decision-making in medical contexts by drawing attention to new ethical actors, new organizational settings, an expanded definition of ethical challenges, and a broader conceptualization of gatekeeping.

  15. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

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    Shah M


    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  16. A Qualitative Study of Prescription Contraception Use: The Perspectives of Users, General Practitioners and Pharmacists.

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    Leigh-Ann Sweeney

    Full Text Available The oral contraceptive pill (OCP remains the most popular form of prescription contraception in many countries, despite adherence difficulties for many. Uptake of long acting reversible contraceptives (LARCs, which are less reliant on user adherence, remains low. The aim of this study was to explore the experiences of, and attitudes towards, prescription contraception amongst samples of contraception users, general practitioners (GPs and pharmacists.We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked.There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all

  17. Addressing the Issue of Chronic, Inappropriate Benzodiazepine Use: How Can Pharmacists Play a Role?

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    Helen C. Gallagher


    Full Text Available Prescribing guidelines do not recommend the long-term use of benzodiazepines since their effectiveness with chronic use is out-weighed by risks including dependence, memory and cognitive impairment, hip fractures and traffic accidents. Despite these guidelines, historical data points to an increasing proportion of inappropriate, repeat prescribing of benzodiazepines in Ireland and elsewhere, with up to 33% of patients who use these drugs doing so long-term. The typical long-term benzodiazepine user is an older, socio-economically disadvantaged patient who has been prescribed these medicines by their general practitioner (GP and dispensed them by their community pharmacist. Misuse of benzodiazepines in nursing homes and psychiatric institutions is also of concern, with one Irish study indicating that almost half of all admissions to a psychiatric hospital were prescribed these drugs, usually despite a lack of clear clinical need. Discontinuation of benzodiazepines has proven to be of benefit, as it is followed by improvements in cognitive and psychomotor function, particularly in elderly patients. It is obvious that an inter-professional effort, focusing on the primary care setting, is required to address benzodiazepine misuse and to ensure appropriate pharmaceutical care. Pharmacists must be an integral part of this inter-professional effort, not least because they are uniquely positioned as the health professional with most frequent patient contact. There is already some supporting evidence that pharmacists’ involvement in interventions to reduce benzodiazepine use can have positive effects on patient outcomes. Here, this evidence is reviewed and the potential for pharmacists to play an expanded role in ensuring the appropriate use of benzodiazepines is discussed.

  18. Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP) therapy for HIV prevention. (United States)

    Clauson, Kevin A; Polen, Hyla H; Joseph, Shine A; Zapantis, Antonia


    With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP) is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies). They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an "evening before pill". The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy, and developing policy

  19. Project ImPACT: Hypertension Outcomes of a Pharmacist-Provided Hypertension Service

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    Carrie Wentz Nemerovski, PharmD, BCPS


    Full Text Available Objective: To evaluate the impact of pharmacists, working collaboratively with patients, on blood pressure control, lifestyle goal setting, adherence to antihypertensive therapy, patient knowledge and satisfaction, and modification of cardiovascular risk factors.Methods: Self-declared hypertensive patients met with the pharmacist for blood pressure monitoring, lifestyle goal setting, and education about medications and disease state on four occasions over a 6–month period.Practice innovation: A community pharmacy partnered with an employer wellness plan to provide education and monitoring for patients with hypertension based on home blood pressure readings obtained using monitors that wirelessly transmit information to the pharmacist. Main outcome measure(s: Percentage of patients at blood pressure goal, mean blood pressure, percentage of patients with lifestyle goals, medication adherence, patient knowledge and satisfaction, and modification of cardiovascular risk factors. Results: Patients not at their goal blood pressure at baseline had a significant decrease in blood pressure and a significant increase in achievement of their blood pressure goals. Across the population, no significant changes were seen in the primary outcome, lifestyle goals, medication adherence or modification of cardiovascular risk factors. Patient knowledge increased from baseline and satisfaction with the service was high. Conclusion: Blood pressure control improved in patients not at their treatment goal. All patients increased their knowledge about hypertension and reported high satisfaction with the pharmacy service. Pharmacy services should be offered to patients who are more likely to reap a benefit. Home blood pressure readings are useful to inform clinical decision making and supplement patient consultation within the pharmacy setting.

  20. [Review of drug information provided to patients from the viewpoint of hospital pharmacists]. (United States)

    Orii, Takao


    Risks for patients and consumers can be minimized depending on how they are provided appropriate drug information. Therefore, from the viewpoint of hospital pharmacists, I would like to report on how information should be provided in order to minimize patient risk. For example, there is an ongoing opinion that the provision of easy-to-understand drug information to patients and consumers "does not appear necessary". The reasons for this include the following: Because the level of understanding varies greatly among patients, it is difficult to define what "easy-to-understand" information entails; rather, it may cause misunderstanding. These problems occur repeatedly if they are resolved by individual institutions. Therefore, it is essential to standardize the drug information provided to patients, that is, to establish a system to transmit drug information to patients and consumers. Regardless of whether the development of a hospital information system is in progress or not, it can be said that the development of such information systems is gradually spreading outside of hospitals and the situation is changing. From the viewpoint of patients, medical services are not limited to those from hospitals. Patient-centered collaboration between hospitals/clinics and pharmacies (but not the collaboration between hospital pharmacists and community pharmacists (why not?)) can provide good medical services only if patient information is shared. It is essential to establish a system for providing a drug guide for patients, in order to have patients understand drug information. The preparation of Drug Information for Patients would provide health care specialists a communication tool that helps minimize patient risk.

  1. Patterns of Adverse Drug Reactions in Different Age Groups: Analysis of Spontaneous Reports by Community Pharmacists.

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    Yun Mi Yu

    Full Text Available To evaluate the clinical manifestations and causative drugs associated with adverse drug reactions (ADRs spontaneously reported by community pharmacists and to compare the ADRs by age.ADRs reported to the Regional Pharmacovigilance Center of the Korean Pharmaceutical Association by community pharmacists from January 2013 to June 2014 were included. Causality was assessed using the WHO-Uppsala Monitoring Centre system. The patient population was classified into three age groups. We analyzed 31,398 (74.9% ADRs from 9,705 patients, identified as having a causal relationship, from a total pool of 41,930 ADRs from 9,873 patients. Median patient age was 58.0 years; 66.9% were female.Gastrointestinal system (34.4%, nervous system (14.4%, and psychiatric (12.1% disorders were the most frequent symptoms. Prevalent causative drugs were those for acid-related disorders (11.4%, anti-inflammatory products (10.5%, analgesics (7.2%, and antibacterials (7.1%. Comparisons by age revealed diarrhea and antibacterials to be most commonly associated with ADRs in children (p < 0.001, whereas dizziness was prevalent in the elderly (p < 0.001. Anaphylactic reaction was the most frequent serious event (19.7%, mainly associated with cephalosporins and non-steroidal anti-inflammatory drugs. Among 612 ADRs caused by nonprescription drugs, the leading symptoms and causative drugs were skin disorders (29.6% and non-steroidal anti-inflammatory drugs (16.2%, respectively.According to the community pharmacist reports, the leading clinical manifestations and causative drugs associated with ADRs in outpatients differed among age groups.

  2. [Pharmacy, pharmacists and society--pharmaceutical science and practice with philosophy]. (United States)

    Nagai, Tsuneji


    In Japanese pharmaceutical community, there seems to be a lack of "Science of Science" and "Research on Research" which are to utilize unit sciences and research for the benefit of human being. In other words, pharmaceutical people in Japan should have much more pharmaceutical philosophy. The late Professor Komei Miyaki, founder Editor-in-Chief of FARUMASHIA, the monthly membership magazine of Pharmaceutical Society of Japan, under whom I worked as one of editorial board members, taught me that scientists should have their own philosophy of their sciences. Such a pharmaceutical philosophy as mentioned above should be established on the basis of complete separation of medical profession between doctors and pharmacists, which form the most important and necessary issue in safety assurance for patients with the complete zero defect (ZD action), as there is a long history for that in Europe since the separation was completed by King Friedrich II in 1240. Therefore, we have to learn the social status of European/American pharmacist practitioners who are the great No. 1 among all the professions. European pharmacists guarantee the safety of every chemical used for human body and pets, such as medicines, cosmetics, foods, tooth stuffs and so on. Regarding the pharmaceutical sciences in Japan also there seems to be a lack of pharmaceutical philosophy, as pharmaceutical scientists have no identity in research object that may be similar to basic scientists who are non-pharmacy graduates. Japanese sciences generally have developed along the lines of the Western model, reaching the current high level. We now not only should receive profits from the outside but also should embark on a mission to support pharmaceutical sciences throughout the world, especially Asian courtiers. At the present, we do not seem to be fulfilling our mission to do that, even though general activity includes significant international exchange. We have to make much more effort for international

  3. Depression during pregnancy: views on antidepressant use and information sources of general practitioners and pharmacists

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    Schobben Fred


    Full Text Available Abstract Background The use of antidepressants during pregnancy has increased in recent years. In the Netherlands, almost 2% of all pregnant women are exposed to antidepressants. Although guidelines have been developed on considerations that should be taken into account, prescribing antidepressants during pregnancy is still a subject of debate. Physicians and pharmacists may have opposing views on using medication during pregnancy and may give contradictory advice on whether or not to take medication for depression and anxiety disorders during pregnancy. In this study, we investigated information sources used by general practitioners (GPs and pharmacists and their common practices. Methods A questionnaire on the use of information sources and the general approach when managing depression during pregnancy was sent out to 1400 health care professionals to assess information sources on drug safety during pregnancy and also the factors that influence decision-making. The questionnaires consisted predominantly of closed multiple-choice questions. Results A total of 130 GPs (19% and 144 pharmacists (21% responded. The most popular source of information on the safety of drug use during pregnancy is the Dutch National Health Insurance System Formulary, while a minority of respondents contacts the Dutch national Teratology Information Service (TIS. The majority of GPs contact the pharmacy with questions concerning drug use during pregnancy. There is no clear line with regard to treatment or consensus between GPs on the best therapeutic strategy, nor do practitioners agree upon the drug of first choice. GPs have different views on stopping or continuing antidepressants during pregnancy or applying alternative treatment options. The debate appears to be ongoing as to whether or not specialised care for mother and child is indicated in cases of gestational antidepressant use. Conclusion Primary health care workers are not univocal concerning therapy for

  4. Outreach visits by clinical pharmacists improve screening for the metabolic syndrome among mentally ill patients

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Hansen, Per Sveistrup; Kristensen, Anne Mette Fisker


    Background: Patients suffering from schizophrenia and affective disorder have an increased risk of the metabolic syndrome (MeS); hence identification of patients developing MeS may help preventing morbidity and mortality. Aims: The aim of the study was to evaluate the effect of outreach visit...... by clinical pharmacists to support the implementation of screening of MeS at a psychiatric ward. Methods: The study was conducted at the psychiatric ward, Odense University Hospital. In 2008, clinical guidelines for systematic screening and prevention of metabolic risk were developed and implemented...

  5. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless? (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia


    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  6. Validation of the knowledge, attitude and perceived practice of asthma instrument among community pharmacists using Rasch analysis. (United States)

    Akram, Waqas; Hussein, Maryam S E; Ahmad, Sohail; Mamat, Mohd N; Ismail, Nahlah E


    There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software®) for dichotomous and polytomous data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.

  7. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s

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    Freeman Christopher


    Full Text Available Abstract Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist into the Australian general practice environment. Methods A sample of general practitioners, health care consumers, pharmacists and practice managers in South-East Queensland were invited to participate in focus groups or semi-structured interviews. Seeding questions common to all sessions were used to facilitate discussion. Sessions were audio recorded and transcribed verbatim. Leximancer software was used to qualitatively analyse responses. Results A total of 58 participants took part in five focus groups and eighteen semi-structured interviews. Concepts relating to six themes based on the seeding questions were identified. These included positively viewed roles such as medication reviews and prescribing, negatively viewed roles such as dispensing and diagnosing, barriers to pharmacist integration such as medical culture and remuneration, facilitators to pharmacist integration such as remuneration and training, benefits of integration such as access to the patient’s medical file, and potential funding models. Conclusions These findings and future research may aid the development of a new model of integrated primary health care services involving pharmacist practitioners.

  8. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s (United States)


    Background Pharmacists are viewed as highly trained yet underutilised and there is growing support to extend the role of the pharmacist within the primary health care sector. The integration of a pharmacist into a general practice medical centre is not a new concept however is a novel approach in Australia and evidence supporting this role is currently limited. This study aimed to describe the opinions of local stakeholders in South-East Queensland on the integration of a pharmacist into the Australian general practice environment. Methods A sample of general practitioners, health care consumers, pharmacists and practice managers in South-East Queensland were invited to participate in focus groups or semi-structured interviews. Seeding questions common to all sessions were used to facilitate discussion. Sessions were audio recorded and transcribed verbatim. Leximancer software was used to qualitatively analyse responses. Results A total of 58 participants took part in five focus groups and eighteen semi-structured interviews. Concepts relating to six themes based on the seeding questions were identified. These included positively viewed roles such as medication reviews and prescribing, negatively viewed roles such as dispensing and diagnosing, barriers to pharmacist integration such as medical culture and remuneration, facilitators to pharmacist integration such as remuneration and training, benefits of integration such as access to the patient’s medical file, and potential funding models. Conclusions These findings and future research may aid the development of a new model of integrated primary health care services involving pharmacist practitioners. PMID:22852792

  9. [Research survey on the information gathering methods, attitudes, and requests from care managers about the pharmaceutical service by pharmacists in home care]. (United States)

    Nanaumi, Yoko; Onda, Mitsuko; Sakurai, Hidehiko; Tanaka, Rie; Tsubota, Kenichi; Matoba, Shunya; Mukai, Yusuke; Arakawa, Yukio; Hayase, Yukitoshi


    Care Managers (CMs) were surveyed to clarify the issues involving the promotion of cooperation between care managers and pharmacists in long-term-care and explore solutions. The length of work experience, occupational background, experience of pharmaceutical service; pharmacist visit patients' home for providing medicine and pharmaceutical care into a care plan, degree of understanding on pharmaceutical service, and awareness of work involved in pharmaceutical service were studied to see whether there made differences in the requests from CMs for information on pharmacists and for information gathering methods. The χ(2) test was used to this end. The opinions and requests described by the CMs were validated through text mining. More CMs tended to obtain information and knowledge through training sessions and professional magazines than those who did so through cooperation with pharmacists on a practical level. However, the survey strongly indicated that CMs with high level of understanding and awareness of pharmaceutical service wished to obtain information on pharmacists through cooperation with them on a practical level, and CMs with low level of understanding and awareness of pharmaceutical service wished to obtain such information through training sessions and professional magazines. Results of text mining showed that CMs wished pharmacists to strengthen the cooperation with physicians and provide information on pharmaceutical service. These findings have led to the conclusion that the issues surrounding the promotion of cooperation between CMs and pharmacists centered around "work cooperation on a practical level" and "provision of information to CMs about the roles of pharmacies and pharmacists and their work."

  10. Potentiometric surfaces in the Cockfield and Wilcox aquifers of southern and northeastern Arkansas, 2003 (United States)

    Yeatts, Daniel S.


    This report presents the results of water-level measurements made at wells in the Cockfield Formation and Wilcox Group of southern and northeastern Arkansas during 2003, and the water levels are displayed in potentiometric-surface maps and hydrographs. During March and April 2003, the water level was measured at 55 wells completed in the Cockfield aquifer, 13 wells completed in the Wilcox aquifer of southern Arkansas, and 43 wells completed in the Wilcox aquifer of northeastern Arkansas. The Cockfield Formation generally consists of discontinuous sand units interbedded with silt, clay, and lignite in southeastern Arkansas. Sand beds near the base of the Cockfield Formation constitute most of the Cockfield aquifer. Withdrawals from the Cockfield aquifer in the study area during 2000 totaled about 9 million gallons per day. The potentiometric surface of the Cockfield aquifer constructed from the 2003 water levels shows that regional direction of ground-water flow generally is towards the east and southeast, away from the outcrop, except in areas of intense ground-water withdrawals. Some local ground-water flow in the outcrop area is toward rivers that have eroded into the Cockfield Formation and deposited alluvium in south Bradley and Calhoun Counties (Ouachita River), and in north Dallas County (Saline River). An evaluation of 20 wells with water-level data from 1983 to 2003 shows that water levels in 15 wells have declined at a rate of -0.04 to -0.97 feet per year, and water levels in 5 wells have risen at a rate of 0.07 to 0.32 feet per year. An evaluation of the same 20 wells from 2000 to 2003 shows that water levels have declined in only 8 wells, and water levels have risen in 12 wells. The Wilcox Group is distributed throughout most of southern and eastern Arkansas. There are two study areas in southern and northeastern Arkansas. The Wilcox Group of the southern study area consists of interbedded clay, sandy clay, sand, and lignite. Thin discontinuous sand

  11. The contribution of a clinical pharmacist to the improvement of medication at a geriatric hospital unit in Norway.

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    Veggeland T


    Full Text Available The aim of the study was to use a clinical pharmacist in order to improve the medication of patients in a geriatric hospital unit. The hospital had no experience of using a clinical pharmacist before.Methods: A clinical pharmacist participated in the therapeutic team for 27 days during a 4-year period. Drug-related problems were recorded prospectively and discussed before and at the ward round. The results of the physician’s decisions on the current day about potential changes in medication proposed by the pharmacist were continuously recorded.Results: The pharmacist evaluated the medication of 250 patients. At least one drug- related problem was found in 188 (75% of the patients. For these patients, the physician made 606 decisions concerning potential changes in the medication (3.2 per patient. Thirty percent (184/606 of the decisions were connected to further measurements and to the follow-up of laboratory results, mainly (82%, 151/184 for cardiovascular drugs. Forty-two percent (255/606 of the decisions resulted in the discontinuation of drugs, dosage reduction or a decision to revise the assessment at a later stage during hospitalisation. Medicines with anticholinergic adverse effects were to a great extent withdrawn. Twenty-one percent (129/606 of the decisions were made on drugs with an addiction potential: hypnotics, anxiolytics, as well as analgesics containing tramadol and codeine. The result was often (71%, 91/129 dosage reduction, a change from fixed medication to medication on demand or to discontinuation. Conclusion: Even with a modest participation of once a month, the evaluation of a patient’s medication by a clinical pharmacist led to improved changes and the follow-up of the medication of the elderly.

  12. Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges

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    Bajorek B


    Full Text Available Background: Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP pressure control in patients with hypertension. Objective: The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges. Method: A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups: Group A (Control – usual care, Group B (Intervention, or Group C (Short Intervention. Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service. Results: Significant changes to key outcome measures were observed in Group C: reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively, improvement in medication adherence scores (P=0.01, and a slight improvement in quality of life (EQ-5D-3L Index scores (P=0.91. There were no significant changes in Group B (the full intervention, and no differences in comparison to Group A (usual care. Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening. Conclusion: A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context.

  13. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

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    David O Riordan


    Full Text Available Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid, Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect,, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America. Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of

  14. Analysis of pharmacists' opinions, attitudes and experiences with generic drugs and generic substitution in the Czech Republic. (United States)

    Maly, Josef; Dosedel, Martin; Kubena, Ales; Vlcek, Jiri


    Generic substitution (GS) is an integral part of drug policy in many countries. Similarly to other countries its introduction in the Czech Republic gave rise to a vibrant discussion. The aim of the study was to map and analyze pharmacists' opinions of, attitudes towards and experiences with generic drugs and GS after the first year from its legislative embodiment in the Czech Republic. All 7,665 members of the Czech Chamber of Pharmacists were addressed to participate in a questionnaire survey between November 2008 and March 2009. The questionnaire consisted of 28 questions concerning the issue of generic drugs and GS and was divided into five sections. All collected data were analyzed using descriptive statistics and correlations were tested by selected parametric and non-parametric tests. A total of 615 completed questionnaire forms were returned (a questionnaire return rate of 8.0%). The demographic characteristics of the respondents were as follows: 470 (76.4%) females, mean age of 37.5 years (SD = 10.4) and 429 (69.6%) pharmacists with a practice specialization. Altogether 345 (56.1%) respondents became aware of the issue of brand name and generic drugs during their undergraduate studies. 378 (61.5%) respondents considered generic drugs as bioequivalent and 455 (74.0%) respondents as therapeutically equivalent to the respective brand name drugs. 99 (16.1%) pharmacists believed that generic products are of lower quality than branded drugs and 69 (11.2%) respondents expected generics to cause more adverse drug reactions. GS was perceived as a positive tool by 476 (77.4%) respondents. Only 71 (11.5%) respondents showed acquaintance with all the legal rules for GS. Legislation awareness and attitude towards GS was correlated with age (p generic drugs and GS. Approaching patients on an individual basis and pharmacists' awareness can minimize adverse drug events caused by generic drugs and at the same time enhance the professional status of pharmacists.

  15. Should pharmacists have a role in harm reduction services for IDUs? A qualitative study in Tallinn, Estonia. (United States)

    Vorobjov, Sigrid; Uusküla, Anneli; Abel-Ollo, Katri; Talu, Ave; Jarlais, Don Des


    Despite the high number of injecting drug users (IDUs) in Estonia, little is known about involving pharmacies into human immunodeficiency virus (HIV) prevention activities and potential barriers. Similarly, in other Eastern European countries, there is a need for additional sources for clean syringes besides syringe exchange programmes (SEPs), but data on current practices relating to pharmacists' role in harm reduction strategies is scant. Involving pharmacies is especially important for several reasons: they have extended hours of operation and convenient locations compared to SEPs, may provide access for IDUs who have avoided SEPs, and are a trusted health resource in the community. We conducted a series of focus groups with pharmacists and IDUs in Tallinn, Estonia, to explore their attitudes toward the role of pharmacists in HIV prevention activities for IDUs. Many, but not all, pharmacists reported a readiness to sell syringes to IDUs to help prevent HIV transmission. However, negative attitudes toward IDUs in general and syringe sales to them specifically were identified as important factors restricting such sales. The idea of free distribution of clean syringes or other injecting equipment and disposal of used syringes in pharmacies elicited strong resistance. IDUs stated that pharmacies were convenient for acquiring syringes due to their extended opening hours and local distribution. IDUs were positive toward pharmacies, although they were aware of stigma from pharmacists and other customers. They also emphasized the need for distilled water and other injection paraphernalia. In conclusion, there are no formal or legislative obstacles for providing HIV prevention services for IDUs at pharmacies. Addressing negative attitudes through educational courses and involving pharmacists willing to be public health educators in high drug use areas would improve access for HIV prevention services for IDUs.

  16. Impact of drugs counselling by an undergraduate pharmacist on cardiac surgical patient’s compliance to medicines

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    Zerafa N


    Full Text Available Open heart surgery is a procedure which warrants patient education about the complexity of drug regimens and lifestyle modifications. Patient nonadherence is likely to have a considerable negative impact on the patients’ quality of life post-cardiac surgery.Objective: To evaluate the impact of pharmacist intervention on patients’ adherence to medication and lifestyle changes.Method: This case-controlled study was conducted at the Cardiac Surgical Ward and Outpatients Clinic of Mater Dei Hospital, Malta. Eighty consecutive patients who underwent coronary artery bypass or heart valve surgery were interviewed on their day of discharge using the ‘Past Medical History Questionnaire’. The patients were then randomized to receive pharmacist intervention or usual care. Those who received intervention (40 patients were given a chart with pictorial explanation of the time of day together with a colorful photograph of each tablet prescribed. This group of patients was also counselled to comply to oral analgesia and exercise and also on the avoidance of alcohol and smoking during the recovery period. The control patients received usual care without the pharmacist intervention. All patients were re-interviewed eight weeks after discharge using the ‘Assessing Patient Compliance Questionnaire’. Any differences between the control and experimental groups were analysed using Chi-square, Three-Way Cross tabulation One-Way ANOVA and Two-Way ANOVA tests using the SPSS software version 17.0.Results: A statistically significant difference between the two groups in the mean percentage compliance was registered following pharmacist intervention (p<0.05. Patients in the experimental group had a higher mean percentage compliance score (88% than patients in the control group (66%.Conclusion: The statistically significant difference in the mean percentage compliance between the two groups following pharmacist intervention shows conclusive evidence of the

  17. The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

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    Ann M. Fugit, Pharm.D., BCPS


    Full Text Available Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: Types of interventions documented during the patient-pharmacist visit, categorized as medication review, patient education, or adherence monitoring. Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%, patient education (23.3%, and adherence monitoring (9.8%. Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS (P = 0.01, have current or history of opportunistic infection (OI (P=0.01, and have current or history of OI prophylaxis (P = 0.03. Adherence monitoring was less common amongst the non-Hispanics (7.1% compared to the Hispanic sub-population (16.5%, (P = 0.04. Conclusion: The role of ambulatory care pharmacists in a free and bilingual clinic goes beyond adherence monitoring. Pharmacists can be a valuable part of the patient care team by providing medication review and patient education for HIV and other co-morbidities within free clinics. Further research is warranted to assess outcomes and to further explore the underlying barriers to early HIV diagnosis and adherence within the Hispanic population.

  18. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review (United States)

    Riordan, David O; Walsh, Kieran A; Galvin, Rose; Sinnott, Carol; Kearney, Patricia M; Byrne, Stephen


    Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid), Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect,, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America). Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of patients. PMID

  19. Air pollution and cardiovascular and respiratory emergency visits in Central Arkansas: A time-series analysis (United States)

    Rodopoulou, Sophia; Samoli, Evangelia; Chalbot, Marie-Cecile G.; Kavouras, Ilias G.


    Background Heart disease and stroke mortality and morbidity rates in Arkansas are among the highest in the U.S. While the effect of air pollution on cardiovascular health was identified in traffic-dominated metropolitan areas, there is a lack of studies for populations with variable exposure profiles, demographic and disease characteristics. Objective Determine the short-term effects of air pollution on cardiovascular and respiratory morbidity in the stroke and heart failure belt. Methods We investigated the associations of fine particles and ozone with respiratory and cardiovascular emergency room visits during the 2002–2012 period for adults in Central Arkansas using Poisson generalized models adjusted for temporal, seasonal and meteorological effects. We evaluated sensitivity of the associations to mutual pollutant adjustment and effect modification patterns by sex, age, race and season. Results We found effects on cardiovascular and respiratory emergencies for PM2.5 (1.52% [95%CI: −1.10, 4.20]; 1.45% [95%CI: −2.64, 5.72] per 10 μg/m3) and O3 (0.93% [95%CI: −0.87, 2.76]; 0.76 [95%CI: −1.92, 3.52] per 10 ppbv) during the cold period (October–March). The effects were stronger among whites, except for the respiratory effects of O3 that were higher among Blacks/African-Americans. Effect modification patterns by age and sex differed by association. Both pollutants were associated with increases in emergency room visits for hypertension, heart failure and asthma. Effects on cardiovascular and respiratory emergencies were observed during the cold period when particulate matter was dominated by secondary nitrate and wood burning. Conclusion Outdoor particulate pollution during winter had an effect of cardiovascular morbidity in central Arkansas, the region with high stroke and heart disease incidence rates. PMID:26232212

  20. Medication problems are frequent and often serious in a Danish emergency department and may be discovered by clinical pharmacists

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Thisted, Anette Rehn; Olsen, Inger


    Transferring a patient from one health-care sector to another implies a risk of medication errors. It is of interest to evaluate whether a specialist in clinical pharmacy is beneficial for the patients in the emergency departments (ED). The aim of the present study was to report the incidence......, categories and seriousness of medication problems discovered by clinical pharmacists in an ED and to evaluate if it is possible for pharmacists to identify those groups of patients who are most at risk of medication problems....

  1. [Role of pharmacists during serious disasters and peace time--from the view of a physician]. (United States)

    Matsuda, Satoshi


    From April 9 to 16, 2011, I joined the first medical team at Ishinomaki as one of the supporting volunteers of Japan Primary Care Association for the 2011 East Japan Earthquake. I participated in launching the intensive care temporary clinic at Yugakukan. Yugakukan was one of the shelters set up right after the earthquake and tsunami on March 11, 2011. Later, it became the care unit for inpatients moved from Ishinomaki City General Hospital, which was crushed by the tsunami. Patients ranged in age and needs: from infant to elderly, and those needing internal and/or surgical medication or artificial dialysis. Under such conditions, we, as the first medical team members dispatched to the shelter, were concerned with the assessment of refugees and establishment of the management system of the shelter. Through the activities, I realized the utmost importance of "networking". In this paper, the role of pharmacists in disaster medicine, preparation for disaster medicine, and the role and function of pharmacists in community medicine under normal conditions will be demonstrated in relation to this keyword.

  2. The efficacy of practical skills mastering by students pharmacists during compounding practical training

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    L. O. Puchkan


    Full Text Available Introduction. Practical training give students opportunity of good mastering of practical skills. The aim of this article was to study efficacy of practical skills mastering by students pharmacists during practical training. Materials and methods. 110 5-thyear students pharmacists took part in this study. 200 tests were used as a base for practical skills assess. Statistic analysis with confidence level p<0,5 was used. Results and discussion. It was ascertained that average assess on the course was 93%±2%. Also 81 students from 110 got over 95%, 15 students got over 93% and 14 students got over 91%. Obtained results confirmed high quality of student’s training practical classes. Conclusions. Adoption of new technology in training is a necessity in process of student’s studying. Use of modern practical bases, workbooks and supervisor’s experience allow students to master practical skills. This experiment confirmed that students have average 93±2 per cent in computer tests and practical skills during practical studies.

  3. A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

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    Shamala Ayadurai


    Full Text Available Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods. A search on randomised controlled trials (RCT on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established. Conclusion. Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.

  4. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students]. (United States)

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori


    A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, "This health provider is professional", or "What a great person he/she is as a health provider". We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy-American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students).

  5. Prevention, education and information: the role of the community pharmacist in the management of headaches. (United States)

    Giaccone, M; Baratta, F; Allais, G; Brusa, P


    Headaches are among the most common disorders of the nervous system. On a global level, it is estimated that the prevalence of headache disorder in adults is 47 %. A proper treatment of headaches requires training of health care personnel, careful diagnosis and recognition of the condition, appropriate treatment with cost-effective drugs, simple changements in lifestyle and patient education. Unfortunately, a large number of people suffering from headache disorders are not diagnosed and treated. The unsatisfied needs in migraine can be faced by involving the pharmacist in the management of the pathology. To really understand which are the activities and the potential of community pharmacies in the management of patients with headache or migraine we took into account studies conducted around the world during the last 5 years. Based on the data collected it is clear that the role of the community pharmacist may be crucial in managing patients with headache or migraine but only if he receives an adequate and continuous education both on the management of therapies and maintains a stable relationship with the medical doctor and/or patient. In Piedmont a specific study to identify migraine sufferers has involved the community pharmacies in the administration of a questionnaire, specially crafted by the Italian Headache Foundation (FICEF non-profit association).

  6. A Model for Partnering First-Year Student Pharmacists With Community-Based Older Adults (United States)

    Porter, Andrea L.; Shawl, Lauren; Motl Moroney, Susannah E.


    Objectives. To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists’ views on aging and medication use through their work with a healthy, community-based older-adult population. Design. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). Assessment. As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. Conclusions. The model for partnering first-year student pharmacists with community-based older adults improved students’ skills and fostered their connections to pharmacist roles and growth as person-centered providers. PMID:22761526

  7. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

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    Ma CSJ


    Full Text Available Carolyn SJ Ma Department of Pharmacy Practice, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Honolulu, HI, USA Abstract: Oncology pharmacists, also known as oncology pharmacy specialists (OPSs have specialized knowledge of anticancer medications and their role in cancer. As essential member of the interdisciplinary team, OPSs optimize the benefits of drug therapy, help to minimize toxicities and work with patients on supportive care issues. The OPSs expanded role as experts in drug therapy extends to seven major key elements of medication management that include: selection, procurement, storage, preparation/dispensing, prescribing/dosing/transcribing, administration and monitoring/evaluation/education. As front line caregivers in hospital, ambulatory care, long-term care facilities, and community specialty pharmacies, the OPS also helps patients in areas of supportive care including nausea and vomiting, hematologic support, nutrition and infection control. This role helps the patient in the recovery phase between treatment cycles and adherence to chemotherapy treatment schedules essential for optimal treatment and outcome. Keywords: oncology pharmacist, oncology pharmacy specialist, medication management, chemotherapy

  8. The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. (United States)

    Carter, Barry L; Bosworth, Hayden B; Green, Beverly B


    Team-based care is one of the key components of the patient-centered medical home. Studies have consistently demonstrated that teams involving pharmacists or nurses in patient management can significantly improve blood pressure control. These findings have been demonstrated in several meta-analyses and systematic reviews. These reviews have generally found that team-based care can reduce systolic blood pressure by 4-10 mm Hg over usual care. However, these reviews have also concluded that many of the studies had various limitations and that additional research should be conducted. The present state of the art review paper will highlight newer studies, many of which were funded by the National Institutes of Health. Newer strategies involve telephone and/or web-based management which is an evolving area to improve blood pressure control in large populations. Social media and other technology is currently being investigated to assist pharmacists or nurses in communicating with patients to improve hypertension management. Few cost-effectiveness analyses have been performed but generally have found favorable costs for team-based care when considering the potential to reduce morbidity and mortality. The authors will suggest additional research that needs to be conducted to help evaluate strategies to best implement team-based care to improve blood pressure management.

  9. [Pharmacists in transition. Academy and Pharmacy in Mexico from 1833 to 1865]. (United States)

    Morales-Cosme, Alba Dolores; Viesca-Treviño, Carlos


    From the second half of the 19th century, health disciplines went through an institutional and professional restructuring, which progressively altered the guild order that had characterized them to that point. In the case of Pharmacy, this process implied the generation of officially recognized spaces, as the chairs of Pharmacy and Medical Substance, founded during the Establecimiento de Ciencias Médicas (Establishment of Medical Sciences) (1833). In those spaces it was sought to institutionalize knowledge and modern practices related to Pharmacy. In this work we look over the first academic experience of the pharmaceutical community in that new space of instruction, based on the records belonging to the students enrolled in the Establecimiento de Ciencias Médicas from 1833 to 1865, year of the enrollment of the last generation. The information contained in those 163 records displays the way the pharmaceutical field was transformed, after the aforementioned restructuring. The reader will notice the diverse normativity, which regulated the joining of pharmacists to academic life (of which, until then, they were excluded). He will also realize how, among the first students enrolled in the Establecimiento de Ciencias Médicas, said normativity was broke in order to adapt it to the known ways of students and professors. Progressively, the guild instruction would be ousted by the institutional instruction (for example, the years of practice in the drugstores were rejected), so that the guild ways of teaching were changing to turn the pharmacist into an individual of institutional instruction.

  10. How to write and publish scientific papers: scribing information for pharmacists. (United States)

    Hamilton, C W


    The principles of writing and publishing scientific papers are outlined. Scientific writing can be both professionally and financially rewarding, but many pharmacists hesitate to write for publication. A primary obstacle is not knowing how to begin. Thoughtful planning is the first and most important step. Before writing a word, the writer should identify the main message, audience, target journal, resource materials, type of manuscript, and authorship. The sections of a paper reporting original research include the title, abstract, introduction, methods, results, discussion, conclusion, references, and tables and figures. Some of these elements also appear in review papers and columns. In general, information given in one section should not duplicate information in another. The writer typically drafts the methods section first, followed by the results, the discussion, and the introduction. Along with intellectual responsibility for the paper, an author must assume various ethical responsibilities, such as ensuring that it contains no plagiarism, that all sources of funding have been acknowledged, and that the paper has not been simultaneously submitted to other journals. To enhance the likelihood of publication, the writer should edit the manuscript carefully and follow the target journal's instructions to contributors. Once the writer has submitted a paper, it must pass the muster of editors and, for peer-reviewed journals, outside experts. Several revisions may be requested before final acceptance. Pharmacists who adhere to the established pattern for writing and submitting scientific papers have the best chance of seeing their work in print.

  11. Benefits and risks of benzodiazepines and Z-drugs: comparison of perceptions of GPs and community pharmacists in Germany. (United States)

    Hoffmann, Falk


    Hintergrund und Fragestellung: Die neueren Benzodiazepinrezeptor-Agonisten Zolpidem und Zopiclon (“Z-Drugs”) werden in letzter Zeit häufiger als Hypnotika vom Benzodiazepintyp verschrieben, obwohl keine Belege für Unterschiede bezüglich des Nutzens und Schaden existieren. Ziel dieser Studie war es zu vergleichen, wie Hausärzte und Apotheker erwünschte und unerwünschte Wirkungen dieser Mittel einschätzen.Methoden: Ein schriftlicher Fragebogen wurde 2012 an eine Zufallsauswahl von 1.350 Hausärzten und 600 Apothekenleitern versendet. Die gleichen Items wurden auf einer 5-Punkte-Likert-Skala sowohl für Benzodiazepine wie Z-Drugs abgefragt. Zum Vergleich zwischen Hausärzten und Apothekern wurden Wilcoxon Signed Rank Tests durchgeführt. Aufgrund der zahlreichen Tests wurden nur p-Werte ≤0,01 als statistisch signifikant angesehen.Ergebnisse: Insgesamt antworteten 458 Hausärzte und 202 Apotheker (Rücklauf 33,9% und 33,7%). Hausärzte waren durchschnittlich 53,3 Jahre (40,6% weiblich) und Apotheker 48,8 Jahre alt (59,2% weiblich). Keine Unterschiede in der Einschätzung des Nutzens von Benzodiazepinen (bzw. Z-Drugs) fanden sich bei 3 (bzw. 2) von 5 Items. Keine Unterschiede zeigten sich auch bei 3 von 5 Items zu unerwünschten Wirkungen von Benzodiazepinen. Hingegen schätzten Apotheker, dass 4 der 5 untersuchten unerwünschten Wirkungen von Z-Drugs häufiger vorkamen als Hausärzte (p=0,003 oder kleiner). Beispielsweise antworteten 45,2% der Apotheker, dass Entzugserscheinungen häufig bzw. sehr häufig/immer unter Z-Drugs auftreten, hingegen nur 28,3% der Hausärzte.Schlussfolgerungen: Obwohl es insgesamt schwierig ist, eindeutige Schlussfolgerungen aus diesen Befunden zu ziehen, scheinen Apotheker einen kritischeren Blick auf Z-Drugs und deren unerwünschte Wirkungen zu haben.

  12. Drug advertising directed to pharmacists in Brazil: information or sales promotion?

    Directory of Open Access Journals (Sweden)

    Jussara Calmon Reis de Souza Soares


    Full Text Available Analyses of drug advertising reveal important social and cultural values and attitudes at a certain point in history. The purpose of this paper was to investigate how pharmaceutical industry communicates with pharmacists in Brazil, using drug promotion as a valuable tool. The point of departure was the analysis of a series of drug advertisements published in three Brazilian technical journals targeted at pharmacists and other health professionals. For the present study, the focus was on the content of the messages directed to pharmacists, in order to critically analyze the role attributed to these professionals as portrayed by the ads, and to discuss it in the context of pharmaceutical care. The collection and analysis of the data followed Anvisa's methodology. Pharmacists' social responsibility includes the reduction of preventable drug-related morbidity and mortality, but the information provided by the ads only refers to sales growth and profitability. Pharmacists are portrayed as salesmen, rather than health professionals, and encouraged to sell pharmaceutical drugs which are being heavily advertised to medical doctors. Consequences for pharmaceutical care are discussed.Análises de propaganda de medicamentos revelam importantes valores socioculturais e atitudes em um determinado contexto histórico. O objetivo deste trabalho foi analisar como a indústria farmacêutica se comunica com os farmacêuticos no Brasil, tendo a promoção farmacêutica como instrumento. O ponto de partida foi a análise de uma série de propagandas de medicamentos publicadas em três revistas técnicas dirigidas a farmacêuticos e outros profissionais de saúde. Para o presente estudo, o foco foi no conteúdo linguístico das mensagens, a fim de possibilitar uma reflexão crítica sobre o papel dos farmacêuticos no contexto da assistência farmacêutica, a partir das mensagens veiculadas pelos anúncios. A coleta e análise dos dados seguiu metodologia proposta

  13. Habitat use of woodpeckers in the Big Woods of eastern Arkansas (United States)

    Krementz, David G.; Lehnen, Sarah E.; Luscier, J.D.


    The Big Woods of eastern Arkansas contain some of the highest densities of woodpeckers recorded within bottomland hardwood forests of the southeastern United States. A better understanding of habitat use patterns by these woodpeckers is a priority for conservationists seeking to maintain these high densities in the Big Woods and the Lower Mississippi Alluvial Valley as a whole. Hence, we used linear mixed-effects and linear models to estimate the importance of habitat characteristics to woodpecker density in the Big Woods during the breeding seasons of 2006 and 2007 and the winter of 2007. Northern flicker Colaptes auratus density was negatively related to tree density both for moderate (. 25 cm diameter at breast height) and larger trees (>61 cm diameter at breast height). Red-headed woodpeckers Melanerpes erythrocephalus also had a negative relationship with density of large (. 61 cm diameter at breast height) trees. Bark disfiguration (an index of tree health) was negatively related to red-bellied woodpecker Melanerpes carolinus and yellow-bellied sapsucker Sphyrapicus varius densities. No measured habitat variables explained pileated woodpecker Dryocopus pileatus density. Overall, the high densities of woodpeckers observed in our study suggest that the current forest management of the Big Woods of Arkansas is meeting the nesting, roosting, and foraging requirements for these birds.

  14. Curriculum alignment and higher order thinking in introductory biology in Arkansas public two-year colleges (United States)

    Crandall, Elizabeth Diane

    This dissertation identified the cognitive levels of lecture objectives, lab objectives, and test questions in introductory majors' biology. The study group included courses offered by 27 faculty members at 18 of the 22 community colleges in Arkansas. Using Bloom's Taxonomy to identify cognitive levels, the median lecture learning outcomes were at level 2 (Comprehension) and test assessments at Level 1 (Knowledge). Lab learning outcomes were determined to have a median of level 3 (Analysis). A correlation analysis was performed using SPSS software to determine if there was an association between the Bloom's level of lecture objectives and test assessments. The only significant difference found was at the Analysis level, or Bloom's level 4 (p=.043). Correlation analyses were run for two other data sets. Years of college teaching experience and hours of training in writing objectives and assessments were compared to the Bloom's Taxonomy level of lecture objectives and test items. No significant difference was found for either of these independent variables. This dissertation provides Arkansas two-year college biology faculty with baseline information about the levels of cognitive skills that are required in freshman biology for majors courses. It can serve to initiate conversations about where we are compared to a national study, where we need to be, and how we get there.

  15. The Effect of Performance-Pay in Little Rock, Arkansas on Student Achievement. Working Paper 2008-02 (United States)

    Winters, Marcus; Greene, Jay P.; Ritter, Gary; Marsh, Ryan


    This paper examines evidence from a performance-pay program implemented in five Little Rock, Arkansas elementary schools between 2004 and 2007. Using a differences-in-differences approach, the evidence shows that students whose teachers were eligible for performance pay made substantially larger test score gains in math, reading, and language than…

  16. 76 FR 67175 - Riverbank Hydro No. 2 LLC, Lock Hydro Friends Fund XXXVI, Arkansas Electric Cooperative Corp... (United States)


    ... Engineers' (Corps) Joe Hardin Lock & Dam No. 3, located on the Arkansas River in Lincoln and Jefferson...), and operate run-of-river utilizing surplus water from the Joe Hardin Lock & Dam No. 3, as directed by... 196.358 GWh, and operate run-of-river utilizing surplus ] water from the Joe Hardin Lock & Dam No....

  17. EPSPS gene amplification in glyphosate-resistant in Italian ryegrass (Lolium perenne ssp. multiflorum) populations from Arkansas, USA (United States)

    Glyphosate-resistant Italian ryegrass was detected in Arkansas, USA in 2007. In 2014, 45 populations were confirmed resistant in eight counties across the state. The level of resistance and resistance mechanisms in six populations was studied to assess the severity of the problem and identify altern...

  18. 33 CFR 207.275 - McClellan-Kerr Arkansas River navigation system: use, administration, and navigation. (United States)


    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false McClellan-Kerr Arkansas River navigation system: use, administration, and navigation. 207.275 Section 207.275 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE NAVIGATION REGULATIONS §...


    Directory of Open Access Journals (Sweden)



    Full Text Available Millions of people today use nutritional supplements along with prescription and non prescription medications. Although many consumers believe that nutritional supplements are safe, the adverse drug reactions which derive from them, especially from their interactions with drugs, are not always widely understood or known by patients.Objectives: 1. To evaluate the knowledge regarding the common drug– nutritional supplements interactions among the patients 2. To evaluate the role of pharmacists in preventing these interactions. Materials and Methods: The survey included randomly selected 200 patients who visited different community pharmacies located in the city of Tirana, Albania between December 2013 and May 2014. Results: Among 71 % of the patients who used nutritional supplements, 39.5 % were aware that nutritional supplements can interact with medications. Patients who were more informed for these interactions, were mainly 18-25 and 26-40 years old. About 23.86 % of patients claimed that pharmacists always asked them about medications or nutritional supplements administered simultaneously, while approximately 28% of pharmacists affirmed that they always informed their patients about interactions nutritional supplements- medicaments. Conclusions: Nutritional supplements are often considered safe and natural and people are unaware of possible adverse effects associated to their use, especially when they are combined with drugs. The role of the pharmacist in preventing adverse effects resulting by the interactions drugs-nutritional supplements is essential in preserving the patient's life.

  20. Medication review and reconciliation with cooperation between pharmacist and general practitioner and the benefit for the patient : a systematic review

    NARCIS (Netherlands)

    Geurts, Marlies M. E.; Talsma, Jaap; Brouwers, Jacobus R. B. J.; de Gier, Johan J.


    This article systematically reviews the literature on the impact of collaboration between pharmacists and general practitioners and describes its effect on patients' health. A systematic literature search provided 1041 articles. After first review of title and abstract, 152 articles remained. After

  1. Over the counter sale of drugs for medical abortion- Knowledge, Attitude, and Practices of pharmacists of Delhi, India

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    Archana Mishra


    Full Text Available Introduction: Despite the well defined law and highly liberal policy Government approved medical facilities are not the leading provider of abortion in Indian Scenario. Whether legally or not Pharmacists are already acting as provider of medical abortion for large number of women in India. Dispense of Medical abortion drugs via pharmacist has the advantages of convenience, relative anonymity, hasty transaction, easy accessibility and saving cost.Aims and Objectives: Objective of present study was to assess the over the counter sale of medical abortion in terms of knowledge, attitude and practices of pharmacists of Delhi, India.Material and Methods: It was a cross sectional interview based study conducted in 110 pharmacies of 6 districts of State of Delhi.Results: A total of 75 pharmacists and 35 pharmacy workers were interviewed. Knowledge and practices of all of them was inadequate in some aspects. 68% knew Medical abortion is legal and 57% thought that over the counter sale of drugs of medical abortion is also legal. Only 40.9% knew the correct regimen of mifepristone + misoprostol combination.Most of them is not aware of any serious side effects and failure rate. Their attitude is indifferent towards the clients but positive towards training in updating knowledge if given option.Conclusion: Their knowledge, attitude and practices while dispensing drugs for medical abortion were inappropriate to qualify them as an independent mid level provider in present scenario. Unregulated OTC sale of abortifacients is responsible for high number of self induced abortion related complications.

  2. The effect of a clinical pharmacist-led training programme on intravenous medication errors : a controlled before and after study

    NARCIS (Netherlands)

    Nguyen, Huong; Pham, Hong-Tham; Vo, Dang-Khoa; Nguyen, Tuan-Dung; van den Heuvel, Edwin R.; Haaijer-Ruskamp, Flora M.; Taxis, Katja


    Background Little is known about interventions to reduce intravenous medication administration errors in hospitals, especially in low-and middle-income countries. Objective To assess the effect of a clinical pharmacist-led training programme on clinically relevant errors during intravenous medicatio

  3. Incomplete and incorrect epinephrine auto-injector training to food-allergic patients by pharmacists in the Netherlands

    NARCIS (Netherlands)

    Saleh-Langenberg, J; de Vries, S; Bak, E; Kollen, B J; Flokstra-de Blok, B M J; Dubois, A E J


    BACKGROUND: Successful treatment of anaphylaxis in the community relies on early and correct use of epinephrine auto-injectors (EAI). In the Netherlands pharmacists supply EAIs to patients and have a crucial role in instructing patients in how and when to use EAI. However, there are currently no dat

  4. Effects of electronic communication between the GP and the pharmacist. The quality of medication data on admission and after discharge

    NARCIS (Netherlands)

    van der Kam, WJ; Meyboom-de Jong, B; Tromp, T; Moorman, PW; van der Lei, J


    Background. When a patient is admitted to a hospital, the need for information about the medications prescribed is an important issue. Objectives. Our aim was to assess whether electronic communication between the GP and the pharmacist provides better information regarding current medication when a

  5. [A study of the pharmacist work changes associated with dispensing unit-of-use packaging in community pharmacies]. (United States)

    Kobayashi, Daisuke; Sakamaki, Hiroyuki; Komatsu, Ryou; Iijima, Tomonori; Iijima, Yasunori; Ootsuga, Hiroyuki; Saito, Katsuya; Seki, Tetsuya; Nakamura, Hidetoshi; Yamaura, Tomoyuki; Yokobayashi, Kuniaki


    This study aimed to determine how much time can be saved with the use of unit-of-use packaging for prescription drugs as compared with bulk packaging in community pharmacies as well as to determine the number of errors. In a simulation, mock prescriptions were dispensed either in unit-of-use packages or by transferring medication from a bulk container, and a time study was conducted to measure the time spent on dispensing and prescription auditing by pharmacists. Pharmacists' and patients' degree of satisfaction was also surveyed. The time saved with unit-of-use packaging was 66.25 s per prescription. The sole dispensing error that was found in the study occurred with bulk dispensing. Among both pharmacists and patients, many were of the opinion that dispensing with unit-of-use packaging was preferable to bulk dispensing. Unit-of-use packaging shortens the time that pharmacists spend on dispensing activities and increases the efficiency of their work. Unit-of-use packaging is also thought to reduce the number of counting errors.

  6. Unraveling Motivational Profiles of Health Care Professionals for Continuing Education : The Example of Pharmacists in the Netherlands

    NARCIS (Netherlands)

    Tjin A Tsoi, Sharon L N M; de Boer, Anthonius; Croiset, Gerda; Koster, Andries S; Kusurkar, Rashmi A


    INTRODUCTION: Continuing education (CE) can support health care professionals in maintaining and developing their knowledge and competencies. Although lack of motivation is one of the most important barriers of pharmacists' participation in CE, we know little about the quality or the quantity of mot

  7. Antibiotics dispensing for URTIs by community pharmacists and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients


    Alabid, Alamin Hassan M. A.; Ibrahim, Mohamed Izham Mohamed; Hassali,Mohamed Azmi


    Background: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular. Aim: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics...

  8. The influence of generic substitution on the content of patient-pharmacist communication in Swedish community pharmacies

    DEFF Research Database (Denmark)

    Olsson, Erika; Wallach-Kildemoes, Helle; Ahmed, Ban


    OBJECTIVES: The objective was to study the relationship between the length and content of patient-pharmacist communication in community pharmacies, and generic substitution. METHODS: The study was conducted in six community pharmacies in Sweden. Non-participant observations with audio recordings...

  9. Interdisciplinary collaboration in the provision of a pharmacist-led discharge medication reconciliation service at an Irish teaching hospital.

    LENUS (Irish Health Repository)

    Holland, Deirdre M


    Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.

  10. Perceived Barriers to the Implementation of Pharmaceutical Care among Pharmacists in Private and Government Hospitals in Metro Manila

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    Full Text Available This study determined the private and government hospital pharmacists’ perceived major barriers to the implementation of the pharmaceutical care practice in the Philippines. It employed a cross-sectional, descriptive research design using self-administered survey as data collection method. The weighted mean scores from the results of the Likert scale were used to determine the perceived major barriers in the provision of pharmaceutical care. A total of 194 pharmacists from private and government hospitals in Metro Manila participated in the study. The perceived major barrier to the implementation of pharmaceutical care among hospital pharmacist was the lack of support from other health professionals. This result has been consistent with the observation across different countries. However, pharmacists practicing in private hospitals identify the lack of economic incentives for delivering pharmaceutical care as the greater barrier towards pharmaceutical care practice in the Philippines as compared to their counterpart in the government hospitals. This may be attributed to the lower salary and compensation in these types of hospitals as compared to those in the government hospital in the Philippines. Comparison of the responses also revealed that government hospital pharmacist on the other hand perceive insufficient physical space as another major barrier towards their provision of pharmaceutical care, which was less likely considered to be a barrier by their private hospital counterparts. Other perceived major barriers identified were related to documentation, time and lack of guidelines.

  11. Management of type 2 diabetes mellitus in the elderly: role of the pharmacist in a multidisciplinary health care team

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    Grossman S


    Full Text Available Samuel GrossmanDepartment of Veterans Affairs, New York Harbor Healthcare System, New York, NY, USA; Diabetes Care On-The-Go Inc, Brooklyn, NY, USA; Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, NY, USA; Arnold and Marie Schwartz College of Pharmacy of Long Island University, Brooklyn, NY, USA; Garden State Association of Diabetes Educators, Edison, NJ, USAAbstract: Intensive glycemic control using insulin therapy may be appropriate for many healthy older adults to reduce premature mortality and morbidity, improve quality of life, and reduce health care costs. However, frail elderly people are more prone to develop complications from hypoglycemia, such as confusion and dementia. Overall, older persons with type 2 diabetes mellitus are at greater risk of death from cardiovascular disease (CVD than from intermittent hyperglycemia; therefore, diabetes management should always include CVD prevention and treatment in this patient population. Pharmacists can provide a comprehensive medication review with subsequent recommendations to individualize therapy based on medical and cognitive status. As part of the patient’s health care team, pharmacists can provide continuity of care and communication with other members of the patient’s health care team. In addition, pharmacists can act as educators and patient advocates and establish patient-specific goals to increase medication effectiveness, adherence to a medication regimen, and minimize the likelihood of adverse events.Keywords: glycemic control, hyperglycemia, continuity of care, hypertension and cardiovascular disease, elderly, type 2 diabetes, pharmacist

  12. The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

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    Kristin Wisell


    Full Text Available Community pharmacies are balancing between business (selling medicines and other products and healthcare (using the pharmacists’ knowledge in order to improve drug utilization. This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector.

  13. Pharmacist contributions for basic care from the perspective of professionals of familial health care teams

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    Gecioni Loch-Neckel


    Full Text Available This study aimed to investigate the social representations of professionals included in the team of Family Health Strategy (physicians, nurses and dentists respecting the action possibilities and contributions of the pharmacist for the basic care, and based on social psychology and, particularly, on the theory of social representations. The epistemological basis of the research is qualitative, and the data were collected by means of individual semi-structured interviews, which were submitted to analysis of categorical thematic content. Apparently, the majority of professionals already inserted in the team know and recognize the importance of professional pharmacists in the basic care, as well as their potential contribution to this topic. The representations were constructed according to the following parameters: a the study object and the intervention area, b the individual practice of every professional and c his/her action in specific cases. The quality of the professional or personal experience concerning the action of these professionals has contributed for the knowledge about the possibilities of pharmacists' intervention in basic care.Este estudo teve por objetivo investigar as representações sociais dos profissionais incluídos na equipe de Estratégia em Saúde da Família (médico, enfermeiro e odontólogo, sobre as possibilidades de atuação e as contribuições do farmacêutico na atenção básica, tendo por fundamento a psicologia social e, particularmente, a teoria das representações sociais. A base epistemológica da pesquisa é qualitativa, sendo os dados coletados por meio de entrevistas individuais semi-estruturadas e analisados por meio de análise de conteúdo categorial temático. Constatou-se que a maioria dos profissionais já inseridos na equipe conhece e reconhece a importância do profissional farmacêutico na atenção básica e as suas possibilidades de contribuição. As representações foram construídas a

  14. Perceptions about HIV pre-exposure prophylaxis among healthcare professionals in Spain (PERPPRES Study

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    Javier Sánchez-Rubio Ferrández


    Full Text Available Objective: To determine the level of support, knowledge and perceptions of pre-exposure prophylaxis (PrEP by Infectious Disease Specialists and Hospital Pharmacists in Spain. Methods: Cross-sectional study through an on-line 31-item survey (sociodemographical data, employment status/experience, knowledge of PrEP, use, identified barriers and economic issues. A univariate analysis was performed to evaluate the variables associated with support for PrEP, and compare the assessments by Specialists and Pharmacists. The questions about support for PrEP and agreement with the indication approval were repeated after showing data from published studies. The significance of the change in the answers was analyzed using the McNemar Test. Results: 211 questionnaires were received (80.1% from Pharmacists. 40.3% had low/no familiarity with PrEP (46.2% Pharmacists vs. 16.7% Physicians; p < 0.01. A 53.6% of them would support the use of PrEP (49.7% Pharmacists vs. 69% Physicians; p = 0.038. The minimum acceptable efficacy in order to support PrEP was 85.0 ± 15.5% (82.6 ± 12.1% by Physicians vs. 85.6 ± 15.0% by Pharmacists; p = 0.02. The variables associated with support were: medical profession (OR = 2.26; 95%CI 1.1-4.6; p = 0.038 and lower demand for efficacy (difference = 10.5%; 95%CI 6.9 to 14.1; p < 0.001. After receiving the information, there was an increase in their support for use and indication approval. Most participants (81.5% did not support its reimbursement. The main barriers identified were: an increase in risk behaviour (24.1%, increase in sexually transmitted diseases (19.0%, resistance (16.6% and cost (16.0%. Conclusions: More than half of participants were familiar with PrEP. The majority of them would support its use and the approval of the indication, but would not reimburse it. The use of PrEP in real practice is currently low.

  15. Improving hypertension management through pharmacist prescribing; the rural alberta clinical trial in optimizing hypertension (Rural RxACTION: trial design and methods

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    Campbell Norman RC


    Full Text Available Abstract Background Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta being the first province in Canada to have independent prescribing by pharmacists, it offers a unique opportunity to evaluate outcomes in patients who are prescribed antihypertensive therapy by pharmacists. Methods The study is a randomized controlled trial of enhanced pharmacist care, with the unit of randomization being the patient. Participants will be randomized to enhanced pharmacist care (patient identification, assessment, education, close follow-up, and prescribing/titration of antihypertensive medications or usual care. Participants are patients in rural Alberta with undiagnosed/uncontrolled blood pressure, as defined by the Canadian Hypertension Education Program. The primary outcome is the change in systolic blood pressure between baseline and 24 weeks in the enhanced-care versus usual-care arms. There are also three substudies running in conjunction with the project examining different remuneration models, investigating patient knowledge, and assessing health-resource utilization amongst patients in each group. Discussion To date, one-third of the required sample size has been recruited. There are 15 communities and 17 pharmacists actively screening, recruiting, and following patients. This study will provide high-level evidence regarding pharmacist prescribing. Trial Registration NCT00878566.

  16. Patient And phaRmacist Telephonic Encounters (PARTE in an underserved rural population with asthma: methods and rationale

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    Henry N. Young, PhD


    Full Text Available Purpose: Methods used to deliver and test a pharmacy-based asthma care telephonic service for an underserved, rural patient population are described. Summary: In a randomized controlled trial (RCT, the Patient And phaRmacist Telephonic Encounters (PARTE project is assessing the feasibility, acceptability, and preliminary impact of providing pharmacy-based asthma care service telephonically. The target audience is a low income patient population across a large geographic area served by a federally qualified community health center. Ninety-eight participants have been randomized to either standard care or the intervention group who received consultation and direct feedback from pharmacists via telephone regarding their asthma self-management and medication use. Pharmacists used a counseling framework that incorporates the Indian Health Services 3 Prime Questions and the RIM Technique (Recognition, Identification, and Management for managing medication use problems. Pharmacists encouraged patients to be active partners in the decision-making process to identify and address the underlying cause of medication use problems. Uniquely, this trial collected process and summative data using qualitative and quantitative approaches. Pharmacists’ training, the fidelity and quality of pharmacists’ service delivery, and short term patient outcomes are being evaluated. This evaluation will improve our ability to address research challenges and intervention barriers, refine staff training, explore patient perspectives, and evaluate measures’ power to provide preliminary patient outcome findings. Conclusion: A mixed method evaluation of a structured pharmacist intervention has the potential to offer insights regarding staff training, service fidelity and short term outcomes using quantitative and qualitative data in an RCT. Results will provide evidence regarding the feasibility and quality of carrying out the study and service delivery from the multiple

  17. Non-prescription proton-pump inhibitors for self-treating frequent heartburn: the role of the Canadian pharmacist

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    Armstrong D


    Full Text Available Heartburn and acid regurgitation are the cardinal symptoms of gastroesophageal reflux and occur commonly in the Canadian population. Multiple non-prescription treatment options are available for managing these symptoms, including antacids, alginates, histamine-H2 receptor antagonists (H2RAs, and proton-pump inhibitors (PPIs. As a result, pharmacists are ideally positioned to recommend appropriate treatment options based upon an individual’s needs and presenting symptoms, prior treatment response, comorbid medical conditions, and other relevant factors. Individuals who experience mild heartburn and/or have symptoms that occur predictably in response to known precipitating factors can manage their symptoms by avoiding known triggers and using on-demand antacids and/or alginates or lower-dose non-prescription H2RAs (e.g. ranitidine 150 mg. For those with moderate symptoms, lifestyle changes, in conjunction with higher-dose non-prescription H2RAs, may be effective. However, for individuals with moderate-to-severe symptoms that occur frequently (i.e. ≥2 days/week, the non-prescription (Schedule II PPI omeprazole 20 mg should be considered. The pharmacist can provide important support by inquiring about the frequency and severity of symptoms, identifying an appropriate treatment option, and recognizing other potential causes of symptoms, as well as alarm features and atypical symptoms that would necessitate referral to a physician. After recommending an appropriate treatment, the pharmacist can provide instructions for its correct use. Additionally, the pharmacist should inquire about recurrences, respond to questions about adverse events, provide monitoring parameters, and counsel on when referral to a physician is warranted. Pharmacists are an essential resource for individuals experiencing heartburn; they play a crucial role in helping individuals make informed self-care decisions and educating them to ensure that therapy is used in an optimal

  18. Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

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    Tommasello Anthony C


    Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use

  19. Hospital Executives’ Perceptions of End-of-Life Care

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    Kimberly K. Garner


    Full Text Available Hospital executives are key stakeholders in the hospital setting. However, despite extensive medical and nursing literature on the importance of end-of-life (EOL care in hospitals, little is known about hospital executives’ perceptions of the provision of EOL care in their facilities. The objective of this study was to capture hospital executives’ perceptions of the provision of EOL care in the hospital setting. This descriptive, naturalistic phenomenological, qualitative study utilized in-person interviews to explore executives’ opinions and beliefs. The sample consisted of 14 individuals in the roles of medical center directors, chiefs of staff, chief medical officers, hospital administrators, hospital risk managers, and regional counsel in Arkansas, Louisiana and Texas. An interview guide was developed and conducted utilizing a global question followed by probes concerning perceptions of EOL care provision. Hospital executives acknowledged that EOL care was a very important issue, and more attention should be paid to it in the hospital setting. Their comments and suggestions for improvement focused on (a current EOL care, (b barriers to changing EOL care, and (c enhancing provision of EOL care in the hospital setting. The findings of this study suggest that hospital executives although key change agents, may have insufficient EOL information to implement steps toward cultural and infrastructural change and should therefore be included in any EOL discussions and education.

  20. Complying with Occupational Safety and Health Administration regulations: a guide for compounding pharmacists. (United States)

    Mixon, Bill; Nain, John


    In the compounding pharmacy, compliance with Occupational Safety and Health Administration regulations is essential to protect employees and customers from exposure to hazardous substances and a dangerous environment, to avert heavy fines and penalties levied for noncompliance, and to fulfill the moral obligation of pharmacists to do no harm. Without adequate vigilance, compounders are vulnerable to lapses in adherence to Occupational Safety and Health Administration requirements, the results of which can be dire in a climate of increased scrutiny about the safety and integrity of pharmaceutical compounding. Proactively addressing necessary compliance with essential safety regulations can only benefit compounders and their staff and clients, and guidance from an expert in Occupational Safety and Health Administration requirements can be a key factor in accomplishing that goal.

  1. Management of acute fever in children: guideline for community healthcare providers and pharmacists. (United States)

    Green, Robin; Jeena, Prakash; Kotze, Shane; Lewis, Humphrey; Webb, David; Wells, Mike


    Fever is a normal physiological response to illness that facilitates and accelerates recovery. Although it is often associated with a self-limiting viral infection in children, it may also be a presenting symptom of more serious conditions requiring urgent medical care. Therefore, it is essential to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who can be managed conservatively at home. This guideline aims to assist pharmacists, primary healthcare workers and general practitioners in risk-stratifying children who present with fever, deciding on when to refer, the appropriate use of antipyretic medication and how to advise parents and caregivers. 

  2. [The role of the pharmacist in the educational charge of the asthmatic patient]. (United States)

    Courdent, L; Sonneville, A; Narcisse, G; Faure, N; Ernouf, D; Mor, B


    The problem of educative charge of the asthmatic patient has mobilised general physicians, specialists and kinesitherapists for many years. The first mutual aid associations for asthmatic patients, created at the initiative of pneumologists and allergists or their patients date back for a score or so of years and their principal objectives are the adaption of educational measures, in transmission of clear information and in the loan of surveillance equipment, to ensure that inhalation equipment is adapted appropriately to the case. Since, the mediatisation has reinforced this action in all directions, in the interests of and for the great benefit of asthmatic patients; and so the role of the pharmacist has also become essential not only in the field of information but also in that of control of the self-evaluation of the patient; three inseparable aspects are thus emphasized: information aspect, technical aspect, initiation of surveillance of the illness.

  3. A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors. (United States)

    Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José


    Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare.

  4. [André Detoeuf (1884-1931): pharmacist, industrialist and chemist]. (United States)

    Leclercq, Loïc


    During the transition between the 19th and 20th century, Auguste Béhal (1859-1941), a native of Lens (France, Pas-de-Calais), renewed organic chemistry teaching at the Paris School of Pharmacy by the introduction of atomic notation and pre-electronic mechanisms. This revolution primarily affects the future pharmacists. Thus, Béhal becomes the leader of a "School" of thought and directs the work of many students called "Béhaliens": Ernest Fourneau (1872-1949), Marc Tiffeneau (1873-1945), Marcel Sommelet (1877-1952), etc. Among these students, three are also from Lens: Amand Valeur (1870-1927), Raymond Delaby (1891-1958) and André Detoeuf (1884-1931). The latter, initially, will follow the footsteps of his older siblings (pharmacy studies, writing a thesis under the direction of Behal); however, despite having started a career in academia, he left his post for the industry (Etablissements Kuhlmann and Billault).

  5. Pharmaceutical care as narrative practice? Rethinking patient-centered care through a pharmacist's perspective. (United States)

    Naß, Janine; Banerjee, Mita; Efferth, Thomas; Wohlmann, Anita


    Illness is a disruptive experience that requires high-quality care. The best evidence-based medical treatment risks losing some of its efficacy, however, when patients feel misunderstood when faced with the complexity of their experiences. They might stop treatment, refuse to disclose relevant information or seek unsound alternatives. A narrative-based approach to health care understands the patient's case history as a narrative that can be read or analyzed like a story. In other words, this approach honors individual illness experiences through the stories that patients tell. While programs that train 'narrative competence' have been successfully implemented in medical education, an application to pharmaceutical training is missing so far. We argue for the necessity to complement evidence-based pharmaceutical practice with narrative-based approaches to ensure high-quality care. Using the perspective of a pharmacist in a case scenario, we exemplify the centrality of "narrative pharmacy" for improving the quality and safety of pharmaceutical health care.

  6. Prescriber-pharmacist collaboration: re-engineering the partnership to optimize pain patient care. (United States)

    Ruble, James H


    The Walgreen Companies recently settled a Drug Enforcement Administration (DEA) administrative action and other investigations arising in connection with a controlled substance distribution facility in Florida and several of its retail pharmacies. These DEA enforcement actions upon a national chain pharmacy have resulted in a series of policies and professional practices that appear to functionally disrupt continuity of patient care. The policy issues transcend the professions and go to the core of our responsibilities to patients. It is unfortunate that regulations intended to prevent diversion also dramatically disrupt interprofessional relations. Based on public statements of professional organizations, unification on this issue seems possible. This presents an opportunity to revisit collaboration among prescribers and pharmacists in legislative and regulatory advocacy. A uniform definition of "legitimate medical purpose" is needed to maximize patient access to needed pharmacotherapy while remaining vigilant for diversion.

  7. Geodatabase of the available top and bottom surface datasets that represent the Edwards-Trinity aquifer system, Arkansas, Oklahoma, and Texas (United States)

    U.S. Geological Survey, Department of the Interior — This geodatabase contains the spatial datasets that represent the Edwards-Trinity aquifer system in the States of Arkansas, Oklahoma, and Texas. Included are: (1)...

  8. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

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    Angalakuditi M


    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  9. Title: A Study of Role of Clinical Pharmacist in Medication Review and Patient Education

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    Shah Jainam V


    Full Text Available Purpose: Identifying, preventing, and resolving the Drug Related Problems (DRPs is an important issue in healthcare process. Factors leading to DRPs are social pressure to prescribers, inadequate patients’ knowledge regarding therapy, structure of health system and pharmaceutical marketing. Method: Fifty adult patients including both genders were recruited for this study. DRPs were assessed using PCNE classification Version 5.01 and patient knowledge was assessed before and after providing education. DRP occurrence was correlated with age, gender, number of drugs prescribed and co-morbid conditions. The patient’s knowledge regarding disease, therapy and life-style were assessed. For this, the medication related points were more focused such as name, strength, dose, schedule, possible ADRs, etc. Results: The maximum positive correlation was found between DRPs and number of drugs (0.42. Drug interaction is a major factor leading to DRPs in case of polypharmacy. Out of all the classes included in PCNE classification, drug choice was a major problem. The highest number of DRPs was found in the age group of 51 to 60 years i.e. 25 DRPs. Among both the genders, relatively more DRPs were found in females. After education, there was a considerable increase in patients’ knowledge by 156.73%. Conclusion: Thus it is concluded from study that if clinical pharmacist proclaims a role in the assessment of DRPs it seems better to focus on the identification, evaluation and prevention of patient- and prescriber- related problems. Clinical pharmacist can also increase patient’s knowledge and awareness by providing counselling leading to reduction in DRPs to a greater extent.

  10. Cost-Effectiveness of a Community Pharmacist-Led Sleep Apnea Screening Program - A Markov Model.

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    Clémence Perraudin

    Full Text Available Despite the high prevalence and major public health ramifications, obstructive sleep apnea syndrome (OSAS remains underdiagnosed. In many developed countries, because community pharmacists (CP are easily accessible, they have been developing additional clinical services that integrate the services of and collaborate with other healthcare providers (general practitioners (GPs, nurses, etc.. Alternative strategies for primary care screening programs for OSAS involving the CP are discussed.To estimate the quality of life, costs, and cost-effectiveness of three screening strategies among patients who are at risk of having moderate to severe OSAS in primary care.Markov decision model.Published data.Hypothetical cohort of 50-year-old male patients with symptoms highly evocative of OSAS.The 5 years after initial evaluation for OSAS.Societal.Screening strategy with CP (CP-GP collaboration, screening strategy without CP (GP alone and no screening.Quality of life, survival and costs for each screening strategy.Under almost all modeled conditions, the involvement of CPs in OSAS screening was cost effective. The maximal incremental cost for "screening strategy with CP" was about 455€ per QALY gained.Our results were robust but primarily sensitive to the treatment costs by continuous positive airway pressure, and the costs of untreated OSAS. The probabilistic sensitivity analysis showed that the "screening strategy with CP" was dominant in 80% of cases. It was more effective and less costly in 47% of cases, and within the cost-effective range (maximum incremental cost effectiveness ratio at €6186.67/QALY in 33% of cases.CP involvement in OSAS screening is a cost-effective strategy. This proposal is consistent with the trend in Europe and the United States to extend the practices and responsibilities of the pharmacist in primary care.

  11. Eliciting comprehensive medication histories in the emergency department: the role of the pharmacist.

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    Crook M


    Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient’s pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%. There were 563 (48.9% complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated dermatological and ear, nose and throat disorders but approximately 29% were used to treat cardiovascular disorders. This study provides support for the presence of an Emergency Department pharmacist who can compile a comprehensive and accurate medication history to enhance medication management along the continuum of care. It is recommended that the patient’s community pharmacy and GP be contacted for clarification and confirmation of the medication history.

  12. Pharmacist Theodor Salzer (1833-1900) and the discovery of bisphosphonates. (United States)

    Petroianu, G A


    Herbert Fleisch, the father of the therapeutic use of bisphosphonates in modern medicine, repeatedly stated in his numerous reviews that bisphosphonates were first synthesized 1865 in Germany by the Russian chemist Menschutkin. He was wrong on two counts. Had Menschutkin synthesized bisphosphonates, as he was a student of Wurtz at the time of the "synthesis", the birthplace of the substances would have been France and not Germany; but he did not. By reacting phosphorous acid with acetyl-chloride he obtained derivatives of pyro-phosphorous and pyro-phosphoric acids (P-O-P backbone) and not bisphosphonates (P-C-P backbone). The discovery of the first bisphosphonate occurred indeed in Germany but some thirty years later and not without some drama. First 1894 the pharmacist Theodor Salzer (1833-1900) described an impurity contained in commercially available phosphoric acid but failed to identify it as acetodiphosphoric acid, a bisphosphonate. 1896, an undergraduate student, Hans von Baeyer working in Munich at the Royal Academy of Sciences in the chemical laboratory of his father Adolf (the 1905 Nobel Prize laureate and discoverer of the barbiturates) synthesized an unknown substance which his famous father summarily rejected as some "Dreck" or impurity. Only due to the tenacity of young Hans work on the matter was continued and the paper describing the synthesis published a year later. The correctness of the chemical structure of the compound as assumed by von Baeyer (and his Ph.D. supervisor Hofmann) was confirmed 1901 by Heidepriem, a Ph.D. student of Hofmann. This short report attempts to shed some light on the life of the lesser known pharmacists and chemists involved in the synthesis of the first bisphosphonate, focusing on Salzer, Heidepriem and von Baeyer.

  13. Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives (United States)

    Morecroft, Charles W; Mackridge, Adam J; Stokes, Elizabeth C; Gray, Nicola J; Wilson, Sarah E; Ashcroft, Darren M; Mensah, Noah; Pickup, Graham B


    Objective To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Design Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October–November 2012 and April 2013); interviews with CPs (February–April 2013); follow-up interviews with patients (April–May 2013); interactive feedback sessions with general practice teams (October–November 2013). Setting 22 community pharmacies and 6 general practices in Northwest England. Participants 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Results Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were ‘loaned’ in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. Conclusions CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured

  14. Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria

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    Poluyi EO


    Full Text Available Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies. Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria. Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria. Results: The quantitative survey revealed that the majority (72.1% of the respondents were aged between 20 and 40 years, predominantly male (60.8%, Yoruba (50.2% or Igbo (40.3% ethnicity and had been practicing pharmacy for ten years or less (72.2%. A majority (90.1% of respondents were aware that tobacco is harmful to health. Slightly less (75.8% were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4% and esophageal (68.9% cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%, chronic obstructive pulmonary disease (27.8%, bladder cancer (47.2%, peripheral vascular disease (35.8% and sudden death (31.1%. Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC. A little over half of the respondents (53.8% were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%, in public places (79.2%, and in restaurants, nightclubs and bars (73.6%. For

  15. Geochemical and geostatistical evaluation, Arkansas Canyon Planning Unit, Fremont and Custer Counties, Colorado (United States)

    Weiland, E.F.; Connors, R.A.; Robinson, M.L.; Lindemann, J.W.; Meyer, W.T.


    A mineral assessment of the Arkansas Canyon Planning Unit was undertaken by Barringer Resources Inc., under the terms of contract YA-553-CTO-100 with the Bureau of Land Management, Colorado State Office. The study was based on a geochemical-geostatistical survey in which 700 stream sediment samples were collected and analyzed for 25 elements. Geochemical results were interpreted by statistical processing which included factor, discriminant, multiple regression and characteristic analysis. The major deposit types evaluated were massive sulfide-base metal, sedimentary and magmatic uranium, thorium vein, magmatic segregation, and carbonatite related deposits. Results of the single element data and multivariate geostatistical analysis indicate that limited potential exists for base metal mineralization near the Horseshoe, El Plomo, and Green Mountain Mines. Thirty areas are considered to be anomalous with regard to one or more of the geochemical parameters evaluated during this study. The evaluation of carbonatite related mineralization was restricted due to the lack of geochemical data specific to this environment.

  16. Chesterian davidsoniacean and orthotetacean brachiopods, Ozark region of Arkansas and Oklahoma. (United States)

    Henry, T.W.; Gordon, M.


    Three species of orthotetaceans and one species of davidsoniacean are among the strophomenid brachiopods from Chesterian (Upper Mississippian) rocks of northern Arkansas and northeastern Oklahoma. Type material from the Fayetteville Shale, Orthotetes subglobosus and O. subglobosus var. protensus, is figured for the first time. We regard these species, and O. subglobosus var. batesvillensis Girty from the Batesville Sandstone, as distinct species, for which we are selecting lectotypes. We describe a fourth species, O. stenopsis n.sp., from the Pitkin Limestone. Another species, described from the Pitkin as Streptorhynchus suspectum, has an impunctate shell and is thus not an orthotetacean. This bizarre species generally has a long twisted beak, high interarea, and large forked cardinal process; a myophragm may occur in either valve, but more commonly is in the brachial valve alone. We designate a lectotype for this species and propose a new genus Adectorhynchus and a new family Adectorhynchidae, under the Davidsoniacea, for this taxon.-from Authors

  17. Hope, Arkansas to Hope, Albania: naivete and idealism to reality and tragedy. (United States)

    Bennett, B C


    The wars in Croatia, Bosnia and Kosovo were perpretrated by a radical nationalist Serbian cultural political consciousness that the American cultural political consciousness and leadership had difficulty responding to and understanding. There is a great cultural divide between a 'pathology' in Serbian culture, Milosević's radical nationalism, and a humane 'naivete' in American cultural consciousness. I discuss why, finally, American political leadership, Bill Clinton from Hope, Arkansas, responded to the tragedy of these wars. However, we are still left with the question of good vs evil: What is the course of human history; psychotic political leadership causing repetitive human tragedy or can there be a higher humane and moral order to human cultural events?

  18. Interpreting temporal variations in river response functions: an example from the Arkansas River, Kansas, USA (United States)

    Brookfield, A. E.; Stotler, R. L.; Reboulet, E. C.


    Groundwater/surface-water interactions can play an important role in management of water quality and quantity, but the temporal and spatial variability of these interactions makes them difficult to incorporate into conceptual models. There are simple methods for identifying the presence of groundwater/surface-water interactions; however, identifying flow mechanisms and pathways can be challenging. More complex methods are available to better identify these mechanisms and pathways but are often too time consuming or costly. In this work, a simple method for interpreting and identifying flow mechanisms and sources using temporal variations of river response functions is presented. This approach is demonstrated using observations from two sites along the Arkansas River in Kansas, USA. A change in flow mechanisms between the rising and falling limbs of river hydrographs was identified, along with a second surface-water source to the aquifer, a finding that was validated with stable isotope analyses.

  19. Implementation of a pharmacist-led antimicrobial management team in a community teaching hospital: use of pharmacy residents and pharmacy students in a prospective audit and feedback approach. (United States)

    Laible, Brad R; Nazir, Jawad; Assimacopoulos, Aris P; Schut, Jennifer


    Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist. Due to limited resources, our institution chose to implement a pharmacist-led antimicrobial stewardship service on 1 medical/surgical ward, with the existing clinical pharmacist and 3 infectious disease physicians as core members. This clinical pharmacist was not trained in infectious disease specialty, and stewardship activities were only one part of his daily activities. Pharmacy residents and students were extensively utilized to assist in the stewardship process. Approximately two thirds of stewardship recommendations were accepted using primarily a prospective audit and feedback approach.

  20. Changes in school environments with implementation of Arkansas Act 1220 of 2003. (United States)

    Phillips, Martha M; Raczynski, James M; West, Delia S; Pulley, LeaVonne; Bursac, Zoran; Gauss, C Heath; Walker, Jada F


    Changes in school nutrition and physical activity policies and environments are important to combat childhood obesity. Arkansas Act 1220 of 2003 was among the first and most comprehensive statewide legislative initiatives to combat childhood obesity through school-based change. Annual surveys of principals and superintendents have been analyzed to document substantial and important changes in school environments, policies, and practices. For example, results indicate that schools are more likely to require that healthy options be provided for student parties (4.5% in 2004, 36.9% in 2008; P students in cafeterias (white milk: 26.1% in 2004, 41.0% in 2008, P chocolate milk: 9.0% in 2004, 24.0% in 2008, P Arkansas Act 1220 of 2003 is associated with a number of changes in school environments and policies, resulting from both statewide and local initiatives spawned by the Act.