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.
Willis Jon A
Full Text Available Abstract Background Complementary and alternative medicines (CAMs are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. Methods A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. Results Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. Conclusions Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to
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
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.
Kreshnik Hoti; Jeffery Hughes; Bruce Sunderland
Expanded pharmacist prescribing is a new professional practice area for pharmacists. Currently, Australian pharmacists’ prescribing role is limited to over-the-counter medications. This review aims to identify Australian studies involving the area of expanded pharmacist prescribing. Australian studies exploring the issues of pharmacist prescribing were identified and considered in the context of its implementation internationally. Australian studies have mainly focused on the attitudes of com...
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.
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.
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.
Culverhouse Sarah E
Full Text Available Abstract Background Complementary medicines (CMs are widely used by the Australian public, and pharmacies are major suppliers of these medicines. The integration of CMs into pharmacy practice is well documented, but the behaviours of pharmacists in recommending CMs to customers are less well studied. This study reports on factors that influence whether or not pharmacists in Australia recommend CMs to their customers. Methods Data were collected from semi-structured interviews with twelve practicing pharmacists based in Brisbane, Australia. The qualitative data were analysed by thematic analysis. Results The primary driver of the recommendation of CMs was a desire to provide a health benefit to the customer. Other important drivers were an awareness of evidence of efficacy, customer feedback and pharmacy protocols to recommend a CM alongside a particular pharmaceutical medication. The primary barrier to the recommendation of CMs was safety concerns around patients on multiple medications or with complex health issues. Also, a lack of knowledge of CMs, a perceived lack of evidence or a lack of time to counsel patients were identified as barriers. There was a desire to see a greater integration of CM into formal pharmacy education. Additionally, the provision of good quality educational materials was seen as important to allow pharmacists to assess levels of evidence for CMs and educate them on their safe and appropriate use. Conclusions Pharmacists who frequently recommend CMs identify many potential benefits for patients and see it as an important part of providing a ‘healthcare solution’. To encourage the informed use of CMs in pharmacy there is a need for the development of accessible, quality resources on CMs. In addition, incorporation of CM education into pharmacy curricula would better prepare graduate pharmacists for community practice. Ultimately, such moves would contribute to the safe and effective use of CMs to the benefit of
Catic, Tarik; Jusufovic, Fatima Insanic; Tabakovic, Vedad
Community pharmacists play a significant role in patient/disease management and perception by patients is increasingly important. A self-administered questionnaire was developed consisted of sociodemographic part and 15 questions. Patients have a positive overall perception of community pharmacists that is comparable to most studies in Europe. Community pharmacists’ beyond dispensing drugs play a significant role in patient and disease management. This role of the pharmacist is performed thro...
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…
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.
... Pharmaceutical industry pharmacists work in areas such as marketing, sales, or research and development. They may design ... workers was $36,200. Recommend this page using: Facebook Twitter LinkedIn tools Areas at a Glance Industries ...
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
Catic, Tarik; Jusufovic, Fatima Insanic; Tabakovic, Vedad
Community pharmacists play a significant role in patient/disease management and perception by patients is increasingly important. A self-administered questionnaire was developed consisted of sociodemographic part and 15 questions. Patients have a positive overall perception of community pharmacists that is comparable to most studies in Europe. Community pharmacists' beyond dispensing drugs play a significant role in patient and disease management. This role of the pharmacist is performed through pharmaceutical care. Patient's opinion is increasingly considered to be a useful component in the determination of care outcomes and consumer satisfaction is an integral component of the quality of primary health care. For the purpose of this study we developed self-administered questionnaire consisted of sociodemographic part, and 15 questions. Survey has been conducted in 10 pharmacies. Results are presented in tables and figures and descriptive statistics has been used. We found that patients in Bosnia and Herzegovina have a positive overall perception of community pharmacists and of the services offered from community pharmacies that is comparable to most studies in Europe, but there is still room for improvement of relationships and pharmaceutical services. PMID:24167438
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.
Full Text Available
Blenkinsopp, A.; Jepson, M; Drury, M.
A pilot scheme was set up to evaluate a notification card to be used by community pharmacists when referring patients to their general practitioner, with the aim of improving communication. Six community pharmacists and 15 general practitioners took part in the study. During the 18 month study period 120 cards were issued by pharmacists. The majority of patients (71%) advised to see their general practitioner by the pharmacist did so. Fourteen cards (12%) were issued for suspected adverse dru...
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...
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 ...
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
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…
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
Mossialos, Elias; Courtin, Emilie; Naci, Huseyin; Benrimoj, Shalom; Bouvy, Marcel; Farris, Karen; Noyce, Peter; Sketris, Ingrid
Community pharmacists are the third largest healthcare professional group in the world after physicians and nurses. Despite their considerable training, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as p
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
Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.
OBJECTIVE: To identify determinants of the care-providing function of the community pharmacists (CPs) to explain variations in professional practice. SETTING: The Netherlands 2001. PARTICIPANTS: 328 CPs. METHOD: A cross-sectional questionnaire survey was performed. Questionnaires were used to collec
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. PMID:17622026
Sen S.; Bowen JF; Ganetsky VS; Hadley D; Melody K; Otsuka S; Vanmali R; Thomas T
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...
Full Text Available Abstract Background Community Pharmacists and General Practitioners (GPs are increasingly being encouraged to adopt more collaborative approaches to health care delivery as collaboration in primary care has been shown to be effective in improving patient outcomes. However, little is known about pharmacist attitudes towards collaborating with their GP counterparts and variables that influence this interprofessional collaboration. This study aims to develop and validate 1 an instrument to measure pharmacist attitudes towards collaboration with GPs and 2 a model that illustrates how pharmacist attitudes (and other variables influence collaborative behaviour with GPs. Methods A questionnaire containing the newly developed “Attitudes Towards Collaboration Instrument for Pharmacists” (ATCI-P and a previously validated behavioural measure “Frequency of Interprofessional Collaboration Instrument for Pharmacists” (FICI-P was administered to a sample of 1215 Australian pharmacists. The ATCI-P was developed based on existing literature and qualitative interviews with GPs and community pharmacists. Principal Component Analysis was used to assess the structure of the ATCI-P and the Cronbach’s alpha coefficient was used to assess the internal consistency of the instrument. Structural equation modelling was used to determine how pharmacist attitudes (as measured by the ATCI-P and other variables, influence collaborative behaviour (as measured by the FICI-P. Results Four hundred and ninety-two surveys were completed and returned for a response rate of 40%. Principal Component Analysis revealed the ATCI-P consisted of two factors: ‘interactional determinants’ and ‘practitioner determinants’, both with good internal consistency (Cronbach’s alpha = .90 and .93 respectively. The model demonstrated adequate fit (χ2/df = 1.89, CFI = .955, RMSEA = .062, 90% CI [.049-.074] and illustrated that ‘interactional determinants’ was
Driesenaar, J.A.; Smet, P.A.G.M. de; Hulten, R. van; Horne, R.; Zwikker, H.E.; Bemt, B.J.F. van den; Dulmen, S. van
Objectives: To compare pharmacists' and pharmacy technicians' perceptions of patients' beliefs regarding inhaled corticosteroids (ICS) with those of patients and to compare the ICS beliefs of pharmacists and technicians with those of patients with asthma. Methods: 1269 community pharmacies were app
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.
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.
Bond, C.; Matheson, C.; Williams, S; Williams, P.; Donnan, P
BACKGROUND: Traditional systems of managing repeat prescribing have been criticised for their lack of clinical and administrative controls. AIM: To compare a community pharmacist-managed repeat prescribing system with established methods of managing repeat prescribing. METHOD: A randomised controlled intervention study (19 general medical practices, 3074 patients, 62 community pharmacists). Patients on repeat medication were given sufficient three-monthly scripts, endorsed for monthly dispens...
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.
Full Text Available Wei Wen Chong,1,2 Parisa Aslani,1 Timothy F Chen1 1Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia; 2Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Recent studies have shown that pharmacists have a role in addressing antidepressant nonadherence. However, few studies have explored community pharmacists' actual counseling practices in response to antidepressant adherence-related issues at various phases of treatment. The purpose of this study was to evaluate counseling practices of community pharmacists in response to antidepressant adherence-related issues. Methods: A simulated patient method was used to evaluate pharmacist counseling practices in Sydney, Australia. Twenty community pharmacists received three simulated patient visits concerning antidepressant adherence-related scenarios at different phases of treatment: 1 patient receiving a first-time antidepressant prescription and hesitant to begin treatment; 2 patient perceiving lack of treatment efficacy for antidepressant after starting treatment for 2 weeks; and 3 patient wanting to discontinue antidepressant treatment after 3 months due to perceived symptom improvement. The interactions were recorded and analyzed to evaluate the content of consultations in terms of information gathering, information provision including key educational messages, and treatment recommendations. Results: There was variability among community pharmacists in terms of the extent and content of information gathered and provided. In scenario 1, while some key educational messages such as possible side effects and expected benefits from antidepressants were mentioned frequently, others such as the recommended length of treatment and adherence-related messages were rarely addressed. In all scenarios, about two thirds of pharmacists explored patients' concerns about antidepressant treatment. In scenarios 2 and 3, only half of all pharmacists
Urbonas, Gvidas; Kubilienė, Loreta
Background Community pharmacies have an increasing role in self-medication and community health is dependent on the quality of counselling services provided to patients. Some studies show that pharmacists' job satisfaction affects their work quality; other studies found that higher involvement in clinical services increases pharmacists' job satisfaction. Objective To test the relationship between job satisfaction and over-the-counter counselling practice at community pharmacies. Setting Community pharmacies in Lithuania. Method A convenience sample (n = 305) of community pharmacists participated in the cross-sectional survey where they expressed satisfaction with job and reported on their over-the-counter counselling behaviour on self-report scales. The Partial Least Squares Structural Equation Modelling approach was employed for data analysis. Main outcome measure The strength of the relationship between job satisfaction and over-the-counter counselling service. Results A bidirectional relationship between job satisfaction and over-the-counter counselling service was found. In addition, job satisfaction and over-the-counter counselling quality depended on pharmacists' age. Conclusion Organizations were recommended to create a counselling friendly environment that would increase pharmacists' job satisfaction and, in return, counselling quality. Also, additional motivation of the retired pharmacists, as well as development of counselling skills of the younger pharmacy workforce, were seen as a means to improve both organizational climate and counselling quality over the counter. PMID:26666908
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.
Shimane, Takuya; Matsumoto, Toshihiko; Wada, Kiyoshi
The nonmedical use or abuse of prescription drugs, including psychotropic medicines, is a growing health problem in Japan. Patient access to psychotropic drugs, specifically from the oversupply of medications due to overlapping prescriptions, may increase the risk of drug abuse and dependence. However, very little is known about such overlapping prescriptions. Today, the dispensing of prescriptions is generally moving from inside to outside of hospitals, with psychotropic drugs mainly dispensed at community pharmacies. In this study, we used health insurance claims (i.e., receipts) for dispensing as the main source of information in an investigation of overlapping prescriptions of psychotropic drugs. A total of 119 patients were found to have received overlapping prescriptions, as identified by community pharmacists who were members of the Saitama Pharmaceutical Association, using patient medication records, followed by medication counseling and prescription notes for the patient. According to our findings, the most frequently overlapping medication was etizolam. Etizolam can be prescribed for more than 30 days since it is not regulated under Japanese law as a "psychotropic drug." Generally, when a drug can be prescribed for a greater number of days, it increases the likelihood of an overlapping prescription during the same period. As a result, the long-term prescription of etizolam increases the risk of overlapping prescriptions. We also found that the patients who received overlapping prescriptions of etizolam were mostly elderly and the most common pattern was prescription from both internal medicine and orthopedics physicians. Etizolam has wide range of indications that are covered by health insurance. Our results suggest that patients who received overlapping prescriptions of etizolam may receive prescriptions from different prescribers for different purposes. Therefore, it may be appropriate to regulate etizolam as a "psychotropic drug" under Japanese law
Van de Putte, M; Appels, S; Boone, T; Collienne, S; Daems, T; De Lepeleire, J; Foulon, V
Medication management in home care is an error prone process. In a small pilot project in Flanders, community pharmacists collaborated with physicians and home care nurses through a shared electronic care plan, to optimize the medication management of their home care patients. The pilot project shows that GPs and nurses are positive about the possible contribution of the pharmacist in medication management of home care patients. A larger follow up study is necessary to further identify possible roles of pharmacists in home care and to show related health benefits. PMID:23697093
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...
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 < 0.001) and skills scores (p < 0.001) at pre- and post-training. Cronbach's alpha for the nine-item satisfaction scale was 0.73 and the majority pharmacists (92.1-100 %) were satisfied with the various aspects of the training program. Conclusion The web-based training program positively enhanced pharmacists' knowledge and skills associated with chronic kidney disease screening. These
Ferguson Jill S
conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health.
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 ...
Saengcharoen, Woranuch; Jaisawang, Pornchanok; Udomcharoensab, Palita; Buathong, Kittika; Lerkiatbundit, Sanguan
Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria and to identify factors related to antibiotic dispensing. Setting 1040 Thai community pharmacists. Method A cross-sectional survey of community pharmacists was conducted in November 2012 to March 2013. The self-administered questionnaires were mailed to 57 % of community pharmacists in the south of Thailand (n = 1040). The survey included questions on diagnosis of streptococcal pharyngitis, knowledge on pharyngitis, and attitudes and control beliefs regarding antibiotic dispensing. Main outcome measure The appropriateness of diagnosis of streptococcal pharyngitis according to the original and modified Centor criteria and determinants of antibiotic dispensing including demographic characteristics of pharmacists, knowledge on pharyngitis, and attitudes and control beliefs on antibiotic dispensing. Results Approximately 68 % completed the questionnaires (n = 703). Compared to the pharmacists who reported not dispensing antibiotics in the hypothetical case with common cold, those reported dispensing antibiotics were more likely to consider the following conditions-presence of cough, mild sore throat and patients with age >60 years as cues for diagnosis of streptococcal pharyngitis (p 5 years) [odds ratio (OR) 1.52; 95 % confidence interval (CI) 1.03-2.23], belief that antibiotics could shorten duration of pharyngitis (OR 1.48; 95 % CI 1.11-1.99), belief that antibiotics could prevent the complications (OR 1.44; 95 % CI 1.09-1.91) and belief that dispensing antibiotics could satisfy the patients (OR 1.31; 95 % CI 1.01-1.71). Nonetheless, antibiotic dispensing was negatively associated with
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.
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...
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
Engaging community pharmacists in the primary prevention of cardiovascular disease: protocol for the Pharmacist Assessment of Adherence, Risk and Treatment in Cardiovascular Disease (PAART CVD pilot study
Mc Namara Kevin P
Full Text Available Abstract Background Cardiovascular disease (CVD is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role. Methods/Design This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months. Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients' overall CVD risk and individual risk factors, as well as identifying modifiable health behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation. Discussion This study will assess the feasibility of implementing holistic
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
Liekens, Sophie; Smits, Tim; Laekeman, Gert; Foulon, Veerle
Objective: The aim of the present study was to measure stigma among community pharmacists regarding patients with depression, using social distance as a proxy measure. Furthermore, factors influencing stigmatization were identified. Methods: A survey consisting of questions regarding social distance, cognitive attitude components, stereotypical beliefs and behavioural tendencies towards pharmaceutical care for patients with depression was carried out. The survey was completed b...
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…
Bereznicki Luke RE
Full Text Available Abstract Background Shorter periods of hospitalisation and increasing warfarin use have placed stress on community-based healthcare services to care for patients taking warfarin after hospital discharge, a high-risk period for these patients. A previous randomised controlled trial demonstrated that a post-discharge service of 4 home visits and point-of-care (POC International Normalised Ratio (INR testing by a trained pharmacist improved patients' outcomes. The current study aims to modify this previously trialled service model to implement and then evaluate a sustainable program to enable the smooth transition of patients taking warfarin from the hospital to community setting. Methods/Design The service will be trialled in 8 sites across 3 Australian states using a prospective, controlled cohort study design. Patients discharged from hospital taking warfarin will receive 2 or 3 home visits by a trained 'home medicines review (HMR-accredited' pharmacist in their 8 to 10 days after hospital discharge. Visits will involve a HMR, comprehensive warfarin education, and POC INR monitoring in collaboration with patients' general practitioners (GPs and community pharmacists. Patient outcomes will be compared to those in a control, or 'usual care', group. The primary outcome measure will be the proportion of patients experiencing a major bleeding event in the 90 days after discharge. Secondary outcome measures will include combined major bleeding and thromboembolic events, death, cessation of warfarin therapy, INR control at 8 days post-discharge and unplanned hospital readmissions from any cause. Stakeholder satisfaction will be assessed using structured postal questionnaire mailed to patients, GPs, community pharmacists and accredited pharmacists at the completion of their study involvement. Discussion This study design incorporates several aspects of prior interventions that have been demonstrated to improve warfarin management, including POC INR
Full Text Available Stephanie W Young, Lisa D Bishop, Amy ConwaySchool of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, CanadaPurpose: Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role.Patients and methods: A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained.Results: Nine student–pharmacist pairs submitted data from nine pharmacies in rural (n = 3 and urban (n = 6 centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%, and 86% had either public or private insurance. Over three-quarters of the interventions (77% were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%, drug product not available (16%, dosage too low (16%, and missing prescription information (15%. The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved.Conclusion: Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related
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.
Anthony Scott; Christine Bond; Jackie Inch; Aileen Grant
Background: Major changes in the roles and responsibilities of pharmacists across the world are occurring. A new Scottish Community Pharmacy contract was introduced in April 2006, following the introduction of a similar contract in England in 2005. This contract encourages greater involvement in medicines management and other clinical cognitive roles, whilst retaining a supply function. Objective: To use a discrete choice experiment (DCE) to examine the strength of preference of community pha...
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 recommended.ClinicalTrials.gov NCT
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
Frisk, Pia; Bergman, Ulrika; Kälvemark Sporrong, Sofia
Background Patient self-reported data are important in drug utilization research, but often logistically difficult to collect. During 2006–2012, 72 Swedish community pharmacies regularly collected such data through structured survey interviews at the pharmacy counter, performed by the dispensing...... eligible patients, due to the immediate increase in work load. The limited availability of staff resources was the most apparent area of improvement. Conclusion Under certain conditions, community pharmacies are feasible as a setting for conducting patient surveys in drug utilization research...... of surveying. Setting 72 Swedish community pharmacies, distributed all over the country. Method (a) A questionnaire was distributed to approximately 400 dispensing pharmacists at the pharmacies conducting the patient surveys; (b) semi-structured telephone interviews conducted with 19 pharmacists at 12...
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
Full Text Available Objectives: We explored factors influencing Indonesian primary care pharmacists’ practice in chronic noncommunicable disease management and proposed a model illustrating relationships among factors. Methods: We conducted in-depth, semistructured interviews with pharmacists working in community health centers (Puskesmas, n=5 and community pharmacies (apotek, n=15 in East Java Province. We interviewed participating pharmacists using Bahasa Indonesia to explore facilitators and barriers to their practice in chronic disease management. We audiorecorded all interviews, transcribed ad verbatim, translated into English and analyzed the data using an approach informed by “grounded-theory”. Results: We extracted five emergent themes/factors: pharmacists’ attitudes, Puskesmas/apotek environment, pharmacy education, pharmacy professional associations, and the government. Respondents believed that primary care pharmacists have limited roles in chronic disease management. An unfavourable working environment and perceptions of pharmacists’ inadequate knowledge and skills were reported by many as barriers to pharmacy practice. Limited professional standards, guidelines, leadership and government regulations coupled with low expectations of pharmacists among patients and doctors also contributed to their lack of involvement in chronic disease management. We present the interplay of these factors in our model. Conclusion: Pharmacists’ attitudes, knowledge, skills and their working environment appeared to influence pharmacists’ contribution in chronic disease management. To develop pharmacists’ involvement in chronic disease management, support from pharmacy educators, pharmacy owners, professional associations, the government and other stakeholders is required. Our findings highlight a need for systematic coordination between pharmacists and stakeholders to improve primary care pharmacists’ practice in Indonesia to achieve continuity of care.
Barbanel, D; Eldridge, S; Griffiths, C
Background: No randomised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists. Most randomised trials of asthma self-management have recruited participants from secondary care; there is uncertainty regarding its effectiveness in primary care. A randomised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at...
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
SHARMA, H; Jindal, D.; Aqil, M.; Alam, M. S.; Karim, S.; Kapur, P.
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 v...
S. J. Showande* and A. O. Olaifa
ABSTRACT: The focus of this exploratory study was to determine if community pharmacists order laboratory tests, why they order the tests, type of tests they order and what they do with the outcome of such tests. Self-administered pre-tested 34-item semi-structured questionnaires were used to carry out this study among superintendent pharmacists’ of registered pharmacy premises in two south-western states in Nigeria. Descriptive statistics (frequency and percentages), Mann-Whitney U and Kruska...
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
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.
S. J. Showande* and A. O. Olaifa
Full Text Available ABSTRACT: The focus of this exploratory study was to determine if community pharmacists order laboratory tests, why they order the tests, type of tests they order and what they do with the outcome of such tests. Self-administered pre-tested 34-item semi-structured questionnaires were used to carry out this study among superintendent pharmacists’ of registered pharmacy premises in two south-western states in Nigeria. Descriptive statistics (frequency and percentages, Mann-Whitney U and Kruskal-Wallis tests were used to appropriately summarize the data obtained. All the respondents who consented to take part had ordered laboratory tests for patients prior to this study. The types of invasive and non-invasive tests ordered, ranged from simple dipstick pregnancy test to more varied tests like: fasting blood glucose 24(36.9%, blood pressure measurement 58(89.2%, malaria parasite test 47(72.3%, full blood count 16(24.6%, widal reaction test 45(69.2%, urinalysis 10(15.4% mantoux test 3(4.6% and hepatitis B & C test 3(4.6%. Some of the perceived benefits derived from interpreting laboratory test results were patient trust and confidence in pharmacists 28(43.1%, job satisfaction and relevance to the community 8(12.3% and revenue generation 5(7.7%. Community pharmacists in the two South-western states of Nigeria ordered various types of invasive and non-invasive laboratory tests and interpreted the outcomes of such tests either alone or in conjunction with physicians. This aspect of the pharmaceutical care continuum could be harnessed to foster the collaboration between pharmacists and physicians and ultimately improve patient care.
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.
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
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.
Olsson, Erika; Ingman, Pontus; Ahmed, Ban;
of prescribed medicines at Swedish community pharmacies. METHOD: Non-participant observations and audio recordings were used as data-collecting methods. The content of the dialog was categorized into 2 deductively decided main categories-medicinal and non-medicinal issues-and 12 inductively decided...... subcategories. RESULTS: A total of 282 pharmacy encounters were observed and recorded, of which 259 fully coincided with the inclusion criteria. After categorizing the content of each encounter the results showed that there was little or no dialog regarding medicinal issues during the pharmacy encounter...... in Swedish community pharmacies. Forty percent of the dialog concerns non-medical issues and almost half of the encounter was silent. CONCLUSION: Medicines are an essential treatment method in healthcare, and pharmaceutical expertise is available to patients who enter a community pharmacy. The results...
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).
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.
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
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
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...
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.
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
Beshir, Semira A; Hanipah, Monalina A
Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of
Anthony Scott; Michela Tinelli; Christine Bond
Background: Coronary heart disease (CHD) is the most common cause of death in the UK. CHD cost the UK National Health Service (NHS) Lstg 3.5 billion in 2003. The economic impact of community pharmacists providing a medicines management service for patients with CHD has not been rigorously evaluated; the full economic costs of such interventions are rarely presented in the literature. Objective: To examine the incremental costs of a 1-year community pharmacist-led medicines management service ...
Fathima, Mariam; Naik-Panvelkar, Pradnya; Saini, Bandana; Carol L. Armour
Objective The purpose of this review was to evaluate the role of community pharmacists in provision of screening with/without subsequent management of undiagnosed chronic obstructive pulmonary disease (COPD) and uncontrolled asthma. Methods An extensive literature search using four databases (ie. Medline, PubMed, International Pharmaceutical Abstracts (IPA) and Scopus) with search terms pharmacy, screening, asthma or COPD was conducted. Searches were limited to the years 2003-2013, those in E...
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
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
Tiago Marques dos Reis
Full Text Available The objective of the study was to evaluate the knowledge of pharmacists and check their conduct in relation to dispensing of drugs. This is a cross-sectional study performed in four municipalities from South and Southeast of Brazil, which are reference in health national scenario and concentrate 73.6% of national economic activity. Pharmacists who works in community pharmacies were invited to answer a questionnaire prepared by the authors of this study and validated. The main outcome measured was the pharmaceutical knowledge, rated according to the number of correct answers on that questionnaire prepared by the researchers, and professional conduct in relation to dispensing of drugs. The data collection occurred from September to December 2012 and the information obtained were tabulated in duplicate by two independent researchers for later analysis. 486 community pharmacies were visited but only 112 professionals participated in the study. Among the participants, 78.6% (n = 88 did not have adequate knowledge to perform the dispensing of drugs, despite this same number of pharmacists claiming to have participated in conferences and courses after graduation. The main sources of information on drugs used by participants have a low level of scientific evidence. The performance of non-employment related tasks reduces the time available for the care of medication users. In addition, the indiscriminate sale of antimicrobials and the sale of products other than health, mischaracterize the role of the pharmacist in the community pharmacy. There are gaps in the knowledge of professionals, limiting the satisfactory completion of dispensing of drugs. In addition, the excess of other duties and inadequate professional conduct compromise the promotion of the rational use of drugs.
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.
Full Text Available Abstract This article explores trends in social activism across Australian ethnic minority communities over a ten year period (1999-2009 and its relationship to indicators of social cohesion. It explores the impact of social modernisation in enabling the facilitation of effective grassroots campaigns on issues relevant the communities', and how they may influence public policy. Consideration is afforded to the impact on community participation with the rise of security policy on the national agenda, and significant events on domestic and global scales over a period which encompassed extraordinary acts of terrorism, irregular arrivals of asylum seekers, and unparalleled political and community confutation. It is asserted that participation in social activism is an important indicator of political empowerment within the dominant political structure, and could suitably enrich research into social cohesion in Australia. Keywords: political participation, public policy, social activism, social cohesion, social modernisation
Chen, Xi; Ung, Carolina Oi Lam; Hu, Hao; Liu, Xiaodan; Zhao, Jing; Hu, Yuanjia; Li, Peng; Yang, Qing
This study aimed to investigate community pharmacists' perceived responsibility, practice behaviors, knowledge, perceived barriers, and improvement measures towards provision of pharmaceutical care in relation to traditional medicine (TM) products in Guangzhou, China. A self-completion questionnaire was used to survey licensed pharmacists working at community pharmacies. This study found that the community pharmacists in Guangzhou, China, were involved in the provision of TM products during their daily practice but only provided pharmaceutical care in this area with a passive attitude. Extrinsic barriers such as lack of scientific evidence for the safety and efficacy of TM products and unclear definition of their roles and responsibilities were highlighted while intrinsic factors such as insufficient TM knowledge were identified. PMID:27066101
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.
Bond, C M; C. Bradley
Pharmacists play an important part in primary health care, and their accessibility is a key factor. Their NHS payments relate predominantly to the dispensing of prescribed medicines; to recognise the service element of their advisory role, an NHS funded professional fee could be built into the cost structure for pharmacy medicines. The increased number of medicines available over the counter has highlighted the need for training for counter assistants; it will become compulsory in July 1996, ...
Since 1994 there have been considerable additions to the range of health care professionals (HCPs) that can prescribe in the United Kingdom (UK). These HCPs include nurses, pharmacists, radiographers, physiotherapists, podiatrists, chiropodists and optometrists. After a period of specific prescribing training these HCPs are often referred to as non-medical prescribers (NMPs). There has been a limited amount of research that has investigated the influences on the prescribing behaviour of NMPs....
Gerber Ben S
Full Text Available Abstract Background Given the increasing prevalence of diabetes and the lack of patients reaching recommended therapeutic goals, novel models of team-based care are emerging. These teams typically include a combination of physicians, nurses, case managers, pharmacists, and community-based peer health promoters (HPs. Recent evidence supports the role of pharmacists in diabetes management to improve glycemic control, as they offer expertise in medication management with the ability to collaboratively intensify therapy. However, few studies of pharmacy-based models of care have focused on low income, minority populations that are most in need of intervention. Alternatively, HP interventions have focused largely upon low income minority groups, addressing their unique psychosocial and environmental challenges in diabetes self-care. This study will evaluate the impact of HPs as a complement to pharmacist management in a randomized controlled trial. Methods/Design The primary aim of this randomized trial is to evaluate the effectiveness of clinical pharmacists and HPs on diabetes behaviors (including healthy eating, physical activity, and medication adherence, hemoglobin A1c, blood pressure, and LDL-cholesterol levels. A total of 300 minority patients with uncontrolled diabetes from the University of Illinois Medical Center ambulatory network in Chicago will be randomized to either pharmacist management alone, or pharmacist management plus HP support. After one year, the pharmacist-only group will be intensified by the addition of HP support and maintenance will be assessed by phasing out HP support from the pharmacist plus HP group (crossover design. Outcomes will be evaluated at baseline, 6, 12, and 24 months. In addition, program and healthcare utilization data will be incorporated into cost and cost-effectiveness evaluations of pharmacist management with and without HP support. Discussion The study will evaluate an innovative, integrated
Jové, Anna Maria; Fernández, Ana; Hughes, Carmel; Guillén-Solà, Mireia; Rovira, Marta; Rubio-Valera, Maria
According to the theory of reasoned action (TRA), collaboration is only possible when it is perceived as useful by the participants involved. This paper describes a qualitative study using semi-structured interviews to explore the preceived usefulness of general practitioner (GPs)-community pharmacists (CPs)' collaboration from these professionals' perspectives based in two Spanish regions. Thirty-seven interviews were conducted with GPs and CPs with and without previous experience of collaborating with the other groups of professionals. Analysis of the data indicated that the GPs and CPs considered that collaboration between practitioners and pharmacists to have different forms of usefulness, ranging from positive to negative perceptions of usefulness. Negative and neutral opinions (collaboration generates conflict and/or is not benefitial) could prevent practitioners from initiating collaboration with the other group of professionals, which is explained by the TRA. These perceptions were only found among those participants without experience in collaboration. When collaboration was perceived as advantageous, it could be beneficial on three levels: health system (i.e. provision of integrated care, increased efficiency of the system), GPs and CPs (i.e. increased job satisfaction and patient loyalty) and patients (i.e. improved patient safety). Although GPs and CPs with experience identified benefits using a range of examples, GPs and CPs who had never collaborated also believed that if collaboration was undertaken there would be benefits for the health system, patients and health professionals. These results should be considered when developing strategies to encourage and improve the implementation of collaborative working relationships between GPs and pharmacists in primary care. PMID:24625196
Briggs, A; Scott, E.; Steele, K
The aim of this study was to ascertain general practitioners' (GPs') and pharmacists' knowledge of analgesics, to establish professional opinion on their use, and to assess the extent of pharmacist input into the prescribing of analgesics. Pharmacists displayed a better knowledge of analgesics than their colleagues in general practice, but had little input into the prescribing decisions made by GPs. Pharmacists' knowledge is not being put to best use in contributing to the preparation of prac...
Charrois, Theresa L; Meagen Rosenthal; Kreshnik Hoti; Christine Hughes
Several jurisdictions throughout the world, such as the UK and Canada, now have independent prescribing by pharmacists. In some areas of Canada, initial access prescribing can be done by pharmacists. In contrast, Australian pharmacists have no ability to prescribe either in a supplementary or independent model. Considerable research has been completed regarding attitudes towards pharmacist prescribing from the perspective of health care professionals, however currently no literature exists re...
Harris Stewart B
Full Text Available Abstract Background Limited evidence exists on the effectiveness of external diabetes support provided by diabetes specialists and community retail pharmacists to facilitate insulin-prescribing in family practice. Methods A stratified, parallel group, randomized control study was conducted in 15 sites across Canada. Family physicians received insulin initiation/titration education, a physician-specific ‘report card’ on the characteristics of their type 2 diabetes (T2DM population, and a registry of insulin-eligible patients at a workshop. Intervention physicians in addition received: (1 diabetes specialist/educator consultation support (active diabetes specialist/educator consultation support for 2 months [the educator initiated contact every 2 weeks] and passive consultation support for 10 months [family physician initiated as needed]; and (2 community retail pharmacist support (option to refer patients to the pharmacist(s for a 1-hour insulin-initiation session. The primary outcome was the insulin prescribing rate (IPR per physician defined as the number of insulin starts of insulin-eligible patients during the 12-month strategy. Results Consenting, eligible physicians (n = 151 participated with 15 specialist sites and 107 community pharmacists providing the intervention. Most physicians were male (74%, and had an average of 81 patients with T2DM. Few (9% routinely initiated patients on insulin. Physicians were randomly allocated to usual care (n = 78 or the intervention (n = 73. Intervention physicians had a mean (SE IPR of 2.28 (0.27 compared to 2.29 (0.25 for control physicians, with an estimated adjusted RR (95% CI of 0.99 (0.80 to 1.24, p = 0.96. Conclusions An insulin support program utilizing diabetes experts and community retail pharmacists to enhance insulin prescribing in family practice was not successful. Too few physicians are appropriately intensifying diabetes management through insulin initiation, and
Brimblecombe, Julie; Maypilama, Elaine; Colles, Susan; Scarlett, Maria; Dhurrkay, Joanne Garnggulkpuy; Ritchie, Jan; O'Dea, Kerin
We explored with Aboriginal adults living in a remote Australian community the social context of food choice and factors perceived to shape food choice. An ethnographic approach of prolonged community engagement over 3 years was augmented by interviews. Our findings revealed that knowledge, health, and resources supporting food choice were considered "out of balance," and this imbalance was seen to manifest in a Western-imposed diet lacking variety and overrelying on familiar staples. Participants felt ill-equipped to emulate the traditional pattern of knowledge transfer through passing food-related wisdom to younger generations. The traditional food system was considered key to providing the framework for learning about the contemporary food environment. Practitioners seeking to improve diet and health outcomes for this population should attend to past and present contexts of food in nutrition education, support the educative role of caregivers, address the high cost of food, and support access to traditional foods. PMID:24549409
Reutzel, T J
The patient counselling and prospective drug utilization review mandates of the Omnibus Budget Reconciliation Act of 1990 raise the question of how compatible the retail pharmacy setting in the United States is with a patient-based model of pharmacy practice. In order to investigate this question, a self-administered questionnaire was distributed by pharmacy students to a convenience sample of pharmacists with at least one year's experience in the community setting. The questionnaire asks respondents to recall two incidents: one that caused them to gain or retain a patient or that was for some reason a source of professional satisfaction, and one that may have caused the loss of a patient or that they would handle differently if faced with the situation or problem again. The respondents practice in pharmacies in and around a large midwestern city. Data analysis showed that respondents tend to identify patient-based activities when recalling appropriate behaviours and traditional or customer-based activities when recalling inappropriate behaviours or mistakes. Patient-based activities can sometimes result in the loss of business, but they can also result in patronage gains, especially when performed in conjunction with good customer service. In summary, these pharmacists do implement a patient-based model in some situations. The patient-based and customer-based models can be complementary in that the patient can benefit from the services of an expert health professional while simultaneously being treated with the respect and 'customer knows best' attitudes indicative of the retail setting. PMID:7806601
Yokoi, Masayuki; Tashiro, Takao
This study examined the economic efficiency of the separation of prescription and dispensation medicines between doctors in medical institutions and pharmacists in pharmacies. The separation system in Japanese prefectures was examined with publicly available data (Ministry of Health, Labour and Welfare, 2012-2014; retrieved from http://www.mhlw.go.jp/topics/medias/year). We investigated whether the separation system reduces the number of medicines or the medication cost of a prescription because of separating the economic management between prescribing and dispensing and the effect of mutual observation between doctors and pharmacists. It is optional for Japanese medical institutions to participate in the separation system. Consequently, the spreading rate of the separation system in each administrative district is highly variable. We examined the separation system effect using the National Healthcare Insurance data for three years, 2012-2014. We tested whether the separation system ratio for each prefecture was significantly correlated to the medication price or the number of medicines on a prescription. If spreading the separation system influenced the price of prescribed daily medications or the number of medicines, the correlation would be significant. As a result, the medication price was significantly negatively correlated with the separation system ratio, but the number of medicines was not significant. Therefore, the separation system was effective in reducing daily medication cost but had little influence on reducing the number of daily medicines. This was observed over three years in Japan. PMID:27157157
Sara D Leonhardt
Full Text Available Bacterial symbionts of insects have received increasing attention due to their prominent role in nutrient acquisition and defense. In social bees, symbiotic bacteria can maintain colony homeostasis and fitness, and the loss or alteration of the bacterial community may be associated with the ongoing bee decline observed worldwide. However, analyses of microbiota associated with bees have been largely confined to the social honeybees (Apis mellifera and bumblebees (Bombus spec., revealing--among other taxa--host-specific lactic acid bacteria (LAB, genus Lactobacillus that are not found in solitary bees. Here, we characterized the microbiota of three Australian stingless bee species (Apidae: Meliponini of two phylogenetically distant genera (Tetragonula and Austroplebeia. Besides common plant bacteria, we find LAB in all three species, showing that LAB are shared by honeybees, bumblebees and stingless bees across geographical regions. However, while LAB of the honeybee-associated Firm4-5 clusters were present in Tetragonula, they were lacking in Austroplebeia. Instead, we found a novel clade of likely host-specific LAB in all three Australian stingless bee species which forms a sister clade to a large cluster of Halictidae-associated lactobacilli. Our findings indicate both a phylogenetic and geographical signal of host-specific LAB in stingless bees and highlight stingless bees as an interesting group to investigate the evolutionary history of the bee-LAB association.
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.
Full Text Available This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu respectively to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English respectively. The study focuses on language input from primary caregivers to a group of preschool children, and on the children’s productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately two years apart, to explore changes in adult input over time and developmental patterns in the children’s speech.At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT, there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio. For measures of morphosyntactic complexity (MLU, children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study’s findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children’s language and linguistic input varies diachronically across time. As
Gabbe, B; Finch, C F; Wajswelner, H; Bennell, K
The progress of injury prevention research in Australian football to date has been slow despite its recognition as a public health goal. In particular, field-based studies to identify injury risk factors and evaluate the effectiveness of injury prevention strategies need to be undertaken to ensure safety gains in this sport. For these types of studies to be successful and complied with, considerable support is required from clubs, coaches and players. To date, the actual level of support for injury prevention research at the community-level of football has not been established. A survey of 82 club administrators and coaches from the Victorian Amateur Football Association was undertaken to determine the level of support for injury prevention research, along with incentives for, and barriers towards, participation in such research. The highest priorities for injury prevention research were given as the prevention of knee, hamstring and concussion injuries and investigation into the content of training programs. The most common incentives reported as being necessary for participation in injury prevention research were financial assistance (59.5%), more club staff (57.0%) and further education (36.7%). The most commonly reported barriers to research were the expertise (50.0%) and number of (48.8%) of club medical staff members. Overall community-level football club administrators and coaches rank the importance of injury prevention research highly. The findings of this study are positive for injury prevention researchers and suggest that clubs are keen to participate in such research.
Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John
Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.
Winslade, Nancy; Eguale, Tewodros; Tamblyn, Robyn
Objective To evaluate the impact of comparative performance feedback to community pharmacists on provision of professional services and the quality of patients’ medication use. Design Randomised, controlled, single-blind trial. Setting All 1833 community pharmacies in the Quebec province, Canada. Participants 1814 pharmacies not opting out and with more than 5 dispensings of the target medications during the 6-month baseline were randomised by a 2×2 factorial design to feedback first for hypertension adherence (907 control, 907 intervention) followed by randomisation for asthma adherence (791 control, 807 intervention). 1422 of 1814 pharmacies had complete information available during the follow-up for hypertension intervention (706 intervention, 716 control), and 1301 of 1598 had the follow-up information for asthma (657 intervention, 644 control). Intervention Using provincial billing data to measure performance, mailed comparative feedback reported the pharmacy-level percentage of dispensings to patients non-adherent to antihypertensive medications or overusing asthma rescue inhalers. Primary and secondary outcome measures The number of hypertension/asthma services billed per pharmacy and percentage of dispensings to non-adherent patients over the 12 months post intervention. Results Feedback on the asthma measure led to increased provision of asthma services (control 0.2, intervention 0.4, RR 1.58, 95% CI 1.02 to 2.46). However, this did not translate into reductions in patients’ overuse of rescue inhalers (control 45.5%, intervention 44.6%, RR 0.99, 95% CI 0.98 to 1.01). For non-adherence to antihypertensive medications, feedback resulted in no difference in either provision of hypertension services (control 0.7, intervention 0.8, RR 1.25, 95% CI 0.86 to 1.82) or antihypertensive treatment adherence (control 27.9%, intervention 28.0%, RR 1.0, 95% CI 0.99 to 1.00). Baseline performance did not influence results, and there was no evidence of a cumulative
Rubio Valera, Maria
1) Objectives: - To systematically evaluate the effectiveness of pharmacist care compared with usual care (UC) on improving adherence to antidepressants in depressed outpatients. - To evaluate the effectiveness and cost‐effectiveness of a community pharmacist intervention (CPI) compared to UC in the improvement of adherence to antidepressants and patient wellbeing in a primary care population initiating treatment with antidepressants. 2) Methods: A systematic review and meta‐a...
Harris Stewart B; Gerstein Hertzel C; Yale Jean-François; Berard Lori; Stewart John; Webster-Bogaert Susan; Tompkins Jordan W
Abstract Background Limited evidence exists on the effectiveness of external diabetes support provided by diabetes specialists and community retail pharmacists to facilitate insulin-prescribing in family practice. Methods A stratified, parallel group, randomized control study was conducted in 15 sites across Canada. Family physicians received insulin initiation/titration education, a physician-specific ‘report card’ on the characteristics of their type 2 diabetes (T2DM) population, and a regi...
Paul RutterSchool of Pharmacy, University of Wolverhampton, Wolverhampton, UKAbstract: This review highlights the growing prominence of self-care and explores the contribution of community pharmacy. Firstly, background to self-care is discussed, followed by placing self-care in context with regard to the general public and accessing community pharmacy. From this perspective the contribution community pharmacy currently makes is assessed, paying particular attention to the factors that negativ...
Martin, Beth A.; 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.
Pharo, Emma; Davison, Aidan; McGregor, Helen; Warr, Kristin; Brown, Paul
We report on the establishment of communities of practice at four Australian institutions and evaluate their effectiveness and durability as a means of building staff and institutional capacity for interdisciplinary teaching. A community of practice approach is a potentially valuable methodology for overcoming dynamics of fragmentation, isolation…
Loakes, Deborah; Moses, Karin; Wigglesworth, Gillian; Simpson, Jane; Billington, Rosey
Indigenous children growing up in the remote regions of Australia live in multilingual communities which are often undergoing rapid language shift. In these communities, children are exposed to a range of language input, including the traditional language of the area, a local creole and Standard Australian English. The extent to which the…
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.
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…
Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn
Background Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Healt...
Full Text Available This study was carried out to determine the attitudes of the Australian community to IVF by a reliable community poll. Cross-sectional surveys, conducted by telephone of a random sample of 650 Australians were undertaken. The sample was drawn from the residential phone numbers in the Australian electronic “White Pages” and stratified by geographical area with quotas controlled by gender and age to be representative of the Australian population. The participants were asked to answer to three questions about gender selection, and their response was measured as “yes-allowed,” “no-not allowed,” or “undecided” for each of the questions. Whilst 91% of respondents supported the use of IVF to help infertile couples, only 20% supported gender selection within IVF or for family balancing. When it came to the use of IVF only for gender selection, only 17% were in favour. This survey shows that Australian community overwhelmingly opposes gender selection for social reasons.
Wang, Jun; Hu, Xiamin; Liu, Juan; Li, Lei
The aim of this study was to evaluate the attitudes towards physician-pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students' attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP(2)C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP(2)C among 235 Chinese pharmacy students was 51.44. Cronbach's alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE. PMID:27310204
Full Text Available Background: The incidence of serotonin syndrome is increasing due to the widening use of serotonergic drugs. Identification of serotonin syndrome is challenging as the manifestations are diverse. Misdiagnosis can lead to delay in care and inappropriate treatment. Objectives: The objectives of this study were to determine if staff of community pharmacies in Australia could identify the symptoms of serotonin syndrome in simulated patients and recommend an appropriate course of action. Methods: Agents acting on behalf of a simulated patient were trained on a patient scenario that reflected possible serotonin syndrome due to an interaction between duloxetine and recently prescribed tramadol. They entered 148 community pharmacies in Australia to ask for advice about a 60 year old male simulated patient who was ‘not feeling well’. The interaction was audio recorded and analysed for degree of access to the pharmacist, information gathered by pharmacy staff, management advice given and pharmacotherapy recommended. Results: The simulated patient’s agent was consulted by a pharmacist in 94.0% (139/148 of cases. The potential for serotonin syndrome was identified by 35.1% (52/148 of pharmacies. Other suggested causes of the simulated patient’s symptoms were viral (16.9%; 25/148 and cardiac (15.5%; 23/148. A total of 33.8% (50/148 of pharmacies recommended that the simulated patient should cease taking tramadol. This advice always came from the pharmacist. Immediate cessation of tramadol was advised by 94.2% (49/52 of pharmacists correctly identifying serotonin syndrome. The simulated patient was advised to seek urgent medical care in 14.2% (21/148 of cases and follow up with a doctor when possible in 68.2% (101/148 of cases. The majority of pharmacies (87.8%; 130/148 did not recommend non-prescription medicines. Conclusion: While not identifying the cause of the simulated patient’s symptoms in the majority of cases, community pharmacies
Cooke, Penelope R.; Hemmings, Brian C.
The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…
Gordon, M.; Lockwood, M.; Schirmer, Jacki; Vanclay, F.; Hanson, D.
This paper provides practical insight into what can be done to improve the adoption of community engagement (CE) in the corporate culture of two Australian forest plantation companies. Previous research has identified that CE can be limited by corporate cultures that promote a narrow range of CE ben
Narit Thaochan; Richard A.I. Drew; Anuchit Chinajariyawong; Anurag Sunpapao; Chaninun Pornsuriya
The community structure of the alimentary tract bacteria of two Australian fruit fly species, Bactrocera cacuminata (Hering) and Bactrocera tryoni (Froggatt), was studied using a molecular cloning method based on the 16S rRNA gene. Differences in the bacterial community structure were shown between the crops and midguts of the two species and sexes of each species. Proteobacteria was the dominant bacterial phylum in the flies, especially bacteria in the order Gammaproteobacteria w...
Niurka María Dupotey Varela; Djenane Ramalho de Oliveira; Caridad Sedeño Argilagos; Kisvel Oliveros Castro; Elisveidis Mosqueda Pérez; Yelina Hidalgo Clavel; Nelly Sánchez Bisset
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,. T...
You, Joyce H.; Wong, Fiona Y; Chan, Frank W.; Wong, Eliza L; Yeoh, Eng-Kiong
Background The choices for self-medication in Hong Kong are much diversified, including western and Chinese medicines and food supplements. This study was to examine Hong Kong public knowledge, attitudes and behaviours regarding self-medication, self-care and the role of pharmacists in self-care. Methods A cross-sectional phone survey was conducted, inviting people aged 18 or older to complete a 37-item questionnaire that was developed based on the Thematic Household surveys in Hong Kong, fin...
O'Toole, Kevin; Burdess, Neil
State and federal governments in Australia have developed a range of policy instruments for rural areas in Australia that are infused with a new sense of "community," employing leading concepts like social capital, social enterprise, community development, partnerships and community building. This has encouraged local people and organisations to…
... Status Recognition Every pharmacist's effort is needed to achieve provider status recognition. Be part of the team working toward this goal. MORE Spotlight Zika Outbreak: What Pharmacists Need to ...
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
MacLean, Sarah; Harney, Angela; Arabena, Kerry
Crystal methamphetamine (commonly known as 'ice') use is currently a deeply concerning problem for some Australian Indigenous peoples and can cause serious harms to individual, families and communities. This paper is intended to support best practice responses by primary health-care staff working with Australian Indigenous people who use methamphetamine. It draws on a systematic search of relevant databases to identify literature from January 1999 to February 2014, providing an overview of prevalence, treatment, education and harm reduction, and community responses. The prevalence of methamphetamine use is higher in Indigenous than non-Indigenous communities, particularly in urban and regional settings. No evidence was identified that specifically related to effective treatment and treatment outcomes for Indigenous Australians experiencing methamphetamine dependence or problematic use. While studies involving methamphetamine users in the mainstream population suggest that psychological and residential treatments show short-term promise, longer-term outcomes are less clear. Community-driven interventions involving Indigenous populations in Australia and internationally appear to have a high level of community acceptability; however, outcomes in terms of methamphetamine use are rarely evaluated. Improved national data on prevalence of methamphetamine use among Indigenous people and levels of treatment access would support service planning. We argue for the importance of a strength-based approach to addressing methamphetamine use, to counteract the stigma and despair that frequently accompanies it. PMID:25704260
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
Dare, Melanie (Lain); Vanclay, Frank; Schirmer, Jacki
The rapid expansion of timber plantations across Australia has been contentious, with ongoing debate in rural communities about the social, economic and environmental impacts of plantations. The need for effective and ongoing community engagement (CE) has been highlighted by this ongoing contention
Full Text Available While the notion that communities require resources in the form of financial capital for their development and wellbeing has long been recognised, it has become increasingly apparent that economic resources alone do not lead to community sustainability and wellbeing. The building and supporting of strong, safe, socially cohesive communities that embrace social connections and commitment, has become an important goal of policy and initiatives at all levels of government. The aims of this study were to identify a common understanding of the concept of ‘community cohesion’, and to develop a set of indicators based on both the experiences of residents in a rural community and the relevant contemporary academic literature. Because community cohesion is an intangible concept subject to multiple meanings, qualitative research methods were used. We identified four main themes which could be translated into the key indicators. The most significant finding is that neighbourliness was identified by participants as the key aspect of community cohesion. Yet, whilst it is central, this does not mean excessive familiarity or the taking of liberties. Indeed, part of neighbourliness involves respecting each other’s boundaries and respect for diversity.
This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.
This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults. PMID:26881483
Lionel Frost; Margaret Lightbody; Abdel Halabi
Australian Football clubs have traditionally been seen as contributing social benefits to the rural communities in which they are embedded. Declining numbers of participants, both players and volunteers, suggest that this role may not be as strong today. Critical explorations of the extent to which football has driven social inclusion and exclusion in such environments emphasise a historic â€˜masculineâ€™ culture of drinking and violence that segregates and marginalises women and children. Le...
Powell, S M; Tamplin, M L
The role of specific spoilage organisms (SSO) in products such as Atlantic salmon has been well documented. However, little is known about what other micro-organisms are present and these organisms may indirectly influence spoilage by their interactions with the SS0. We used a combination of culture-based and DNA-based methods to explore the microbial communities found on Atlantic salmon fillets packed in a modified atmosphere of carbon dioxide and nitrogen. After 15 days the communities were dominated by Shewanella spp. or Carnobacterium spp. and a variety of other genera were present in smaller numbers. Variability in the microbial community composition in packages processed on the same day was also observed. This was mostly due to differences in the presence of minor members of the community including species from genera such as Iodobacter, Serratia, Morganella and Yersinia. The combination of culture-based and culture-independent methods provided greater insight into the development of microbial communities on Atlantic salmon than would have been possible using only one method. This work highlights the potential importance of lactic acid bacteria (LAB) in fresh Atlantic salmon stored under modified atmosphere conditions.
MacDougall, Colin; Gibbs, Lisa; Clark, Rachel
The Victorian Country Fire Authority in Australia runs the Community Fireguard (CFG) programme to assist individuals and communities in preparing for fire. The objective of this qualitative research was to understand the impact of CFG groups on their members' fire preparedness and response during the 2009 Australian bushfires. Social connectedness emerged as a strong theme, leading to an analysis of data using social capital theory. The main strength of the CFG programme was that it was driven by innovative community members; however, concerns arose regarding the extent to which the programme covered all vulnerable areas, which led the research team to explore the theory of diffusion of innovation. The article concludes by stepping back from the evaluation and using both applied theories to reflect on broad options for community fire preparedness programmes in general. The exercise produced two contrasting options for principles underlying community fire preparedness programmes. PMID:24601916
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
Full Text Available Salem Hasn Abukres, Kreshnik Hoti, Jeffery David Hughes School of Pharmacy, Curtin Health and Innovation Research Institute, Curtin University, Perth, WA, Australia Background: In Australia, “continued dispensing” (CD is a new model for supply of prescription medications. Under specific circumstances, community pharmacists are allowed to dispense a further one month supply of prescription only medications without a valid prescription. It allows continuation and treatment adherence when patients run out of statin and/or oral contraceptive (OC medications, when it is not practical or they fail to plan accordingly to get a new prescription. Objective: The aim of this study was to explore patient attitudes towards a CD model, including any perceived concerns or associated risks with CD prior to its introduction.Methods: An Australia-wide computer-assisted telephone interview survey of statin and OC users aged 18 years or older was conducted in July 2013 prior to implementation of the CD model. A telephone number list was generated via a random number generation function based on a broad breakdown of the Australian population as outlined in the June 2013 Australian Bureau of Statistics data. The sample target for the survey was 300, consisting of 150 statin users and 150 OC users.Results: There were a total of 301 respondents, comprising 151 statin users and 150 OC users. Approximately 37% of all respondents had experienced running out of their medications in the past 12 months, of whom 35.4% had temporarily stopped treatment and 33.6% requested their medication from a pharmacist without a valid prescription. OC users were more likely to run out of their medications (P=0.021. The majority of respondents had a regular pharmacy (86% and therefore would be eligible for CD in the future. The majority of those surveyed had no concerns about CD or perceived it as posing no risks. Concerns raised included consultation privacy and the pharmacist’s lack
Al Rahbi, Hussain Abdullah Mubarak; Al-Sabri, Raid Mahmood; Chitme, Havagiray R
Interventions by the pharmacists have always been considered as a valuable input by the health care community in the patient care process by reducing the medication errors, rationalizing the therapy and reducing the cost of therapy. The primary objective of this study was to determine the number and types of medication errors intervened by the dispensing pharmacists at OPD pharmacy in the Khoula Hospital during 2009 retrospectively. The interventions filed by the pharmacists and assistant pha...
Boateng Edmund A; Marfo Afia FA; Owusu-Daaku Frances T
Abstract Background There is scant knowledge of the involvement of developing country pharmacists in mental healthcare. The objectives of this study were: to examine the existing role of Ghanaian community and hospital pharmacists in the management of mental illness, and to determine the barriers that hinder pharmacists' involvement in mental healthcare in Ghana. Method A respondent self-completion questionnaire was randomly distributed to 120 superintendent community pharmacists out of an es...
Hanna T; Bajorek B; LeMay K; Armour CL
Highlights: • Marine debris and marine wildlife entanglement remains a significant global issue. • We examined awareness of this issue in an Australian community sample. • Findings reveal gaps exist in terms of what entanglement is and the risks posed. • Enhancing community understanding may facilitate greater conservation action. • The ‘Seal the Loop’ initiative provides one potential mechanism for such education. - Abstract: Marine debris remains a global challenge, with significant impacts on wildlife. Despite this, there is a paucity of research examining public understanding about marine wildlife entanglement [MWE], particularly within an Australian context. The present study surveyed two hundred and thirteen participants across three coastal sites to assess familiarity with MWE and the effectiveness of a new community education initiative ‘Seal the Loop’ [STL]. Results revealed attitudes toward marine wildlife were very positive (M 40.5, SD 4.12); however 32% of participants were unable to correctly explain what MWE is and risks to wildlife were under-estimated. STL may be one method to enhance public understanding and engagement-if community familiarity with the program can be increased. For those aware of STL (<13% of the sample at the time of the study), findings revealed this was having a positive impact (e.g. learning something new, changed waste disposal behaviours)
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.
Durfee, Sharon M
Nutrition support is a pharmacy specialty in which pharmacists work with prescribers, conduct order review, and either perform or oversee compounding of these complex parenteral nutrition formulations. Pharmacists should be certified in this specialty, and the options for certification are outlined in this article. PMID:22275326
Theresa L. Charrois
Full Text Available Several jurisdictions throughout the world, such as the UK and Canada, now have independent prescribing by pharmacists. In some areas of Canada, initial access prescribing can be done by pharmacists. In contrast, Australian pharmacists have no ability to prescribe either in a supplementary or independent model. Considerable research has been completed regarding attitudes towards pharmacist prescribing from the perspective of health care professionals, however currently no literature exists regarding pharmacy student views on prescribing. The primary objective of this study is to examine pharmacy student’s opinions and attitudes towards pharmacist prescribing in two different settings. Focus groups were conducted with selected students from two universities (one in Canada and one in Australia. Content analysis was conducted. Four main themes were identified: benefits, fears, needs and pharmacist roles. Students from the Australian University were more accepting of the role of supplementary prescribing. In contrast, the Canadian students felt that independent prescribing was moving the profession in the right direction. There were a number of similarities with the two groups with regards to benefits and fears. Although the two cohorts differed in terms of their beliefs on many aspects of prescribing, there were similarities in terms of fears of physician backlash and blurring of professional roles.
@@ Introduction The Australian Research Council(ARC) is the Australian Government's main agency for allocating research funding to academics and researchers in Australian universities.Its mission is to deliver policy and programs that advance Australian research and innovation globally and benefit the community.
Shikamura, Yoshiaki; Mano, Yasunari; Komoda, Masayo; Negishi, Kenichi; Sato, Tsugumichi; Miyazaki, Satoru
This nationwide survey aimed to evaluate reduction of drug and medical costs due to prevention of serious adverse drug reactions through pharmaceutical inquires by community pharmacist, and investigate relation with iyaku bungyo (separation of dispensing from medical practice) rates. Using the national list of pharmacies, 10% of pharmacies were randomly selected by prefecture and asked to participate in an Internet-based survey. The survey period was 7 days, from July 21 to July 27, 2015. Of the 5575 pharmacies queried, 818 responded to the survey (response rate: 14.7%). The proportion of inquiries to total prescriptions was 2.6%. Among these, the proportion of prescriptions changed in response to inquiry was 74.9%. An estimated 103 million yen was saved by reducing drug costs, and 133 million yen was saved by reducing medical costs due to prevention of serious adverse drug reactions. Comparison of prescription change rates between pharmacies with high and low iyaku bungyo rates indicated that the proportion of prescriptions changed was significantly higher in pharmacies with high iyaku bungyo rates than in those with low iyaku bungyo rates (78.2% vs. 69.9%, pcost of healthcare. They also suggest that iyaku bungyo promotes prescription changes through inquiries, leading to proper use of pharmaceutical products. PMID:27592829
Boateng Edmund A
Full Text Available Abstract Background There is scant knowledge of the involvement of developing country pharmacists in mental healthcare. The objectives of this study were: to examine the existing role of Ghanaian community and hospital pharmacists in the management of mental illness, and to determine the barriers that hinder pharmacists' involvement in mental healthcare in Ghana. Method A respondent self-completion questionnaire was randomly distributed to 120 superintendent community pharmacists out of an estimated 240 pharmacists in Kumasi, Ashanti Region of Ghana. A purposive sampling method was utilized in selecting two public psychiatric hospital pharmacists in Accra, the capital city of Ghana for a face-to-face interview. A semi-structured interview guide was employed. Results A 91.7% response rate was obtained for the community pharmacists' questionnaire survey. Approximately 65% of community pharmacists were not involved in mental health provision. Of the 35% who were, 57% counseled psychiatric patients and 44% of these dispensed medicines for mental illness. Perceived barriers that hindered community pharmacists' involvement in the management of mental health included inadequate education in mental health (cited by 81% of respondents and a low level of encounter with patients (72%. The psychiatric hospital pharmacists were mostly involved in the dispensing of medicines from the hospital pharmacy. Conclusion Both community and hospital pharmacists in Ghana were marginally involved in the provision of mental healthcare. The greatest barrier cited was inadequate knowledge in mental health.
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.
In Australia, renewable energy is under pressure in the context of a highly politicised debate about how to act on climate change. The recent repeal of an established carbon tax has seen the defunding of significant renewable energy initiatives and a controversial review of the national Renewable Energy Target is threatening key drivers for investment in renewable energy. The current regulatory focus on community ‘acceptance’ does not facilitate the active community support necessary to challenge this increasingly hostile policy context. This research considers current experiences of community engagement in wind farm governance in one Australian jurisdiction. Through documentary analysis and two qualitative case studies, it examines legal and non-legal requirements for community governance mechanisms and considers how these influence wind farm development in rural areas. Findings include a problematic reliance on procedural compliance in assessing wind farm consultation, domination by vested interests, and reduced expertise in community engagement at the time it is needed most. Recommendations include integration of best practice guidelines in current regulation; harmonisation of policy settings to ensure equity across energy sectors; and an evidence-based commitment to benefit sharing as a strategy for increasing community support of rural wind farm development. - Highlights: • Changes to renewable energy policy in Australia threaten wind farm development. • Active community support is required to ensure ongoing viability of the industry. • Benefit sharing models are shown to increase community support for wind farms. • Legal frameworks reinforce a minimum compliance paradigm and entrench vested interests. • Best practice guidelines improve implementation of community engagement procedures
Pollitt, P A
The concept of dementia in old age in Australian Aboriginal and Torres Strait Islander communities is intrinsically paradoxical. Firstly, few indigenous people reach old age. Secondly, from some indigenous points of view, dementia is either not recognized as a condition or as a problem, or, in the case of the more disruptive manifestations of cognitive impairment, is perceived as 'madness'. Moreover, in the wider context of profound political, social and economic inequality experienced by most indigenous people, the western medical category of dementia may appear to be of relatively minor importance. However, government initiatives in aged care generally and dementia care in particular which are designed to address the ageing of the Australian population as a whole also include the nation's older indigenous people. This article-based on a review of published work, supplemented by discussions with indigenous and non-indigenous individuals involved in indigenous aged care and mental health-examines some of the issues surrounding cognitive decline in old age for Aborigines and Torres Strait Islanders. More specifically, it looks at the problems involved in assessing and diagnosing cognitive decline and dementia, especially among people who follow more traditional ways of life, and in providing services to sufferers and their carers. In doing so, it considers some of the relative meanings of "old age', "abnormal old age', "mental disorder', "sickness' and "dementia'. PMID:9097208
Full Text Available Abstract Background Naturopaths and Western herbal medicine (WHM practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM practitioners within the pharmacy setting. Method Practising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. Results 479 practitioners participated. 24% of respondents (n = 111 reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n = 15 did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future. Conclusions The level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies
Colles, Susan L; Maypilama, Elaine; Brimblecombe, Julie
Contemporary diets of Aboriginal people living in remote Australia are characterised by processed foods high in fat and sugar. Within the 'new' food system, evidence suggests many Aboriginal people understand food in their own terms but lack access to consumer information about store-purchased foods, and parents feel inadequate as role models. In a remote Australian Aboriginal community, purposive sampling identified adults who participated in semistructured interviews guided by food-based themes relating to the contemporary food system, parental guidance of children's food choice and channels through which people learn. Interpretive content analysis was used to identify salient themes. In discussions, people identified more closely with dietary qualities or patterns than nutrients, and valued a balanced, fresh diet that made them feel 'light'. People possessed basic knowledge of 'good' store foods, and wanted to increase familiarity and experience with foods in packets and cans through practical and social skills, especially cooking. Education about contemporary foods was obtained from key family role models and outside the home through community-based organisations, including school, rather than pamphlets and flip charts. Freedom of choice was a deeply held value; carers who challenged children's autonomy used strategic distraction, or sought healthier alternatives that did not wholly deny the child. Culturally safe approaches to information sharing and capacity building that contribute to the health and wellbeing of communities requires collaboration and shared responsibility between policy makers, primary healthcare agencies, wider community-based organisations and families. PMID:25053144
Full Text Available The community structure of the alimentary tract bacteria of two Australian fruit fly species, Bactrocera cacuminata (Hering and Bactrocera tryoni (Froggatt, was studied using a molecular cloning method based on the 16S rRNA gene. Differences in the bacterial community structure were shown between the crops and midguts of the two species and sexes of each species. Proteobacteria was the dominant bacterial phylum in the flies, especially bacteria in the order Gammaproteobacteria which was prominent in all clones. The total bacterial community consisted of Proteobacteria (more than 75% of clones, except in the crop of B. cacuminata where more than 50% of clones belonged to Firmicutes. Firmicutes gave the number of the secondary community structure in the fly’s gut. Four orders, Alpha-, Beta-, Delta- and Gammaproteobacteria and the phyla Firmicutes and Actinobacteria were found in both fruit fly species, while the order Epsilonproteobacteria and the phylum Bacteroidetes were found only in B. tryoni. Two phyla, Actinobacteria and Bacteroidetes, were rare and less frequent in the flies. There was a greater diversity of bacteria in the crop of the two fruit fly species than in the midgut. The midgut of B. tryoni females and the midgut of B. cacuminata males had the lowest bacterial diversity.
K. A. Stone
Full Text Available Chemistry climate models are important tools for addressing interactions of composition and climate in the Earth System. In particular, they are used for assessing the combined roles of greenhouse gases and ozone in Southern Hemisphere climate and weather. Here we present an evaluation of the Australian Community Climate and Earth System Simulator-Chemistry Climate Model, focusing on the Southern Hemisphere and the Australian region. This model is used for the Australian contribution to the international Chemistry-Climate Model Initiative, which is soliciting hindcast, future projection and sensitivity simulations. The model simulates global total column ozone (TCO distributions accurately, with a slight delay in the onset and recovery of springtime Antarctic ozone depletion, and consistently higher ozone values. However, October averaged Antarctic TCO from 1960 to 2010 show a similar amount of depletion compared to observations. A significant innovation is the evaluation of simulated vertical profiles of ozone and temperature with ozonesonde data from Australia, New Zealand and Antarctica from 38 to 90° S. Excess ozone concentrations (up to 26.4 % at Davis during winter and stratospheric cold biases (up to 10.1 K at the South Pole outside the period of perturbed springtime ozone depletion are seen during all seasons compared to ozonesondes. A disparity in the vertical location of ozone depletion is seen: centered around 100 hPa in ozonesonde data compared to above 50 hPa in the model. Analysis of vertical chlorine monoxide profiles indicates that colder Antarctic stratospheric temperatures (possibly due to reduced mid-latitude heat flux are artificially enhancing polar stratospheric cloud formation at high altitudes. The models inability to explicitly simulated supercooled ternary solution may also explain the lack of depletion at lower altitudes. The simulated Southern Annular Mode (SAM index compares well with ERA-Interim data. Accompanying
... to Know About Zika & Pregnancy 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 ...
Anderson, Heather; Kowal, Emma
The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia. PMID:22881383
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.
Full Text Available Australian Subtropical White Syndrome (ASWS is an infectious, temperature dependent disease of the subtropical coral Turbinaria mesenterina involving a hitherto unknown transmissible causative agent. This report describes significant changes in the coral associated bacterial community as the disease progresses from the apparently healthy tissue of ASWS affected coral colonies, to areas of the colony affected by ASWS lesions, to the dead coral skeleton exposed by ASWS. In an effort to better understand the potential roles of bacteria in the formation of disease lesions, the effect of antibacterials on the rate of lesion progression was tested, and both culture based and culture independent techniques were used to investigate the bacterial communities associated with colonies of T. mesenterina. Culture-independent analysis was performed using the Oligonucleotide Fingerprinting of Ribosomal Genes (OFRG technique, which allowed a library of 8094 cloned bacterial 16S ribosomal genes to be analysed. Interestingly, the bacterial communities associated with both healthy and disease affected corals were very diverse and ASWS associated communities were not characterized by a single dominant organism. Treatment with antibacterials had a significant effect on the rate of progress of disease lesions (p = 0.006, suggesting that bacteria may play direct roles as the causative agents of ASWS. A number of potential aetiological agents of ASWS were identified in both the culture-based and culture-independent studies. In the culture-independent study an Alphaproteobacterium closely related to Roseovarius crassostreae, the apparent aetiological agent of juvenile oyster disease, was found to be significantly associated with disease lesions. In the culture-based study Vibrio harveyi was consistently associated with ASWS affected coral colonies and was not isolated from any healthy colonies. The differing results of the culture based and culture-independent studies
Menz Hylton B
Full Text Available Abstract Background Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated. Methods One hundred and four community-dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short-Form 36 (SF-36 questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment. Results The MFPDI score ranged from 1 to 30 (median 14, out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF-36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%, and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%. Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back. Conclusions Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health-related quality of life. These findings are broadly similar to previous studies in English-speaking older people in Australia. However, only a small
work in hospitals than in community pharmacies, and all groups of internationally trained pharmacist are more likely to work full-time than British-trained ones. Adjudication pharmacists appear to stay on the Register longer than their reciprocal and European colleagues. Conclusion Analysis of the Register of Pharmacists provides novel insights into the origins, composition and destinations of internationally trained pharmacists. They represent a notable proportion of the Register, indicating that British employers are relying on their contribution for the delivery of pharmacy services. With the increasing mobility of health care professionals across geographical borders, it will be important to undertake primary research to gain a better understanding of the expectations, plans and experiences of pharmacists entering from outside Great Britain.
Chilton, Angela; Woodhouse, Jason; Neilan, Brett
A key aspect for successful ecological rehabilitation is understanding the naturally occurring ecosystem and landscape function which is to be restored. This allows for recovery indicators to be identified and criteria to be developed to assess progress and outcomes. In arid rangelands, environmental stresses result in characteristically heterogeneous landscapes where biological soil crusts (BSCs) cover large expanses of inter-plant areas. Here, BSCs perform crucial roles in nutrient cycling and re-distribution, affect hydrological patterns and stabilise the soil surface. They also serve as a large reservoir of microbial and avascular plant biodiversity. The recognition of these important roles has resulted in increased global arid rehabilitation efforts employing BSCs. Within Australia, research has focused on the macro components of BSCs including lichens and mosses, however, there have been insufficient studies examining the BSC bacterial communities and their dynamics over different successional stages. This project surveyed the bacterial community of crust-free soil and three successional stages of undisturbed BSCs from New South Wales (NSW), Australia, in order to provide reference standards of naturally occurring Australian BSCs. Visual assessments were conducted and BSCs were categorised as Early, Mid or Late stage depending on colour, thickness, topography and presence of lichens and mosses. The crust-free soil and different stages were sampled within three 50 m2 plots of the same edaphic conditions near the town of Cobar, NSW. High throughput sequencing using the Illumina MiSeq platform was performed targeting the V2 region of the 16S rRNA gene. Preliminary analysis has revealed a clear distinction between the crust-free and crusted soil while Canonical Analysis of Principal Co-ordinates (CAP) suggests the presence of two distinct BSC microbial communities despite three stages being sampled. Across all sample types, the dominant phyla were Actinobacteria
Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.
With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…
Kylie Lee, K S; Sukavatvibul, Krisakorn; Conigrave, Katherine M
Anecdotal reports have linked cannabis use to violence in some remote Australian Aboriginal communities. We examine the relationship between cannabis use and presentations to local clinics for violence-related trauma at a population level. As part of a larger study, estimates of cannabis and alcohol use status were obtained for 264 randomly selected individuals aged 14-42. These estimates were collected from Aboriginal health workers and respected community informants using a previously validated approach. Clinic records for the sample were audited for physical trauma presentations between January 2004 and June 2006. One in 3 individuals (n = 88/264) presented to the clinic with physical trauma. Of these, the majority (65.9%, n = 58/88) had at least one presentation that was violence-related. Nearly 2 in every 3 of the total presentations for trauma following violence (n = 40/63) involved the use of a weapon. Hunting tools were most often used, followed by wooden or rock implements. Individuals who reported any current cannabis use were nearly 4 times more likely than nonusers to present at least once for violent trauma after adjusting for current alcohol use, age, and sex (OR = 3.8, 95% CI [1.5, 9.8]). Aboriginal individuals in these remote communities experience high rates of physical trauma and violence, often involving weapons. A comprehensive study is needed to explore the association between cannabis and violence. At the same time, an investment in local programmes is needed to address cannabis use and underlying risk factors for substance use and for violence.
McDonald, Elizabeth; Cunningham, Teresa; Slavin, Nicola
Background The No Germs on Me (NGoM) Social Marketing Campaign to promote handwashing with soap to reduce high rates of infection among children living in remote Australian Aboriginal communities has been ongoing since 2007. Recently three new television commercials were developed as an extension of the NGoM program. This paper reports on the mass media component of this program, trialling an evaluation design informed by the Theory of Planned Behaviour (TPB). Methods A survey questionnaire t...
Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret
Background Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. Methods Data were collected from 1,139 Austra...
Yeo, Soo See; Meiser, Bettina; Barlow-Stewart, Kristine; Goldstein, David; Tucker, Katherine; Eisenbruch, Maurice
Ethnography was employed to investigate the hypothesis that the cultural meaning of cancer is one of the possible barriers to access of cancer services. The objectives were to identify indigenous terminologies, taxonomies and illness explanatory models of cancer in a community-based sample of 15 Chinese-Australians and a sample of 16 informants who had been recruited through two Sydney familial cancer clinics. Many of the informants included in their narrative terms that seemed to match Western biomedical explanations for cancer. The majority of informants also maintained traditional Chinese beliefs, despite high acculturation and beliefs in biomedical explanations about cancer. Explanations of illness including cancer, referred to the following concepts: (i) karma (yeh), (ii) retribution (bao ying), (iii) fate (ming yun) or Heaven's or God's will, (iv) geomancy (feng-shui), (v) touched evil (zhong chia), (vi) misfortune or bad luck (shui wan, dong hark); (vii) offending the gods or deities requiring prayers or offerings for appeasement; and (viii) kong-tau (spells invoked through human intervention). Taking into consideration the heterogeneity of the Chinese population, the findings provide an insight into Chinese illness conceptualization that may assist health professionals to develop an understanding of how the cultural explanatory models affect access to screening services, communication of diagnosis of cancer and management of treatment regimen. PMID:15386778
Full Text Available Increasing attention to formal recognition of indigenous and community conserved areas (ICCAs as part of national and/or global protected area systems is generating novel encounters between the customary institutions through which indigenous peoples and local communities manage these traditional estates and the bureaucratic institutions of protected area management planning. Although management plans are widely considered to be important to effective management of protected areas, little guidance has been available about how their form and content can effectively reflect the distinctive socio-cultural and political characteristics of ICCAs. This gap has been particularly apparent in Australia where a trend to rapidly increased formal engagement of indigenous people in environmental management resulted, by 2012, in 50 indigenous groups voluntarily declaring their intent to manage all or part of their estates for conservation in perpetuity, as an indigenous protected area (IPA. Development and adoption of a management plan is central to the process through which the Australian Government recognizes these voluntary declarations and invests resources in IPA management. We identified four types of innovations, apparent in some recent IPA plans, which reflect the distinctive socio-cultural and political characteristics of ICCAs and support indigenous people as the primary decision makers and drivers of knowledge integration in IPAs. These are (1 a focus on customary institutions in governance; (2 strategic planning approaches that respond to interlinkages of stewardship between people, place, plants, and animals; (3 planning frameworks that bridge scales by considering values and issues across the whole of an indigenous people’s territory; and (4 varied communication modes appropriate to varied audiences, including an emphasis on visual and spatial modes. Further research is warranted into how governance and management of IPAs, and the plans that
Freeman, Toby; Baum, Frances E; Jolley, Gwyneth M; Lawless, Angela; Edwards, Tahnia; Javanparast, Sara; Ziersch, Anna
Community participation is a key principle of comprehensive primary health care (PHC). There is little literature on how community participation is implemented at Australian PHC services. As part of a wider study conducted in partnership with five South Australian PHC services, and one Aboriginal community controlled health service in the Northern Territory, 68 staff, manager, regional health executives, and departmental funders were interviewed about community participation, perceived benefits, and factors that influenced implementation. Additional data were collected through analysis of policy documents, service reports on activity, and a web-based survey completed by 130 staff. A variety of community participation strategies was reported, ranging from consultation and participation as a means to improve service quality and acceptability, to substantive and structural participation strategies with an emphasis on empowerment. The Aboriginal community controlled health service in our study reported the most comprehensive community participation. Respondents from all services were positive about the benefits of participation but reported that efforts to involve service users had to compete with a centrally directed model of care emphasising individual treatment services, particularly at state-managed services. More empowering substantive and structural participation strategies were less common than consultation or participation used to achieve prescribed goals. The most commonly reported barriers to community participation were budget and lack of flexibility in service delivery. The current central control of the state-managed services needs to be replaced with more local management decision making if empowering community participation is to be strengthened and embedded more effectively in the culture of services. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24789355
Full Text Available Susan A NancarrowSchool of Health and Human Sciences, Southern Cross University, East Lismore, NSW, AustraliaAbstract: For over a decade, organizations have attempted to include the measurement and reporting of health outcome data in contractual agreements between funders and health service providers, but few have succeeded. This research explores the utility of collecting health outcomes data that could be included in funding contracts for an Australian Community Care Organisation (CCO. An action-research methodology was used to trial the implementation of outcome measurement in six diverse projects within the CCO using a taxonomy of interventions based on the International Classification of Function. The findings from the six projects are presented as vignettes to illustrate the issues around the routine collection of health outcomes in each case. Data collection and analyses were structured around Donabedian's structure–process–outcome triad. Health outcomes are commonly defined as a change in health status that is attributable to an intervention. This definition assumes that a change in health status can be defined and measured objectively; the intervention can be defined; the change in health status is attributable to the intervention; and that the health outcomes data are accessible. This study found flaws with all of these assumptions that seriously undermine the ability of community-based organizations to introduce routine health outcome measurement. Challenges were identified across all stages of the Donabedian triad, including poor adherence to minimum dataset requirements; difficulties standardizing processes or defining interventions; low rates of use of outcome tools; lack of value of the tools to the service provider; difficulties defining or identifying the end point of an intervention; technical and ethical barriers to accessing data; a lack of standardized processes; and time lags for the collection of data. In no case was
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.
Paul A Thuesen
Full Text Available BACKGROUND: Indo-Pacific high island streams experience extreme hydrological variation, and are characterised by freshwater fish species with an amphidromous life history. Amphidromy is a likely adaptation for colonisation of island streams following stochastic events that lead to local extirpation. In the Wet Tropics of north-eastern Australia, steep coastal mountain streams share similar physical characteristics to island systems. These streams are poorly surveyed, but may provide suitable habitat for amphidromous species. However, due to their ephemeral nature, common non-diadromous freshwater species of continental Australia are unlikely to persist. Consequently, we hypothesise that coastal Wet Tropics streams are faunally more similar, to distant Pacific island communities, than to nearby faunas of large continental rivers. METHODS/PRINCIPAL FINDINGS: Surveys of coastal Wet Tropics streams recorded 26 species, 10 of which are first records for Australia, with three species undescribed. This fish community is unique in an Australian context in that it contains mostly amphidromous species, including sicydiine gobies of the genera Sicyopterus, Sicyopus, Smilosicyopus and Stiphodon. Species presence/absence data of coastal Wet Tropics streams were compared to both Wet Tropics river networks and Pacific island faunas. ANOSIM indicated the fish fauna of north-eastern Australian coastal streams were more similar to distant Pacific islands (R = 0.76, than to nearby continental rivers (R = 0.98. MAIN CONCLUSIONS/SIGNIFICANCE: Coastal Wet Tropics streams are faunally more similar to distant Pacific islands (79% of species shared, than to nearby continental fauna due to two factors. First, coastal Wet Tropics streams lack many non-diadromous freshwater fish which are common in nearby large rivers. Second, many amphidromous species found in coastal Wet Tropics streams and Indo-Pacific islands remain absent from large rivers of the Wet Tropics
McDonald, Elizabeth; Slavin, Nicola; Bailie, Ross; Schobben, Xavier
A social marketing campaign promoting hand-washing with soap was implemented to reduce the high burden of infection experienced by Australian Aboriginal children living in remote communities. Epidemiological evidence of effect and other evidence were used to identify the hygiene intervention and health promotion approach for the project. We drew on the findings of: (i) a systematic literature review to identify the intervention for which there is strong effect in similar populations and contexts; and (ii) a narrative literature review to determine our health promotion approach. This process provided practitioners with confidence and understanding so they could address a complex problem in a politically and otherwise sensitive context. PMID:21721304
De Wulf, Isabelle; Boussery, Koen; De Vriese, Carine; Meyer, Guido; Foulon, Veerle; Lacour, Valérie; Mehuys, Els; Steurbaut, Stephane; Van Hees, Thierry
Aim of project/study (1) To study the frequency and nature of drug related problems (DRP) detected by community pharmacists and internship students when dispensing prescribed medicines. (2) To investigate the nature and frequency of interventions by pharmacists. (3) To study whether there is a difference between DRP detection at the moment of dispensing versus in a quiet setting.
Full Text Available Abstract Background Low back pain (LBP is the most prevalent musculo-skeletal condition in rural and remote Australian Aboriginal communities. Smoking, physical inactivity and obesity are also prevalent amongst Indigenous people contributing to lifestyle diseases and concurrently to the high burden of low back pain. Objectives This paper aims to examine the association between LBP and modifiable risk factors in a large rural Indigenous community as a basis for informing a musculo-skeletal and related health promotion program. Methods A community Advisory Group (CAG comprising Elders, Aboriginal Health Workers, academics, nurses, a general practitioner and chiropractors assisted in the development of measures to assess self-reported musculo-skeletal conditions including LBP risk factors. The Kempsey survey included a community-based survey administered by Aboriginal Health Workers followed by a clinical assessment conducted by chiropractors. Results Age and gender characteristics of this Indigenous sample (n = 189 were comparable to those reported in previous Australian Bureau of Statistics (ABS studies of the broader Indigenous population. A history of traumatic events was highly prevalent in the community, as were occupational risk factors. Thirty-four percent of participants reported a previous history of LBP. Sporting injuries were associated with multiple musculo-skeletal conditions, including LBP. Those reporting high levels of pain were often overweight or obese and obesity was associated with self-reported low back strain. Common barriers to medical management of LBP included an attitude of being able to cope with pain, poor health, and the lack of affordable and appropriate health care services. Though many of the modifiable risk factors known to be associated with LBP were highly prevalent in this study, none of these were statistically associated with LBP. Conclusion Addressing particular modifiable risk factors associated with LBP
The paper investigates the perspectives of Greek origin people as regards their intention to maintain their ancestral culture within the Australian context of social values. This qualitative research study, influenced by Humanistic Sociology, analyses data collected through questionnaires from first and second generation parents and teachers of…
Andrews, Dan; Green, Colin; Mangan, John
Data taken primarily from the Australian Youth Survey were used to model unemployment as a function of personal characteristics, family structure, and neighborhood composition using binomial probit estimation techniques. The cross-sectional model developed indicated that significant neighborhood effects on unemployment outcomes exist in high- and…
Horner, Jonathan; Cairns, Ann; Short, Wayne
In recent years, the striking gender imbalance in the physical sciences has been a topic for much debate. National bodies and professional societies in the astronomical and space sciences are now taking active steps to understand and address this imbalance. In order to begin this process in the Australian Space Research community, we must first understand the current state of play. In this work, we therefore present a short 'snapshot' of the current gender balance in our community, as observed at the 15th Australian Space Research Conference. We find that, at this year's conference, male attendees outnumbered female attendees by a ratio of 3:1 (24% female). This gender balance was repeated in the distribution of conference talks and plenary presentations (25 and 22% female, respectively). Of the thirteen posters presented at the conference, twelve were presented by men (92%), a pattern repeated in the awards for the best student presentations (seven male recipients vs one female). The program and organising c...
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.
Gabbe, B J; Branson, R; Bennell, K L
Hamstring injuries are the most common injury sustained by Australian Football players. Eccentric training has been proposed as a potential preventative strategy. This pilot randomised controlled trial (RCT) evaluated the effectiveness of a pre-season eccentric training program for preventing hamstring injuries at the community level of Australian Football. Seven amateur clubs (n=220 players) were recruited. Players were randomised within clubs to the intervention (eccentric exercise) or control (stretching) groups and randomisation was stratified according to previous history of hamstring injury. Five exercise sessions were completed over a 12-week period, three during the pre-season and two during the first 6 weeks of the season. Compliance was recorded and players were monitored for the season to collect injury and participation data. There was no difference between the control (n=106) or intervention (n=114) groups with respect to baseline characteristics. Only 46.8% of all players completed at least two program sessions. Compliance was poorest for the intervention group. Intention-to-treat analysis suggested that players in the intervention group were not at reduced risk of hamstring injury (RR 1.2, 95% CI: 0.5, 2.8). When only control and intervention group players who participated in at least the first two sessions were analysed, 4.0% of intervention and 13.2% of control group players sustained a hamstring injury (RR 0.3, 95% CI: 0.1, 1.4; p=0.098). The findings suggest that a simple program of eccentric exercise could reduce the incidence of hamstring injuries in Australian Football but widespread implementation of this program is not likely because of poor compliance.
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
Ryan, M; Bond, C
Recent years have seen an increase in the number of dispensing physicians in the UK. There have also been suggestions that legislation restricting certain drugs to prescription-only availability should be relaxed and that pharmacists should take a more active role in the provision of drugs. General medical practitioners and pharmacists have common ancestry in the medieval spicers, who dispensed medicines and offered medical advice. Rural practitioners have been allowed to dispense drugs since 1911. Physician dispensing can benefit patients via savings in time and the monetary cost of visiting a pharmacist, but it restricts drug choice, can compromise safety, and encourages overprescribing except for physicians with drugs budgets. The effects of physician dispensing on government costs are not yet clear. Over-the-counter (OTC) purchase can save patients the cost of a physician visit and reduce drug costs to some patients, but it can also provide an incentive to pharmacists to profit twice from a drug, at government expense. Switching drugs from prescription-only to OTC reduces the government drug bill, but provides an incentive to pharmacists to overprescribe, and may not be as safe for patients. Liberalising prescribing by doctors would discourage community pharmacies which provide an advisory service to patients. Liberalising OTC switches would reduce opportunistic assessment of patients by doctors and could compromise patient safety. Separation of physician and pharmacist functions is probably safer for patients. It is concluded that the current situation in the UK, whereby most dispensing is done by pharmacists, is the preferred option other than for those patients who do not live within easy access of a pharmacy. A reassessment of the legal status of drugs and subsequent OTC switch of drugs used to treat minor self-limiting illnesses is also favoured. PMID:10146862
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. PMID:25362816
Rattray, Alex; Ierodiaconou, Daniel; Laurenson, Laurie; Burq, Shoaib; Reston, Marcus
Information regarding the composition and extent of benthic habitats on the South East Australian continental shelf is limited. In this habitat mapping study, multibeam echosounder (MBES) data are integrated with precisely geo-referenced video ground-truth data to quantify benthic biotic communities at Cape Nelson, Victoria, Australia. Using an automated decision tree classification approach, 5 representative biotic groups defined from video analysis were related to hydro-acoustically derived variables in the Cape Nelson survey area. Using a combination of multibeam bathymetry, backscatter and derivative products produced highest overall accuracy (87%) and kappa statistic (0.83). This study demonstrates that decision tree classifiers are capable of integrating variable data types for mapping distributions of benthic biological assemblages, which are important in maintaining biodiversity and other system services in the marine environment.
Lyons, Anthony; Heywood, Wendy; Rozbroj, Tomas
HIV-positive gay men may experience multiple sources of adversity and stress, related both to their HIV diagnosis and sexual identity. Most of these men, however, do not experience mental health problems. Little is known about factors that help them achieve resilience in the face of life challenges. This study examined psychosocial factors associated with resilience in a national community-based sample of 357 Australian HIV-positive gay men. Resilience was measured using the Connor-Davidson Resilience Scale. Higher levels of resilience were linked with experiencing low or no internalized HIV-related stigma, having no previous history of mental health problems, and a number of socioeconomic indicators. In addition to providing a more complete picture of the mental health of HIV-positive gay men, findings from this study can be used to inform strength-based approaches to mental health prevention and support. PMID:26884311
Ireland, Sarah; Narjic, Concepta Wulili; Belton, Suzanne; Saggers, Sherry; McGrath, Ann
Sexual health indicators for young remote-living Aboriginal women are the worst of all of Australian women. This study aimed to describe and explore young women's behaviour and knowledge in relation to sexual health, as well as to provide health professionals with cross-cultural insights to assist with health practice. A descriptive ethnographic study was conducted, which included: extended ethnographic field work in one remote community over a six-year period; community observation and participation; field notes; semi-structured interviews; group reproductive ethno-physiology drawing and language sessions; focus-group sessions; training and employment of Aboriginal research assistants; and consultation and advice from a local reference group and a Cultural Mentor. Findings reveal that young women in this remote community have a very poor biomedical understanding of sexually transmitted infections and contraception. This is further compounded by not speaking English as a first language, low literacy levels and different beliefs in relation to body functions. In their sexual relationships, young women often report experiences involving multiple casual partners, marijuana use and violence. Together, the findings contribute to a better understanding of the factors underlying sexual health inequity among young Aboriginal women in Australia.
Benrimoj, Shalom I; Werner, Joel B; Raffaele, Catherine; Roberts, Alison S
There is a growing trend, globally, for consumers to self-medicate with non-prescription medications for common ailments. Pharmacists and pharmacy assistants are thought to be in a unique position to support consumers' purchases of these medicines through the application of knowledge and skills, in an environment in which safety and quality remains paramount. Standards of practice have been developed by the profession to address the provision of these medicines, using a consumer-focused and risk management approach. The application of these standards has been monitored since 2002, by the Quality Care Pharmacy Support Centre (QCPSC), created as a joint venture between the University and the Pharmacy Guild of Australia. The establishment of the QCPSC has allowed the development of a system to monitor and improve the application of standards for the provision of non-prescription medicines to consumers in community pharmacies in Australia. This system is unique in two aspects. The first is the use of pseudo-patient methodology, also called "mystery shoppers", "pseudo-customers" and "simulated patients", for the purpose of both assessment and quality improvement. The second unique aspect is the capturing of data based on assessments of behaviour in practice environments. To date, the centre has conducted 14,738 standards maintenance assessment (SMA) visits, involving over 4,200 pharmacies across all states and territories in Australia. The data generated by such a system create a feedback mechanism for policy decision-making in the area of Quality Use of Medicines (QUM) for non-prescription medicines, which is of critical importance to the health and safety of consumers. PMID:17939057
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.
Full Text Available We implement a new stomatal conductance model, based on the optimality approach, within the Community Atmosphere Biosphere Land Exchange (CABLE land surface model. Coupled land-atmosphere simulations are then performed using CABLE within the Australian Community Climate and Earth Systems Simulator (ACCESS with prescribed sea surface temperatures. As in most land surface models, the default stomatal conductance scheme only accounts for differences in model parameters in relation to the photosynthetic pathway, but not in relation to plant functional types. The new scheme allows model parameters to vary by plant functional type, based on a global synthesis of observations of stomatal conductance under different climate regimes over a wide range of species. We show that the new scheme reduces the latent heat flux from the land surface over the boreal forests during the Northern Hemisphere summer by 0.5 to 1.0 mm day-1. This leads to warmer daily maximum and minimum temperatures by up to 1.0 °C and warmer extreme maximum temperatures by up to 1.5 °C. These changes generally improve the climate model's climatology and improve existing biases by 10–20 %. The change in the surface energy balance also affects net primary productivity and the terrestrial carbon balance. We conclude that the improvements in the global climate model which result from the new stomatal scheme, constrained by a global synthesis of experimental data, provide a valuable advance in the long-term development of the ACCESS modelling system.
Muijrers, P.E.; Grol, R.P.T.M.; Sijbrandij, J.; Janknegt, R.; Knottnerus, J.A.
BACKGROUND: Community pharmacists, pharmaceutical industry and differences in prescribing between GPs. OBJECTIVE: To explore the role of the pharmacists and pharmaceutical industry representatives. METHODS: A cross-sectional survey was undertaken of 1434 GPs in The Netherlands in 2001. Prescribing i
Law, Michael R.; Ma, Tracey; Fisher, Judith; Sketris, Ingrid S
Background: While pharmacists are trained in the selection and management of prescription medicines, traditionally their role in prescribing has been limited. In the past 5 years, many provinces have expanded the pharmacy scope of practice. However, there has been no previous systematic investigation and comparison of these policies.
Watson, C. J.
Vegetation phenology is relatively well-studied in northern hemisphere temperate biomes, but limited research has been conducted on phenological drivers and responses in Australian temperate ecosystems. Australian temperate grasslands represent a broad range of plant communities from exotic pastures to native grasslands, but all are important for food security (livestock grazing) and biodiversity retention. Climate predictions for temperate Australia include higher temperatures, altered rainfall frequency/seasonality, increased drought severity and more regular wildfires. The ecosystem response to these climatic factors is unknown, and the need to improve the monitoring of these highly dynamic grassland systems at a landscape scale is acute. The aim of this research is to use high-frequency phenological data to improve the identification of grassland functional types and ultimately use this to improve the inter-annual monitoring of dynamic grassland systems. We use hourly repeat photography and the Green Chromatic Coordinate vegetation index to characterize the vegetative phenology of several native and exotic grassland communities. Monthly vegetation surveys allow us to correlate plant functional groups with indicator features on the phenology profile. C4-dominated grasslands are characterized by a consistent low greenness during winter, the commencement of greening in late spring/early summer and the retention of green vegetation throughout the summer. Exotic C4 grasslands can be distinguished from native ecosystems by their early-spring flush of annual grasses and forbs prior to the primary greening in late spring/early summer. Native C3 grasslands are more variable in response to rainfall and exhibit multiple greening/browning cycles within the year. They tend to green up earlier in the spring and brown off rapidly in response to high temperatures and low rainfall. Exotic C3 grasslands also green up in early spring but exhibit a more traditional unimodal
Ehsani Jonathon P
Full Text Available Abstract Background Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. Methods Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. Results The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit. Conclusion Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should
Amanda J Wade
Full Text Available Hepatitis C treatment uptake in Australia is low. To increase access to hepatitis C virus treatment for people who inject drugs, we developed a community-based, nurse-led service that linked a viral hepatitis service in a tertiary hospital to primary care clinics, and resulted in hepatitis C treatment provision in the community.A retrospective cohort study of patients referred to the community hepatitis service was undertaken to determine the cascade of care. Logistic regression analyses were used to identify predictors of hepatitis C treatment uptake.Four hundred and sixty-two patients were referred to the community hepatitis service; 344 attended. Among the 279 attendees with confirmed chronic hepatitis C, 257 (99% reported ever injecting drugs, and 124 (48% injected in the last month. Of 201 (72% patients who had their fibrosis staged, 63 (31% had F3-F4 fibrosis. Fifty-five patients commenced hepatitis C treatment; 26 (47% were current injectors and 25 (45% had F3-F4 fibrosis. Nineteen of the 27 (70% genotype 1 patients and 14 of the 26 (54% genotype 3 patients eligible for assessment achieved a sustained virologic response. Advanced fibrosis was a significant predictor of treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006.Our community hepatitis service produced relatively high rates of fibrosis assessment, hepatitis C treatment uptake and cure, among people who inject drugs. These findings highlight the potential benefits of providing community-based hepatitis C care to people who inject drugs in Australia-benefits that should be realised as direct-acting antiviral agents become available.
Full Text Available Locally-commissioned pharmacy public health services have developed in England over the last 20 years. Few studies have sought pharmacist views on commissioning and provision of public health services in general. This study sought views of community pharmacists (n = 778 in 16 areas of England on services provided, decisions about services, support, promotion and future developments, using a postal questionnaire with two reminders. Response rate was 26.5% (206. Funded public health services provided most frequently were: emergency contraception (71%, smoking cessation (62%, and supervised drug consumption (58%. Blood pressure monitoring was provided by 61% and was considered to be one of the services pharmacists perceived as being most valued by customers, but was not National Health Services (NHS-funded. Motivation for providing public health services was professional not financial, particularly from those working in independent pharmacies. Only 35% were personally involved in deciding which services to deliver, and fewer than 20% based decisions on local public health reports. Pharmacists had positive attitudes towards providing public health services, but mixed views on support for services and their promotion. Most thought services would increase in future, but were concerned about commissioning. Both national and local support is needed to ensure future commissioning of pharmacy public health services.
Guitart, Daniela A; Pickering, Catherine M; Byrne, Jason A
Community garden research has focused on social aspects of gardens, neglecting systematic analysis of what food is grown. Yet agrodiversity within community gardens may provide health benefits. Diverse fruit and vegetables provide nutritional benefits, including vitamins, minerals and phytochemicals. This paper reports research that investigated the agro-biodiversity of school-based community gardens in Brisbane and Gold Coast cities, Australia. Common motivations for establishing these gardens were education, health and environmental sustainability. The 23 gardens assessed contained 234 food plants, ranging from 7 to 132 plant types per garden. This included 142 fruits and vegetables. The nutritional diversity of fruits and vegetable plants was examined through a color classification system. All gardens grew fruits and vegetables from at least four food color groups, and 75% of the gardens grew plants from all seven color groups. As places with high agrodiversity, and related nutritional diversity, some school community gardens can provide children with exposure to a healthy range of fruit and vegetables, with potential flow-on health benefits. PMID:24434081
Gordon, Melissa; Schirmer, Jacki; Lockwood, Michael; Vanclay, Frank; Hanson, Dallas
Although community engagement (CE) is widely recognised as an essential element of sustainable management, few studies have evaluated CE at an industry-wide scale, i.e. in terms of the specific CE needs and best practice methods needed when addressing engagement issues that apply across more than on
There has been much recent interest and debate in Australia around the topics of university engagement, knowledge transfer, and engaged scholarship. Diverse responses relating to teaching and learning, research, and community service are evident in many institutions. However, there is a paucity of empirical research describing institutional…
Short, Alison; Phillips, Rebecca; Nugus, Peter; Dugdale, Paul; Greenfield, David
Networks in health care typically involve services delivered by a defined set of organizations. However, networked associations between the healthcare system and consumers or consumer organizations tend to be open, fragmented and are fraught with difficulties. Understanding the role and activities of consumers and consumer groups in a formally initiated inter-organizational health network, and the impacts of the network, is a timely endeavour. This study addresses this aim in three ways. First, the Unbounded Network Inter-organizational Collaborative Impact Model, a purpose-designed framework developed from existing literature, is used to investigate the process and products of inter-organizational network development. Second, the impact of a network artefact is explored. Third, the lessons learned in inter-organizational network development are considered. Data collection methods were: 16 h of ethnographic observation; 10 h of document analysis; six interviews with key informants and a survey (n = 60). Findings suggested that in developing the network, members used common aims, inter-professional collaboration, the power and trust engendered by their participation, and their leadership and management structures in a positive manner. These elements and activities underpinned the inter-organizational network to collaboratively produce the Health Expo network artefact. This event brought together healthcare providers, community groups and consumers to share information. The Health Expo demonstrated and reinforced inter-organizational working and community outreach, providing consumers with community-based information and linkages. Support and resources need to be offered for developing community inter-organizational networks, thereby building consumer capacity for self-management in the community.
Haby Michelle M
Full Text Available Abstract Background Interest in community-based interventions (CBIs for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required. Methods The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders. Results CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation. Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours. Conclusions CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.
Abdel Shaheed, Christina; Maher, Christopher G; Williams, Kylie A; McLachlan, Andrew J
Pharmacists have the potential to take a lead role in the primary care management of people with acute low back pain. The aim of this study was to investigate pharmacists' views on implementing a care program for people with acute low back pain in the community pharmacy. Recruitment of pharmacists for this study took place between July 2012 and March 2013. A convenience sample of 30 pharmacists who collaborated in recruiting participants for a low back pain clinical trial in Sydney (n=15 pharmacist recruiters and n=15 non-recruiters) completed an open-ended questionnaire. There was no marked variation in responses between the two groups. Participating pharmacists were receptive to the idea of implementing a care program for people with low back pain, highlighting the need for adequate reimbursement and adequate training of staff to ensure it is successful. Pharmacists identified that the follow up of people receiving such a service is dependent on several factors such as effective reminder systems and the proximity of patients to the pharmacy. PMID:25719762
Senior, Kate; Chenhall, Richard
Recently, social determinants of health frameworks are receiving some criticism in that they do not engage with questions related to individual subjectivity and agency as they relate to health decision-making behavior. This article examines the different ways in which people living in a remote Arnhem Land community in the Northern Territory of Australia, take responsibility for their own health and the extent to which they are able to prevent illness. A number of related sub-questions are explored relating to how people perceive their health and their role in health care in their community, including their engagement with the health clinic, traditional medicines, and the influence of sorcery on ill health and sickness.
Full Text Available The use of public spaces can promote social cohesion and facilitate interpersonal interactions within the community. However, the ways racial and ethnic groups interact in public spaces can also reflect and influence informal segregation in the wider community. The present study aimed to examine patterns of intergroup contact within public spaces in Victoria, Australia through short-term observation in four localities. Data were collected on within-group, intergroup and absence of contact for people from minority and majority groups. A total of 974 contacts were observed. Findings indicate that in the observed public spaces, people from visible minority groups tended to have no contact with others or to interact with people from other ethnic/racial groups. In contrast, those from the majority group tended to interact predominately with other majority group members. This suggests that majority group members are more likely to ‘self-segregate’ in public spaces than those from minority groups.
Jan Hammill argues that family dysfunction is widespread in contemporary western society but is even more so in impoverished Indigenous communities forcibly stripped of their cultural practices. Alcohol and illicit and prescription drugs have become coping elixirs for profound feelings of despair and hopelessness which is then manifested in high rates of child abuse and neglect, interpersonal violence, suicide and early death. Increasingly the impact is borne most heavily by those whose value...
Paterson, James S.; Nayar, Sasi; Mitchell, James G.; Seuront, Laurent
Despite the increasing awareness of the role of viruses and heterotrophic bacteria in microbial dynamics and biogeochemical cycles, there is still a critical lack of information on their community composition and dynamics, especially in relation to upwellings. We investigated, within surface waters and the Deep Chlorophyll Max, the community composition and dynamics of flow cytometrically defined sub-populations of heterotrophic bacteria and virus-like particles in nearby water masses that were affected and unaffected by a localised wind-driven coastal upwelling. In contrast to previous studies we uniquely identified a 4-fold increase in total viral abundance and a decrease in bacterial abundance, from upwelled to offshore waters. Individual viral sub-populations were seen to correlate significantly to both bacterial populations and chlorophyll a, suggesting the possibility of individual viral populations infecting multiple host species rather than the often assumed single host species. The percentage of HDNA bacteria was high (84.3-93.4%) within upwelled waters, in accordance with the highest recorded values within an upwelling system, and decreased down to 35.5-42.6% away from the upwelling. Additionally, changes in the community composition of individual bacterial sub-populations suggest individual populations might be better adapted to distinct environments. We suggest that each flow cytometrically defined bacterial population may possess its own environmental niche where favourable conditions for that population result in an increase in abundance, cellular activity and productivity.
Abukres SH; Hoti K; Hughes JD
Salem Hasn Abukres, Kreshnik Hoti, Jeffery David Hughes School of Pharmacy, Curtin Health and Innovation Research Institute, Curtin University, Perth, WA, Australia Background: In Australia, “continued dispensing” (CD) is a new model for supply of prescription medications. Under specific circumstances, community pharmacists are allowed to dispense a further one month supply of prescription only medications without a valid prescription. It allows continuation and treatment adhere...
Panegyres, P K; McGrath, F
Huntington disease (HD) in indigenous Australians is a poorly analysed and difficult problem. This study addresses the issue of HD in remote indigenous Australian populations in the north-west of Western Australia. Proband identification, clinical assessment, neurogenetic studies and pedigree analysis led to the discovery of HD in the 63-year-old male proband and his family. HD in remote indigenous Australian communities is a challenging diagnostic and management problem compounded by the complexity of distance. PMID:18290828
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.
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.
Emily G Hudson
Full Text Available Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information-together with model outputs-would be used to inform decision makers on the best control strategies and improve Australia's preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10-20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community
Hudson, Emily G; Dhand, Navneet; Dürr, Salome; Ward, Michael P
Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information-together with model outputs-would be used to inform decision makers on the best control strategies and improve Australia's preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA) in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10-20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community. More than half of the
Al Rahbi, Hussain Abdullah Mubarak; Al-Sabri, Raid Mahmood; Chitme, Havagiray R
Interventions by the pharmacists have always been considered as a valuable input by the health care community in the patient care process by reducing the medication errors, rationalizing the therapy and reducing the cost of therapy. The primary objective of this study was to determine the number and types of medication errors intervened by the dispensing pharmacists at OPD pharmacy in the Khoula Hospital during 2009 retrospectively. The interventions filed by the pharmacists and assistant pharmacists in OPD pharmacy were collected. Then they were categorized and analyzed after a detailed review. The results show that 72.3% of the interventions were minor of which 40.5% were about change medication order. Comparatively more numbers of prescriptions were intervened in female patients than male patients. 98.2% of the interventions were accepted by the prescribers reflecting the awareness of the doctors about the importance of the pharmacy practice. In this study only 688 interventions were due to prescribing errors of which 40.5% interventions were done in changing the medication order of clarifying the medicine. 14.9% of the interventions were related to administrative issues, 8.7% of the interventions were related to selection of medications as well as errors due to ignorance of history of patients. 8.2% of the interventions were to address the overdose of medications. Moderately significant interventions were observed in 19.4% and 7.5% of them were having the impact on major medication errors. Pharmacists have intervened 20.8% of the prescriptions to prevent complications, 25.1% were to rationalize the treatment, 7.9% of them were to improve compliance. Based on the results we conclude that the role of pharmacist in improving the health care system is vital. We recommend more number of such research based studies to bring awareness among health care professionals, provide solution to the prescription and dispensing problems, as it can also improve the documentation
Rogers, Kelly C.; Finks, Shannon W.
The pharmacist shortage, increasing numbers of female pharmacy graduates, more pharmacy schools requiring faculty members, and a lower percentage of female faculty in academia are reasons to develop unique arrangements for female academic pharmacists who wish to work part-time. Job sharing is an example of a flexible alternative work arrangement that can be successful for academic pharmacists who wish to continue in a part-time capacity. Such partnerships have worked for other professionals b...
Stephen Arthur Hudson; John Jackson Mc Anaw; Barbara Julienne Johnson
A clinical role for pharmacists has developed inresponse to the societal need to improve the use ofmedicines. Clinical role development has been led byinitiatives in the hospital sector which have enabledSchools of Pharmacy to make shifts in the pre-graduateeducation of pharmacists. The increasing complexity inthe management of drug therapy has given pharmacistsclear roles that integrate within the healthcare team.The history is one in which the development ofchanging roles of pharmacists is ...
Koh, Karen J; Parker, Colin J; Ellis, David H; Pruim, Bert; Leysley, Loyla; Currie, Bart J
Tinea of the skin and nails is a common problem in remote Aboriginal communities of the Top End of Australia. A retrospective study was performed on data collected from 104 patients from several indigenous communities. Worksheets were filled in by district medical officers and rural general practitioners, detailing the extent of the tinea. Patients were prescribed between 4 and 12 weeks of 250 mg daily oral terbinafine. Fifty-two patients were followed up, with 45 having a good response to treatment (87%) and with 22 of these patients having full clearance of tinea (42%). A prospective study with 44 subjects was performed. The extent of the tinea was documented and fungal scrapings/clippings were taken. Forty subjects were recruited and given oral terbinafine (2-12 weeks depending on skin/nail involvement) or topical terbinafine if oral treatment was contraindicated. Twenty-five of the 40 (63%) subjects were reviewed. Twenty-three (92%) subjects that were followed up improved clinically, with 8/25 (32%) clearing completely. Twenty (80%) of followed-up patients complied fully with treatment. Terbinafine was found to be a well-tolerated and effective treatment of tinea of the skin and nails. PMID:14616489
Kendall, E; Muenchberger, H; Catalano, T; Amsters, D; Dorsett, P; Cox, R
This study aimed to determine the core competencies that underpin the practice of community rehabilitation (CR) practitioners working in a single state in Australia. Using a recursive and consultative methodology designed to build consensus, CR professionals, trainers, educators, and researchers developed a preliminary set of core interprofessional competencies that were considered essential to their practice. Data were collected in four main stages that engaged practitioners and experts in the CR field in the process of identifying, defining, validating, and endorsing a set of competencies. The first stage involved focus groups with 50 senior practitioners in metropolitan, rural/remote, regional, and indigenous communities. The second and third stages involved expert panels consisting of 20 trainers/educators, senior leaders, and scholars who refined, defined and validated the competency areas and developed statements that reflected the data.These statements formed the basis of a survey that was distributed to all current CR practitioners based in this state for endorsement, 40 of whom responded. Ten competencies emerged from this process. Although there are limitations to the application of competencies, they will have significant implications for the future training of CR practitioners who can transcend professional boundaries.
Rodríguez, Alexander J; Scott, David; Khan, Belal; Khan, Nayab; Hodge, Allison; English, Dallas R; Giles, Graham G; Ebeling, Peter R
Age-related loss of skeletal muscle is associated with increased risk of functional limitation and cardiovascular (CV) mortality. In the elderly abdominal aortic calcification (AAC) can increase CV risk by altering aortic properties which may raise blood pressure and increase cardiac workload. This study investigated the association between low muscle mass and AAC in community-dwelling older Australians. Data for this cross-sectional analysis were drawn from a 2010 sub-study of the Melbourne Collaborative Cohort Study in the setting of community-dwelling older adults. Three hundred and twenty-seven participants [mean age = 71 ± 6 years; mean BMI = 28 ± 5 kg/m(2); females n = 199 (62 %)] had body composition determined by dual-energy x-ray absorptiometry (DXA) and AAC determined by radiography. Participants were stratified into tertiles of sex-specific BMI-normalised appendicular lean mass (ALM). Those in the lowest tertile were considered to have low relative muscle mass. Aortic calcification score (ACS) was determined visually as the extent of calcification on the aortic walls between L1 and L4 vertebrae (range: 0-24). Severe AAC was defined as ACS ≥ 6. Prevalence of any AAC was highest in participants with low relative muscle mass (74 %) compared to the middle (65 %) and upper (53 %) tertiles (p trend = 0.006). The lower ALM/BMI tertile had increased odds (Odds ratio = 2.3; 95 % confidence interval: 1.1-4.6; p = 0.021) of having any AAC; and having more severe AAC (2.2; 1.2-4.0; p = 0.009) independent of CV risk factors, serum calcium and physical activity. AAC is more prevalent and severe in community-dwelling older adults with low relative muscle mass. Maintaining muscle mass could form part of a broader primary prevention strategy in reducing AAC. PMID:27272030
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
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.
Full Text Available Abstract Background There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health. Methods Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study. Results Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR 3.00; 95%CI 1.36-6.63, but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection - evidence of poor temperature control in the house (OR 3.25; 95%CI 1.06-9.94, evidence of pests and vermin in the house (OR 2.88; 95%CI 1.25-6.60; for respiratory infection - breastfeeding in infancy (OR 0.27; 95%CI 0.14-0.49; for diarrhoea/vomiting - hygienic state of food preparation and storage areas (OR 2.10; 95%CI 1.10-4.00; for ear infection - child care attendance (OR 2.25; 95%CI 1.26-3.99. Conclusion These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.
Francis, Caitlin F; Feyer, Anne-Marie; Smith, Ben J
The evaluation of the Sharing Health Care Initiative addressed the translation of different models of chronic disease self-management into health and community service contexts in Australia. Across seven projects, four intervention models were adopted: (1) the Stanford Chronic Disease Self Management course; (2) generic disease management planning, training and support; (3) tailored disease management planning, training and support, and; (4) telephone coaching. Targeted recruitment through support groups and patient lists was most successful for reaching high-needs clients. Projects with well developed organisational structures and health system networks demonstrated more effective implementation. Engagement of GPs in recruitment and client support was limited. Future self-management programs will require flexible delivery methods in the primary health care setting, involving practice nurses or the equivalent. After 12 months there was little evidence of potential sustainability, although structures such as consumer resource centres and client support clubs were established in some locations. Only one project was able to use Medicare chronic disease-related items to integrate self-management support into routine general practice. Participants in all projects showed improvements in self-management practices, but those receiving Model 3, flexible and tailored support, and Model 4, telephone coaching, reported the greatest benefits. PMID:17973606
Kala, J.; De Kauwe, M. G.; Pitman, A. J.; Lorenz, R.; Medlyn, B. E.; Wang, Y.-P.; Lin, Y.-S.; Abramowitz, G.
We implement a new stomatal conductance scheme, based on the optimality approach, within the Community Atmosphere Biosphere Land Exchange (CABLEv2.0.1) land surface model. Coupled land-atmosphere simulations are then performed using CABLEv2.0.1 within the Australian Community Climate and Earth Systems Simulator (ACCESSv1.3b) with prescribed sea surface temperatures. As in most land surface models, the default stomatal conductance scheme only accounts for differences in model parameters in relation to the photosynthetic pathway but not in relation to plant functional types. The new scheme allows model parameters to vary by plant functional type, based on a global synthesis of observations of stomatal conductance under different climate regimes over a wide range of species. We show that the new scheme reduces the latent heat flux from the land surface over the boreal forests during the Northern Hemisphere summer by 0.5-1.0 mm day-1. This leads to warmer daily maximum and minimum temperatures by up to 1.0 °C and warmer extreme maximum temperatures by up to 1.5 °C. These changes generally improve the climate model's climatology of warm extremes and improve existing biases by 10-20 %. The bias in minimum temperatures is however degraded but, overall, this is outweighed by the improvement in maximum temperatures as there is a net improvement in the diurnal temperature range in this region. In other regions such as parts of South and North America where ACCESSv1.3b has known large positive biases in both maximum and minimum temperatures (~ 5 to 10 °C), the new scheme degrades this bias by up to 1 °C. We conclude that, although several large biases remain in ACCESSv1.3b for temperature extremes, the improvements in the global climate model over large parts of the boreal forests during the Northern Hemisphere summer which result from the new stomatal scheme, constrained by a global synthesis of experimental data, provide a valuable advance in the long-term development
Simmons Annie M
Full Text Available Abstract Background Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008 project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region. Methods The project was supported by Deakin University (training and evaluation, a Reference Committee (strategic direction, budgetary approval and monitoring and a Project Management Committee (project delivery. A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities. Results The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as
Jackson, Anita N; Orr, K Kelly; Bratberg, Jeffrey P; Silverblatt, Frederic
OBJECTIVES To enhance public access to prophylaxis for Lyme disease following an identified Ixodes scapularis tick bite through pharmacist-initiated antibiotic therapy and to assess patient satisfaction with the pharmacy-based service provided. SETTING Independent community pharmacy in Charlestown, RI, from May to October 2012. PRACTICE DESCRIPTION Under a collaborative practice agreement, trained pharmacists at an independent pharmacy identified patients eligible for postexposure antibiotic prophylaxis following attachment and removal of an I. scapularis tick (commonly known as a deer tick) and dispensed two 100 mg tablets of doxycycline. Patients were included if they were 18 years or older, provided informed consent, had an estimated time of tick attachment of 36 hours or more, had the tick removed within 72 hours of visit, denied contraindications to doxycycline therapy, and reported telephone access for follow-up. Patients enrolled in the study protocol were given counseling related to doxycycline, signs and symptoms of Lyme disease, and future tick prevention strategies. PRACTICE INNOVATION Pharmacist initiation of doxycycline prophylaxis has not been described in the literature previously. Successful pharmacist initiation of antibiotic prophylaxis may have broader implications for states with endemic Lyme disease or other infectious disease public health concerns. MAIN OUTCOME MEASURES Patient self-reported adverse outcomes and satisfaction with the pharmacy-based service. RESULTS Eight patients enrolled in the study and completed the follow-up survey. The results indicated a high level of satisfaction with the pharmacy services provided, with no reports of the subsequent development of Lyme disease symptoms or major adverse events. CONCLUSION The project has expanded to three community pharmacy sites in southern Rhode Island based on this experience. Similar pharmacy-based collaborative practice models should be considered in highly endemic Lyme disease
Robertson Jan A
Full Text Available Abstract Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT, extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive
Loakes, Deborah; Moses, Karin; Simpson, Jane; Wigglesworth, Gillian
This article reports on the development and piloting of a vocabulary recognition test designed for Indigenous Australian children. The research is both application oriented and development oriented. The aims of the article are to determine how well the test is used as a test instrument and the extent to which children recognize vocabulary items in…
McKennon, Skye A; Arnold, Jennifer
Objective. To develop, implement, and evaluate a targeted educational module on tuberculosis screening with second-year professional pharmacy students that improves their knowledge, skills, and attitudes regarding tuberculosis screening. Design. A tuberculosis-screening educational module was developed in collaboration with the Washington State Pharmacy Association and Department of Health and incorporated in a core student pharmacist class. Students completed online didactic training and a live practicum, each lasting 90 minutes. Assessment. Students were assessed using a pre/postdidactic assessment, live practicum tuberculin skin testing (TST) administration and evaluation assessment, and postprogram written reflection. Student pre/postknowledge assessment scores improved in all areas except in documentation. Conclusion. The tuberculosis screening educational module significantly improved student knowledge, skills, and attitudes regarding tuberculosis screening. PMID:27073277
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.
Rubio Valera, Maria; March Pujol, Marian; Fernández Sánchez, Ana; Peñarrubia María, María Teresa; Travé i Mercadé, Pere; López del Hoyo, Yolanda; Serrano Blanco, Antoni
Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients ...
Robert M. Balen; Jewesson, Peter J
Background To use technology effectively for the advancement of patient care, pharmacists must possess a variety of computer skills. We recently introduced a novel applied informatics program in this Canadian hospital clinical service unit to enhance the informatics skills of our members. Objective This study was conducted to gain a better understanding of the baseline computer skills and needs of our hospital pharmacists immediately prior to the implementation of an applied informatics progr...
Full Text Available Christopher R Freeman,1 W Neil Cottrell,1 Greg Kyle,2 Ian D Williams,3 Lisa M Nissen11School of Pharmacy, University of Queensland, Brisbane, Australia; 2Faculty of Health, University of Canberra, Canberra, Australia; 3Camp Hill Healthcare, Camp Hill, Brisbane, AustraliaBackground: In 2009, a pharmacist commenced working in a nondispensing role at a primary care medical center located in a metropolitan suburb of Brisbane, Australia. Research into the role and function of a practice pharmacist in this setting is still in its infancy.Methods: Ethnographic methods were used over a 3-month period to record activities undertaken by the practice pharmacist on a daily basis.Results: During the 3-month period, 296 hours of activity were documented. Activities the practice pharmacist performed most frequently included medication review, “pharmaceutical opinion,” student supervision, drug information, and administrative tasks.Conclusion: This study demonstrates the broad range of activities which were conducted by a practice pharmacist in the primary care setting as part of a multidisciplinary team.Keywords: practice pharmacist, general practice, integration, medical center
Ann E. Fleming
Full Text Available There is significant evidence that culture-aligned economies are more effective in engaging remote-living Indigenous Australians in work long-term. Despite this evidence, governments remain resistant to investing substantially in these economies, with the result that low employment rates persist. This article argues that governmental systems of organisation are not designed to support non-mainstream economies and this position is unlikely to change. Similarly, the commercial sector lacks confidence that investing in culture-aligned economies will generate financial returns. This article presents a localised, pragmatic approach to Indigenous business support that works within existing systems of government, business and culture. Most unsuccessful programs fail to recognise the full suite of critical factors for sustained market engagement by both business and Indigenous people. This article reports on work to bring all critical factors together into a business support framework to inform the design and implementation of an aquaculture development program in a remote Indigenous Australian community.
Wong Eliza LY
condition to participate in self-management in order to prevent health deterioration and to save healthcare costs. The role of pharmacists should not be limited to drugs and should be extended in the primary healthcare system. Pharmacist-led patient self-management could be developed gradually with the support of government by enhancing pharmacists' responsibilities in health services and developing public-private partnership with community pharmacists. Developing facilitating measures to enhance the implementation of the pharmacist-led approach should also be considered, such as allowing pharmacists to access electronic health records, as well as deregulation of more prescription-only medicines to pharmacy-only medicines.
Constable, Sophie; Dixon, Roselyn; Dixon, Robert
As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…
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'.
Takano, Yusuke; Hanya, Manako; Tatematsu, Michiko; Nakamura, Chikako; Abe, Keiko; Fujisaki, Kazuhiko; Kamei, Hiroyuki
We performed a survey of cancer patients' needs for drug treatment and support from pharmacists during treatment and evaluated the support that cancer patients can expect from community pharmacists in the future. The patients consisted of 16 members of the Cancer Patient Association in Aichi prefecture who underwent chemotherapy. The results of a semistructured group interview were qualitatively analyzed using the grounded theory method. Patients undergoing chemotherapy had high hopes for its effectiveness but were worried about side effects and medical costs. To overcome these problems, they hoped for a decrease in the economic burden, compassionate-use system, and development of novel drugs. The patients had anxiety because the side effects of chemotherapy often caused physical and psychological damage. Despite patients' confusion, pharmacists sometimes did not give adequate explanations to them. The patients expected more from pharmacists regarding medication support and hoped for a system allowing continuous side effect monitoring and consultation without hesitation. For patients undergoing cancer chemotherapy who are confused regarding side effects, pharmacists should understand the patient explanatory model and become more involved with patients as partners in treatment. PMID:26632155
Linda Burney of the Wiradjuri Nation and Minister for Community Services in New South Wales discusses how xenophobia has manifested itself as forms of political and institutional racism in Australian history. She asks us to think of Australia as a giant and beautiful mosaic with over 200 Aboriginal Nations and for the rest of the Australian population to welcome ways to work with all its nation's people.
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.
Cawley, Michael J; Warning, William J
Background Obstructive sleep apnea (OSA) is a chronic sleep disorder associated with a varying degree of upper airway collapse during sleep. Left untreated, OSA can lead to the development of cardiovascular disease including risk of stroke and increased mortality. Pharmacists are the most accessible and underutilized healthcare resource in the community and can have a significant role in screening patients for OSA. The result may include an expedited referral to the patient's general practitioners or sleep disorder specialists for further diagnostic assessment and therapeutic intervention. Aim of the review The primary aim of this review was to identify the current published evidence of pharmacists providing OSA screening services in a community pharmacy setting. Methods A literature search was conducted to identify evidence of pharmacists providing OSA screening services. The literature search including five databases [PubMed, (1946-January 2015), Cumulative Index of Nursing and Allied Health Literature, International Pharmaceutical Abstracts (1970 to January 2015), Cochrane Database of Systematic Reviews and Google Scholar] with search terms of ("pharmacist or pharmacy") AND ("obstructive sleep apnea") AND ("sleep disorders") AND ("continuous positive airway pressure-CPAP") were used. Articles were limited to English and reported in humans. Results A total of seven publications (four Australia, two Switzerland and one France) were selected and evaluated. Pharmacists utilized validated screening tools in 6/7 (86 %) of clinical studies to assist in the identification of patients with sleep disorders in community pharmacies. A total of 1701 pharmacies encompassing 9177 patients were screened in the clinical studies. Pharmacists were able to identify between 21.4 and 67 % of patients that were at risk for developing OSA or required a referral to a general practitioner or sleep disorder specialist for further diagnostic testing. Conclusion Studies assessing the role
Pharmacists have a professional obligation in medicine. As a member of a medical team to provide a safe medication, it is important that they be involved with drug safety in mind. Currently a pharmacist in a business operating with a focus on traditional dispensing and drug administration also functions with a focus on patient care and the provision of drug information. It is important that a pharmacist has a risk management approach to medicine. Together with the institutions responsible for drug safety, he must be cognizant of published reports to prevent serious adverse drug reactions as well as taking part in post-marketing surveillance. Management of safety information for high-risk pharmaceutical drugs, also falls to the pharmacist. Thus he must have knowledge of the skill required for the job of each member of the health care team. Recent newly added responsibilities are: advice in planning patient treatment, checking vital signs and the prescription brought to him to fill. In short a pharmacist working in the medical field must, above all, respect and assure safety to the patients he serves. PMID:21628969
... 159384.html For Better Heart Care, Get a Pharmacist on Your Team Canadian study highlights a potential ... cut their chances of future trouble by having pharmacists help manage their care, new Canadian research suggests. ...
It appears to be entirely appropriate for pharmacists to administer vaccinations if restricted to a limited number of vaccines and a well-defined set of recipients. Recommended types of vaccines would be inert vaccines with no contraindications, including flu vaccines, booster shots for diphtheria, tetanus, pertussis, and polio, and HPV vaccines for the prevention of cervical cancer. Recipients targeted for these types of vaccinations would only be adults and adolescents. In addition, pharmacist-administered vaccinations would not be recommended for pregnant women, people with immunodeficiencies, chronic diseases, or cystic fibrosis, people under treatment (anticoagulants) or with known allergies, and haemophiliacs. They would not be recommended either when needed in the context of employment and for traveling abroad. Training is essential to manage the successful implementation of a pharmacist-administered vaccination program (maintaining cold storage, monitoring, space allocation, vaccination administration process, preventive measures, quick recognition and management of anaphylactic chock…). PMID:23177558
Kyra Y L Chua
Full Text Available Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA USA300 has spread rapidly across North America, and CA-MRSA is also increasing in Australia. However, the dominant Australian CA-MRSA strain, ST93-IV [2B] appears distantly related to USA300 despite strikingly similar clinical and epidemiological profiles. Here, we compared the virulence of a recent Australian ST93 isolate (JKD6159 to other MRSA, including USA300, and found that JKD6159 was the most virulent in a mouse skin infection model. We fully sequenced the genome of JKD6159 and confirmed that JKD6159 is a distinct clone with 7616 single nucleotide polymorphisms (SNPs distinguishing this strain from all other S. aureus genomes. Despite its high virulence there were surprisingly few virulence determinants. However, genes encoding α-hemolysin, Panton-Valentine leukocidin (PVL and α-type phenol soluble modulins were present. Genome comparisons revealed 32 additional CDS in JKD6159 but none appeared to encode new virulence factors, suggesting that this clone's enhanced pathogenicity could lie within subtler genome changes, such as SNPs within regulatory genes. To investigate the role of accessory genome elements in CA-MRSA epidemiology, we next sequenced three additional Australian non-ST93 CA-MRSA strains and compared them with JKD6159, 19 completed S. aureus genomes and 59 additional S. aureus genomes for which unassembled genome sequence data was publicly available (82 genomes in total. These comparisons showed that despite its distinctive genotype, JKD6159 and other CA-MRSA clones (including USA300 share a conserved repertoire of three notable accessory elements (SSCmecIV, PVL prophage, and pMW2. This study demonstrates that the genetically distinct ST93 CA-MRSA from Australia is highly virulent. Our comparisons of geographically and genetically diverse CA-MRSA genomes suggest that apparent convergent evolution in CA-MRSA may be better explained by the rapid
Takano-Ohmuro, Hiromi; Nakajima, Yayoi; Saito, Mitsuo; Yuda, Yasukatsu
Kampo medicines must be used according to an individual's physical characteristics and symptoms to avoid lack of efficacy, adverse reactions or interactions with other drugs. As category-2 over-the-counter drugs (OTCs), Kampo OTCs are not targets of active explanations by pharmacists, and consumers usually decide to use OTCs by themselves on the basis of drug label information. However, information on the label is occasionally brief. To promote the proper use of Kampo OTCs, we herein propose an informative tool based on the Australian Shelf-Talker (information on the proper use of OTCs with a self-check questionnaire for consumers), the Self-Check Card (SCC). We also prepared the informative material, Information to the Pharmacist (IP), directed at pharmacists regarding these Kampo OTCs. We created SCCs and IPs for 16 prescriptions in the 5 most demanded categories (cold, cough/sore throat, urination problems, women's diseases, and shoulder stiffness or joint/nerve pain). The SCC with questions in a simplified language specifies individuals who should avoid the drug, or those who should consult a pharmacist before purchase, according to the safety information on the respective drug labels. The IP provides information to pharmacists on safety issues and those concerning recognition of the consumer's symptoms and physical characteristics needed for the selection of appropriate Kampo OTCs. Such SCCs and IPs are now in use in 2 pharmacies to know pharmacists' suggestions about improvements and consumer's opinions and degree of satisfaction. We believe these risk-benefit communication tools, SCC and IP, will contribute to improve the proper use of Kampo OTCs. PMID:26831805
Natalie A. DiPietro, PharmD, MPH
Full Text Available Objectives: To evaluate the effectiveness of an educational intervention on knowledge of cardiovascular disease (CVD and to increase awareness of risk factors among female patients of a community health center with an on-site 340B pharmacy.Methods: The program consisted of a 10-minute educational intervention and brief pre-test, post-test, and participant satisfaction survey. Adult female patients at the clinic for any provider visit or prescription fill were eligible to participate. Participants met individually with a student pharmacist or faculty member and verbally completed the pre-test. The participant received education regarding CVD, risk factors, and symptoms of myocardial infarction and were screened for hypertension and/or hyperlipidemia. The post-test was then verbally administered. Participants answered the satisfaction survey privately. Based on individual needs, educational materials and information on available pharmacy clinical services were provided. The university IRB deemed the study exempt. Results: Eighty-four individuals received educational materials and/or a screening test. Of those, 30 women (mean age 46.9 years completed the educational intervention. Thirteen (43% reported smoking; 22 (73% identified themselves as overweight. Fourteen (47% indicated a preexisting diagnosis of hypertension. Correct responses for 6 of 8 knowledge-based questions were statistically significantly improved from pre-test to post-test (p<0.05. Twenty-nine patients (97% rated the program as “useful” or “very useful”. Conclusion: CVD is the leading cause of death in U.S. women. Data from this program indicate that through screening and education, pharmacists and student pharmacists can impact female patients’ knowledge of CVD risk factors. Continued efforts in this area may help to reduce the public health burden of CVD.
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.
Timothy McPherson, PhD, RPh
Full Text Available Leaders in the profession of pharmacy have articulated a vision of pharmacists as providers of patient-centered care (PCC services and the Doctor of Pharmacy was established as the required practice degree to achieve this vision. Pharmacist-provided PCC services have been shown to reduce medication costs and improve patient compliance with therapies. While community pharmacists are capable of, and are ideally placed for, providing PCC services, in fact they devote most of their time to prescription dispensing rather than direct patient care. As professionals, community pharmacists are charged with protecting society by providing expert services to help consumers manage risks associated with drug therapies. Historically pharmacists fulfilled this responsibility by accurately dispensing prescription medications, verifying doses, and allergy checking. This limited view of pharmacy practice is insufficient in light of the modern view of pharmacists as providers of PCC. The consumers’ view of community pharmacy as a profession represents a barrier to transforming the basis of community pharmacy from product distribution to providing PCC services. Community pharmacists are conferred with social authority to dictate the manner in which their professional services are provided. Pharmacists can therefore facilitate the transition to PCC as the primary function of community pharmacy by exercising their social authority to engage consumers in their roles in the new patient-pharmacist relationship. Each pharmacist must decide to provide PCC services. Suggestions for initiating PCC services in community pharmacy are offered.
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
Science Teacher, 2005
Massive extinctions of animals and the arrival of the first humans in ancient Australia--which occurred 45,000 to 55,000 years ago--may be linked. Researchers at the Carnegie Institution, University of Colorado, Australian National University, and Bates College believe that massive fires set by the first humans may have altered the ecosystem of…
Segar, Simon T.; Dunn, Derek W.; Darwell, Clive T.; Cook, James M.
Endophytic insects and their parasitoids provide valuable models for community ecology. The wasp communities in inflorescences of fig trees have great potential for comparative studies, but we must first describe individual communities. Here, we add to the few detailed studies of such communities by describing the one associated with Ficus rubiginosa in Australia. First, we describe community composition, using two different sampling procedures. Overall, we identified 14 species of non-pollinating fig wasp (NPFW) that fall into two size classes. Small wasps, including pollinators, gallers and their parasitoids, were more abundant than large wasps (both galler and parasitoid species). We show that in figs where wasps emerge naturally, the presence of large wasps may partly explain the low emergence of small wasps. During fig development, large gallers oviposit first, before and around the time of pollination, while parasitoids lay eggs after pollination. We further show that parasitoids in the subfamily Sycoryctinae, which comprise the majority of all individual NPFWs, segregate temporally by laying eggs at different stages of fig development. We discuss our results in terms of species co-existence and community structure and compare our findings to those from fig wasp communities on other continents.
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.
Marra Carlo A
Full Text Available Abstract Background Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC, Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use. Methods/Design We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals. Discussion In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based.
Dare, Melanie (Lain); Vanclay, Frank; Schirmer, Jacki
Social concerns surrounding commercial plantation forest management practices in Australia have resulted in calls for more participatory forms of forest management decision-making. Public participation (or community engagement, CE) processes provide opportunities for affected and interested communit
Full Text Available Abstract Background The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY. Methods/Design The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD extracted data from a community pharmacy dispensing software system (FRED Dispense®. The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG or 'Usual Care Group' (UCG. To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data. Discussion To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient
Hayden, Helen L; Mele, Pauline M; Bougoure, Damian S; Allan, Claire Y; Norng, Sorn; Piceno, Yvette M; Brodie, Eoin L; Desantis, Todd Z; Andersen, Gary L; Williams, Amity L; Hovenden, Mark J
The microbial community structure of bacteria, archaea and fungi is described in an Australian native grassland soil after more than 5 years exposure to different atmospheric CO2 concentrations ([CO2]) (ambient, +550 ppm) and temperatures (ambient, + 2°C) under different plant functional types (C3 and C4 grasses) and at two soil depths (0-5 cm and 5-10 cm). Archaeal community diversity was influenced by elevated [CO2], while under warming archaeal 16S rRNA gene copy numbers increased for C4 plant Themeda triandra and decreased for the C3 plant community (P < 0.05). Fungal community diversity resulted in three groups based upon elevated [CO2], elevated [CO2] plus warming and ambient [CO2]. Overall bacterial community diversity was influenced primarily by depth. Specific bacterial taxa changed in richness and relative abundance in response to climate change factors when assessed by a high-resolution 16S rRNA microarray (PhyloChip). Operational taxonomic unit signal intensities increased under elevated [CO2] for both Firmicutes and Bacteroidetes, and increased under warming for Actinobacteria and Alphaproteobacteria. For the interaction of elevated [CO2] and warming there were 103 significant operational taxonomic units (P < 0.01) representing 15 phyla and 30 classes. The majority of these operational taxonomic units increased in abundance for elevated [CO2] plus warming plots, while abundance declined in warmed or elevated [CO2] plots. Bacterial abundance (16S rRNA gene copy number) was significantly different for the interaction of elevated [CO2] and depth (P < 0.05) with decreased abundance under elevated [CO2] at 5-10 cm, and for Firmicutes under elevated [CO2] (P < 0.05). Bacteria, archaea and fungi in soil responded differently to elevated [CO2], warming and their interaction. Taxa identified as significantly climate-responsive could show differing trends in the direction of response ('+' or '-') under elevated CO2 or warming, which could then not be used to
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 Clinicaltrials.gov NCT00878566.
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.
Slimano, F; Roessle, C; Blanc, C; De Maleissye, M-F; Bauler, S
Melanoma is a skin cancer that represents an actual public health problem. Its incidence is increasing every year. Environmental risk factors have been clearly identified. Early diagnosis of a suspicious skin lesion should be possible by any health professionals because the prognosis is correlated with the evolution of the disease and the presence of metastases. The advent of new therapies in metastatic forms with the development of immunotherapies and kinases inhibitors has significantly changed the management of this disease. New therapies are available in retail pharmacies and involve health professionals out of the hospital. This article is intended for community and hospital pharmacists and summarizes recommendations for primary and secondary prevention. It updates on new targeted therapies. It wants to give advices to the community pharmacists about the effective use of those treatments for melanoma. PMID:26968263
Janevik-Ivanovska, Emilija; Sterjova, Marija; Popeska, Biljana
The aim of our paper is to review and to describe the opportunities and obligations for pharmacists regarding doping control in sports, and to present information and resources on drugs and dietary supplements that are popular among athletes for performance enhancement. Doping is controversial mainly because the medical community has not defined where restoration of normative function ends and performance enhancement begins. Those opposed to doping contend that it undermines the traditiona...
This text was presented at the V Congress on Pharmacy Care/Riopharma with the intent to approach some aspects important for discussing the role of the pharmacist as health professional and citizen capable of acting in society. To this purpose we decided to recall some of the cornerstones of the Brazilian health reform; the pressure of the industry on health professionals and regulatory agencies; the inequity in the distribution of medicaments among the different social classes. Some of the changes proposed in this paper are: to widen the role the pharmacist plays in pharmacotherapy; to prohibit drug advertising; a global and independent evaluation of the national regulatory agency; inclusion of information about medicament consumption during hospitalizations in the national databases. PMID:21936158
Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah; Torkamandi, Hassan; Javadi, Mohammadreza
Introduction: Weight management is a new public health role for community pharmacists in many countries. Lack of expertise is one of the key barriers to counseling obese patients. We evaluated the comparative efficacy of three alternative continuing education (CE) meetings on weight management. Methods: We designed a randomized controlled trial…
Rogers, Kelly C; Finks, Shannon W
The pharmacist shortage, increasing numbers of female pharmacy graduates, more pharmacy schools requiring faculty members, and a lower percentage of female faculty in academia are reasons to develop unique arrangements for female academic pharmacists who wish to work part-time. Job sharing is an example of a flexible alternative work arrangement that can be successful for academic pharmacists who wish to continue in a part-time capacity. Such partnerships have worked for other professionals but have not been widely adopted in pharmacy academia. Job sharing can benefit the employer through retention of experienced employees who collectively offer a wider range of skills than a single employee. Benefits to the employee include balanced work and family lives with the ability to maintain their knowledge and skills by remaining in the workforce. We discuss the additional benefits of job-sharing as well as our experience in a non-tenure track job-sharing position at the University of Tennessee College of Pharmacy. PMID:19960092
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 http://www.sustc-genome.org.cn/vp or installed as a local web server. The codes and documentation are available at the GitHub repository (https://github.com/VirtualPharmacist/vp. Administrators can download the source codes to customize access settings for further development.
Kanitz, J; Birken, B; Ward, V
During the past two years, a multi-discipline health team has been meeting with selected diabetic "problem" patients on a regular basis at the North York General Hospital (NYGH). The patients are referred to the programme by their physicians when they appear to be having difficulty handling or coping with their diabetes. The participants in the programme attend the Diabetic Education Centre (DEC) for one week as day patients in the hospital and are exposed to various types of counselling from members of the Diabetic Education Centre Team (DECT), one of which is the pharmacist. Follow-up from this week of intensive education is made at annual intervals. The main purpose of the pharmacist in the clinic is to provide information for the patients regarding their prescriptions and over the counter (OTC) medication. This is achieved by means of individual patient interviews and informal group discussions, as well as rounds with other team members and contact with patients' families. This programme provides a forum for the patient and the patient's family to obtain valid information about diabetes, as well as problems associated with the disease, and aids in coping with these problems. The team concept enables the patient to be analyzed by all disciplines in order to assess his teaching needs and fulfill them. The pharmacist is continually involved in this information system and plays a valuable role on the team. PMID:10257341
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.
Full Text Available Thi-My-Uyen Nguyen,1 Esther TL Lau,1,3 Kathryn J Steadman,1 Julie AY Cichero,1 Kaeleen Dingle,2 Lisa M Nissen1,3 1School of Pharmacy, University of Queensland, Brisbane, QLD, Australia; 2School of Public Health, Queensland University of Technology, Brisbane, QLD, Australia; 3School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia Background: People often modify oral solid dosage forms when they experience difficulty swallowing them. Modifying dosage forms may cause adverse effects to the patient, and the person undertaking the modification. Pharmacists are often the first point of contact for people in the general community seeking advice regarding medications. Nurses are at the forefront of administering medications to patients and are likely to be most directly affected by a patient’s swallowing ability, while general practitioners (GPs are expected to consider swallowing abilities when prescribing medications. Objective: To compare the perspectives and experiences of GPs, pharmacists, and nurses regarding medication dosage form modification and their knowledge of medication modification. Method: Questionnaires tailored to each profession were posted to 630 GPs, and links to an online version were distributed to 2,090 pharmacists and 505 nurses. Results: When compared to pharmacists and GPs, nurses perceived that a greater proportion of the general community modified solid dosage forms. Pharmacists and GPs were most likely to consider allergies and medical history when deciding whether to prescribe or dispense a medicine, while nurses’ priorities were allergies and swallowing problems when administering medications. While nurses were more likely to ask their patients about their ability to swallow medications, most health professionals reported that patients “rarely” or “never” volunteered information about swallowing difficulties. The majority of health professionals would advise a patient to
McMahon, Emma; Clarke, Rozlynne; Jaenke, Rachael; Brimblecombe, Julie
Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g) versus Standard (~400 mg Na/100 g) white and wholemeal breads (n = 62 for white; n = 72 for wholemeal). Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability). Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA). Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change. PMID:26999196
McMahon, Emma; Clarke, Rozlynne; Jaenke, Rachael; Brimblecombe, Julie
Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g) versus Standard (~400 mg Na/100 g) white and wholemeal breads (n = 62 for white; n = 72 for wholemeal). Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability). Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA). Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change.
Full Text Available Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g versus Standard (~400 mg Na/100 g white and wholemeal breads (n = 62 for white; n = 72 for wholemeal. Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability. Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA. Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change.
Full Text Available Abstract Background Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Methods Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. Results The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies. In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59. There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies, as well as the provision of water supply, sanitation and hygiene education (two studies on reducing rates of diarrhoeal disease. The size of these effects is
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. PMID:26613738
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.
Taylor, Jeff Gordon; Joubert, Ray
Pharmacists have a long history of helping Canadians with minor ailments. This often has involved management with over-the-counter medications. If pharmacists felt that the best care required something more robust, they would refer the patient to a physician. In hopes of improving the care of such ailments, Canadian provinces have granted pharmacists the option of selecting medications traditionally under physician control. This review examines the Canadian perspective on pharmacists prescribing for minor ailments and the evidence of value for these programs. It might provide guidance for other jurisdictions contemplating such a move. PMID:27570460
Sequential antibiotic therapy has a number of advantages in terms of patient benefit and value for money in drug use. Introduction and maintenance of a process to ensure sequential therapy is multidisciplinary, involving clinicians, pharmacists, microbiologists and possibly nurses. The contribution of pharmacists is multi-faceted and involves senior and junior pharmacists working in a number of areas. Pharmacy managers will be involved at policy setting level through the Drug and Therapeutics committee and similar bodies. Purchasing and formulary pharmacists will be involved in negotiating purchasing agreements while clinical pharmacists provide data on the costs and outcomes of treatment. The drug information pharmacist is a valuable resource in searching and interpreting the available literature. Whatever system is used, clinical pharmacists have an important role in identifying patients and monitoring prescribing. In many schemes described in the literature, pharmacists have had an important role in auditing the effectiveness of sequential therapy. There may be scope for developing the clinical pharmacist's role further by devolving, under protocol, increased decision making and medicines management responsibilities. PMID:9756371
Ethical and legal issues arising for a community pharmacist, when a GP requests morphine to be urgently supplied to a patient with cancer who is approaching end of life, but where a legal prescription is not available: What can be done to prevent this ethical/legal dilemma arising?
Morphine is the cornerstone of treatment for distressing cancer pain in palliative and end of life care. Legal restraints governing the supply of this medicine require that a doctor’s prescription is presented to a pharmacist before morphine may be legally dispensed to a patient. Patient symptoms can deteriorate suddenly at end of life. Situations may arise whereby a pharmacist may be called upon by a GP to urgently dispense morphine to such patients before a legal prescription can be provide...
Holt, Martin; Lee, Evelyn; Prestage, Garrett P; Zablotska, Iryna; de Wit, John; Mao, Limin
To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000-2001 to 2008-2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000-2001 and 11,083 in 2008-2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men. PMID:22639958
R. M. Law
Full Text Available Earth System Models (ESMs that incorporate carbon-climate feedbacks represent the present state of the art in climate modelling. Here, we describe the Australian Community Climate and Earth System Simulator (ACCESS-ESM1 that combines existing ocean and land carbon models into the physical climate model to simulate exchanges of carbon between the land, atmosphere and ocean. The land carbon model can optionally include both nitrogen and phosphorous limitation on the land carbon uptake. The ocean carbon model simulates the evolution of nitrate, oxygen, dissolved inorganic carbon, alkalinity and iron with one class of phytoplankton and zooplankton. From two multi-centennial simulations of the pre-industrial period with different land carbon model configurations, we evaluate the equilibration of the carbon cycle and present the spatial and temporal variability in key carbon exchanges. For the land carbon cycle, leaf area index is simulated reasonably, and seasonal carbon exchange is well represented. Interannual variations of land carbon exchange are relatively large, driven by variability in precipitation and temperature. We find that the response of the ocean carbon cycle shows reasonable agreement with observations and very good agreement with existing Coupled Model Intercomparison Project (CMIP5 models. While our model over estimates surface nitrate values, the primary productivity agrees well with observations. Our analysis highlights some deficiencies inherent in the carbon models and where the carbon simulation is negatively impacted by known biases in the underlying physical model. We conclude the study with a brief discussion of key developments required to further improve the realism of our model simulation.
Law, R. M.; Ziehn, T.; Matear, R. J.; Lenton, A.; Chamberlain, M. A.; Stevens, L. E.; Wang, Y. P.; Srbinovsky, J.; Bi, D.; Yan, H.; Vohralik, P. F.
Earth System Models (ESMs) that incorporate carbon-climate feedbacks represent the present state of the art in climate modelling. Here, we describe the Australian Community Climate and Earth System Simulator (ACCESS)-ESM1 that combines existing ocean and land carbon models into the physical climate model to simulate exchanges of carbon between the land, atmosphere and ocean. The land carbon model can optionally include both nitrogen and phosphorous limitation on the land carbon uptake. The ocean carbon model simulates the evolution of nitrate, oxygen, dissolved inorganic carbon, alkalinity and iron with one class of phytoplankton and zooplankton. From two multi-centennial simulations of the pre-industrial period with different land carbon model configurations, we evaluate the equilibration of the carbon cycle and present the spatial and temporal variability in key carbon exchanges. For the land carbon cycle, leaf area index is simulated reasonably, and seasonal carbon exchange is well represented. Interannual variations of land carbon exchange are relatively large, driven by variability in precipitation and temperature. We find that the response of the ocean carbon cycle shows reasonable agreement with observations and very good agreement with existing Coupled Model Intercomparison Project (CMIP5) models. While our model over estimates surface nitrate values, the primary productivity agrees well with observations. Our analysis highlights some deficiencies inherent in the carbon models and where the carbon simulation is negatively impacted by known biases in the underlying physical model. We conclude the study with a brief discussion of key developments required to further improve the realism of our model simulation.
Mitchison, Deborah; Morin, Alexandre; Mond, Jonathan; Slewa-Younan, Shameran; Hay, Phillipa
Objective Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD). Method Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828) surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated) and completed measures of ED symptoms (Eating Disorder Examination Questionnaire), HRQoL (12-item Medical Outcomes Study Short Form), and PD (Kessler Psychological Distress Scale). Results Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year) improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups. Conclusions Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs. PMID:25812047
Full Text Available Studies that have investigated quality of life (QoL in eating disorders (EDs have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL and psychological distress (PD.Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828 surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated and completed measures of ED symptoms (Eating Disorder Examination Questionnaire, HRQoL (12-item Medical Outcomes Study Short Form, and PD (Kessler Psychological Distress Scale.Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups.Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs.
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, ClinicalTrials.gov, 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
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, ClinicalTrials.gov, 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
Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.
Smith Danielle M
Full Text Available Abstract Background Pharmacies are venues in which patients seek out products and professional advice in order to improve overall health. However, many pharmacies in the United States continue to sell tobacco products, which are widely known to cause detrimental health effects. This conflict presents a challenge to pharmacists, who are becoming increasingly more involved in patient health promotion activities. This study sought to assess Western New York (WNY area pharmacists’ opinions about the sale of tobacco products in pharmacies, and pharmacists’ opinions on their role in patient smoking cessation. Methods Participants responded to two parallel surveys; a web-based survey was completed by 148 university-affiliated pharmacist preceptors via a list based sample, and a mail-based survey was completed by the supervising pharmacist in 120 area pharmacies via a list-based sample. The combined response rate for both surveys was 31%. Univariate and bivariate analyses were performed to determine any significant differences between the preceptor and supervising pharmacist survey groups. Results Over 75% of respondents support legislation banning the sale of tobacco products in pharmacies. Over 86% of respondents would prefer to work in a pharmacy that does not sell tobacco products. Differences between preceptor and supervising pharmacist groups were observed. Action regarding counseling patients was uncommon among both groups. Conclusions Pharmacists support initiatives that increase their role in cessation counseling and initiatives that restrict the sale of tobacco products in pharmacies. These data could have important implications for communities and pharmacy practice.
A proposal has been prepared for the installation in Australia of a national high performance synchrotron light facility called Boomerang. The Boomerang proposal had its origin in the establishment of the Australian Synchrotron Research Program (ASRP) which was one of the seven Major National Research Facilities announced by the Federal Government in December 1995. The ASRP provides the opportunity and funding for Australian researchers to access international synchrotron facilities, specifically two consortia at the Advanced Photon Source (APS) at the Argonne National Laboratory, USA and continued interaction with the Photon Factory at the KEK Laboratory in Japan. The ASRP was the successor to the Australian National Beamline Facility project (ANBF) which began in 1991 following the ASTEC inquiry titled 'Small Country - Big Science'. The Federal Government also provided funding for a Feasibility Study to determine the value of establishing an Australian-based synchrotron radiation facility. The Feasibility Study was completed in August 1998 and endorsed by the institutional members of the ASRP and the research community in general. The study concluded that, on the data available in Australia, there was a strong case for the installation of an Australian-based facility. The study considered several options for an Australian-based facility and recommended that these options and the data supporting the general conclusions receive further investigation. A mission was arranged to a select group of overseas laboratories to explore these questions in detail. The review team included a mix of scientific and industrial experience and also represented the interests of the ASRP and an Industrial Synchrotron Consortium based in Victoria. Based on the conclusions of the overseas mission and incorporating the advice of all international specialists in the design and use of synchrotron facilities consulted during the mission, the most cost-effective option was an extended
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.
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. PMID:26997602
Colin W. Binns; Xingqiong Meng; Kerr, Deborah A; Kun Zhu; Amanda Devine; Vicky Solah; Richard L. Prince
The role of calcium in the prevention of bone loss in later life has been well established but little data exist on the adequacy of calcium intakes in elderly Australian women. The aim of this study was to compare the dietary intake including calcium of elderly Australian women with the Australian dietary recommendation, and to investigate the prevalence of calcium supplement use in this population. Community-dwelling women aged 70–80 years were randomly recruited using the Electoral Roll for...
... 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 § 35.57, the licensee shall require the authorized nuclear pharmacist to be a pharmacist who— (a) Is...
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.
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. PMID:26700216
Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy
Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care. PMID:27412312
Pullinger, W.; Franklin, B. D.
Objectives We aimed to identify potential barriers to hospital pharmacists' documentation in patients' hospital health records, and to explore pharmacists' training needs. Our objectives were to identify the methods used by pharmacists to communicate and document patient care issues, to explore pharmacists' attitudes towards documentation of patient care issues in health records, to identify and examine the factors influencing whether or not pharmacists document their care in health records a...
Miller, Evonne; Buys, Laurie; Bell, Lorraine
This article documents the rationale and experience of a pilot Australian sustainability education programme, "Living Smart Homes" (LSH) based on a community-based social marketing model. Inspired by the Australian "Land for Wildlife" scheme, LSH is designed to engage homeowners with sustainable practices through face-to-face workshops, an…
Salter, Zarin; Venville, Grady; Longnecker, Nancy
This paper documents a case study involving a Perth primary school accompanied on its sustainability journey by Millennium Kids Inc, a local not-for-profit community organisation. Tension between the school's sustainability focus, its prestige as an elite private school and a "lucky country" mentality frames the Australian-ness of this…
Kawamura, K; Okuda, J
The Code of Ethics for pharmacists clarifies the standards of professional conduct. The code should be positively enforced in every country, and must play its role as the conduct standard for pharmacists at all times. American pharmacists did not suddenly become ethical in the 1980s. An appreciation of the importance of professional ethics has a long history starting when the Philadelphia College of Pharmacy adopted a Code of Ethics in 1848. Since the first legislation of the American Pharmacy Code of Ethics as far back as 1852, the code has been revised in 1922, 1952, 1969, 1981 and 1994. The term of between revisions has gotten shorter over the years, reflecting the change in the status and the proficiency of pharmacists in 146 years. Its historical meaning is quite significant. PMID:11623965
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.
Full Text Available Understanding the public's view of professional competency is extremely important; however little has been reported on the public’s perception of community pharmacists in PalestineObjectives: To determine the perception of Palestinian consumers of the community pharmacist and the services they offerMethod: This project used the survey methodology administered by structured interviews to consumers who attended the 39 randomly selected pharmacies, in six main cities in Palestine. The questionnaire had range of structured questions covering: Consumers’ patronage patterns, consumers’ interaction with community pharmacists, consumers’ views on how the pharmacist dealt with personal health issues, procedure with regard to handling private consultations.Results: Of 1,017 consumers approached, 790 consumers completed the questionnaire (77.7 %. Proximity to home and presence of knowledgeable pharmacist were the main reasons for patients to visit the same pharmacy. Physicians were identified as the preferred source of advice by 57.2% and pharmacists by 23.8%. Only 17% of respondents considered pharmacists as health professionals who know a lot about drugs and are concerned about and committed to caring for the public. In addition, 49% indicated that pharmacists spoke more quietly cross the counter during counseling and almost one third reported that the pharmacist used a private area within the pharmacy. The majority of respondents would be happy to receive different extended services in the community pharmacy like blood pressure monitoring.Conclusions: Palestinian consumers have a positive overall perception of community pharmacists and the services they offer. Awareness should be created amongst the public about the role of pharmacist and the added value they can provide as health care professional. There is a need to consider privacy when giving patient counseling to increase user satisfaction.
Code of ethics represents the principles that form the fundamental basis of the roles and responsibilities of pharmacists in pharmaceutical practice. According to pharmacy practice, pharmacists are confirmed as healthcare professionals with unique knowledge, skills and responsibilities for safe and efficient medication therapy management in order to optimize therapeutic outcomes. The scope of pharmacy practice includes technical aspects of pharmaceutical services, the preparation of p...
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 suc...
Taylor, Jeff; Joubert,Ray
Jeff Gordon Taylor,1 Ray Joubert,2 1College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, 2Saskatchewan College of Pharmacy Professionals, Regina, SK, Canada Abstract: Pharmacists have a long history of helping Canadians with minor ailments. This often has involved management with over-the-counter medications. If pharmacists felt that the best care required something more robust, they would refer the patient to a physician. In hopes of improving the care of such ailments, ...
Zhou, Ling; Ma, Jingjing; Gao, Jie; Chen, Shiqi; Bao, Jianan
Pharmacists' role may be ideal for improving rationality of drug prescribing practice. We aimed to study the impact of multifaceted pharmacist interventions on antibiotic prophylaxis in patients undergoing clean or clean-contaminated operations in cardiothoracic department. A pre-test-post-test quasiexperimental study was conducted in a cardiothoracic ward at a tertiary teaching hospital in Suzhou, China. Patients admitted to the ward were collected as baseline group (2011.7-2012.12) and intervention group (2013.7-2014.12), respectively. The criteria of prophylaxis antibiotic utilization were established on the basis of the published guidelines and official documents. During the intervention phase, a dedicated pharmacist was assigned and multifaceted interventions were implemented in the ward. Then we compared the differences in antibiotic utilization, bacterial resistance, clinical and economic outcomes between the 2 groups. Furthermore, patients were collected after the intervention (2015.1-2015.6) to evaluate the sustained effects of pharmacist interventions. 412 and 551 patients were included in the baseline and intervention groups, while 156 patients in postintervention group, respectively. Compared with baseline group, a significant increase was found in the proportion of antibiotic prophylaxis, the proportion of rational antibiotic selection, the proportion of suitable prophylactic antibiotic duration, and the proportion of suitable timing of administration of the first preoperative dose (P pharmacist intervention resulted in favorable outcomes with significantly decreased rates of surgical site infections, prophylactic antibiotic cost, and significantly shortened length of stay (P Pharmacist interventions in cardiothoracic surgery result in a high adherence to evidence-based treatment guidelines and a profound culture change in drug prescribing with favorable outcomes. The effects of pharmacist intervention are sustained and the role of pharmacists is
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.
Wang, Indriani; Dopheide, Julie Ann; Gregerson, Paul
Limited access to a psychiatrist prompted a collaborative practice agreement between a psychiatric pharmacist, a psychiatric pharmacy resident, and primary care physicians at the Center for Community Health, a safety-net clinic providing comprehensive care to the homeless in Skid Row, Los Angeles, CA, USA. From July 2009 to February 2010, 36 (75%) of the 48 patients referred to the psychiatric pharmacy resident met the criteria for the chart review. Twenty-six (54%) were seen for regular foll...
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 data...
Full Text Available The treatment of chronic pain consumes a significant share of primary care. Community and family health team pharmacists frequently see patients with chronic pain, thus have the opportunity to improve their care. To assess the knowledge, perceptions, and attitudes of Ontario pharmacists, we invited 5,324 Ontario pharmacists, to participate in an online survey we developed using Qualtrics. The 31-question survey gathered demographic information, assessed pharmacists' knowledge of three chronic pain conditions; chronic lower back pain (CLBP, eight true/false statements; chronic headache disorder (CHD, eight true/false statements and painful diabetic neuropathy (PDN, seven true/false statements, and their attitudes toward and perceptions of patients with these conditions, and knowledge, attitudes, and perceptions of opioids in pain management. We received 688 responses (12.9% and 392 pharmacists completed the survey. The mean age of respondents was 48.5 years and 48.5% were male. More than 50% of respondents were in practice for more than 20 years and 58.7% worked 25-40 hours per week. The mean knowledge scores were 4.5/8, 5.5/8, and 5.3/8 for CBLP, CHD, and PDN respectively. While 95% of respondents were aware of the increasing death rates due to opioid use, only half were familiar with the Canadian guideline for safe opioid prescribing for non-cancer use. Responses were compared based on gender, time in practice and location of practice. Pharmacists with more than ten years of experience scored significantly higher than those with less experience. Fewer differences were found in comparisons of gender and location of practice. Safe and effective care of chronic pain patients, particularly with opioids, will require additional pharmacist education.
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.
Full Text Available Krishneeta C Kashyap,1 Lisa M Nissen,1 Simon S Smith,2 James A Douglas,3 Greg J Kyle41School of Pharmacy, University of Queensland, Woolloongabba, Queensland, Australia; 2Centre for Accident Research and Road Safety, Queensland University of Technology, Kelvin Grove, Queensland, Australia; 3The Prince Charles Hospital, Chermside, Queensland, Australia; 4School of Pharmacy, University of Canberra, Bruce, Canberra, AustraliaBackground: When experiencing sleep problems for the first time, consumers may often approach community pharmacists for advice as they are easily accessible health care professionals in the community. In Australian community pharmacies there are no specific tools available for use by pharmacists to assist with the assessment and handling of consumers with sleep enquiries.Objective: To assess the feasibility of improving the detection of sleep disorders within the community through the pilot of a newly developed Community Pharmacy Sleep Assessment Tool (COP-SAT.Method: The COP-SAT was designed to incorporate elements from a number of existing, standardized, and validated clinical screening measures. The COP-SAT was trialed in four Australian community pharmacies over a 4-week period.Key findings: A total of 241 community pharmacy consumers were assessed using the COP-SAT. A total of 74 (30.7% were assessed as being at risk of insomnia, 26 (10.7% were at risk of daytime sleepiness, 19 (7.9% were at risk of obstructive sleep apnea, and 121 (50.2% were regular snorers. A total of 116 (48.1% participants indicated that they consume caffeine before bedtime, of which 55 (47% had associated symptoms of sleep onset insomnia. Moreover, 85 (35% consumed alcohol before bedtime, of which 50 (58% experienced fragmented sleep, 50 (58% were regular snorers, and nine (10.6% had apnea symptoms. The COP-SAT was feasible in the community pharmacy setting. The prevalence of sleep disorders in the sampled population was high, but generally
Jenkins, Andrew Ian; Hughes, Mary Louise; Mantzourani, Efthymia; Smith, Mathew Wayne
In recent years, the delivery of health services has seen a shift towards interprofessional teamwork in order to effectively utilise the skills of each member of the healthcare team to deliver optimal patient care. Nevertheless, a variety of barriers, including lack of communication between healthcare professionals (HCPs), have been identified. The expanding clinical services provided by community pharmacies have increased the potential for pharmacist-HCP interaction; however, primary care pharmacy environments vary from individual distinct premises to part of interprofessional 'health centres'. As such, one potential factor affecting interprofessional communication could be the geographical location ('space') of HCPs. This study sought to determine whether these different primary healthcare 'spaces' impact on the frequency of interprofessional interactions. An anonymous, self-complete questionnaire was sent to all community pharmacies in Wales (n = 716) to quantify the frequency of interprofessional interactions between community pharmacists and other HCPs. A response rate of 62% was achieved. Results showed that pharmacists working in pharmacies physically linked to general practitioner (GP) surgeries had significantly more frequent interaction with HCPs based within the surgeries. This suggests that housing HCPs in the same physical space will enable more interprofessional interaction, supporting the drive to improve the quality of patient care. PMID:27351784
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
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
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
Watson, Jane M.
This article compares the definition of "box plot" as used in the "Australian Curriculum: Mathematics" with other definitions used in the education community; describes the difficulties students experience when dealing with box plots; and discusses the elaboration that is necessary to enable teachers to develop the knowledge necessary to use them…
Full Text Available The objective of the PHAR-QA (Quality assurance in European pharmacy education and training project was to investigate how competence-based learning could be applied to a healthcare, sectoral profession such as pharmacy. This is the first study on evaluation of competences from the pharmacists’ perspective using an improved Delphi method with a large number of respondents from all over Europe. This paper looks at the way in which hospital pharmacists rank the fundamental competences for pharmacy practice. European hospital pharmacists (n = 152 ranked 68 competences for pharmacy practice of two types (personal and patient care, arranged into 13 clusters. Results were compared to those obtained from community pharmacists (n = 258. Generally, hospital and community pharmacists rank competences in a similar way. Nevertheless, differences can be detected. The higher focus of hospital pharmacists on knowledge of the different areas of science as well as on laboratory tests reflects the idea of a hospital pharmacy specialisation. The difference is also visible in the field of drug production. This is a necessary competence in hospitals with requests for drugs for rare diseases, as well as paediatric and oncologic drugs. Hospital pharmacists give entrepreneurship a lower score, but cost-effectiveness a higher one than community pharmacists. This reflects the reality of pharmacy practice where community pharmacists have to act as entrepreneurs, and hospital pharmacists are managers staying within drug budgets. The results are discussed in the light of a “hospital pharmacy” specialisation.
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
Barry, Arden R.; Pammett, Robert T.
Background: In 2013, Jorgenson et al. published guidelines for pharmacists integrating into primary care teams. These guidelines outlined 10 evidence-based recommendations designed to support pharmacists in successfully establishing practices in primary care environments. The aim of this review is to provide a detailed, practical approach to implementing these recommendations in real life, thereby aiding to validate their effectiveness. Methods: Both authors reviewed the guidelines independently and ranked the importance of each recommendation respective to their practice. Each author then provided feedback for each recommendation regarding the successes and challenges they encountered through implementation. This feedback was then consolidated into agreed upon statements for each recommendation. Results and Discussion: Focusing on building relationships (with an emphasis on face time) and demonstrating value to both primary care providers and patients were identified as key aspects in developing these new roles. Ensuring that the environment supports the practice, along with strategic positioning within the clinic, improves uptake and can maximize the usefulness of a pharmacist in primary care. Demonstrating consistent and competent clinical and documentation skills builds on the foundation of the other recommendations to allow for the effective provision of clinical pharmacy services. Additional recommendations include developing efficient ways (potentially provider specific) to communicate with primary care providers and addressing potential preconceived notions about the role of the pharmacist in primary care. Conclusion: We believe these guidelines hold up to real-life integration and emphatically recommend their use for new and existing primary care pharmacists.
The "School Health and Safety Act" was enforced in April 2009 in Japan, and "school environmental health standards" were established by the Minister of Education, Culture, Sports, Science and Technology. In Article 24 of the Enforcement Regulations, the duties of the school pharmacist have been clarified; school pharmacists have charged with promoting health activities in schools and carrying out complete and regular checks based on the "school environmental health standards" in order to protect the health of students and staff. In supported of this, the school pharmacist group of Japan Pharmaceutical Association has created and distributed digital video discs (DVDs) on "check methods of school environmental health standards" as support material. We use the DVD to ensure the basic issues that school pharmacists deal with, such as objectives, criteria, and methods for each item to be checked, advice, and post-measures. We conduct various workshops and classes, and set up Q&A committees so that inquiries from members are answered with the help of such activities. In addition, school pharmacists try to improve the knowledge of the school staff on environmental hygiene during their in-service training. They also conduct "drug abuse prevention classes" at school and seek to improve knowledge and recognition of drugs, including "dangerous drugs". PMID:27252053
Sato, Hirotaka; Shimamori, Yoshimitu
Keeping track of patients' medication histories is an important component of pharmacy practice. In this study, we conducted a questionnaire survey on medication histories among pharmacists and performed covariance structure analysis to investigate pharmacists' attitudes toward medication histories. The survey was conducted among pharmacists who work at pharmacies. With regard to the questions on medication histories, factor analysis and covariance structure analysis were performed to create a path diagram. The response rate to the questionnaire was 97.0%. The factor analysis revealed six factors, including: "patient assessment", "learning attitude", "practicing the recording of medication histories", "conscious effort to improve medication histories", "uniformity in medication histories" and "issues regarding medication histories". Meanwhile, covariance structure analysis revealed that the five-factor model excluding "issues regarding medication histories" was the best-fitted model. According to this model, it was clear that the pharmacists were extremely conscious about introducing improvements to the content of medication histories. In this study, covariance structure analysis enabled the effective analysis of the attitudes of pharmacists toward medication histories. We believe that creating and conducting a training program to clarify and resolve issues related to medication histories and then reviewing the outcome of such a training program will lead to quality improvement and standardization of the future management of medication histories. PMID:21532278
Hamacher, Duane W
We present 25 accounts of comets from 40 Australian Aboriginal communities, citing both supernatural perceptions of comets and historical accounts of bright comets. Historical and ethnographic descriptions include the Great Comets of 1843, 1861, 1901, 1910, and 1927. We describe the perceptions of comets in Aboriginal societies and show that they are typically associated with fear, death, omens, malevolent spirits, and evil magic, consistent with many cultures around the world. We also provide a list of words for comets in 16 different Aboriginal languages.
Hamacher, Duane W.; Norris, Ray P.
We present 25 accounts of comets from 40 Australian Aboriginal communities, citing both supernatural perceptions of comets and historical accounts of historically bright comets. Historical and ethnographic descriptions include the Great Comets of 1843, 1861, 1901, 1910, and 1927. We describe the perceptions of comets in Aboriginal societies and show that they are typically associated with fear, death, omens, malevolent spirits, and evil magic, consistent with many cultures around the world. We also provide a list of words for comets in 16 different Aboriginal languages.
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
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.
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.
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
Greenhill, Nicola H.
The importance of communication skills for pharmacists has been widely acknowledged. Research has shown that the use of good communication skills can improve patient health outcomes but little research has focussed on communication within new consultation based roles of pharmacists. This study aimed to explore the communication between pharmacists and patients in clinic style consultations and to investigate participant perceptions of communication and consultations. Eleven pharmacists ...
Sankaranarayanan, Jayashri; Murante, Lori J.; Moffett, Lisa M.
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...
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.
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.
Kasbekar, Rupal; Maples, Meghan; Bernacchi, Ann; Duong, Linh; Oramasionwu, Christine U
Approximately 1.5 million medication errors occur each year in the United States. Older adults may be at increased risk for these errors as a result of a variety of contributing factors such as inappropriate medication use, polymorbidity, and complexities in managing dosage adjustments for geriatric patients. Pharmacists, as trained medication experts, are uniquely poised to lead efforts to prevent, detect, and resolve medications errors. As the American population continues to age, future pharmacists are likely to play an even greater role in promoting safe and effective medication use in older adults. In this paper, we highlight common settings for medication errors in older individuals, explore tools and solutions for error prevention, and outline the unique role that pharmacists have in preventing medication errors in older adults. PMID:25521659
Stratton, T P; Wu, B; Nakagawa, R S
Marketing theory is used to explain how Pharmacy Department managers at a Vancouver-area hospital secured a new ICU pharmacist position in a period of severe fiscal constraint. Market segmentation, target marketing and pull marketing strategy were combined to obtain support for the new position. Improved drug information services for ICU nurses were promoted to Nursing Administration and enhanced pharmacotherapy monitoring was promoted to the two critical care physicians primarily responsible for patient care in the ICU. These physicians and Nursing Administration voiced their support for the new position to the V.P. of Nursing (the functional officer for Pharmacy), who then promoted the new position to Hospital Administration. A half-time DUR commitment by the ICU pharmacist was offered to Hospital Administration, expanding this already successful service and guaranteeing cost recovery for the new position. Hospital Administration approved the new ICU clinical pharmacist position in a budget which saw other hospital departments lose several positions. PMID:10126865
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.
Benslimane, Nabila; Khalifa, Mohamed
High turnover rate among healthcare professionals is a very expensive price that healthcare organizations might pay if they don't have the proper strategies for motivating and satisfying their employees. Healthcare organizations should be able to identify areas that require more attention. Many studies discussed the vital link that bonds job satisfaction with motivation, which has a major impact on productivity, innovation, and overall organizational performance. Our study explored the level of job satisfaction and factors that motivate pharmacists in Saudi hospitals using mixed quantitative and qualitative methods. From pharmacy managers' point of view; financial rewards are more important than non-financial incentives and benefits. This contradicts with pharmacists' opinions; who ranked recognition, promotion, job satisfaction, job feedback, autonomy and task significance among the most influential motivators to pharmacists. These results show that managers need to revise their plans and provide further attention to ensure that effective motivation and retention strategies are put in place. PMID:27350504
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. PMID:25540194
Full Text Available Albert T Bach, Jeffery A Goad School of Pharmacy, Chapman University, Irvine, California, USA Abstract: Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home. Keywords: immunization, pharmacy practice, pharmacists, continuity of care
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.
Full Text Available Introduction: Gay and bisexual men (GBM with undiagnosed HIV are believed to contribute disproportionately to HIV transmission in Australia but national prevalence estimates have been lacking. Methods: From November 2013 to November 2014, we recruited men at gay venues and events in six Australian states and territories. Of 7291 survey participants, 3071 men also provided an oral fluid sample for testing and decided whether to receive their test results or not. We calculated raw and population-weighted prevalence estimates and identified associations with undiagnosed infection using logistic regression. Results: Of 3071 participants, 213 men tested HIV-positive (6.9%, 95% confidence interval [CI] 6.0 to 7.8%, of whom 19 (8.9%, 95% CI 5.8 to 13.5% were previously undiagnosed. After weighting for the size of the gay and bisexual male population in each state or territory, national HIV prevalence was estimated to be 7.2% (95% CI 6.3 to 8.1, of which 9.1% (95% CI 6.0 to 13.6% were estimated to be undiagnosed. Compared with HIV-negative participants, men with undiagnosed HIV were more likely to report meeting partners at sex venues, using antiretroviral drugs as pre-exposure prophylaxis, condomless anal intercourse with casual partners, using party drugs for sex, injecting drugs and using amyl nitrite, crystal methamphetamine or gamma hydroxybutyrate in the six months prior to the survey. Discussion: The results indicate that the prevalence of undiagnosed HIV is relatively low among Australian GBM but is higher among men who report riskier sex and drug practices. Conclusions: The results underline the importance of targeted HIV prevention and frequent testing for men at increased risk of infection.
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....
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
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…
Franklin, B D; O'Grady, K.; Donyai, P.; Jacklin, A.; Barber, N
It is likely that electronic prescribing will be a common feature in tomorrow’s hospitals. However, we do not yet know how its introduction will affect the practice of hospital pharmacists. We are evaluating a closed-loop electronic prescribing, automated dispensing, bar-coded administration system (ServeRx) on one surgical ward. As part of this evaluation, we wanted to explore its impact on the ward pharmacist. Our objectives were to assess the impact of ServeRx on the time spent providing a...
Conclusion: This study concludes that the current status of community pharmacy practice is below par. There is a need to involve more pharmacists at community level and develop awareness programs to counter patients′ routine drug issues and reducing the burden of disease from society.
Cotta, Menino O; Dulhunty, Joel M; Roberts, Jason A; Myburgh, John; Lipman, Jeffrey
Although there is a biological precedent for administration of β-lactam antibiotics by continuous or extended infusion, there is no definitive evidence of a survival benefit compared with intermittent administration. The aim of this study was to explore clinician uncertainty with regard to the administration of β-lactam antibiotics by continuous infusion. Doctors and pharmacists in Australian and New Zealand intensive care units (ICUs) were surveyed to investigate current β-lactam antibiotic administration practices as well as the degree of uncertainty regarding the benefit of continuous infusion of two commonly used broad-spectrum β-lactams, namely meropenem and piperacillin/tazobactam (TZP). There were 111 respondents to the survey. Intermittent infusion was reported as standard practice for meropenem (73.9%) and TZP (82.0%). A greater proportion of pharmacists compared with doctors believed continuous infusion to be more effective than intermittent administration (85.4% vs. 34.3%, respectively; P <0.001). Both groups reported uncertainty as to whether administration by continuous infusion resulted in better patient outcomes (65.9% and 74.6%, respectively; P = 0.85). Overall, 91.0% of respondents were prepared to enrol eligible patients into a definitive randomised controlled trial on β-lactam antibiotic administration. In conclusion, there is equipoise among clinicians working in Australian and New Zealand ICUs as to whether administration by continuous infusion offers a survival benefit in critically ill patients. PMID:27179814
Hamacher, Duane W
We explore 50 Australian Aboriginal accounts of lunar and solar eclipses to determine how Aboriginal groups understood this phenomenon. We summarise the literature on Aboriginal references to eclipses, showing that many Aboriginal groups viewed eclipses negatively, frequently associating them with bad omens, evil magic, disease, blood and death. In many communities, Elders or medicine men were believed to have the ability to control or avert eclipses by magical means, solidifying their role as provider and protector within the community. We also show that many Aboriginal groups understood the motions of the sun-earth-moon system, the connection between the lunar phases and tides, and acknowledged that solar eclipses were caused by the moon blocking the sun.
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
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 leveltext 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). PMID:26831812
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.
Australian Education Review (AER) 58 surveys the international and national research on the role and effect of arts-rich programming in schools and in the broader community, and examines the policies and practices that inhibit or support these initiatives. It puts the case that embedding the Arts in learning would be a powerful catalyst for…
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.
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)
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.
Yakop who ran a pharmacy in Istanbul was accused of malpractice in 1853. The pharmacist had prepared a bottle of cod liver oil for a patient and a bottle of croton oil for another one. He had neglected to label the bottles which were administered by mistake to the patients by his apprentice. The patient who drank a spoonful of croton oil was intoxicated immediately and died. As soon as the event was reported, the police asked the deceased person's family if they intended to sue the pharmacist. They did not. However, the police forces started an investigation and asked the School of Medicine whether the pharmacist was guilty. The School answered that the pharmacist had neglected to label the bottles and was found guilty of causing the death. The Supreme Court took up the matter and sentenced Mr. Yakop to six months imprisonment and decided to close his pharmacy. The decision was published in Takvim-i Vekayi, the official newspaper of the State. PMID:11624174
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
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
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.
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 educational intervention, including personal genotyping, was feasible, and positively enhanced students' reflections, and attitudes toward
Full Text Available Background and Objectives: A critically ill patient is treated and reviewed by physicians from different specialties; hence, polypharmacy is a very common. This study was conducted to assess the impact and effectiveness of having a clinical pharmacist in an Indian Intensive Care Unit (ICU. It also evaluates the clinical pharmacist interventions with a focus on optimizing the quality of pharmacotherapy and patient safety. Materials and Methods: The prospective, observational study was carried out in medical and surgical/trauma ICU over a period of 1 year. All detected drug-related problems and interventions were categorized based on the Pharmaceutical Care Network Europe system. Results: During the study period, average monthly census of 1032 patients got treated in the ICUs. A total of 986 pharmaceutical interventions due to drug-related problems were documented, whereof medication errors accounted for 42.6% (n = 420, drug of choice problem 15.4% (n = 152, drug-drug interactions were 15.1% (n = 149, Y-site drug incompatibility was 13.7% (n = 135, drug dosing problems were 4.8% (n = 47, drug duplications reported were 4.6% (n = 45, and adverse drug reactions documented were 3.8% (n = 38. Drug dosing adjustment done by the clinical pharmacist included 140 (11.9% renal dose, 62 (5.2% hepatic dose, 17 (1.4% pediatric dose, and 104 (8.8% insulin dosing modifications. A total of 577 drug and poison information queries were answered by the clinical pharmacist. Conclusion: Clinical pharmacist as a part of multidisciplinary team in our study was associated with a substantially lower rate of adverse drug event caused by medication errors, drug interactions, and drug incompatibilities.
Cowley, Paul [IT Power Australia (Australia)
This presentation mainly talks about the actions taken by the Australian country concerning the use of renewable energy and the reduction of the peak load in some areas. In the first part, there are found both the geographical aspects as well as the major political, e.g. Asia-Pacific Partnership on Clean development and Climate. There are also explained the issues related to peak load growth and it is shown a comparison graphic having information about the most used photovoltaic systems. Then, there are mentioned the communities that are testing one of the model photovoltaic systems in order to: reduce the peak load, use the energy in a properly way, reduce the energy cost, among others. Finally, it is succinctly explained the photovoltaic rebate program as well as the use of the off-grid systems, besides, it is given relevant information about those remote communities of Australia and the benefits of the implementation of Bushlight. [Spanish] Esta presentacion trata primordialmente de las acciones, referentes al uso de energia renovable, tomadas por Australia y creadas con el fin de reducir la maxima demanda en algunas regiones de este pais. En la primera parte, se encuentran tanto los aspectos geograficos como los principales aspectos politicos; por ejemplo, la Sociedad Asia-Pacifico para el Desarrollo no Contaminante y el Clima. Asimismo, se da una explicacion acerca de las cuestiones relacionadas al crecimiento de la maxima demanda; ademas, se muestra un cuadro comparativo, que contiene informacion relacionada con los sistemas fotovoltaicos mas utilizados. Despues, se mencionan aquellas comunidades que tienen en periodo de prueba alguno de los modelos fotovoltaicos con el fin de: reducir la maxima demanda, utilizar eficientemente la energia, reducir el costo de la misma, entre otros aspectos mas. Finalmente, se explica escuetamente el programa de reembolso centrado en el uso de sistemas fotovoltaicos, asi como el uso de sistemas asilados de la red; ademas, se
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.
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
Seale, Holly; Kaur, Rajneesh; Mahimbo, Abela; MacIntyre, C. Raina; Zwar, Nicholas; Smith, Mitchell; Worth, Heather; Heywood, Anita E
Background Migrant travellers who return to their country of origin to visit family and friends (VFR) are less likely to seek travel-related medical care and are less likely to adhere to recommended medications and travel precautions. Through this study, we aimed to get an understanding of the views of stakeholders from community migrant centres and primary care providers on barriers for migrants, particularly from non-English speaking backgrounds, in accessing travel health advice and the st...
O'Brien Jon; Paul Christine; Bonevski Billie; Bryant Jamie; Oakes Wendy
Abstract Background Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appro...
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 medication. We used two questionnaires to compare the results from the deaf participants with those from the HH and hearing participants. We found that before the lecture, the deaf participants' understanding of medication use was lower than that of the HH and hearing participants. The deaf participants' knowledge increased after the lecture, but did not improve to the level exhibited by the HH participants. However, the deaf participants felt confident using medication despite their low comprehension levels. In conclusion, adjusting the medication information provided by pharmacists according to the recipient's reading level could help improve deaf patients' knowledge; however, such measures might not increase deaf patients' comprehension levels sufficiently. PMID:27262170
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......-based patient interview and three follow-up telephone calls. There was no difference in the primary outcome, the composite medication possession ratio (MPR) for antiplatelets, anticoagulants and statins during the year after hospitalisation, as assessed by analysing prescription refill records. At 12 months...... to the one in the first study, except that the patient interview was more structured using the Drug Adherence Work-up (DRAW) tool and an adherence questionnaire for identifying potential adherence and lifestyle-related problems. At 12 months, 20.3% of the patients in the intervention group (N=231) were non...
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
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.
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
Al Motlaq, Khaled
When patients are discharged from hospital it is vital that the information regarding their medication is provided to the General Practitioner (GP) as accurately and efficiently as possible. However errors frequently occur and the NHS is currently investigating how to improve discharge systems, one approach is to use pharmacists to write discharge prescriptions or To Take Out (TTOs). The aim of the audit was to compare discrepancies on TTOs (To take out) between different transcribers: doctor...
Radley, A S; Hall, J; Farrow, M.; Carey, P J
AIMS--To compare the quality of outpatient anticoagulant control before and after the transfer of dosing responsibility to designated trained pharmacists from rotating junior medical staff. METHODS--All International Normalised Ratio (INR) values for an eight month period either side of the staff changeover were assessed for precision of therapeutic control according to described standards. Allowing for patient associated effects, observed and expected frequencies of "successful" control for ...
Pharmacy prescribing policy in Israel has been negotiated and changed in recent years in order to improve patient treatment and access to medicines, and reduce national health insurance costs by allowing pharmacists to prescribe medications. Various stakeholders and institutions were involved in the formulation process, affecting the process while representing different motives. The complexity of pharmacy prescribing policy formulation is universal - any policy project needs, for strategic an...
Preslaski, Candice R; Lat, Ishaq; MacLaren, Robert; Poston, Jason
Critical care pharmacy services in the ICU have expanded from traditional dispensing responsibilities to being recognized as an essential component of multidisciplinary care for critically ill patients. Augmented by technology and resource utilization, this shift in roles has allowed pharmacists to provide valuable services in the form of assisting physicians and clinicians with pharmacotherapy decision-making, reducing medication errors, and improving medication safety systems to optimize patient outcomes. Documented improvements in the management of infections, anticoagulation therapy, sedation, and analgesia for patients receiving mechanical ventilation and in emergency response help to justify the need for clinical pharmacy services for critically ill patients. Contributions to quality improvement initiatives, scholarly and research activities, and the education and training of interdisciplinary personnel are also valued services offered by clinical pharmacists. Partnering with physician and nursing champions can garner support from hospital administrators for the addition of clinical pharmacy critical care services. The addition of a pharmacist to an interprofessional critical care team should be encouraged as health-care systems focus on improving the quality and efficiency of care delivered to improve patient outcomes.
Gundersen, R; Torgauten, O; Olsen, H
Since 1995, parallel import of drugs to Norway has been allowed under the European Economic Area Agreement. The health authorities have stated that there are no concerns connected with the use of parallel-imported drugs. This study is an interview survey among general practitioners, pharmacy staff and pharmacists working in pharmacies. The findings show that 91% of the pharmacies dispense parallel-imported drugs and that there is a certain amount of scepticism regarding the use of parallel-imported drugs. Most respondents feel that parallel-imported pharmaceuticals may have financial advantages for the individual patient and economic advantages for society at large, but 50% of the pharmacists and 54% of the physicians were of the opinion that parallel-imported pharmaceuticals represented an increased medical risk for the patients. Approximately 15% of doctors and pharmacy staff had knowledge of either incorrect treatment or adverse drug reactions due to the use of parallel-imported drugs. The time used for prescribing and dispensing parallel-imported drugs is longer than for directly imported preparations. The survey shows that approximately every fifth doctor will use the right of reservation in connection with the dispensing of parallel-imported drugs, whereas approximately every fourth pharmacist will disregard the right of reservation. PMID:10385799
Full Text Available Melanie A Jordan, Jonathan HarmonCollege of Pharmacy – Glendale, Midwestern University, Glendale, AZ, USAAbstract: Obesity is currently a worldwide pandemic, with overweight (body mass index [BMI] ≥25 kg/m2 and obesity (BMI ≥30 kg/m2 estimated at 35% and 12% of the global adult population, respectively. According to data collected from the United States National Health and Nutrition Examination Survey, approximately 68.8% of US adults are overweight or obese. Additionally, a large burden of health care costs can be attributed directly to obesity as well as multiple, potentially preventable, comorbidities such as cancer, cardiovascular disease, and diabetes. As a result, national and international organizations, such as the US Centers for Disease Control and World Health Organization, have made halting the rise of the obesity epidemic a top priority. Pharmacists, commonly considered one of the most trustworthy and accessible health care professionals, are ideally situated to provide counseling for weight and lifestyle management. This review presents examples of pharmacist-led as well as collaborative practices that have been somewhat successful in educating and monitoring patient progress in attaining weight-loss goals. Common barriers and potential solutions to administration of lifestyle counseling and monitoring programs, such as limited pharmacist time and resources, lack of expertise and/or confidence in program administration, and patient perception and awareness, are also discussed.Keywords: pharmacy, obesity, counseling, weight loss, lifestyle management
Munger, M A; Green, J A; Greve, P A; Lovejoy, L S
The increased complexity of pharmacotherapeutics and the expanded role of pharmacists in the drug-use process may bring about an increased liability exposure for failure to conform to a professional standard of care. Therefore, a survey of 51 state pharmacy practice acts was conducted: (1) to establish a nationwide statutory definition of pharmacy practice, and (2) to outline possible use of the statutes in civil and administrative law. Twenty percent of state statutes contain no definition of pharmacy practice. Of the remaining 41 states, dispensing (97.5 percent), compounding (92.5 percent), interpretation and evaluation of prescriptions (68.2 percent), and consultation (73 percent) are legally defined. Pharmacokinetic consultation, drug administration, pharmacist prescribing, and pharmaceutical research are defined in one, seven, four, and one state(s), respectively. Pharmacists may face legal responsibilities from both the courts and state boards of medical and pharmacy practice. Aggressively updating the statutes and regulations to reflect contemporary pharmacy practice may provide a mechanism for a defense in court litigation and regulatory action.
Wang, Zhiqiang; Hoy, Wendy E.
Objective To determine whether the association between obesity and coronary heart disease (CHD) in Aboriginal adults depends on age. Design, setting and participants A cohort study with up to 20 years of follow-up of 849 participants aged 18–76 years in a remote Aboriginal community in the Northern Territory of Australia. Main outcome measures Newly diagnosed CHD cases were identified through hospital records according to ICD codes during the follow-up period. Cox proportional hazard model wa...
Deborah Mitchison; Alexandre Morin; Jonathan Mond; Shameran Slewa-Younan; Phillipa Hay
Objective Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD). Method Structural equation modeling was applied to longitudinal data collected from a community s...
Norris, Ray P
The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes, such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees.
Gu NY; Gai Y; Hay JW
There are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. Objectives: The objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. Methods: We analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in Kaiser Permanente Southern California fro...
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, pharmacists were also able to achieve their objectives - geographical expansion of their officially recognized monopoly and the safeguarding of the pharmacist's key role in the dispensing of drugs, including proprietary ...
Sebastiaan Rothmann; Madeleine Malan
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-rel...
Bishop, Lisa; Young, Stephanie; Twells, Laurie; Dillon, Carla; Hawboldt, John
Background A pharmacist managed anticoagulation service was initiated in a multi-physician family medicine clinic in December 2006. In order to determine the patient and physician satisfaction with the service, a study was designed to describe the patients’ satisfaction with the warfarin education and management they received from the pharmacist, and to describe the physicians’ satisfaction with the level of care provided by the pharmacist for patients taking warfarin. A self-administered sur...
Brolan, Claire E.; Gomez, Miriam Taylor; Lennox, Nicholas G.; Ware, Robert S.
The authors review available data on Australians from a non-English speaking background (NESB) with intellectual disability (ID). They find that intellectual disability in the Australian NESB community has received limited attention in terms of both qualitative and quantitative research. The existing literature is over 10 years old and is relevant…
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
Wiegel, Joshua J; Olyaei, Ali J
Pharmacists may play a key role on the multidisciplinary transplant team. This article describes the development and current status of pharmacists in the management of transplant recipients in the United States. Traditionally, pharmacists played an important support role in transplant medicine. This role has been expanded to include direct patient care for the avoidance, detection, and/or treatment of side effects from the polypharmacy necessary in the management of these complex patients. Pharmacists provide pre- and post-transplant education to transplant recipients to enhance adherence to complicated medical regimens and thereby reduce readmission to hospital and unscheduled, costly visits to urgent care centers and/or hospital emergency departments. PMID:27555676
Sharpley, Christopher F.
Full Text Available Aim. Although both have shown significant effects upon depression in clinical samples, no direct comparison has been reported of the relative power of psychological resilience and the short form of the serotonin transporter gene 5-HTTLPR as predictors of depression in a community sample. Material and methods. In a sample set by a priori power analysis, 67 adult females and 59 adult males were used to enable a comparison between a single genetic factor, childhood stressors, recent stressors, psychological resilience and depression. Results. None of genotype, childhood or recent stressors was significantly associated with depression scores, but resilience was a significant inverse predictor of depression scores and also of the presence of clinically significant depression. Discussion. These data suggest that measures of an individual’s ability to resist or recover from stress may be useful in assessing vulnerability to depression when used with ‘at risk’ individuals in everyday practice.
Bullen, Tracey; Rosenberg, John P; Smith, Bradley; Maher, Kate
Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care. PMID:24871345
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
The Australian Natural Disaster Resilience Index Martin Thoms, Melissa Parsons, Phil Morley Bushfire and Natural Hazards Cooperative Research Centre, Geography and Planning, University of New England, Armidale NSW 2351, Australia. Natural hazard management policy directions in Australia - and indeed internationally - are increasingly being aligned to ideas of resilience. Resilience to natural hazards is the ability of individuals and communities to cope with disturbance and adversity and to maintain adaptive behaviour. Operationalizing the measurement and assessment of disaster resilience is often undertaken using a composite index, but this exercise is yet to be undertaken in Australia. The Australian Natural Disaster Resilience Index is a top-down, national scale assessment of the resilience of communities to natural hazards. Resilience is assessed based on two sets of capacities: coping and adaptive capacities. Coping capacity relates to the factors influencing the ability of a community to prepare for, absorb and recover from a natural hazard event. Adaptive capacity relates to the arrangements and processes that enable adjustment through learning, adaptation and transformation. Indicators are derived under themes of social character, economic capital, infrastructure and planning, emergency services, community capital, information and engagement and governance/leadership/policy, using existing data sets (e.g. census data) or evaluation of policy and procedure (e.g. disaster management planning). A composite index of disaster resilience is then computed for each spatial division, giving national scale coverage. The results of the Australian Natural Disaster Resilience Index will be reported in a State of Disaster Resilience report, due in 2018. The index is co-designed with emergency service agencies, and will support policy development, planning, community engagement and emergency management.
In providing a continued focus on tasks and activities that help to illustrate key ideas embedded in the new Australian Curriculum, the focus in this issue is on Measurement in the Measurement and Geometry strand. The small unit of work on measurement presented in this article has activities that can be modified to meet the requirements of…
The Australian National University was established by Federal Parliament in 1946 with a mission to bring credit to the nation and to be one of the world’s great universities.It was the country’s only full-time research university at the time,and had no undergraduate teaching responsibilities.
Warren, M. J.; W. Hutchinson
The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.
Oliver, Brittany A
Community service provides pharmacy students with invaluable opportunities for professional growth in communication, organization, and practice skills. Furthermore, students develop relationships with practicing pharmacists, which leads to influential mentoring and networking opportunities. While building students’ confidence and skills, these endeavors can have significant impact on community members’ lives.
Tett Susan E
Full Text Available Abstract Background Multicentre drug use evaluations are described in the literature infrequently and usually publish only the results. The purpose of this paper is to describe the experience of Queensland hospitals participating in the Community-Acquired Pneumonia Towards Improving Outcomes Nationally (CAPTION project, specifically evaluating the implementation of this project, detailing benefits and drawbacks of involvement in a national drug use evaluation program. Methods Emergency departments from nine hospitals in Queensland, Australia, participated in CAPTION, a national quality improvement project, conducted in 37 Australian hospitals. CAPTION was aimed at optimising prescribing in the management of Community-Acquired Pneumonia according to the recommendations of the Australian Therapeutic Guidelines: Antibiotic 12th edition. The project involved data collection, and evaluation, feedback of results and a suite of targeted educational interventions including audit and feedback, group presentations and academic detailing. A baseline audit and two drug use evaluation cycles were conducted during the 2-year project. The implementation of the project was evaluated using feedback forms after each phase of the project (audit or intervention. At completion a group meeting with the hospital coordinators identified positive and negative elements of the project. Results Evaluation by hospitals of their participation in CAPTION demonstrated both benefits and drawbacks. The benefits were grouped into the impact on the hospital dynamic such as; improved interdisciplinary working relationships (e.g. between pharmacist and doctor, recognition of the educational/academic role of the pharmacist, creation of ED Pharmacist positions and enhanced involvement with the National Prescribing Service, and personal benefits. Personal benefits included academic detailing training for participants, improved communication skills and opportunities to present at
Rubio-Valera, Maria; March Pujol, Marian; Fernández, Ana; Peñarrubia-María, M Teresa; Travé, Pere; López Del Hoyo, Yolanda; Serrano-Blanco, Antoni
Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medication-free gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant. Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status. PMID:23219937
Full Text Available This paper has a purpose and that purpose is to tell a story. An important story. A story that will sadden you and perhaps give rise to dismay. But it’s not a story about a princess. This story takes place, not in the glitz and glamour of Europe with fast cars, great shopping and an avid and enthusiastic paparazzi, but rather in the desert of Central Australia where you need a good four-wheel drive to get home on the dusty roads, where shopping is limited to the basics at the local store, but where people are still avidly following the life and times of the ‘Princess of our hearts’. This paper will tell this story and for many reading this, the story will be enough, for much of what I will say is self-evident, so much so that it seems almost ludicrous to have to analyse the impact of the events I will describe. However, in the interests of academic analysis and to further understand and appreciate the impact of these events, I will firstly frame the context of emergent literacy, give the background to the story and detail the findings of some research which I undertook within this community. Finally, I present the broader implications of these findings and make some recommendations.
Thomas L. Lenz, PharmD; Jessica Skradski, PharmD; Maryann Z. Skrabal, PharmD, CDE; Liz Ferguson, MA; Michael S. Monaghan, PharmD, BCPS
Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drugtherapy for patients with chronic diseases can be improved through medication therapy management (MTM) services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to mo...
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
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
Havlicek, Anthony James; Mansell, Holly
As the Canadian population continues to age, the incidence of cancer is on the rise. To help alleviate the burden malignancy imposes on our health care system, a shift toward early cancer detection is necessary. Pharmacists are well positioned and willing to assume a more active role in cancer surveillance. Patients are receptive to pharmacist involvement and seem to prefer a convenient community pharmacy–based location for screening programs. The community pharmacist’s current and potential role in cancer screening and prevention is summarized in this article. A review of screening recommendations and a discussion of opportunities will hopefully inspire pharmacists to consider incorporating malignancy screening initiatives into their practice.
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.
Mansur, Jeannell M
Preventable medication-related adverse events continue to occur in the healthcare setting. While the Institute of Medicine's To Err is Human, published in 2000, highlighted the prevalence of medical and medication-related errors in patient morbidity and mortality, there has not been significant documented progress in addressing system contributors to medication errors. The lack of progress may be related to the myriad of pharmaceutical options now available and the nuances of optimizing drug therapy to achieve desired outcomes and prevent undesirable outcomes. However, on a broader scale, there may be opportunities to focus on the design and performance of the many processes that are part of the medication system. Errors may occur in the storage, prescribing, transcription, preparation and dispensing, or administration and monitoring of medications. Each of these nodes of the medication system, with its many components, is prone to failure, resulting in harm to patients. The pharmacist is uniquely trained to be able to impact medication safety at the individual patient level through medication management skills that are part of the clinical pharmacist's role, but also to analyze the performance of medication processes and to lead redesign efforts to mitigate drug-related outcomes that may cause harm. One population that can benefit from a focus on medication safety through clinical pharmacy services and medication safety programs is the elderly, who are at risk for adverse drug events due to their many co-morbidities and the number of medications often used. This article describes the medication safety systems and provides a blueprint for creating a foundation for medication safety programs within healthcare organizations. The specific role of pharmacists and clinical pharmacy services in medication safety is also discussed here and in other articles in this Theme Issue. PMID:26932714
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.
Locke, S. Jack
The pharmacist-physician-patient relationship is discussed as well as factors that affect the prescribing and dispensing of drugs. It is suggested that pharmacists coordinate their efforts with those of the physicians by taking a more active role in serving their customers. (SF)
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…
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…
Full Text Available The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.
Full Text Available Vivienne SL Mak,1,2 Geoff March,2 Alice Clark,2 Andrew L Gilbert21Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 2Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: A key objective of Australia's health care reform is a skilled, flexible, and well-trained workforce. To meet these requirements, the training of health professionals, including pharmacists, needs to be focused on patient care processes, and students must develop competencies in the delivery of patient care. Pharmacy graduates need to be well prepared for new and alternative career pathways through their education and training, to be a part of the future workforce. This study explores Australian intern pharmacists' perceived preparedness for practice, the match between their expectations and experience to meet the requirements of health professionals in Australia's health care reforms, and their future career intentions.Methods: Two questionnaires were sent by post to all 136 intern pharmacists in South Australia; one was sent early in their internship and the second follow-up questionnaire was sent near the completion of their internship.Results: Pharmacy graduates felt prepared for patient care, medicines information, and primary health care roles. A mismatch between expectations and actual experiences was found. By the end of the internship, 45% agree/strongly agree that they wanted to do something else other than being a practicing pharmacist.Conclusion: The current internship model no longer meets the needs and expectations of knowledgeable and skilled pharmacy graduates. An alternative internship model, which considers the expectations of graduates, is required.Keywords: intern pharmacist, preparedness, expectations, experiences, internship, future career
Meyer, Grischa R. [Monash University, Clayton, Victoria 3800 (Australia); Aragão, David; Mudie, Nathan J.; Caradoc-Davies, Tom T. [Australian Synchrotron, 800 Blackburn Road, Clayton, Victoria 3168 (Australia); McGowan, Sheena; Bertling, Philip J.; Groenewegen, David; Quenette, Stevan M. [Monash University, Clayton, Victoria 3800 (Australia); Bond, Charles S. [The University of Western Australia, 35 Stirling Highway, Crawley 6009, Western Australia (Australia); Buckle, Ashley M. [Monash University, Clayton, Victoria 3800 (Australia); Androulakis, Steve, E-mail: email@example.com [Monash Bioinformatics Platform, Monash University, Clayton, Victoria 3800 (Australia)
The Store.Synchrotron service, a fully functional, cloud computing-based solution to raw X-ray data archiving and dissemination at the Australian Synchrotron, is described. The Store.Synchrotron service, a fully functional, cloud computing-based solution to raw X-ray data archiving and dissemination at the Australian Synchrotron, is described. The service automatically receives and archives raw diffraction data, related metadata and preliminary results of automated data-processing workflows. Data are able to be shared with collaborators and opened to the public. In the nine months since its deployment in August 2013, the service has handled over 22.4 TB of raw data (∼1.7 million diffraction images). Several real examples from the Australian crystallographic community are described that illustrate the advantages of the approach, which include real-time online data access and fully redundant, secure storage. Discoveries in biological sciences increasingly require multidisciplinary approaches. With this in mind, Store.Synchrotron has been developed as a component within a greater service that can combine data from other instruments at the Australian Synchrotron, as well as instruments at the Australian neutron source ANSTO. It is therefore envisaged that this will serve as a model implementation of raw data archiving and dissemination within the structural biology research community.
Many Australian Aboriginal people use a sign language ("hand talk") that mirrors their local spoken language and is used both in culturally appropriate settings when speech is taboo or counterindicated and for community communication. The characteristics of these languages are described, and early European settlers' reports of deaf Aboriginal…
Choi, Tammie S. T.; Walker, Karen Z.; Ralston, Robin A.; Palermo, Claire
Objective: The aim of this study was to evaluate a type 2 diabetes education programme for Chinese Australians, based on the experience of participants and by exploring the unique needs of Chinese patients, their health beliefs and their cultural behaviours. Design and setting: A qualitative ethnographic study was undertaken in a community health…
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.
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.
Hussainy, Safeera Yasmeen; Ghosh, Ayesha; Taft, Angela; Mazza, Danielle; Black, Kirsten Isla; Clifford, Rhonda; Mc Namara, Kevin Peter; Ryan, Kath; Jackson, John Keith
Introduction The rate of unplanned pregnancy in Australia remains high, which has contributed to Australia having one of the highest abortion rates of developed countries with an estimated 1 in 5 women having an abortion. The emergency contraceptive pill (ECP) offers a safe way of preventing unintended pregnancy after unprotected sex has occurred. While the ECP has been available over-the-counter in Australian pharmacies for over a decade, its use has not significantly increased. This paper presents a protocol for a qualitative study that aims to identify the barriers and facilitators to accessing the ECP from community pharmacies in Australia. Methods and analysis Data will be collected through one-on-one interviews that are semistructured and in-depth. Partnerships have been established with 2 pharmacy groups and 2 women's health organisations to aid with the recruitment of women and pharmacists for data collection purposes. Interview questions explore domains from the Theoretical Domains Framework in order to assess the factors aiding and/or hindering access to ECP from community pharmacies. Data collected will be analysed using deductive content analysis. The expected benefits of this study are that it will help develop evidence-based workforce interventions to strengthen the capacity and performance of community pharmacists as key ECP providers. Ethics and dissemination The findings will be disseminated to the research team and study partners, who will brainstorm ideas for interventions that would address barriers and facilitators to access identified from the interviews. Dissemination will also occur through presentations and peer-reviewed publications and the study participants will receive an executive summary of the findings. The study has been evaluated and approved by the Monash Human Research Ethics Committee. PMID:26656987
The Australian Centre for Minesite Rehabilitation Research (ACMRR) is a joint venture between the Australian mining industry through the Australian Mineral Industries Research Association Ltd. (AMIRA) and three of the organizations working most actively in this area in Australia: CSIRO Minesite Rehabilitation Research Program; University of Queensland Centre for Mined Land Rehabilitation; and Curtin University Mulga Research Centre. The ACMRR was established in July 1993 to provide a national framework to conduct Strategic Research into minesite rehabilitation. It is an industry led and funded initiative. The Goals of the Centre include: to conduct strategic research into minesite rehabilitation to provide sustainable environmental solutions which are acceptable to industry, government and the community; to be recognized as a center of excellence undertaking commissioned research on minesite rehabilitation in an independent and thorough manner; to provide scientific and technological foundations to facilitate industry and government in setting acceptable standards; to act as networking and communications focus; and to enhance education and training in minesite rehabilitation. Strategic Research Programs in: Water Systems--downstream surface and groundwater quality; Land--the long-term behavior and stability of constructed landforms; Ecosystems--the long-term sustainability of constructed landforms; Waste--the long-term treatment and disposal of waste products; will allow the ACMRR to achieve these goals through specific research projects in these areas, developed with industry sponsors. This paper will discuss their progress to date, research projects underway, and plans for the future
Full Text Available Michael Taitel1, Jenny Jiang1, Kristi Rudkin2, Susan Ewing2, Ian Duncan 1Clinical Outcomes and Analytics, Walgreens, 2Corporate Innovation Team, Walgreens, Deerfield, Illinois, USAPurpose: To evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT for statin medications.Patients and methods: This retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR, categorical MPR, and medication persistency.Results: After adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2% and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%; this 4.9% difference is significant (P < 0.01. The 12 month categorical MPR also showed significant differences between groups (χ2 = 6.12, P < 0.05; 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.Conclusion: Patients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the
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.
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.
Inoue, Yutaka; Morita, Yuki; Takikawa, Mayu; Takao, Koichi; Kanamoto, Ikuo; Sugibayashi, Kenji
It is important to share information about other countries' pharmacists to optimize cross-border medical cooperation. This paper examines the dispensing systems and the work done by pharmacists in the United Kingdom, Germany, France, Thailand, and Malaysia so as to compare these countries' medical practices and develop a cohesive vision for the future of Japanese pharmacists. All five of the countries have dispensing assistants. Pharmacists in Japan have duties of inventory control, drug dispensing, and providing medication advice. In contrast, assistants working in other countries are responsible for some aspects of dispensing and inventory control, allowing the pharmacists to spend their time and competency in instructing patients on how to take their medication. Because of this, pharmacists were actively involved with health promotion intervention in the United Kingdom, Germany, and France. It is hoped that work done by Japanese pharmacists would transition from primarily dispensing drugs to patient care, advice, and counseling to enrich overall health promotion and health/nutrition counseling. PMID:25443642
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
Mishra, Archana; Saxena, Pikee
Introduction Pharmacists play a key role while dispensing over-the-counter emergency contraception (EC) to the client. Aims The study aims to evaluate the knowledge and over-the-counter services provided by the pharmacists in Delhi. Methods A prestructured questionnaire-based survey was conducted in Delhi, the capital city of India. Results Only 60 out of 85 pharmacies approached agreed to participate in the study. Number of packs sold in a month per pharmacy varied from 2 to 500 packs/month. Sixty-two percent of the pharmacists claimed that majority of the clients repeated use during the same month. Only 18% of the clients were referred by doctors while 82% directly approached the pharmacists. Nearly one third of the clients were adolescents. Sixty-seven percent of the pharmacists had adequate knowledge about EC. Only 3.3% asked about the last menstrual period or the time elapsed since the last unprotected intercourse. No pharmacist inquired whether there were one or multiple unprotected acts of intercourse, if any regular contraceptive method was being used, or explored the reason for EC intake. There were 91.7% who explained the dosage schedule to clients. Only half of them explained that the client may experience side effects. None of the pharmacists advised their clients for a sexually transmitted disease screening, and 35% counseled the clients regarding regular contraception. Conclusion Improving the quality of services provided by the pharmacists can clear misconceptions of the clients and promote subsequent regular contraception along with precautions to avoid sexually transmitted diseases. Mishra A and Saxena P. Over-the-counter sale of emergency contraception: A survey of pharmacists in Delhi. Sex Med 2013;1:16–20. PMID:25356282
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
Bushra, Rabia; Baloch, Saba Ajaz; Jabeen, Aisha; Bano, Nusrat; Aslam, Nousheen
Adverse drug reactions (ADRs) are the undesirable effects of drugs even when administered in daily normal doses. It has been seen that ADRs may arise even after single administration of drug(s), however, long term therapies are more prone to ADRs. Currently it has become a burning issue all around the world and connected with financial expansion owing to hospitalization. Pharmacists are the custodians of drugs especially clinical pharmacists play a vital role in preventing the risks of ADRs. This review deals with the factors leading to possible ADRs, its prevention and the role of pharmacist in management of ADRs.
Foppe van Mil, J W; Westerlund, Tommy; Brown, Lawrence; Chen, Timothy F; Henman, Martin; Hersberger, Kurt; McElnay, James; Schulz, Martin
Optimal communication between physicians and pharmacists is important for patient care. However, pharmacists and doctors do not always seem to understand each other. They have been professionalized differently, and do not always speak the same language. Especially in the areas of prescribing, medication review, and medicine use, there can be differences in views. This contribution clarifies some essential concepts that doctors and pharmacists use. Thus we hope that our commentary contributes to a better understanding of each other's role and the importance of interprofessional cooperation for the benefit of the patient. PMID:26797769
The discussion traces the evolution of Australian migration policy since 1975, arguing that the primary factor shaping policy has been interparty competition for influence within Australia's ethnic communities. Since late 1975 when the Liberal/National Country Party (LibNCP) Conservative Government returned to power, Australian immigration policy has moved in different directions from the previous post World War II experience. The demographic implications have been profound. In 1975 the LibNCP government returned to office committed to restoring an active migration program. By 1980-81 it had largely succeeded in this numerical goal. Australia's migration growth rate at .82% of the total population exceeded almost all other Western society. What was new, in comparison to previous policy, was the migrant selection system and source countries. By the time the government lost office in March 1983, family reunion had become the major migration program souce and Asia was rapidly becoming the dominant place of migrant origin. This emphasis on family reunion was not intended by government immigration planners but was a product of domestic political change and resultant new influences over migration policy. As to the increasing Asian component, it has mainly been an unintended consequence of the expansion in the family reunion program. Although the liberalization of family reunion eligibility has largely been designed to appease the major Southern European ethnic communities, few applications have been forthcoming from these countries. Asian applicants have been numerous. Labor government policy since March 1983 has shown remarkable continuity with that of the LibNCP both in its selection system and in the size of the migrant intake. The motivation for the commitment to immigration derived first from longstanding traditions within the Australian business community that Australia's economic growth and dynamism depended on rapid population growth. More specifically there
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...... data, (2) collection of information about the patient's medical treatment, (3) patient interview, (4) critical examination of the patient's medications and (5) recommendations for the hospital physician.Conclusions We have provided a detailed description of a procedure for pharmacist-led medication...... review. We do so, 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....
Throughout the Qing dynasty, the commodity economy and domestic distribution in China developed dramatically. In this context, the market of Chinese medicines also expanded. At that time, the Zhang-shu-zhen pharmacists, in Jiangxi province, took the initiative in this market. This article explores their activities which were spread across China and it also examines the level of success or failure of their activities as well as the economical impact to the society of Zhang-shu-zhen. Due to its location between two important rivers that were used extensively for trade and their technical proficiency in pharmacy, Zhang-shu-zhen became an emporium of medicines. Nevertheless, many of the druggists were active in the southwest provinces of China. In order words, the activities of the druggists were coupled with the movement of immigration, from midland China to the southwest. PMID:22164690
Farmacevtske kognitivne storitve pri zdravljenju z zdravili - pogled farmacevta svetovalca v ambulanti: Pharmaceutical cognitive services in pharmacotherapy - pharmacist's consultant perspective at an ambulance:
Premuš Marušič, Alenka
Pharmacist cognitive services in different countries in Europe and around the world are carried out in various ways. The range of responsibilities of clinical pharmacists is ranging from prescribing medicine in the United Kingdom and the United States, to pharmacotherapy groups and pharmacist consultant in the Netherlands. Pharmacotherapy Groups and Clinical Pharmacist's Consultation is a currently ongoing development program in Slovenia. Within the program, the clinical pharmacist reviews th...
Waterworth, Pippa; Dimmock, James; Pescud, Melanie; Braham, Rebecca; Rosenberg, Michael
The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians include socio-economic factors, racism, and history. The current study focused on exploring Indigenous participants' perspectives of the factors that affect the health behavior of their community members. Participatory action research methodology and a grounded theory approach were utilized. In total, 120 members of two urban West Australian Indigenous communities participated in focus group discussions. There was substantial similarity between the themes that emerged within the discussions held in the two communities. Factors relating to culture, social connections, racism, communication, and personal aspects were particularly salient to health behavior of the participants. Several of the themes including culture, racism, communication, and distrust highlight the tension caused by being a member of a minority cultural group that has been marginalized by the practices and attitudes of the dominant cultural group. Personal choice was sometimes prioritized over health. PMID:25847855
Two types of 'Big Science' research facility - synchrotron radiation sources and intense neutron beams - are now recognised as essential resources for a wide range of research activities in chemistry, physics and biology. The cost of such facilities and the lack of a sufficiently large user base will probably preclude their construction in Australia in the foreseeable future. The needs of Australian crystallographers for access to such facilities are assessed. In relation to synchrotron radiation sources, the Committee considered only the question of access to such facilities overseas. In relation to neutron beam sources, the Committee's inquiries included not only the question of access to powerful facilities overseas but also the special problems which confront Australian crystallographers as a result of the obsolescence of the HIFAR reactor. The arguments about, and options for, funding Australian use of facilities overseas are presented. The Committee concluded there is a strong case for the purchase of a beam-line at an overseas synchrotron radiation facility and a strong, though less urgent, case for substantial Australian involvement in an overseas neutron beam facility. The Committee recommended that the Australian HIFAR reactor be refurbished in its present shell, retaining the present flux and power levels, and that in the upgrading of the neutron scattering instrumentation at HIFAR special consideration be given to including items which are sufficiently specialised to attract the international neutron scattering community
Lyra DP Jr
Full Text Available Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and affects a large portion of the world’s population. People generally use over-the-counter medications to treat headaches and other minor symptoms. A pharmacist should help patients choose the most effective, safe, and convenient pharmacotherapeutic option. Objective: To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach. Methods: A cross-sectional study was conducted from March 2010 to July 2010. Data were obtained from a convenience sample consisting of one pharmacist from each of the 24 participating community pharmacies. In order to evaluate the pharmacists’ counselling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro camera, and these recordings were analysed using a validated questionnaire. Results: Of the 24 evaluated pharmacists, 19 (79.1% were women. Information was spontaneously provided by 15 (62.5% pharmacists. At least one question was asked by the pharmacist to assess the signs and symptoms. Most pharmacists (n=17, 70.8% recommended sodium dipyrone, either alone or in combination with other drugs. The most discussed items in the simulation visits were contraindications (n=17, 70.8%, indications (n=10, 41.6%, and drug administration times (n=8, 33.3%. None of the pharmacists recommended any non-pharmacological therapeutic alternatives. The overall impressions of the pharmacists’ professional counselling skills ranged from poor to fair. Conclusion: This study showed that the pharmacists’ counselling skills and the guidance provided by the pharmacists to the simulated patient were insufficient for the satisfactory management of headache.
Perepelkin, Jason; Abramovic, Melissa
Recent public opinion polls consistently rank pharmacists as highly trusted health care professionals, but the reasoning for this ranking continues to remain vague and inconclusive. One possible explanation for this high ranking is that it is due in part to the limited expectations the public has of the profession. To gather comparative "before" and "after" data for this study, a self-administered, 33-item paper questionnaire was disseminated to 382 postsecondary (undergraduate) business students in a classroom setting. The questionnaire was designed to assess respondents' baseline perceptions toward (1) the pharmacy profession, in general, and (2) a prerecorded video of a simulated patient-pharmacist counseling session. Most respondents initially reported a "Poor/Fair" understanding of pharmacist education and training (52.1%), what to expect when having a prescription dispensed (55.5%), the content of a counseling session (49.7%), and pharmacist scope of practice (55.5%). After viewing the educational video, the number of respondents who reported a "Poor/Fair" understanding dropped to less than 5%; the majority of respondents reported a "Very Good/Excellent" understanding of pharmacist education and training (63.1%), what to expect when having a prescription dispensed (56.0%), the content of a counseling session (66.4%), and pharmacist scope of practice (60.5%). Results of this study demonstrated that using a public education-type video to increase public awareness for the pharmacy profession and pharmacist counseling duties significantly impacted respondents' knowledge and perception of value toward the profession and of pharmacist counseling. PMID:26642817
Shamala Ayadurai; H. Laetitia Hattingh; Tee, Lisa B.G.; Siti Norlina Md Said
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, na...
Nadir Kheir, Hoda Y Gad, Safae E Abu-Yousef College of Pharmacy, Qatar University, Al Tarfa, Doha, Qatar Objectives: To explore knowledge and attitude of pharmacists in Qatar towards natural health products (NHPs). Methods: The quantitative component of this study consisted of an anonymous, online, self-administered questionnaire to assess knowledge about NHPs among pharmacists in Qatar. Descriptive statistics and inferential analysis were conducted using Statistical Package of Social Scienc...
Jussara Calmon Reis de Souza Soares
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 c...
Sargent, Randall; Brocklebank, Cynthia; Tam-Tham, Helen; Williamson, Tyler; Quail, Patrick; Turner, Diana; Drummond, Neil
Background Warfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care. Methods This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio ...
Herxheimer, Andrew; Davies, Charles
Patients may receive information about their medicine from the prescriber, the pharmacist and the manufacturer (in a package insert). If it is to be used effectively, all this information must be integrated: the different sources should complement, and not seem to contradict one another. Prescribers and pharmacists should therefore have at hand the text of any package inserts that patients will receive with prescribed medicines. In addition, doctors might be helped by an aide-mémoire, remindi...
Auta, A; Strickland-Hodge, B; Maz, J; Alldred, DP
Background: Non-medical professionals including pharmacists have been granted the right to prescribe medicines in the United Kingdom. In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines and patients' access to prescriptions can be seriously affected by a shortage of prescribers and long waiting times in hospitals. Objective: This article presents a review of pharmacist prescribing in the UK including its model, impa...
Lowrie, R.; Mair, F S; Greenlaw, N.; Forsyth, P.; Jhund, P.S.; McConnachie, A.; Rae, B.; McMurray, J.J.V.
Background Meta-analysis of small trials suggests that pharmacist-led collaborative review and revision of medical treatment may improve outcomes in heart failure. Methods and results We studied patients with left ventricular systolic dysfunction in a cluster-randomized controlled, event driven, trial in primary care. We allocated 87 practices (1090 patients) to pharmacist intervention and 87 practices (1074 patients) to usual care. The intervention was delivered by non-specialist pharmac...
Hosmane, Sharath R.; Tucker, Johanna; Osman, Dave; Williams, Steve; Waterworth, Paul
Background Warfarin prescription for anticoagulation after cardiac surgery has always been a challenge for junior medical staff. Methods A prospective study was carried out to assess the quality of anticoagulation control by junior doctors compared with clinical pharmacists at South Manchester University hospitals NHS Trust. The junior medical staff prescribed warfarin for 50 consecutive patients from April to September 2006 (group A, n = 50) and experienced clinical pharmacists dosed 46 cons...
Broom, Alex; Plage, Stefanie; Broom, Jennifer; Kirby, Emma; Adams, Jon
Background Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance (AMR). The impact of Antimicrobial Stewardship (AMS) programs seeking to preserve viable antibiotic drugs by governing their use in hospitals has hitherto been limited. Pharmacists have been delegated a critical role in antibiotic governance in AMS teams within hospitals but the experience of pharmacists in influencing antibiotic use has received limited attention...
Sarah M. Westberg, Pharm.D.; Kathrine Beeksma, R.N.
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, includ...
Kocarnik Beverly Mielke; Liu Chuan-Fen; Wong Edwin S; Perkins Mark; Maciejewski Matthew L; Yano Elizabeth M; Au David H; Piette John D; Bryson Chris L
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 s...
Media promotion of the ideal body as slimness for women and muscularity for men, has led to increasing numbers of both genders reporting dissatisfaction with their bodies and trying to change using weight control products. It has been suggested that pharmacists can play a key role in promoting healthy lifestyles and weight management. The main aim of the research study was to examine the impact of media on body image perception and to investigate the role of pharmacists in weight man...
Introduction and aim It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. The aim of this study was to evaluate a controlled trial of pharmacist-led intervention in general practice to determine whether intervention practices made savings relative to controls and if so, exactly how these savings were made and whether quality of prescribing was maintain...
Richard Hooper1, Abdullah Adam2, Nadir Kheir31Medical Services Department, 2Pharmacy Department, Medical Services, Qatar Petroleum, Doha, Qatar; 3Qatar University, College of Pharmacy, Doha, QatarObjectives: To characterize prescribing error interventions documented by pharmacists in four pharmacies in a primary health care service in Qatar.Methods: The study was conducted in a primary health care service in the State of Qatar in the period from January to March 2008. Pharmacists in four clin...
Latter, Sue; Smith, Alesha; Blenkinsopp, Alison; Nicholls, Peter G.; Little, Paul; Chapman, Stephen
OBJECTIVES: Legislation and health policy enabling nurses and pharmacists to prescribe a comprehensive range of medicines has been in place in the UK since 2006. Our objective was to evaluate the clinical appropriateness of prescribing by these professionals. METHODS: A modified version of the Medication Appropriateness Index (MAI) was used by 10 medical, seven pharmacist and three nurse independent raters to evaluate a sample of 100 audio-recorded consultations in which a medicine was pr...
Rodgers, S.; Avery, A J; Meechan, D; Briant, S; Geraghty, M.; Doran, K; Whynes, D K
BACKGROUND: It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. AIM: To determine whether intervention practices made savings relative to controls. METHOD: An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to...
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.
Full Text Available Background Utilisation of the electronic medical record (EMR is believed to facilitate timely access to patient information, enhance communication between care team members and further promote clinical decision support.Objective To determine if pharmacist-generated electronic consults (e-consults improve blood pressure control among patients with uncontrolled hypertension in a multisite health centre.Methods Pharmacists generated hypertension medication e-consults with review by primary care provider (PCP during the patient appointment. We conducted a retrospective review of consults to determine types of pharmacist recommendations, PCP acceptance rates, and blood pressure changes.Results Pharmacists generated a total of 60 econsults, 41 patients with a systolic blood pressure above their respective goal; e-consults were accepted 46% (n = 19 of the time.Conclusion This pilot project demonstrates a unique way for pharmacists to proactively utilise the EMR when delivering coordinated care within a multisite health centre. In addition, pharmacists were successfully integrated into the planned care approach.
The Chinese authorities plan to gradually rebalance the composition of Chinese economic growth from investment towards household consumption. This article uses the World Input-Output Database (WIOD) to give a general sense of how this rebalancing might affect Australian exports and economic activity. Dollar for dollar, Chinese investment appears to absorb more than twice as much Australian value-added output as Chinese household consumption. This largely reflects the significant role of resou...
Hay, Phillipa; Girosi, Federico; Mond, Jonathan
Background New DSM-5 diagnostic criteria for eating disorders were published in 2013. Adolescent cohort studies in the Australian community indicate that the point prevalence of DSM-5 eating disorders may be as high as 15% in females and 3% in males. The goal of the current study was to determine the 3-month prevalence of DSM-5 disorders in a representative sample of Australian older adolescents and adults. A secondary aim was to explore the demographic correlates of these disorders, specific...
The majority of pharmaceutical expenditure in Ireland occurs in the community for services provided by general practitioners and pharmacists. In the current national and international economic climate, it is anticipated that demand on these services will continue to grow.
Nora Shikeen Amath
Full Text Available There is great interest on issues related to Muslims and Islam; however, a large concentration of the scholarly literature as well as media and political discourses focus predominantly on political issues and actions related to fundamentalism, radicalisation, militancy and terrorism. The dominance of these issues in the discourses does not provide a holistic understanding of Muslims, particularly their role, place and identity as minorities in a Western society. Indeed, we know relatively little about the larger number of Muslim political actors engaged in civil society, especially those involved in creating pathways to social inclusion. Utilising descriptive phenomenology, this paper explores the complex issues of social inclusion and the Australian Muslim communities. Underpinning this discussion is the theory of social capital; as noted by a number of scholars and social policy experts, the theory of social inclusion alone is inadequate and ineffective in creating participation, equality and cohesion. This paper also observes that while many reports and studies provide pragmatic suggestions on how to work towards the social inclusion of Australian Muslims, the concentration on these suggestions tend to focus on how the government can provide these solutions. What is lacking in the literature is the recognition of the Australian Muslim community’s role and agency in initiating and executing the programs needed to address such issues of social exclusion. The 30 unstructured phenomenological interviews demonstrate that Australian MCSOs are proactively engaging with their communities to ensure that they are responding appropriately to these issues. Moreover, they are creating pathways and access for Australian Muslims to better participate, engage in and contribute to mainstream society. In particular, the MCSO actors revealed four themes related to social inclusion: supporting participation in education and training, facilitating participation
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.
Higuchi, Yuji; Inagaki, Masatoshi; Koyama, Toshihiro; Kitamura, Yoshihisa; Sendo, Toshiaki; Fujimori, Maiko; Uchitomi, Yosuke; Yamada, Norihito
Background Opportunities for face-to-face communication with patients is increasing in modern hospital pharmacist practice. This may impose new burdens on hospital pharmacists. We performed a cross-sectional study to examine the prevalence of psychological distress, burnout, and compassion fatigue among hospital pharmacists. We also investigated possible relevant factors, such as sex, years of experience, hospital size, interpersonal work hours, and personality traits related to communication...
Shah, Jigna Samir; Goyal, R. K.
Objective: The aim of the study was to explore the trends and rationale of use of memory and vitality-enhancing medicines (MVEM) in the Gujarat region. Materials and Methods: A prospective pharmacoepidemiological study involving pharmacists of Gujarat region was carried out in the year 2005. Pharmacists (n = 351) working in general and Ayurvedic medical stores were selected from 12 districts of Gujarat region. The pharmacists were explained about the objective of the study and were given a pr...
Acheampong, Franklin; Anto, Berko Panyin
Background Pharmacist involvement in the prevention of medication errors is well documented. One such method, the process by which hospital pharmacists undertake these clinical interventions needs to be described and documented. The perceived barriers to pharmacists succeeding in getting their recommendations accepted could inform future safety strategy development. This study was therefore to trace the typical process involved and explore the perceived barriers to pharmacists’ medication saf...
Bruhn, Hanne; Christine M. Bond; Elliott, Alison M; Hannaford, Philip C; Amanda J Lee; McNamee, Paul; Smith, Blair H; Watson, Margaret C; Holland, Richard; Wright, David
Objectives To compare the effectiveness of pharmacist medication review, with or without pharmacist prescribing, with standard care, for patients with chronic pain. Design An exploratory randomised controlled trial. Setting Six general practices with prescribing pharmacists in Grampian (3) and East Anglia (3). Participants Patients on repeat prescribed pain medication (4815) were screened by general practitioners (GPs), and mailed invitations (1397). 196 were randomised and 180 (92%) complete...
Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa
Background Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods We adopted an exploratory approach using a case study method. Results NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization’s Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. Conclusions The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia. PMID:26596328
Full Text Available Suzanne G Bollmeier, Theresa R ProsserSt Louis College of Pharmacy, St Louis, MO, USAAbstract: Achieving and maintaining asthma control and improving patients’ quality of life are cornerstones of asthma management. This review summarizes the current literature related to services provided by community pharmacists to patients with asthma. Comprehensive asthma programs provided by community pharmacists have improved patients’ knowledge of the disease, device technique skills, patient adherence, and quality of life. One study shows such comprehensive programs are cost effective in patients with severe or uncontrolled asthma, which cannot be extrapolated to all programs. Targeted interventions by pharmacists could be provided to a larger population of patients. Pharmacists have identified that lack of time, resources, and training are barriers to implementing asthma programs. In addition, optimal models are needed to integrate interventions into the dispensing workflow. Optimal training programs should include skills in problem solving, device technique, and counseling. A movement towards “institutionalizing” routine asthma interventions or patient encounters is necessary if consistent services are to be given to all patients, and appropriate compensation is provided for pharmacist services.Keywords: community, pharmacy, pharmacist, asthma, education
Abbott, Penelope A.; Davison, Joyce E.; Moore, Louise F.; Rubinstein, Raechelle
Objectives: To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Methods: Descriptive qualitative approach using semistructured…
Haig, David Addison
Constant Broyer (1833–1911) trained as a herbalist in Victoria during the 1850s and practised as a medical botanist in Carlton in the 1860s. He obtained medical degrees from the Eclectic Medical College of Cincinnati (1875) and Harvard University (1879). He is perhaps the first Australian to have studied at Harvard. He was twice found guilty of manslaughter by a coroner’s jury in 1874 and 1896. Both cases were much publicised but Broyer was not prosecuted on either charge. His wife, Sarah Bro...
Hesty Utami Ramadaniati
Full Text Available AIMS: This study aimed to document and compare the nature of clinical pharmacists' interventions made in different practice settings within a children's hospital. METHODS: The primary investigator observed and documented all clinical interventions performed by clinical pharmacists for between 35-37 days on each of the five study wards from the three practice settings, namely general medical, general surgical and hematology-oncology. The rates, types and significance of the pharmacists' interventions in the different settings were compared. RESULTS: A total of 982 interventions were documented, related to the 16,700 medication orders reviewed on the five wards in the three practice settings over the duration of the study. Taking medication histories and/or patient counselling were the most common pharmacists' interventions in the general settings; constituting more than half of all interventions. On the Hematology-Oncology Ward the pattern was different with drug therapy changes being the most common interventions (n = 73/195, 37.4% of all interventions. Active interventions (pharmacists' activities leading to a change in drug therapy constituted less than a quarter of all interventions on the general medical and surgical wards compared to nearly half on the specialty Hematology-Oncology Ward. The majority (n = 37/42, 88.1% of a random sample of the active interventions reviewed were rated as clinically significant. Dose adjustment was the most frequent active interventions in the general settings, whilst drug addition constituted the most common active interventions on the Hematology-Oncology Ward. The degree of acceptance of pharmacists' active interventions by prescribers was high (n = 223/244, 91.4%. CONCLUSIONS: The rate of pharmacists' active interventions differed across different practice settings, being most frequent in the specialty hematology-oncology setting. The nature and type of the interventions documented in the
Full Text Available Abstract Heroin use causes considerable harm to individual users including dependence, fatal and nonfatal overdose, mental health problems, and blood borne virus transmission. It also adversely affects the community through drug dealing, property crime and reduced public amenity. During the mid to late 1990s in Australia the prevalence of heroin use increased as reflected in steeply rising overdose deaths. In January 2001, there were reports of an unpredicted and unprecedented reduction in heroin supply with an abrupt onset in all Australian jurisdictions. The shortage was most marked in New South Wales, the State with the largest heroin market, which saw increases in price, dramatic decreases in purity at the street level, and reductions in the ease with which injecting drug users reported being able to obtain the drug. The abrupt onset of the shortage and a subsequent dramatic reduction in overdose deaths prompted national debate about the causes of the shortage and later international debate about the policy significance of what has come to be called the "Australian heroin shortage". In this paper we summarise insights from four years' research into the causes, consequences and policy implications of the "heroin shortage".
Stewart, Fraser; Kragt, Marit; Gibson, Fiona
Foreign investment can provide a flow of capital into Australian agriculture and has played an important role meeting the shortfalls in domestic savings throughout Australia’s history. Despite the political and media attention on foreign investment in agriculture, there is little knowledge about stakeholders’ perceptions of foreign investment in their community. This study assesses the opinions of farmers about foreign investment in the Wheatbelt. We investigate the economic, social and envir...
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
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
In collaboration with the National Cancer Institute (NCI), a consortium of Australian Researchers is adapting the ASA24 system to the Australian context to account for variations in food consumed, portion sizes, and nutrient composition.
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.
Johnston, G.; Dawson, J. H.
Over the last decade, the Australian government has through programs like AuScope, the Asia Pacific Reference Frame (APREF), and the Pacific Sea Level Monitoring (PSLM) Project made a significant contribution to the Global Geodetic Observing Program. In addition to supporting the national research priorities, this contribution is justified by Australia's growing economic dependence on precise positioning to underpin efficient transportation, geospatial data management, and industrial automation (e.g., robotic mining and precision agriculture) and the consequent need for the government to guarantee provision of precise positioning products to the Australian community. It is also well recognised within Australia that there is an opportunity to exploit our near unique position as being one of the few regions in the world to see all new and emerging satellite navigation systems including Galileo (Europe), GPS III (USA), GLONASS (Russia), Beidou (China), QZSS (Japan) and IRNSS (India). It is in this context that the Australian geodetic program will build on earlier efforts and further develop its key geodetic capabilities. This will include the creation of an independent GNSS analysis capability that will enable Australia to contribute to the International GNSS Service (IGS) and an upgrade of key geodetic infrastructure including the national VLBI and GNSS arrays. This presentation will overview the significant geodetic activities undertaken by the Australian government and highlight its future plans.
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
Duldig, M L
Australian research into variations of the cosmic ray flux arriving at the Earth has played a pivotal role for more than 50 years. The work has been largely led by the groups from the University of Tasmania and the Australian Antarctic Division and has involved the operation of neutron monitors and muon telescopes from many sites. In this paper the achievements of the Australian researchers are reviewed and future experiments are described. Particular highlights include: the determination of cosmic ray modulation parameters; the development of modelling techniques of Ground Level Enhancements; the confirmation of the Tail-In and Loss-Cone Sidereal anisotropies; the Space Ship Earth collaboration; and the Solar Cycle latitude survey.
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.
Harman, Kay; Treadgold, Elaine
Dissatisfaction with the "corporate" model for university governance, a model advocated by both sides of the Australian parliament and adopted by Australian universities over the past two decades, prompted the Australian Vice-Chancellors' Committee (AVCC) in 2003 to suggest an alternative "trusteeship" model. The paper discusses how this model…
The international and national complexities of the situation in Australia over the question of mining of the country's large and rich uranium deposits are explored with especial reference to the pending general election. The present position is ironical since access to low cost uranium would give a welcome boost to the nuclear industry which is enthusiastically supported by the Australian prime minister and his colleagues yet the Australian government is unable to promote mining as rapidly as it would like because of the international commitments it has made to provide a justification for its policy. (U.K.)
Twigg, Michael; Bhattacharya, Debi; Desborough, James; Wright, David
Background Preparatory work suggests that there may be a role for the pharmacist in managing sub-optimal medication adherence and dose titration of prescribed medicines in patients with type 2 diabetes. Patients have reported that they are receptive towards pharmacists becoming involved in their care providing that this is integrated into the care received from their medical practice. Objective To determine whether a community pharmacy diabetes drop-in clinic is feasible and acceptable to pat...
Freeman Christopher; Cottrell W; Kyle Greg; Williams Ian; Nissen Lisa
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 ...
Hansen, Trine Graabæk; Kjeldsen, Lene Juel
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...... 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...
Rene R. Breault
Full Text Available We aimed to assess the impact of a professional development course on clinical pharmacists’ level of confidence using physical assessment (PA and whether it resulted in changes to their clinical practice. Workshop participants were asked to complete a pre-workshop survey, as well as three post-workshop surveys, to assess the pharmacists’ level of confidence in PA. Pharmacists were also asked about their integration of PA skills and use of Additional Prescribing Authority (APA. Pharmacists’ confidence in performing PA, discussing PA findings, and using PA to manage drug therapy were significantly higher at all time-points post workshop. Pharmacists with APA also indicated increased confidence with prescribing. Professional development in physical assessment may provide opportunities for pharmacists to integrate new knowledge and skills within their practice. Future research should examine if such educational opportunities will support sustainable practice change.
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...... "Medisam" was launched in 2009 at the University of Copenhagen with the aim of "developing, implementing and evaluating a collaboration model for HMRs and medicine reconciliations in Denmark". The Medisam programme involves patients, pharmacy internship students, the (pharmacist) supervisor of the pharmacy...... students and physicians. Objective To explore if it was possible through the Medisam programme to obtain a fruitful HMR collaboration between pharmacy internship students and physicians as a means to develop HMR collaboration between trained pharmacists and physicians further. Setting Ten matching pairs...
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
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…
Atkinson, Jeffrey; De Paepe, Kristien; Pozo, Antonio Sánchez; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries; Wilson, Keith; van Schravendijk, Chris
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 communi
Full Text Available There are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. Objectives: The objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. Methods: We analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in Kaiser Permanente Southern California from 1993 to 1996. We compared treating patient satisfaction as exogenous, in a single-equation probit model, with a bivariate probit model where patient satisfaction was treated as endogenous. Different sets of instrumental variables were employed, including measures of patients' emotional well-being and patients' propensity to fill their prescriptions at a non-Kaiser Permanente (KP pharmacy. The Smith-Blundell test was used to test whether patient satisfaction was endogenous. Over-identification tests were used to test the validity of the instrumental variables. The Staiger-Stock weak instrument test was used to evaluate the explanatory power of the instrumental variables. Results: All tests indicated that the instrumental variables method was valid and the instrumental variables used have significant explanatory power. The single equation probit model indicated that the effect of patient satisfaction with pharmacist consultation was significant (p<0.010. However, the bivariate probit models revealed that the marginal effect of pharmacist consultation on medication adherence was significantly greater than the single equation probit. The effect increased from 7% to 30% (p<0.010 after controlling for endogeneity bias. Conclusion: After appropriate adjustment for endogeneity bias, patients satisfied with their pharmacy services are substantially more likely to adhere to their medication. The results have important policy implications given the increasing focus
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.
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.
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.
Mishra, Archana; Saxena, Pikee
Introduction Pharmacists play a key role while dispensing over-the-counter emergency contraception (EC) to the client. Aims The study aims to evaluate the knowledge and over-the-counter services provided by the pharmacists in Delhi. Methods A prestructured questionnaire-based survey was conducted in Delhi, the capital city of India. Results Only 60 out of 85 pharmacies approached agreed to participate in the study. Number of packs sold in a month per pharmacy varied from 2 to 500 packs/month....
Jen Tsen Kwok
Full Text Available Globalisation and the rise of East Asia have accelerated the migration of Chinese populations across the Asia-Pacific rim. Ethnic Chinese populations from highly diverse sub-ethnic, socio-economic and political backgrounds are increasingly aggregated in major cities throughout the region. Nonetheless, there remains insufficient attention to the implications of greater economic interdependence and accelerated population movement upon the political cultures of host nations such as Australia, especially in the context of ensuing spatial and economic concentrations of activity. Both articulate and interlocking relationships between political and economic fields exist in the metropolitan engagements of Chinese Australian community groups and associations. Many of these political dimensions extend into ‘formal’ modes of politics. Framed by urban regime theory and the broader notion of urban politics, this paper claims that network resource exchange within Chinese Australian communities are tied to ethnic economies, and in certain contexts global processes. These kinds of social dynamics have implications for the expression of diasporic Chinese affinity and constructions of Chineseness. Explorations of transnational political tensions, in fact, highlight the diversity and potential fragility of diasporic interdependence within ethnic Chinese communities – communities that are persistently refashioned through new waves of migration and from different points of origin. This paper seeks to advance these perspectives through a case study of a particular period of tension between two representative peak bodies in Brisbane, Queensland. Grounded in the testimony of elite political actors, it reflects upon the nature of ethnic Chinese community representation in contemporary Australia.
Full Text Available Norio Watanabe,1,2 Keiko Yamamura,3 Yusuke Suzuki,4 Hiroyuki Umegaki,4 Katsuro Shigeno,5 Ryo Matsushita,1 Yoshimichi Sai,1 Ken-ichi Miyamoto,1 Kiyofumi Yamada61Department of Clinical Pharmacy, Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, Ishikawa, Japan; 2Department of Pharmacy, Hashima Municipal Hospital, Hashima, Gifu, Japan; 3Department of Clinical Pharmacy, School of Pharmacy, Aichi Gakuin University, Nagoya, Aichi, Japan; 4Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; 5Department of Pharmacy Practice and Sciences, School of Pharmacy, Aichi Gakuin University, Nagoya, Aichi, Japan; 6Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya, Aichi, JapanAim: Donepezil is widely used to delay the progression of cognitive dysfunction in patients with Alzheimer's disease (AD, but the efficacy of pharmacotherapy is often reduced by poor adherence to medication. In order to improve adherence by providing information about AD and the significance of pharmacotherapy, the Donepezil Outpatient Consultation Service (DOCS was set up. The influence of this service on medication persistence was assessed in the present study.Methods: Among outpatients starting donepezil therapy, we enrolled 59 patients between April 2008 and September 2010 before establishment of the DOCS (non-DOCS group and 52 patients between October 2010 and March 2012 who attended the DOCS (DOCS group. Each patient's and their caregiver's understanding about the clinical features of AD and pharmacotherapy with donepezil were also assessed. Their understanding was compared before and after the DOCS, and the 1-year medication persistence rate and the reasons for discontinuation were also investigated.Results: The 1-year medication persistence rate was significantly higher in the DOCS group than in the non-DOCS group (73
De Young, M
Research on the effects of pharmacist-patient communication that appeared in the pharmacy literature between 1969 and 1994 is reviewed. The terms patients education and patient counseling were used in identifying relevant research. Many authors used these terms interchangeably; also, the terms counseling and consultation often were not clearly defined. Studies of pharmacists' history-taking in institutional settings and of other communication with patients in ambulatory care settings were examined by decade. The research questions, theories, methods, results, and limitations were analyzed. More than 30 studies examined the effect of pharmacists' communication on patient outcomes, primarily knowledge and medication compliance; generally, the results suggested that pharmacists' communication led to increased knowledge and compliance. A few researchers raised concerns about patients' knowledge as an indicator of effective communication by pharmacists, and in the 1980s a few suggested that better medication compliance could be associated with the time and attention given to patients rather than the informational content of the interaction. Little was reported about the communication theories or models on which the studies were based, and there was little indication in most studies that patients' ideas about their therapy were considered. Often, the numbers of patients and pharmacists were small, and the pharmacists may have had training or motivation exceeding that of the average practitioner. In studies of pharmacists' versus physicians' history-taking, the physicians were not well described; their involvement and their approach may not have been comparable to those of the pharmacists. Before 1990, a few researchers had examined outcomes such as pulmonary function and control of diabetes. In the 1990s, more researchers looked at outcomes such as medication-related problems and use of health care resources. The research indicated that pharmacists can increase patients
Riley, Dan; Duncan, Deirdre J.; Edwards, John
Purpose: The purpose of this paper is to estimate the prevalence of staff bullying in Australian schools, to identify bullies and targets and to examine some implications for school leaders in dealing with staff bullying. Design/methodology/approach: The quantitative research design survey instrument contained 11 demographic items, 44 questions of…
Sheng; Jingjing; Sun; Yongjian
As a large country with 7.69 million sq.km, is Australia a vast market for Chinese products such as cars and some traditional arts and crafts as people expect? With such questions bear in mind, China's Foreign Trade interviewed Mrs.Liu Bing, Commissioner of The Australian Trade Commission (Austrade). Let's hear what she said.……
Sheng Jingjing; Sun Yongjian
@@ As a large country with 7.69 million sq.km, is Australia a vast market for Chinese products such as cars and some traditional arts and crafts as people expect? With such questions bear in mind, China's Foreign Trade interviewed Mrs.Liu Bing, Commissioner of The Australian Trade Commission (Austrade). Let's hear what she said.
Varlow, Megan; Wuthrich, Viviana; Murrihy, Rachael; Remond, Louise; Tuqiri, Rebekka; van Kessel, Jacobine; Wheatley, Anna; Dedousis-Wallace, Anna; Kidman, Antony
Stress literacy is a term that refers to knowledge about stress and stress management techniques. Levels of stress literacy were examined in more than nine hundred Australian adolescents by providing a short stress-management education session and assessing stress literacy using a pre-post survey design. It was found that while adolescents had a…
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.
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.
McLaughlin, Jacqueline E.; Amerine, Lindsey B.; Chen, Sheh-Li; Luter, David N.; Arnall, Justin; Smith, Shayna; Roth, Mary T.; Rodgers, Philip T.; Williams, Dennis M.; Pinelli, Nicole R.
Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.
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.
Chan, Agnes L F
Hospital pharmacists have been challenged to face the paradigm shift in their model of services in the 21st century in Taiwan. Patients are increasingly concerned about drug safety and medication errors. Because of the financial crisis of our national insurance bureau, pharmacists are required to care for more patients, use fewer resources, and work faster, better, and more efficiently than ever before while striving to enhance customer satisfaction and quality of care. Under these circumstances, patient safety needs to be a priority of pharmacists. According to a preliminary report on medication error announced by the nonofficial medication error reporting system, pharmacist dispensing error ranked second in the list of errors in Taiwan. In our drive to improve quality, reduce costs, and enhance financial performance, our department has tried the traditional quality-improvement strategy with varying degrees of success. We wanted to achieve a breakthrough result, hence we implemented Six-Sigma methodology. This program is the catalyst needed to combine quality, cost, and patient safety. This article describes our experience using Six-Sigma methodology to reduce dispensing error in our pharmacy department. PMID:15212318
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…
de Maat, M M R; de Boer, A; Koks, C H W; Mulder, J W; Meenhorst, P L; van Gorp, E C M; Mairuhu, A T A; Huitema, A D R; Beijnen, J H
OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe
Maat, M.M. de; Boer, A.T. den; Koks, C.H.W.; Mulder, J.W.; Meenhorst, P.L.; Gorp, E. van; Mairuhu, A.T.; Huitema, A.D.; Beijnen, J.H.
OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe