WorldWideScience

Sample records for clinical pharmacist intervention

  1. Clinical pharmacist interventions to support adherence to thrombopreventive therapy

    DEFF Research Database (Denmark)

    Hedegaard, Ulla

    The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke/transient isch......The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke...... targeted patients with hypertension or stroke in a hospital care setting. Thus, the aim of this thesis was to develop and evaluate in-hospital pharmacist interventions including MI to improve adherence to primary and secondary thrombopreventive therapy. The first study was a RCT, which investigated the...... persistence to specific thrombopreventive medications and a combined clinical endpoint of cardiovascular death, stroke or acute myocardial infarction. The second RCT included 532 patients with hypertension from three hospital outpatient clinics. The study examined the effectiveness of an intervention very...

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

    NARCIS (Netherlands)

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

    2008-01-01

    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

  3. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care

    NARCIS (Netherlands)

    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

    2004-01-01

    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

  4. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care.

    NARCIS (Netherlands)

    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.

    2004-01-01

    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

  5. Pharmacist interventions in depressed patients

    OpenAIRE

    Rubio Valera, Maria

    2012-01-01

    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...

  6. Role of oncology clinical pharmacist: a case of life-saving interventions

    OpenAIRE

    Osama M. Al-Quteimat; Al-Badaineh, Mariam A.

    2013-01-01

    The oncology clinical pharmacist (CP) has a crucial role in cancer patient care through improving medication use including chemotherapy and other high alert medications. As part of multidisciplinary team CP has major role in assuring safe, effective and cost-effective drug therapy. Herein we report a case of 45 years old male patient diagnosed with diffuse large B-cell lymphoma (DLBCL), treated with high dose methotrexate (MTX) as prophylaxis for central nervous system (CNS) lymphoma, and fol...

  7. Pharmacotherapy optimization in older patients by a structured clinical pharmacist assessment and intervention

    OpenAIRE

    O'Sullivan, David

    2014-01-01

    Introduction: Older individuals are particularly vulnerable to potentially inappropriate prescribing (PIP), drug related problems (DRPs) and adverse drug reactions (ADRs). A number of different interventions have been proposed to address these issues. However to-date there is a paucity of well-designed trials examining the impact of such interventions. Therefore the aims of this work were to: (i) establish a baseline PIP prevalence both nationally and internationally using the STOPP, Beers an...

  8. Improving the Quality and Safety of Drug Use in Hospitalized Elderly : Assessing the Effects of Clinical Pharmacist Interventions and Identifying Patients at Risk of Drug-related Morbidity and Mortality

    OpenAIRE

    Alassaad, Anna

    2014-01-01

    Older people admitted to hospital are at high risk of rehospitalization and medication errors. We have demonstrated, in a randomized controlled trial, that a clinical pharmacist intervention reduces the incidence of revisits to hospital for patients aged 80 years or older admitted to an acute internal medicine ward. The aims of this thesis were to further study the effects of the intervention and to investigate possibilities of targeting the intervention by identifying predictors of treatment...

  9. Emerging Roles for Pharmacists in Clinical Implementation of Pharmacogenomics

    Science.gov (United States)

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

    2014-01-01

    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

  10. Desired professional development pathways for clinical pharmacists.

    Science.gov (United States)

    Shord, Stacy S; Schwinghammer, Terry L; Badowski, Melissa; Banderas, Julie; Burton, Michael E; Chapleau, Christopher A; Gallagher, Jason C; Matsuura, Gregory; Parli, Sara E; Yunker, Nancy

    2013-04-01

    The 2012 American College of Clinical Pharmacy (ACCP) Certification Affairs Committee was charged with developing guidelines for the desired professional development pathways for clinical pharmacists. This document summarizes recommendations for postgraduate education and training for graduates of U.S. schools and colleges of pharmacy and describes the preferred pathways for achieving, demonstrating, and maintaining competence as clinical pharmacists. After initial licensure within the state or jurisdiction in which the pharmacist intends to practice, completion of an accredited PGY1 pharmacy residency is recommended to further develop the knowledge and skills needed to optimize medication therapy outcomes. An accredited PGY2 pharmacy residency should be completed if a pharmacist wishes to seek employment in a specific therapeutic area or practice setting, if such a residency exists. Clinical pharmacists intending to conduct advanced research that is competitive for federal funding are encouraged to complete a fellowship or graduate education. Initial certification by the Board of Pharmacy Specialties (BPS) or other appropriate sponsoring organizations should be completed in the desired primary therapeutic area or practice setting within 2 years after accepting a position within the desired specific therapeutic area or practice setting. Clinical pharmacists subsequently will need to meet the requirements to maintain pharmacist licensure and board certification. Traineeships, practice-based activities, and certificate programs can be used to obtain additional knowledge and skills that support professional growth. Pharmacists are strongly encouraged to adopt a lifelong, systematic process for professional development and work with ACCP and other professional organizations to facilitate the development and implementation of innovative strategies to assess core practice competencies. PMID:23401084

  11. Pharmacists' documentation in patients' hospital records: issues and educational interventions

    OpenAIRE

    Pullinger, W.; Franklin, B D

    2006-01-01

    This study aimed to identify potential barriers to pharmacists writing in hospital medical records and explore their training needs. The study was set in a London teaching hospital with 40 clinical pharmacists using a questionnaire and focus group design. 39 pharmacists answered the questionnaire and 32 of those attended focus groups.

  12. The difference in pharmacists' interventions across the diverse settings in a children's hospital.

    Directory of Open Access Journals (Sweden)

    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

  13. Method for evaluating performance of clinical pharmacists.

    Science.gov (United States)

    Schumock, G T; Leister, K A; Edwards, D; Wareham, P S; Burkhart, V D

    1990-01-01

    A performance-evaluation process that satisfies Joint Commission on Accreditation of Healthcare Organizations criteria and state policies is described. A three-part, criteria-based, weighted performance-evaluation tool specific for clinical pharmacists was designed for use in two institutions affiliated with the University of Washington. The three parts are self-appraisal and goal setting, peer evaluation, and supervisory evaluation. Objective criteria within each section were weighted to reflect the relative importance of that characteristic to the job that the clinical pharmacist performs. The performance score for each criterion is multiplied by the weighted value to produce an outcome score. The peer evaluation and self-appraisal/goal-setting parts of the evaluation are completed before the formal performance-evaluation interview. The supervisory evaluation is completed during the interview. For this evaluation, supervisors use both the standard university employee performance evaluation form and a set of specific criteria applicable to the clinical pharmacists in these institutions. The first performance evaluations done under this new system were conducted in May 1989. Pharmacists believed that the new system was more objective and allowed more interchange between the manager and the pharmacist. The peer-evaluation part of the system was seen as extremely constructive. This three-part, criteria-based system for evaluation of the job performance of clinical pharmacists could easily be adopted by other pharmacy departments. PMID:2301420

  14. Interventions by pharmacists in out-patient pharmaceutical care

    OpenAIRE

    Al Rahbi, Hussain Abdullah Mubarak; Al-Sabri, Raid Mahmood; Chitme, Havagiray R

    2013-01-01

    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...

  15. Impact of clinical pharmacist in an Indian Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Mohamed Hisham

    2016-01-01

    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.

  16. 临床药师参与心内科药物治疗及医嘱干预的实践与分析%Practice of clinical pharmacists in drug therapy and intervention in the department of cardiology

    Institute of Scientific and Technical Information of China (English)

    赵萌; 郑南波; 乔宝安; 何建伟

    2013-01-01

    目的:探讨临床药师参与临床药物治疗和医嘱干预的途径和方法。方法对药师参与的6例典型案例进行分析和总结。结果临床药师在参与药物品种选用、提醒医生关注药物的药代动力学、相互作用,以及为患者进行适当的用药教育等方面取得一定成效。结论临床药师在加强药学知识的同时还要补充临床医学知识,主动与临床医护人员合作,可以保障治疗过程中药物使用的安全、有效、经济。%Objective To discuss ways and methods of clinical pharmacists in clinical drug therapy and medication intervention . Methods 6 typical cases were chosen .Results Clinical pharmacists achived results in certain areas ,such as participating in drug selection ,reminding doctors to pay attention to pharmacokinetics and interraction ,and advicing patients on how to use medicines . Conclusion Clinical pharmacists should learn more pharmacy knowledge to make the clinical practice be safe ,effective ,and eco-nomic .

  17. 心内科临床药师参与药物治疗和干预医嘱的实践与分析%Practice of clinical pharmacists in drug therapy and intervention in the department of cardiology

    Institute of Scientific and Technical Information of China (English)

    唐巧云; 黄丽

    2015-01-01

    目的:探讨心内科临床药师参与药物治疗和干预医嘱的途径和方法。方法对临床药师参与心内科药物治疗的4例典型案例进行分析。结果临床药师在参与药物品种选择、剂量调整,提醒医师关注药物的药代动力学、相互作用、不良反应等方面取得一定成效。结论临床药师利用与医护人员互补的药学专业知识,为医师及患者提供药学服务,可促进临床合理用药。%Objective To discuss ways and methods of clinical pharmacists in clinical drug therapy and medication intervention. Methods Clinical pharmacistsˊ experience in the treatment of four typical cases in cardiology department was analyzed. Results Clinical pharmacists achived results in certain areas,such as participating in drug selection and adjusting the dose,reminding doctors to pay attention to pharmacokinetics,interaction and drug adverse reaction. Conclusion Clinical pharmacists should master necessary basic theory of medicine and pharmacy so as to provide pharmaceutical care for doctors and patients,which can promote rational drug use in the clinic.

  18. Pharmacist-patient relationship development in an ambulatory clinic setting.

    Science.gov (United States)

    Hermansen, C J; Wiederholt, J B

    2001-01-01

    We investigated the pharmacist-patient relationship, conceptualizing its interpersonal constructs and dynamics using social exchange principles. The constructs of felt indebtedness (FI), collaborative willingness (CW), interpersonal relationship quality (IRQ), medication use beliefs (MUBs), and critical interpersonal incidents (CII) between pharmacist and patient were proposed, measured, and modeled. Patient responses were collected using interviews and mail surveys in 2 pharmacist-managed anticoagulation clinics. Higher IRQ levels predicted greater FI toward and CW with pharmacists (p pharmacists, and not their therapy, may lead to increased interpersonal exchange and patient collaboration in care. PMID:11550853

  19. Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study.

    Directory of Open Access Journals (Sweden)

    Maria Rubio-Valera

    Full Text Available Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care.Patients were recruited by general practitioners and randomized to community pharmacist intervention (87 that received an educational intervention and usual care (92. Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs, use of healthcare services and productivity losses were measured at baseline, 3 and 6 months.There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective. From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000.A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.ClinicalTrials.gov NCT

  20. Interventions by pharmacists in out-patient pharmaceutical care.

    Science.gov (United States)

    Al Rahbi, Hussain Abdullah Mubarak; Al-Sabri, Raid Mahmood; Chitme, Havagiray R

    2014-04-01

    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

  1. Case Analysis and Intervention of Warfarin Drug Interactions by Clinical Pharmacist%临床药师对华法林药物相互作用的病例分析和干预

    Institute of Scientific and Technical Information of China (English)

    杨周生; 郑萍

    2014-01-01

    Objective: To explore the role of clinical pharmacists in the treatment based on one case analysis and intervention of warfarin drug interactions . Methods: In view of the patient medication and the drug interaction , the mechanism affecting warfarin anticoagulation by combined drug use was explored . Results: Amiodarone was one of the main factors enhancing the effect of warfarin anticoagulation . With the assistance of clinical pharmacist a safe and effective treatment plan for the patient was made . Conclusion: Clinical pharmacist ’ s participating in making therapeutic regimen can provide a safe and effective medication plan for both doctors and patients .%目的:通过临床药师对1例华法林药物相互作用的病例分析和干预,探讨药师在临床治疗中发挥的作用。方法:针对病例的用药情况,从药物相互作用角度,探讨分析合并用药对华法林抗凝作用影响的机制。结果:胺碘酮是增强华法林抗凝作用的主要因素,临床药师协助医师为患者制定了安全、有效的治疗方案。结论:临床药师参与药物治疗方案的制定,可为医师、患者双方提供安全、有效的用药方案。

  2. A Retrospective Evaluation of Remote Pharmacist Interventions in a Telepharmacy Service Model Using a Conceptual Framework

    OpenAIRE

    Sankaranarayanan, Jayashri; Murante, Lori J.; Moffett, Lisa M.

    2014-01-01

    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...

  3. 某院临床药师不合理用药医嘱干预情况分析%Analysis of records of clinical pharmacists' intervention on irrational prescriptions in one hospital

    Institute of Scientific and Technical Information of China (English)

    徐象珍; 陈彬彬

    2014-01-01

    Objective:To analyze effects of clinical pharmacists ' intervention on irrational prescriptions for inpatients during they participated ward round with doctors in departments of psychiatry and psychology, and to discuss its meaning in improving the ra-tional drug use. Methods:On the basis of doctors' acceptance, concerned drugs and medical issues, records of clinical pharmacists' intervention on the irrational prescriptions for the inpatients during they participated in ward round with doctors from October 2012 to September 2013 were analyzed retrospectively. Results:The total success rate of the intervention was 78. 79%. The concerned drugs in the irrational prescriptions were mainly the special drugs and the second kind psychotropic drugs, and the intervention success rate ranged from 33. 33% to 87. 50%. Drug combination and adverse reactions were the most of the medical issues, and the intervention success rate ranged from 36. 36% to 92. 47%. Conclusions: The clinical pharmacists can find out the irrational prescriptions during their participating in the ward round with the doctors, therefore it can reduce the irrational drug use. It is required that the clinical pharmacists should learn more about their major, accumulate experience and communicate more effectively with the doctors to practice the intervention on the irrational prescriptions and to increase the success rate of the intervention.%目的:分析某院临床药师参与精神、心理科临床查房对不合理用药医嘱的干预效果。方法:收集2012年10月至2013年9月临床药师对不合理用药医嘱进行干预的记录,对不合理用药医嘱涉及的药物类别和药学问题以及医师干预的接受情况进行统计、分析。结果:总干预成功率为78.79%;不合理用药医嘱涉及的药物类别以专科用药和二类精神药品为较多,干预成功率33.33%~87.50%;干预涉及的药学问题主要是不良反应和联合用药,干预成功率36

  4. Analysis of Clinical Pharmacists in Clinical Pharmacy Intervention of Irrational Drug Use%临床药师对临床不合理用药的药学干预分析

    Institute of Scientific and Technical Information of China (English)

    柯秋林

    2015-01-01

    目的:探讨临床药师对临床不合理用药的药学干预前后两年的用药改善情况。方法选取1000份医嘱,比较医嘱中不合理用药、重复给药、无适应证给药、抗菌药物使用情况,追踪对应患者的药物费用、抗菌药费用、住院时间、服药依从性和不良反应发生率,并进一步探讨最优干预办法,并选取干预后的1000份医嘱对以上情况进行观察。结果实施药学干预后,不合理医嘱、重复给药、无适应证给药等情况明显减少;抗菌药使用量大大减少;患者医疗费用减少,病程缩短;患者服药依从性和不良反应发生率,与干预前比较,差异有统计学意义(P<0.05)。结论临床药师干预临床用药,可明显降低用药不合理现象的发生,有效改善了患者的用药情况,降低药物不良反应的发生率及患者的病死率,同时提高治疗效果。%Objective To investigate the clinical pharmacist interventions on clinical pharmacy irrational drug use before and after two years of treatment to improve the situation.Methods Select 1 000 copies of orders,orders in comparison of irrational use of drugs, repeated administration,no indications to medicine,the use of antibacterial drugs, drug costs,patient tracking corresponding antibacterial drug cos,time,medication compliance and the incidence of adverse reactions among inpatients,and to further explore the optimal intervention measures.Then choose 1 000 copies of orders to observation the drug costs,antibacterial drug cost,hospitalization time,medication compliance and adverse reaction rate after intervention.Results After the implementation of pharmaceutical intervention,irrational prescriptions,repeated doses,significantly reducing administration and so no indications;antibiotic use is greatly reduced;reduce patient medical costs,shorten the course;patient medication compliance and adverse reaction rates changed significantly

  5. Pharmacists

    Science.gov (United States)

    ... 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 ...

  6. The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

    OpenAIRE

    Ann M. Fugit, Pharm.D., BCPS; Sallie D. Mayer, Pharm.D., MBA, BCPS, CDE; Radha S. Vanmali, Pharm.D., BCACP

    2013-01-01

    Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV) clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: T...

  7. Pharmacist-documented interventions during the dispensing process in a primary health care facility in Qatar

    Directory of Open Access Journals (Sweden)

    Richard Hooper

    2009-11-01

    Full Text Available 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 clinics within the service used online, integrated health care software to document all clinical interventions made. Documented information included: patient’s age and gender, drug therapy details, the intervention’s details, its category, and its outcome. Interventions were categorized according to the Pharmaceutical Care Network Europe Classification of drug-related problems (DRP.Results: The number of patients who had their prescriptions intercepted were 589 (0.71% of the total 82,800 prescriptions received. The intercepted prescriptions generated 890 DRP-related interventions (an average of 1.9% DRPs identified across the four clinics. Fifty-four percent of all interventions were classified as drug choice problems, and 42% had safety problems (dose too high, potential significant interaction. The prescriber accepted the intervention in 53% of all interventions, and the treatment was changed accordingly. Interventions as a result of transcription errors, legality and formulary issues were eliminated from this study through the use of computerized physician order entry (CPOE.Conclusions: Documenting and analyzing interventions should be a routine activity in pharmacy practice setting in primary health care services. Educational outreach visits and other strategies can improve prescribing practices and enhance patient safety.Keywords: pharmacists, interventions, prescribing errors

  8. Emerging Roles for Pharmacists in Clinical Implementation of Pharmacogenomics

    OpenAIRE

    Owusu-Obeng, Aniwaa; WEITZEL, KRISTIN W.; Hatton, Randy C.; Staley, Benjamin J.; Ashton, Jennifer; Cooper-DeHoff, Rhonda M.; Johnson, Julie A.

    2014-01-01

    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...

  9. The effects of pharmacist intervention on emergency department visits in patients 80 years and older : subgroup analyses by number of prescribed drugs and appropriate prescribing

    OpenAIRE

    Anna Alassaad; Maria Bertilsson; Ulrika Gillespie; Johan Sundström; Margareta Hammarlund-Udenaes; Håkan Melhus

    2014-01-01

    Background: Clinical pharmacist interventions have been shown to have positive effect on occurrence of drug-related issues as well as on clinical outcomes. However, evidence about which patients benefiting most from the interventions is limited. We aimed to explore whether pharmacist intervention is equally effective in preventing emergency department (ED) visits in patients with few or many prescribed drugs and in those with different levels of inappropriate prescribing. Methods: Patient and...

  10. Involvement of HMO-based pharmacists in clinical rounds at contract hospitals.

    Science.gov (United States)

    Yee, D K; Veal, J H; Trinh, B; Bauer, S; Freeman, C H

    1997-03-15

    The contributions of managed care pharmacists who participate in clinical rounds at contract hospitals are described. A program in which pharmacists employed by Kaiser Permanente go on rounds at two contract hospitals as part of a multidisciplinary Kaiser team was implemented in January 1995. The rounding pharmacist reviews patients' charts, assesses optimal drug therapy, intervenes proactively, identifies candidates for home i.v. therapy, facilitates patient discharge, and provides on-the-spot drug information. Other services include therapeutic drug monitoring, dosage-adjustment recommendations, counseling, consultations, detecting adverse drug reactions, and education. The pharmacist documents all services and interventions, and their impact. At one hospital, a 500-bed institution, there were 1097 recommendations for intervention between April 1995 and May 1996. More than 99% of these recommendations were accepted. Over the 14-month period, the Kaiser team saved an estimated $523,907 and cost an estimated $57,643 (not counting benefits) in pharmacist participation. Managed care pharmacists on rounds at contract hospitals influenced enrolled patients' pharmacotherapy and reduced the plan's costs. PMID:9075495

  11. Fulfilling an Unmet Need: Roles for Clinical Pharmacists in Preconception Care.

    Science.gov (United States)

    DiPietro Mager, Natalie A

    2016-02-01

    Preconception care refers to a set of interventions that identify and address biomedical, behavioral, and social risks to a woman's health that may negatively impact a future pregnancy. A great need for preconception care currently exists in the United States, and women's attitudes about discussions with health care providers about healthy and safe pregnancies are positive. Clinical pharmacists are well positioned to work with other health care and public health professionals to ensure that all women of childbearing potential have access to preconception care. As part of the collaborative health care team, clinical pharmacists can directly provide services or support and referrals to other members of the health care team or to community resources through clinical-community linkages. Specifically, clinical pharmacists can provide education, counseling, and/or services to women to address family planning, medication and disease state management, immunizations, screenings, health promotion, and substance use. Clinical pharmacists can also impact preconception care through drug information services, advocacy, and research. Preconception care services can be incorporated into daily pharmacy practice, and there are potential means for reimbursement. Multiple roles exist for clinical pharmacists to fulfill unmet needs in preconception care. PMID:26846305

  12. Effectively implementing FDA medication alerts utilizing patient centered medical home clinical pharmacists.

    Science.gov (United States)

    Arenz, Barbara J; Diez, Heidi L; Bostwick, Jolene R; Kales, Helen C; Zivin, Kara; Dalack, Gregory W; Fluent, Tom E; Standiford, Connie J; Stano, Claire; Mi Choe, Hae

    2016-03-01

    FDA medication alerts can be successfully implemented within patient centered medical home (PCMH) clinics utilizing clinical pharmacists. Targeted selection of high-risk patients from an electronic database allows PCMH pharmacists to prioritize assessments. Trusting relationships between PCMH clinical pharmacists and primary care providers facilitates high response rates to pharmacist recommendations. This health system approach led by PCMH pharmacists provides a framework for proactive responses to FDA safety alerts and medication related quality measure improvement. PMID:27001101

  13. A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

    Science.gov (United States)

    Ayadurai, Shamala; Hattingh, H. Laetitia; Tee, Lisa B. G.; Md Said, Siti Norlina

    2016-01-01

    Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods. A search on randomised controlled trials (RCT) on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin) reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established. Conclusion. Although pharmacists' contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful. PMID:27247949

  14. An evaluation of clinical pharmacist service on a neurology care unit.

    Science.gov (United States)

    Yi, Zhan-Miao; Sun, Shu-Sen; Li, Xiao-Xiao; Lu, Ming; Zhai, Suo-Di

    2016-02-01

    Background Medications used to treat neurological diseases may result in adverse effects. Research is needed to demonstrate pharmacist value and their roles in patient care. Objective To categorize the types and severities of the prescribing errors intercepted and to describe clinical activities conducted by neurology ward pharmacists. Method Pharmacists prospectively reviewed medication orders over an 18-month period with inventions documented and categorized. Results A total of 341 prescribing errors in 1183 patients were intercepted. The most common error types were dosing frequency (35.8 %) and medication selection (21.5 %). The top five most detected error medications were those indicated for hyperhomocysteinemia (22.0 %), stress ulcer prophylaxis (12.3 %), poor circulation (10.9 %), hyperglycemia (6.5 %), and infections (5.9 %). Although 67.5 % of the detected errors having the potential causing no harm, 26.4 % of the errors may require intervention, and 6.2 % may increase the length of stay. The number of errors decreased from 19 to 10 per month during the study period. Clinical pharmacists also actively engaged in medication use evaluation, clinical decision support system optimization, and education to patients and providers. Conclusion Presence of clinical pharmacists at the neurology unit may help in early detection of prescribing errors with increased patient safety. PMID:26659084

  15. Retrospective evaluation of a pharmacist-managed warfarin anticoagulation clinic.

    Science.gov (United States)

    Garabedian-Ruffalo, S M; Gray, D R; Sax, M J; Ruffalo, R L

    1985-02-01

    The effectiveness of a pharmacist-managed warfarin anticoagulation clinic in maintaining therapeutic prothrombin times and preventing hospitalizations secondary to inadequate control of anticoagulation was evaluated. Patients who had received warfarin sodium for at least one year before being referred to the anticoagulation clinic were studied using retrospective chart reviews. Clinical pharmacists provided patient education, monitored patients for hemorrhagic and thromboembolic complications, and adjusted warfarin sodium dosage to maintain therapeutic prothrombin times. The patients' primary physicians retained responsibility for overall care and were consulted by pharmacists regarding complications of anticoagulation and patient unreliability. The percentage of patients requiring hospitalization (39% versus 4%) and the percentage of prothrombin times outside the therapeutic range (35.8% versus 14.4%) were significantly higher during the preclinic phase (before referral to the clinic) than during the clinic phase. Eight patients were hospitalized for hemorrhagic complications and four for thromboembolism during the preclinic phase; only one hospitalization for hemorrhage occurred during the clinic phase. The warfarin anticoagulation clinic staffed by specially trained pharmacists provided improved therapy compared with treatment received by patients before their referral to the clinic. PMID:3976675

  16. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    Directory of Open Access Journals (Sweden)

    Angalakuditi M

    2011-06-01

    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  17. Evolving role of clinical pharmacist in the management of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Javedh Shareef

    2015-06-01

    Full Text Available Diabetes mellitus is a metabolic disorder characterised by hyperglycaemia due to impaired insulin secretion with or without insulin resistance. Uncontrolled blood glucose in the long term will lead to micro vascular and macro vascular complications with increased morbidity and mortality and negatively affecting the quality of life. Comprehensive diabetes care is a complex task that takes the entire team of healthcare professionals including the pharmacist to work together to provide, multidisciplinary care for patients. Pharmacist's role has changed dramatically over the past three decades which has changed the concept of pharmacy from product oriented to a patient focused one with the concept of pharmaceutical care. The evolving role of clinical pharmacist in the management of diabetes mellitus - drug therapy, diabetes care and education has been described here. Optimizing the drug therapy for achieving the better therapeutic outcomes without causing drug related problems has been considered as the primary goal of therapy in the diabetes management. Well trained and readily accessible clinical pharmacists are the key healthcare professionals who can move closer towards achieving better medication therapy outcomes for the patients. Clinical pharmacist coordinates with the physician during drug therapy and applies his clinical expertise in identifying, resolving and preventing drug related problems by providing interventions which is of valuable aid in accurate, safe and cost effective use of drugs for the physicians. In addition, pharmacist also plays a very important role on diabetes care and education by screening patients at high risk for diabetes, monitoring diabetic treatment goals, assessing patient's health status and providing counseling for medication adherence which will help in optimizing the blood sugar level and enhancing the quality of life in patients with diabetes mellitus. [Int J Res Med Sci 2015; 3(6.000: 1305-1308

  18. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study

    OpenAIRE

    Klopotowska, J.E.; Kuiper, R; Kan, van, J.; Pont, de, A.C.J.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Vroom, M.B.; Smorenburg, S.M.

    2010-01-01

    Introduction Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an ICU team. As the Dutch Healthcare System is organized differently and the on-ward role of hospital pharmacists in Dutch ICU teams is not well established, we conducted an intervention study to inve...

  19. Medical Oncology Pharmacy: A New Role for the Clinical Pharmacist

    Science.gov (United States)

    Morris, Carl R.; Hickman, Mary Johne

    1977-01-01

    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)

  20. Drug related problems and interventions of pharmacists on prescribed medicines in Belgium

    OpenAIRE

    De Wulf, Isabelle; Boussery, Koen; De Vriese, Carine; Meyer, Guido; Foulon, Veerle; Lacour, Valérie; Mehuys, Els; Steurbaut, Stephane; Van Hees, Thierry

    2013-01-01

    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.

  1. A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

    Directory of Open Access Journals (Sweden)

    Shamala Ayadurai

    2016-01-01

    Full Text Available Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods. A search on randomised controlled trials (RCT on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established. Conclusion. Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.

  2. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

    Science.gov (United States)

    Riordan, David O; Walsh, Kieran A; Galvin, Rose; Sinnott, Carol; Kearney, Patricia M; Byrne, Stephen

    2016-01-01

    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

  3. Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

    Directory of Open Access Journals (Sweden)

    Murray Scott A

    2009-05-01

    Full Text Available Abstract Background Medication errors are an important cause of morbidity and mortality in primary care. The aims of this study are to determine the effectiveness, cost effectiveness and acceptability of a pharmacist-led information-technology-based complex intervention compared with simple feedback in reducing proportions of patients at risk from potentially hazardous prescribing and medicines management in general (family practice. Methods Research subject group: "At-risk" patients registered with computerised general practices in two geographical regions in England. Design: Parallel group pragmatic cluster randomised trial. Interventions: Practices will be randomised to either: (i Computer-generated feedback; or (ii Pharmacist-led intervention comprising of computer-generated feedback, educational outreach and dedicated support. Primary outcome measures: The proportion of patients in each practice at six and 12 months post intervention: - with a computer-recorded history of peptic ulcer being prescribed non-selective non-steroidal anti-inflammatory drugs - with a computer-recorded diagnosis of asthma being prescribed beta-blockers - aged 75 years and older receiving long-term prescriptions for angiotensin converting enzyme inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the preceding 15 months. Secondary outcome measures; These relate to a number of other examples of potentially hazardous prescribing and medicines management. Economic analysis: An economic evaluation will be done of the cost per error avoided, from the perspective of the UK National Health Service (NHS, comparing the pharmacist-led intervention with simple feedback. Qualitative analysis: A qualitative study will be conducted to explore the views and experiences of health care professionals and NHS managers concerning the interventions, and investigate possible reasons why the interventions prove effective, or conversely prove

  4. Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction

    OpenAIRE

    Lowrie, R.; Mair, F S; Greenlaw, N.; Forsyth, P.; Jhund, P.S.; McConnachie, A.; Rae, B.; McMurray, J.J.V.

    2012-01-01

    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...

  5. A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

    OpenAIRE

    Shamala Ayadurai; H. Laetitia Hattingh; Tee, Lisa B.G.; Siti Norlina Md Said

    2016-01-01

    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...

  6. Evaluation of a pharmacist-led intervention to reduce prescribing costs in general practice

    OpenAIRE

    Rodgers, Sarah

    2005-01-01

    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...

  7. Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs.

    OpenAIRE

    Rodgers, S.; Avery, A J; Meechan, D; Briant, S; Geraghty, M.; Doran, K; Whynes, D K

    1999-01-01

    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...

  8. 临床药师在1例儿童心脏术后抗凝治疗中的作用%Intervention of clinical pharmacists on the anticoagulation after cardiac surgery in one child patient

    Institute of Scientific and Technical Information of China (English)

    梁培

    2011-01-01

    文中报道临床药师全程参与1例儿童心脏术后抗凝的治疗,根据血浆凝血酶原时间和国际标准化比值调整抗凝药物剂量,实施药学监护,并进行分析总结.临床药师与医生共同组成治疗团队,有利于提高药物治疗水平,促进合理用药.%A child patient receiving anticoagulation after cardiac surgery was reported. The clinical pharmacists helped the doctor to adjust the dose of warfarin according to prothrombin time (PT) and international normalized ratio (INR). The experience in the treatment was summarized and analyzed. The participation of clinical pharmacists improves the therapy, which is beneficial for the patients.

  9. An exploration of pharmacist-patient communication in clinic-style consultations

    OpenAIRE

    Greenhill, Nicola H.

    2010-01-01

    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 ...

  10. Patient survey of a pharmacist-managed anticoagulation clinic.

    Science.gov (United States)

    Lewis, S M; Kroner, B A

    1997-11-01

    The literature describing pharmacy involvement with anticoagulation services primarily does not include information about patients' perceptions of this involvement. A 22-question survey was developed and administered to 296 patients enrolled in the anticoagulation clinic at the VA Pittsburgh Health Care System. Excluded patients had fewer than four clinic visits or were followed outside of the anticoagulation clinic. The study period was nine weeks and any missed patients were telephoned. The median response to each question was determined. Similar questions were analyzed for acquiescent trends. Results indicate that, overall, patients are comfortable with pharmacists providing warfarin monitoring and dose adjustments. PMID:10174757

  11. Pharmacist-documented interventions during the dispensing process in a primary health care facility in Qatar

    OpenAIRE

    Kheir, Nadir

    2009-01-01

    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...

  12. National survey of training and credentialing methods in pharmacist-managed anticoagulation clinics.

    Science.gov (United States)

    Mehlberg, J; Wittkowsky, A K; Possidente, C

    1998-05-15

    A national survey of pharmacist-managed anticoagulation clinics was conducted to determine how pharmacists are trained to provide care in such clinics. In June 1996 a survey was mailed to 177 pharmacist-managed anticoagulation clinics in the United States. A total of 128 surveys were returned (response rate, 72%). One hundred ten surveys representing 42 states and a variety of institutions were usable. Twenty-five (23%) of the 110 clinics offered an anticoagulation training program for their pharmacists. Most training programs had both didactic and experiential components and had been in existence for one to five years. Thirty-two (29%) of the 110 responding clinics had at least one pharmacist who had completed the ASHP Research and Education Foundation's Anticoagulation Service Traineeship. Twenty-three of the 25 clinics with a training program required successful completion of the program before a pharmacist could practice in the clinic. The overall quality of pharmacists' performance was regularly assessed by 22 of the 25 clinics. Most pharmacist-managed anticoagulation clinics in the United States do not offer formal training in anticoagulation therapy to pharmacists who practice in that setting. PMID:9606455

  13. Evaluation of a pharmacist-managed anticoagulation clinic.

    Science.gov (United States)

    Cohen, I A; Hutchison, T A; Kirking, D M; Shue, M E

    1985-06-01

    Medical records were retrospectively analyzed to evaluate the success of a pharmacist-managed Anticoagulation Surveillance Clinic (ASC). The 78 patients in group I were followed by the ASC. The 17 patients in Group II were followed by other Veterans Administration Medical Center clinics. Demographic characteristics, warfarin indication and potentially complicating conditions were comparable between the groups. Group I patients had shorter intervals between visits to the clinic than Group II patients. Although not statistically different compared to Group II, Group I patients had better prothrombin time control. Group I patients also had fewer complications per treatment year (6.9% vs 9.0%) and received fewer potentially interacting drugs. The ASC was at least as successful as the other clinics in managing patients on warfarin, and results compared very favorably to those reported in the literature for other anticoagulation clinics. PMID:4019790

  14. Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial.

    Science.gov (United States)

    Rubio-Valera, Maria; March Pujol, Marian; Fernández, Ana; Peñarrubia-María, M Teresa; Travé, Pere; López Del Hoyo, Yolanda; Serrano-Blanco, Antoni

    2013-09-01

    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

  15. The effects of pharmacist intervention on emergency department visits in patients 80 years and older: subgroup analyses by number of prescribed drugs and appropriate prescribing.

    Directory of Open Access Journals (Sweden)

    Anna Alassaad

    Full Text Available Clinical pharmacist interventions have been shown to have positive effect on occurrence of drug-related issues as well as on clinical outcomes. However, evidence about which patients benefiting most from the interventions is limited. We aimed to explore whether pharmacist intervention is equally effective in preventing emergency department (ED visits in patients with few or many prescribed drugs and in those with different levels of inappropriate prescribing.Patient and outcome data from a randomized controlled trial exploring the clinical effects of a ward-based pharmacist intervention in patients, 80 years and older, were used. The patients were divided into subgroups according to the number of prescribed drugs (<5 or ≥5 drugs and the level of inappropriate prescribing [using the Screening Tool Of Older People's potentially inappropriate Prescriptions (STOPP and the Screening Tool to Alert doctors to Right Treatment (START with a score of ≥2 (STOPP and ≥1 (START as cutoff points]. The effect of the intervention on the number of times the different subgroups visited the ED was analyzed.The pharmacist intervention was more effective with respect to the number of subsequent ED visits in patients taking <5 drugs on admission than in those taking ≥5 drugs. The rate ratio (RR for a subsequent ED visit was 0.22 [95% confidence interval (CI 0.09-0.52] for <5 drugs and 0.70 (95% CI 0.47-1.04 for ≥5 drugs (p = 0.02 for the interaction. The effect of intervention did not differ between patients with high or low STOPP or START scores.In this exploratory study, the pharmacist intervention appeared to be more effective in preventing visits to the ED for patients who were taking fewer drugs before the intervention. Our analysis of STOPP and START scores indicated that the level of inappropriate prescribing on admission had no effect on the outcomes of intervention with respect to ED visits.

  16. Interventions performed by community pharmacists in one Canadian province: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Young SW

    2012-12-01

    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

  17. NEED OF CLINICAL PHARMACIST FOR RATIONALIZATION OF PRESCRIPTION

    Directory of Open Access Journals (Sweden)

    Naveed Muhammad

    2012-02-01

    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.

  18. The influence of job characteristics on job outcomes of pharmacists in hospital, clinic, and community pharmacies.

    Science.gov (United States)

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

    2007-06-01

    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

  19. A Pharmacist-Staffed, Virtual Gout Management Clinic for Achieving Target Serum Uric Acid Levels: A Randomized Clinical Trial

    Science.gov (United States)

    Goldfien, Robert; Pressman, Alice; Jacobson, Alice; Ng, Michele; Avins, Andrew

    2016-01-01

    Context: Relatively few patients with gout receive appropriate treatment. Objective: To determine whether a pharmacist-staffed gout management program is more effective than usual care in achieving target serum uric acid (sUA) levels in gout patients. Design: A parallel-group, randomized controlled trial of a pharmacist-staffed, telephone-based program for managing hyperuricemia vs usual care. Trial duration was 26 weeks. Main Outcome Measures: Primary outcome measure was achieving sUA levels at or below 6 mg/dL at the 26-week visit. Secondary outcome was mean change in sUA levels in the control and intervention groups. Participants were adults with recurrent gout and sUA levels above 6.0 mg/dL. Participants were randomly assigned to management by a clinical pharmacist following protocol or to monitoring of sUA levels but management of their gout by their usual treating physician. Results: Of 102 patients who met eligibility criteria, 77 subjects obtained a baseline sUA measurement and were entered into the trial. Among 37 participants in the intervention group, 13 (35%) had sUA levels at or below 6.0 mg/dL at 26 weeks, compared with 5 (13%) of 40 participants in the control group (risk ratio = 2.8, 95% confidence interval [CI] = 1.1 to 7.1, p = 0.03). The mean change in sUA levels among controls was +0.1 mg/dL compared with −1.5 mg/dL in the intervention group (sUA difference = −1.6, 95% CI = −0.9 to −2.4, p pharmacist-staffed program was more effective than usual care for achieving target sUA levels. These results suggest a structured program could greatly improve gout management. PMID:27352414

  20. Pharmacist interventions for obesity: improving treatment adherence and patient outcomes

    Directory of Open Access Journals (Sweden)

    Jordan MA

    2015-07-01

    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

  1. Patients’ and physicians’ satisfaction with a pharmacist managed anticoagulation program in a family medicine clinic

    OpenAIRE

    Bishop, Lisa; Young, Stephanie; Twells, Laurie; Dillon, Carla; Hawboldt, John

    2015-01-01

    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...

  2. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study

    NARCIS (Netherlands)

    J.E. Klopotowska; R. Kuiper; H.J. van Kan; A.C. de Pont; M.G. Dijkgraaf; L. Lie-A-Huen; M.B. Vroom; S.M. Smorenburg

    2010-01-01

    Introduction: Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an

  3. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    OpenAIRE

    Sarah M. Westberg, Pharm.D.; Kathrine Beeksma, R.N.

    2010-01-01

    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...

  4. A cluster randomised controlled trial of a pharmacist-led collaborative intervention to improve statin prescribing and attainment of cholesterol targets in primary care

    OpenAIRE

    Richard Lowrie; Suzanne M Lloyd; Alex McConnachie; Jill Morrison

    2014-01-01

    Background Small trials with short term follow up suggest pharmacists’ interventions targeted at healthcare professionals can improve prescribing. In comparison with clinical guidance, contemporary statin prescribing is sub-optimal and achievement of cholesterol targets falls short of accepted standards, for patients with atherosclerotic vascular disease who are at highest absolute risk and who stand to obtain greatest benefit. We hypothesised that a pharmacist-led complex intervention delive...

  5. Inpatient Oral Anticoagulation Management by Clinical Pharmacists: Safety and Cost effectiveness

    OpenAIRE

    Hosmane, Sharath R.; Tucker, Johanna; Osman, Dave; Williams, Steve; Waterworth, Paul

    2010-01-01

    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...

  6. Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial

    OpenAIRE

    Rubio Valera, Maria; March Pujol, Marian; Fernández Sánchez, Ana; Peñarrubia María, María Teresa; Travé i Mercadé, Pere; López del Hoyo, Yolanda; Serrano Blanco, Antoni

    2013-01-01

    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 ...

  7. Effectiveness of the clinical pharmacist in reducing mortality in hospitalized cardiac patients: a propensity score-matched analysis

    Directory of Open Access Journals (Sweden)

    Zhai XB

    2016-02-01

    Full Text Available Xiao-bo Zhai,1 Zhi-chun Gu,2 Xiao-yan Liu2 1Department of Pharmacy, Shanghai East Hospital, Affiliated to Tongji University School of Medicine, 2Department of Pharmacy, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China Background: Pharmacist-led medication review services have been assessed in the meta-analyses in hospital. Of the 135 relevant articles located, 21 studies met the inclusion criteria; however, there was no statistically significant difference found between pharmacists’ interventions and usual care for mortality (odds ratio 1.50, 95% confidence interval 0.65, 3.46, P=0.34. These analyses may not have found a statistically significant effect because they did not adequately control the wide variation in the delivery of care and patient selection parameters. Additionally, the investigators did not conduct research on the cases of death specifically and did not identify all possible drug-related problems (DRPs that could cause or contribute to mortality and then convince physicians to correct. So there will be a condition to use a more precise approach to evaluate the effect of clinical pharmacist interventions on the mortality rates of hospitalized cardiac patients. Objective: To evaluate the impact of the clinical pharmacist as a direct patient-care team member on the mortality of all patients admitted to the cardiology unit. Methods: A comparative study was conducted in a cardiology unit of a university-affiliated hospital. The clinical pharmacists did not perform any intervention associated with improper use of medications during Phase I (preintervention and consulted with the physicians to address the DRPs during Phase II (postintervention. The two phases were compared to evaluate the outcome, and propensity score (PS matching was applied to enhance the comparability. The primary endpoint of the study was the composite of all-cause mortality during Phase I and Phase II

  8. Comparison of two methods for INR determination in a pharmacist-based oral anticoagulation clinic.

    Science.gov (United States)

    Yamreudeewong, W; Johnson, J V; Cassidy, T G; Berg, J T

    1996-01-01

    Warfarin is a commonly used oral anticoagulant that is usually initiated after the definitive diagnosis of a certain thromboembolic disorder or disease. Warfarin therapy will usually be prescribed for 6-12 weeks or more, and some patients may continue therapy throughout life, depending on the type of thromboembolic disorder. Major problems associated with warfarin therapy include adverse effects such as bleeding complications and drug-drug or drug-food interactions. In addition, thromboembolic complications may occur due to subtherapeutic dosages of warfarin. The laboratory reference standards for monitoring warfarin therapy are the prothrombin time (PT) and the International Normalized Ratio (INR). While both the PT or INR will reflect the clinical response in the patient, results reported as INR values have been shown to be more accurate than those reported as PT values. Thirty-two patients were enrolled in this study. Our objectives were to compare INR values measured by both the Coumatrak and conventional laboratory method, and to demonstrate the effects of pharmacist intervention on managing patients receiving warfarin therapy. Results from our study reveal that INR monitoring by Coumatrak is similar to the conventional laboratory method. In addition, our study indicates that patients receiving warfarin therapy can be monitored and managed effectively by pharmacists. PMID:8947990

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

    Directory of Open Access Journals (Sweden)

    Sami Isaac

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

  10. Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and Latinos with Diabetes

    Directory of Open Access Journals (Sweden)

    Gerber Ben S

    2012-10-01

    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

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

    Directory of Open Access Journals (Sweden)

    Kocarnik Beverly Mielke

    2012-11-01

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

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

    OpenAIRE

    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

    2012-01-01

    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...

  13. Comparison of pharmacist managed anticoagulation with usual medical care in a family medicine clinic

    OpenAIRE

    Dillon Carla; Twells Laurie; Bishop Lisa; Young Stephanie; Hawboldt John; O'Shea Patrick

    2011-01-01

    Abstract Background The beneficial outcomes of oral anticoagulation therapy are dependent upon achieving and maintaining an optimal INR therapeutic range. There is growing evidence that better outcomes are achieved when anticoagulation is managed by a pharmacist with expertise in anticoagulation management rather than usual care by family physicians. This study compared a pharmacist managed anticoagulation program (PC) to usual physician care (UC) in a family medicine clinic. Methods A retros...

  14. Are nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations

    OpenAIRE

    Latter, Sue; Smith, Alesha; Blenkinsopp, Alison; Nicholls, Peter G.; Little, Paul; Chapman, Stephen

    2012-01-01

    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...

  15. Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire

    Science.gov (United States)

    Samsuri, Srima Elina; Pei Lin, Lua; Fahrni, Mathumalar Loganathan

    2015-01-01

    Objective To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors. Design A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ). Setting 3 public hospitals and 27 health clinics. Participants 117 pharmacists. Main outcome measure(s) Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation. Results Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98). Conclusions A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety

  16. Pharmacists' Perceptions of the Barriers and Facilitators to the Implementation of Clinical Pharmacy Key Performance Indicators

    Science.gov (United States)

    Minard, Laura V; Deal, Heidi; Harrison, Megan E; Toombs, Kent; Neville, Heather; Meade, Andrea

    2016-01-01

    Background In hospitals around the world, there has been no consensus regarding which clinical activities a pharmacist should focus on until recently. In 2011, a Canadian clinical pharmacy key performance indicator (cpKPI) collaborative was formed. The goal of the collaborative was to advance pharmacy practice in order to improve patient outcomes and enhance the quality of care provided to patients by hospital pharmacists. Following a literature review, which indicated that pharmacists can improve patient outcomes by carrying out specific activities, and an evidence-informed consensus process, a final set of eight cpKPIs were established. Canadian hospitals leading the cpKPI initiative are currently in the early stages of implementing these indicators. Objective To explore pharmacists' perceptions of the barriers and facilitators to the implementation of cpKPIs. Methods Clinical pharmacists employed by the Nova Scotia Health Authority were invited to participate in focus groups. Focus group discussions were audio-recorded and transcribed, and data was analyzed using thematic analysis. Findings Three focus groups, including 26 pharmacists, were conducted in February 2015. Three major themes were identified. Resisting the change was comprised of documentation challenges, increased workload, practice environment constraints, and competing priorities. Embracing cpKPIs was composed of seeing the benefit, demonstrating value, and existing supports. Navigating the unknown was made up of quality versus quantity battle, and insights into the future. Conclusions Although pharmacists were challenged by documentation and other changes associated with the implementation of cpKPIs, they demonstrated significant support for cpKPIs and were able to see benefits of the implementation. Pharmacists came up with suggestions for overcoming resistance associated with the implementation of cpKPIs and provided insights into the future of pharmacy practice. The identification of barriers

  17. Cost-justification of a clinical pharmacist-managed anticoagulation clinic.

    Science.gov (United States)

    Gray, David R; Garabedian-Ruffalo, Susan M; Chretien, Steven D

    2007-03-01

    A cost-benefit evaluation of a clinical pharmacist-managed anticoagulation clinic (AC) was performed. Outpatient and hospital records were examined for 26 patients in the treatment group with an AC clinic and 26 patients in the control group. Therapeutic prothrombin times were maintained within the treatment group to a significantly greater extent than within the control group (ppharmacist-managed AC was effective in maintaining therapeutic prothrombin times, and reducing the incidence of hospitalizations resulting from anticoagulation complications, and can be cost-justified based on a cost-benefit analysis. PMID:17341522

  18. Nine-year experience with a pharmacist-managed anticoagulation clinic.

    Science.gov (United States)

    Conte, R R; Kehoe, W A; Nielson, N; Lodhia, H

    1986-10-01

    A pharmacist-managed anticoagulation clinic is described, and information on patient outcome during a nine-year period is presented. Since 1974, a pharmacist has managed an anticoagulation clinic for ambulatory patients and inpatients at San Francisco General Hospital Medical Center. The pharmacist's primary responsibilities include the following: educating patients about their diseases and the importance of drug therapy, monitoring patients' vital signs, performing physical examinations, and adjusting warfarin dosage to maintain prothrombin times within the therapeutic range (1.7-2.5 times normal using control values of 1.0-1.2). These patients are also under the care of their primary physicians. The pharmacist's work is checked by the chief of the cardiac clinic at the end of each clinic session. The effectiveness of the pharmacist in managing clinic patients is reviewed periodically; from January 1975 through June 1984, the pharmacist had treated 140 patients (141 courses of therapy). Of 1792 prothrombin times taken during this time, 1060 (59.2%) were within the therapeutic range of 17-25 seconds, 510 (28.5%) were less than 17 seconds, and 222 (12.4%) were greater than 25 seconds. Only four major hemorrhagic events (0.002 hemorrhages per patient-treatment month) and 89 minor events (0.05 hemorrhages per patient-treatment month) occurred. The recurrence rate of thromboembolic events was 0.007 per patient-treatment month. Pharmacist-managed warfarin therapy in these clinic patients resulted in a level of anticoagulation control and morbidity that was acceptable to physicians. PMID:3788996

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

    Science.gov (United States)

    2016-01-01

    Background 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. Methods 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. Results 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. Discussion 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

  20. Evaluation of anticoagulant control in a pharmacist operated anticoagulant clinic.

    OpenAIRE

    Radley, A S; Hall, J; Farrow, M.; Carey, P J

    1995-01-01

    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 ...

  1. Effectiveness of alcohol brief intervention delivered by community pharmacists: study protocol of a two-arm randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Dhital Ranjita

    2013-02-01

    Full Text Available Abstract Background There is strong evidence to support the effectiveness of Brief Intervention (BI in reducing alcohol consumption in primary healthcare. Methods and design This study is a two-arm randomised controlled trial to determine the effectiveness of BI delivered by community pharmacists in their pharmacies. Eligible and consenting participants (aged 18 years or older will be randomised in equal numbers to either a BI delivered by 17 community pharmacists or a non-intervention control condition. The intervention will be a brief motivational discussion to support a reduction in alcohol consumption and will take approximately 10 minutes to deliver. Participants randomised to the control arm will be given an alcohol information leaflet with no opportunity for discussion. Study pharmacists will be volunteers who respond to an invitation to participate, sent to all community pharmacists in the London borough of Hammersmith and Fulham. Participating pharmacists will receive 7 hours training on trial procedures and the delivery of BI. Pharmacy support staff will also receive training (4 hours on how to approach and inform pharmacy customers about the study, with formal trial recruitment undertaken by the pharmacist in a consultation room. At three month follow up, alcohol consumption and related problems will be assessed with the Alcohol Use Disorders Identification Test (AUDIT administered by telephone. Discussion The UK Department of Health’s stated aim is to involve community pharmacists in the delivery of BI to reduce alcohol harms. This will be the first RCT study to assess the effectiveness of BI delivered by community pharmacists. Given this policy context, it is pragmatic in design. Trial registration Current Controlled Trials ISRCTN95216873

  2. Comparison of pharmacist managed anticoagulation with usual medical care in a family medicine clinic

    Directory of Open Access Journals (Sweden)

    Dillon Carla

    2011-08-01

    Full Text Available Abstract Background The beneficial outcomes of oral anticoagulation therapy are dependent upon achieving and maintaining an optimal INR therapeutic range. There is growing evidence that better outcomes are achieved when anticoagulation is managed by a pharmacist with expertise in anticoagulation management rather than usual care by family physicians. This study compared a pharmacist managed anticoagulation program (PC to usual physician care (UC in a family medicine clinic. Methods A retrospective cohort study was carried out in a family medicine clinic which included a clinical pharmacist. In 2006, the pharmacist assumed anticoagulation management. For a 17-month period, the PC group (n = 112 of patients on warfarin were compared to the UC patients (n = 81 for a similar period prior to 2006. The primary outcome was the percentage of time patients' INR was in the therapeutic range (TTR. Secondary outcomes were the percentage of time in therapeutic range within ± 0.3 units of the recommended range (expanded TTR and percentage of time the INR was >5.0 or Results The baseline characteristics were similar between the groups. Fifty-five percent of the PC group was male with a mean age of 67 years; 51% of the UC group was male with a mean age of 71 years. The most common indications for warfarin in both groups were atrial fibrillation, mechanical heart valves and deep vein thrombosis. The TTR was 73% for PC and 65% for UC (p 5 were 0.3% for PC patients and 0.1% for UC (p Conclusion The pharmacist-managed anticoagulation program within a family practice clinic compared to usual care by the physicians achieved significantly better INR control as measured by the percentage of time patients' INR values were kept in both the therapeutic and expanded range. Based on the results of this study, a collaborative family practice clinic using pharmacists and physicians may be an effective model for anticoagulation management with these results verified in future

  3. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    Directory of Open Access Journals (Sweden)

    Somers A

    2013-06-01

    Full Text Available Annemie Somers,1 Hugo Robays,1 Peter De Paepe,2 Georges Van Maele,3 Katrina Perehudoff,4 Mirko Petrovic41Department of Pharmacy, Ghent University Hospital, Ghent, Belgium; 2Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium; 3Department of Medical Statistics, Ghent University Hospital, Ghent, Belgium; 4Department of Geriatrics, Ghent University Hospital, Ghent, BelgiumObjective: To evaluate the type, acceptance rate, and clinical relevance of clinical pharmacist recommendations at the geriatric ward of the Ghent university hospital.Methods: The clinical pharmacist evaluated drug use during a weekly 2-hour visit for a period of 4 months and, if needed, made recommendations to the prescribing physician. The recommendations were classified according to type, acceptance by the physician, prescribed medication, and underlying drug-related problem. Appropriateness of prescribing was assessed using the Medication Appropriateness Index (MAI before and after the recommendations were made. Two clinical pharmacologists and two clinical pharmacists independently and retrospectively evaluated the clinical relevance of the recommendations and rated their own acceptance of them.Results: The clinical pharmacist recommended 304 drug therapy changes for 100 patients taking a total of 1137 drugs. The most common underlying drug-related problems concerned incorrect dose, drug–drug interaction, and adverse drug reaction, which appeared most frequently for cardiovascular drugs, drugs for the central nervous system, and drugs for the gastrointestinal tract. The most common type of recommendation concerned adapting the dose, and stopping or changing a drug. In total, 59.7% of the recommendations were accepted by the treating physician. The acceptance rate by the evaluators ranged between 92.4% and 97.0%. The mean clinical relevance of the recommendations was assessed as possibly important (53.4%, possibly low relevance (38.1%, and possibly

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

    Directory of Open Access Journals (Sweden)

    Lee T

    2016-05-01

    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

  5. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.

    2010-01-01

    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  6. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Brandstrup, Lene; Brandslund, Ivan;

    2007-01-01

    OBJECTIVE: To assess the effects and cost effects of introducing clinical pharmacists on hospital wards. METHODS: Comparative prospective study on four orthopaedic surgical wards in two hospitals. The primary effect variables were 10 target areas widely considered to be indicators of good...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  7. Consumption of medicinal plants by patients with heart diseases at a pharmacist-managed anticoagulation clinic in Brazil.

    Science.gov (United States)

    Leite, Paula Mendonça; Castilho, Rachel Oliveira; Ribeiro, Antonio Luiz Pinho; Martins, Maria Auxiliadora Parreiras

    2016-04-01

    Background Medicinal plants (MP) have been used for many years with the purpose of feeding and curing. Several MP may interfere in drug response and are not always considered as potential drug-interactors in clinical practice. Objective To investigate the consumption of MP by outpatients during a one-year follow-up. Method Patients with cardiopathy diagnosis and indication(s) for long-term use of warfarin were recruited at a pharmacist-managed anticoagulation clinic of a Brazilian public hospital. This research employed a descriptive method. The consumption of MP was examined regarding the type, frequency and forms of use. Results A total of 280 patients were studied. Most patients were female (54.6 %) with an average age of 56.8 ± 13.1 years. The consumption of MP was reported by 46 (16.4 %) patients, totalizing 59 occurrences. Lemon, lemon balm and plantain were the most common MP. The main pharmacological uses involved the digestive, urinary, and respiratory tracts. Tea was the predominant form of consumption (87 %). Twelve (33.3 %) plants presented potential herb-warfarin interactions according to the literature. Conclusion We described the consumption of MP among outpatients characterized by their complex disease status, propensity for adverse events, and socioeconomic limitations. These results may guide pharmacist interventions and procedures to prevent clinical complications. PMID:26941093

  8. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    OpenAIRE

    Somers A; Robays H; De Paepe P; Van Maele G; Perehudoff K; Petrovic M

    2013-01-01

    Annemie Somers,1 Hugo Robays,1 Peter De Paepe,2 Georges Van Maele,3 Katrina Perehudoff,4 Mirko Petrovic41Department of Pharmacy, Ghent University Hospital, Ghent, Belgium; 2Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium; 3Department of Medical Statistics, Ghent University Hospital, Ghent, Belgium; 4Department of Geriatrics, Ghent University Hospital, Ghent, BelgiumObjective: To evaluate the type, acceptance rate, and clinical relevance of clinical pharmacist recom...

  9. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

    OpenAIRE

    Riordan, David O; Walsh, Kieran A; Galvin, Rose; Sinnott, Carol; Kearney, Patricia M.; Byrne, Stephen

    2016-01-01

    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...

  10. A retrospective assessment comparing pharmacist-managed anticoagulation clinic with physician management using international normalized ratio stability.

    Science.gov (United States)

    Garton, Lauren; Crosby, Joseph F

    2011-11-01

    To assess the rates of therapeutic international normalized ratio (INR) levels between pharmacist-managed clinics compared to traditional physician-management and to determine the variation in rates of therapeutic INR levels between pharmacist-managed clinic data compared to physician-management. Retrospective, randomized, chart review. Referral only, outpatient, pharmacist based anticoagulation clinic under a community based tertiary care health system. Sixty-four patients with at least 1 year's worth of visits to the pharmacist managed clinic were reviewed for INR stability. The average percentage of visits within the defined therapeutic range, was 71.1% for the physician-managed group versus 81.1% for the pharmacist-managed group (P managed group (365.7) versus the pharmacist-managed group (185.2) (P = 0.004). The pharmacist-managed anti-coagulation clinic had higher rates of INRs determined to be therapeutic and also exhibited significantly less variability in therapeutic INR rates relative to the physician-managed service. PMID:21710189

  11. Outreach visits by clinical pharmacists improve screening for the metabolic syndrome among mentally ill patients

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Hansen, Per Sveistrup; Kristensen, Anne Mette Fisker;

    2013-01-01

    Background: Patients suffering from schizophrenia and affective disorder have an increased risk of the metabolic syndrome (MeS); hence identification of patients developing MeS may help preventing morbidity and mortality. Aims: The aim of the study was to evaluate the effect of outreach visit...... by clinical pharmacists to support the implementation of screening of MeS at a psychiatric ward. Methods: The study was conducted at the psychiatric ward, Odense University Hospital. In 2008, clinical guidelines for systematic screening and prevention of metabolic risk were developed and implemented...... by passive dissemination (PD) followed by a period of active implementation (AI). AI contained outreach visits by clinical pharmacists on a weekly basis. Patients with affective disorder or schizophrenia were included. The study was designed as a before-and-after study, and electronic patient charts were...

  12. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure

    OpenAIRE

    Eggink, R.N.; Lenderink, Albert; Widdershoven, Jos; Bemt, Patricia

    2010-01-01

    textabstractObjective: Heart failure patients are regularly admitted to hospital and frequently use multiple medication. Besides intentional changes in pharmacotherapy, unintentional changes may occur during hospitalisation. The aim of this study was to investigate the effect of a clinical pharmacist discharge service on medication discrepancies and prescription errors in patients with heart failure. Setting: A general teaching hospital in Tilburg, the Netherlands. Method: An open randomized ...

  13. Evaluation of a pharmacist-managed anticoagulation clinic: Improving patient care

    OpenAIRE

    Bungard, Tammy J; Gardner, Leslie; Archer, Stephen L.; Hamilton, Peter; Ritchie, Bruce; Tymchak, Wayne; Tsuyuki, Ross T.

    2009-01-01

    Background Anticoagulation management services (AMSs) are widely used for anticoagulation management in many countries. Our AMS is a pharmacist-run ambulatory clinic with a physician advisory committee that manages patients referred with complicated anticoagulation histories. This paper assesses the adequacy of anticoagulation, rates of anticoagulant-related events and associated health care resource utilization for patients before and after referral to our AMS. Methods Consecutive patients r...

  14. Pharmacist-managed clinics for patient education and counseling in Japan: current status and future perspectives

    OpenAIRE

    Yamada, Kiyofumi; Nabeshima, Toshitaka

    2015-01-01

    To improve the adherence to and knowledge about pharmacotherapy in outpatients and to maximize the efficacy and minimize the adverse drug events, the first pharmacist-managed clinic (PMC) in Japan was established for anticoagulation therapy at Nagoya University Hospital in 2000. Since then, various PMCs such as for asthma/chronic obstructive pulmonary disease, Alzheimer’s disease, hypercholesterolemia, chronic hepatitis C, cancer chemotherapy, palliative care, chronic kidney disease, and cont...

  15. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Saw PS

    2015-03-01

    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

  16. Practice and Experience of Clinical Pharmacist Participation in Clinical Drug Treatment%临床药师参与临床药物治疗的实践与体会

    Institute of Scientific and Technical Information of China (English)

    毕蔚; 刘人春; 毕淮

    2015-01-01

    ObjectiveThe role of clinical pharmacist participating in clinical medication is explored.Methods Three cases of clinical pharmacists intervention treatment are selected randomly in our hospital, introduces the process and experience of the clinical pharmacists to help doctors improve treatment, to reduce or avoid drug adverse reactions, and to guide drug use, etc.Results Because of the reason of expertise, clinical pharmacists to participate in clinical treatment, can promote rational drug use and improve the level of drug treatment.Conclusion Clinical pharmacists in clinical drug treatment can improve the efifcacy and safety of clinical medication.%目的:探讨临床药师参与临床药物治疗的作用。方法随机抽取在我院临床药师干预治疗的病例3例,介绍临床药师协助医师完善治疗方案、减少或避免用药不良反应、指导用药等相关事项的过程和体会。结果临床药师以专业特长参与临床治疗,可促进合理用药,提高药物治疗水平。结论临床药师参与临床药物治疗,能提高临床药物治疗的疗效和安全性。

  17. Effect of pharmacist intervention on physician prescribing in patients with chronic schizophrenia: a descriptive pre/post study

    OpenAIRE

    HASHIMOTO, YASUHIKO; Tensho, Masami

    2016-01-01

    Background Although pharmacotherapy is one of the most important treatments for schizophrenia, the prominent levels of antipsychotic polypharmacy and high-dose regimens used in Japan are thought to be inconsistent with treatment regimens used in other countries. In this study, we evaluated the effect of pharmacist intervention on physician prescribing in patients with chronic schizophrenia. Methods Participants comprised 52 inpatients at Sawa Hospital (Osaka, Japan), treated with at least one...

  18. A Pharmacist-Led Point-of-Care INR Clinic: Optimizing Care in a Family Health Team Setting

    OpenAIRE

    Jennifer Rossiter; Gursharan Soor; Deanna Telner; Babak Aliarzadeh; Jennifer Lake

    2013-01-01

    Purpose. Monitoring patients' international normalized ratio (INR) within a family medicine setting can be challenging. Novel methods of doing this effectively and in a timely manner are important for patient care. The purpose of this study was to determine the effectiveness of a pharmacist-led point-of-care (POC) INR clinic. Methods. At a community-based academic Family Health Team in Toronto, Canada, charts of patients with atrial fibrillation managed by a pharmacist with usual care (bloodt...

  19. A cluster randomised controlled trial of a pharmacist-led collaborative intervention to improve statin prescribing and attainment of cholesterol targets in primary care.

    Directory of Open Access Journals (Sweden)

    Richard Lowrie

    Full Text Available Small trials with short term follow up suggest pharmacists' interventions targeted at healthcare professionals can improve prescribing. In comparison with clinical guidance, contemporary statin prescribing is sub-optimal and achievement of cholesterol targets falls short of accepted standards, for patients with atherosclerotic vascular disease who are at highest absolute risk and who stand to obtain greatest benefit. We hypothesised that a pharmacist-led complex intervention delivered to doctors and nurses in primary care, would improve statin prescribing and achievement of cholesterol targets for incident and prevalent patients with vascular disease, beyond one year.We allocated general practices to a 12-month Statin Outreach Support (SOS intervention or usual care. SOS was delivered by one of 11 pharmacists who had received additional training. SOS comprised academic detailing and practical support to identify patients with vascular disease who were not prescribed a statin at optimal dose or did not have cholesterol at target, followed by individualised recommendations for changes to management. The primary outcome was the proportion of patients achieving cholesterol targets. Secondary outcomes were: the proportion of patients prescribed simvastatin 40 mg with target cholesterol achieved; cholesterol levels; prescribing of simvastatin 40 mg; prescribing of any statin and the proportion of patients with cholesterol tested. Outcomes were assessed after an average of 1.7 years (range 1.4-2.2 years, and practice level simvastatin 40 mg prescribing was assessed after 10 years.We randomised 31 practices (72 General Practitioners (GPs, 40 nurses. Prior to randomisation a subset of eligible patients were identified to characterise practices; 40% had cholesterol levels below the target threshold. Improvements in data collection procedures allowed identification of all eligible patients (n = 7586 at follow up. Patients in practices allocated to SOS were

  20. The role of clinical pharmacists in the treatment of patients in Department of Endocinology%临床药师在内分泌科临床治疗中的作用探析

    Institute of Scientific and Technical Information of China (English)

    许可珍; 李碧峰; 吴佳滨; 陈宜锋

    2011-01-01

    目的:探讨临床药师在内分泌科临床治疗中的作用.方法:通过临床实例,对比分析福建医科大学附属漳州市医院临床药师在内分泌科对医师用药行为实施干预前、后的用药情况.结果:临床药师对医师的用药行为实施干预,可提高药物治疗水平、降低医疗成本、缩短疗程.结论:临床药师在促进合理用药、提升医院疾病治疗的水平方面可发挥积极作用.%Objective: To discuss the role of clinical pharmacists in the treatment of patients in Department of Endocrinology. Methods: The doctors' therapeutic regimens before and after the intervention of clinical pharmacists in Department of Endocrinology.Zhangzhou Municipal Hospital affiliated to Fujian Medical University, were compared with clinical cases. Results:Pharmacists' intervention in doctors ' therapeutic regimens could improve the level of clinical therapy, reduce the medication costs and shorten the course of treatment. Conclusion: Clinical pharmacists can promote the rational use of drugs and enhance the therapeutic level of the hospital by participating in clinical therapy with their professional knowledge of pharmacy.

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

    NARCIS (Netherlands)

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

    2003-01-01

    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

  2. Effectiveness of a Pharmacist-Led Cardiovascular Risk Reduction Clinic in Rural Perry County, Alabama

    Science.gov (United States)

    Sands, Charles; Ford, Frances

    2016-01-01

    Background. The Cardiovascular Risk Reduction Clinic (CRRC) in Perry County, Alabama, provides free pharmacist-led services. Clinic goals include improving health outcomes and reducing cardiovascular risk factors. Objective. To investigate the effectiveness of the CRRC in rural Perry County, Alabama. The reduction of the modifiable cardiovascular risk factors, blood pressure and body mass index, was evaluated to measure a decrease from baseline to last clinic date. Methods. This retrospective chart review identified 130 patients with at least two blood pressure and BMI measurements from baseline to June 30, 2010. The patients' paper files were used to collect baseline data and most recent measurements, which were recorded on a data collection sheet. Results. There was a statistically significant reduction in systolic blood pressure of 4.08 mmHg, 3.25 mmHg reduction in diastolic blood pressure, and 0.42 kg/m2 reduction in mean BMI. At their last visit prior to June 30, 2010, 59% of hypertensive patients and 35% of diabetic patients were meeting their blood pressure goals. Conclusion. Pharmacist-led management of patients with cardiovascular risk factors significantly reduced blood pressure and allowed more patients to meet their hypertension treatment goals. Despite being modest, reductions in blood pressure and BMI help reduce overall cardiovascular risks. PMID:27525302

  3. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students].

    Science.gov (United States)

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori

    2016-01-01

    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

  4. Optimizing Prophylactic Antibiotic Practice for Cardiothoracic Surgery by Pharmacists' Effects.

    Science.gov (United States)

    Zhou, Ling; Ma, Jingjing; Gao, Jie; Chen, Shiqi; Bao, Jianan

    2016-03-01

    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

  5. Good clinical practice in clinical interventional studies

    OpenAIRE

    Pieterse, Herman; Diamant, Zuzana

    2014-01-01

    Good clinical practice (GCP) guidelines should always be implemented and obeyed in clinical interventional studies. In this mini-review, we will address several burning questions relating to GCP in a concise ‘frequently asked questions’ format.While compliance to current rules and regulations is our mission, we also wish to play devil’s advocate attempting to translate the rules into sizeable chunks using a high dose of common sense.Keywords: clinical interventional studies; quality; safety; ...

  6. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis

    Science.gov (United States)

    Mekonnen, Alemayehu B; McLachlan, Andrew J; Brien, Jo-anne E

    2016-01-01

    Objectives Pharmacists play a role in providing medication reconciliation. However, data on effectiveness on patients’ clinical outcomes appear inconclusive. Thus, the aim of this study was to systematically investigate the effect of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions. Design Systematic review and meta-analysis. Methods We searched PubMed, MEDLINE, EMBASE, IPA, CINHAL and PsycINFO from inception to December 2014. Included studies were all published studies in English that compared the effectiveness of pharmacist-led medication reconciliation interventions to usual care, aimed at improving medication reconciliation programmes. Meta-analysis was carried out using a random effects model, and subgroup analysis was conducted to determine the sources of heterogeneity. Results 17 studies involving 21 342 adult patients were included. Eight studies were randomised controlled trials (RCTs). Most studies targeted multiple transitions and compared comprehensive medication reconciliation programmes including telephone follow-up/home visit, patient counselling or both, during the first 30 days of follow-up. The pooled relative risks showed a more substantial reduction of 67%, 28% and 19% in adverse drug event-related hospital revisits (RR 0.33; 95% CI 0.20 to 0.53), emergency department (ED) visits (RR 0.72; 95% CI 0.57 to 0.92) and hospital readmissions (RR 0.81; 95% CI 0.70 to 0.95) in the intervention group than in the usual care group, respectively. The pooled data on mortality (RR 1.05; 95% CI 0.95 to 1.16) and composite readmission and/or ED visit (RR 0.95; 95% CI 0.90 to 1.00) did not differ among the groups. There was significant heterogeneity in the results related to readmissions and ED visits, however. Subgroup analyses based on study design and outcome timing did not show statistically significant results. Conclusion Pharmacist-led medication reconciliation programmes are effective at improving post

  7. Role of community pharmacists in asthma – Australian research highlighting pathways for future primary care models

    OpenAIRE

    Saini B; Krass I.; Smith L; Bosnic-Anticevich S; Armour C

    2011-01-01

    Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade o...

  8. A Pharmacist-Led Point-of-Care INR Clinic: Optimizing Care in a Family Health Team Setting.

    Science.gov (United States)

    Rossiter, Jennifer; Soor, Gursharan; Telner, Deanna; Aliarzadeh, Babak; Lake, Jennifer

    2013-01-01

    Purpose. Monitoring patients' international normalized ratio (INR) within a family medicine setting can be challenging. Novel methods of doing this effectively and in a timely manner are important for patient care. The purpose of this study was to determine the effectiveness of a pharmacist-led point-of-care (POC) INR clinic. Methods. At a community-based academic Family Health Team in Toronto, Canada, charts of patients with atrial fibrillation managed by a pharmacist with usual care (bloodtesting at lab and pharmacist follow up of INR by phone) from February 2008 to April 2008 were compared with charts of patients attending a weekly POC INR clinic from February 2010 to April 2010. Time in therapeutic range (TTR) was measured for both groups. Results. 119 patient charts were reviewed and 114 had TTR calculated. After excluding patients with planned inconsistent Coumadin use (20), such as initiating Coumadin treatment or stopping for a surgical procedure, the mean TTR increased from 64.41% to 77.09% with the implementation of the POC clinic. This was a statistically significant difference of 12.68% (CI: 1.18, 24.18; P = 0.03). Conclusion. A pharmacist-led POC-INR clinic improves control of anticoagulation therapy in patients receiving warfarin and should be considered for implementation in other family medicine settings. PMID:24455250

  9. 我院临床药师参与一例感染病例会诊实践%Consultation practice of clinical pharmacist in a infection case

    Institute of Scientific and Technical Information of China (English)

    潘洁; 金小平

    2012-01-01

    Objective To introduce unknown pathogens involved in infection cases and explore the pharmacist role in the process of clinical drug treatment for infection cases. Methods Clinical pharmacists involved in the drug treatment for a hospital infection case was retrospectively analyzed. Results Clinical pharmacists provided the best treatment options for patients by intervention of medication in cooporation with doctors, and the infection of the patient was effectively controlled. Conclusion Clinical pharmacists participating in drug treatment for infectious diseases,can ensure rational use of antimicrobial drugs,improve the efficacy of antimicrobial drugs.%目的 介绍我院药师参与病原菌不明感染性病例会诊的情况,探讨临床药师在感染性病例药物治疗过程中的作用.方法 回顾性分析我院临床药师参与的1例感染性病例药物治疗过程.结果 临床药师通过干预用药,配合医生为患者提供最佳用药方案,患者感染得到有效控制.结论 临床药师参与感染性疾病的药物治疗,可确保抗菌药物的合理应用,提高了抗菌药物的疗效.

  10. Nonverbal Interventions in Clinical Groups.

    Science.gov (United States)

    Shadish, William R., Jr.

    1980-01-01

    A comparison of nonverbal with verbal clinical group interventions suggested that some traditional self-report devices show less differentiation between these two interventions than do measures of group cohesion. A strong, replicable manipulation tested these findings, which were consistent with previous research. (Author/BEF)

  11. Medication reviews in primary care in Sweden: importance of clinical pharmacists' recommendations on drug-related problems.

    Science.gov (United States)

    Modig, Sara; Holmdahl, Lydia; Bondesson, Åsa

    2016-02-01

    Background One way of preventing and solving drug-related problems in frail elderly is to perform team-based medication reviews. Objective To evaluate the quality of the clinical pharmacy service to primary care using structured medication reviews, focusing on the clinical significance of the recommendations made by clinical pharmacists. Setting A random sample of 150 patients (out of 1541) who received structured team based medication reviews. The patients lived at a geriatric nursing home or were ≥65 years and lived in ordinary housing with medication-related community help. Method Based on information on symptoms, kidney function, blood pressure, diagnoses and the medication list, a pharmacist identified possible drug-related problems and supplied recommendations for the general practitioner to act on. Two independent physicians retrospectively ranked the clinical significance of the recommendations according to Hatoum, with rankings ranging between 1 (adverse significance) and 6 (extremely significant). Main outcome measure The clinical significance of the recommendations. Results In total 349 drug-related problems were identified, leading to recommendations. The vast majority of the recommendations (96 %) were judged to have significance 3 or higher and more than the half were judged to have significance 4 or higher. Conclusion The high proportion of clinically significant recommendations provided by pharmacists when performing team-based medication reviews suggest that these clinical pharmacy services have potential to increase prescribing quality. As such, the medication reviews have the potential for contributing to a better and safer drug therapy for elderly patients. PMID:26582483

  12. Clinical Trials Involving Pharmacists in Pakistan’s Healthcare System: A Leap from Paper to Practice

    Directory of Open Access Journals (Sweden)

    Atta Abbas

    2014-09-01

    Full Text Available The inclusion of pharmacists in the healthcare system of a developing country like Pakistan has always been a subject of debate among the healthcare professionals (HCPs, especially physicians, who have long ruled the healthcare system alone and who have had a long-held position of supremacy. The common argument against the inclusion of pharmacists is the dynamics of the healthcare system, and patients being physician oriented, hence, consider the inclusion of pharmacists as no good. Although the trend of defiance is changing, it is worthwhile mentioning here that the concept of the inclusion of pharmacist was implemented in developed countries by an evidence-based approach, i.e., to actually involve pharmacists in the disease state management of a patient and conducting a trial. This opinion calls for the same to be implemented in a developing country like Pakistan to evaluate its significance.

  13. Assessment of a pharmacist-driven point-of-care spirometry clinic within a primary care physicians office

    OpenAIRE

    Cawley MJ; Pacitti R; Warning W

    2011-01-01

    Objective: To assess value-added service of a pharmacist-driven point-of-care spirometry clinic to quantify respiratory disease abnormalities within a primary care physicians officeMethods: This retrospective, cohort study was an analysis of physician referred patients who attended our spirometry clinic during 2008-2010 due to pulmonary symptoms or disease. After spirometry testing, data was collected retrospectively to include patient demographics, spirometry results, and pulmonary pharmaceu...

  14. Pharmacist-managed clinics for patient education and counseling in Japan: current status and future perspectives.

    Science.gov (United States)

    Yamada, Kiyofumi; Nabeshima, Toshitaka

    2015-01-01

    To improve the adherence to and knowledge about pharmacotherapy in outpatients and to maximize the efficacy and minimize the adverse drug events, the first pharmacist-managed clinic (PMC) in Japan was established for anticoagulation therapy at Nagoya University Hospital in 2000. Since then, various PMCs such as for asthma/chronic obstructive pulmonary disease, Alzheimer's disease, hypercholesterolemia, chronic hepatitis C, cancer chemotherapy, palliative care, chronic kidney disease, and continuous ambulatory peritoneal dialysis have been established and expanded to many hospitals in Japan. Accumulating evidences suggest that PMCs have some beneficial effects on patients' adherence to and knowledge about their pharmacotherapy as well as the clinical outcome, besides being cost-effective. Notably, PMCs for cancer chemotherapy have been approved as a new medical service in hospitals in 2014, which is covered by the universal health coverage in Japan. In this review article, the current status of PMCs for patient education and counseling in Japan and their impact on pharmaceutical care and management are critically reviewed. Furthermore, future perspectives on PMCs are discussed. PMID:26819713

  15. Perceived barriers to pharmacist engagement in adverse drug event prevention activities in Ghana using semi-structured interview

    OpenAIRE

    Acheampong, Franklin; Anto, Berko Panyin

    2015-01-01

    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...

  16. Research and practice on hospital clinical pharmacist system construction%医院临床药师制体系建设的研究与实践

    Institute of Scientific and Technical Information of China (English)

    吴永佩; 颜青

    2011-01-01

    Background of building clinical pharmacist system in aspects of hospital needs suitable human resources system, hospital pharmacy needs transformation, pharmacist should participate in clinical pharmacy and help doctor selecting drug is discussed. Main content of hospital clinical pharmacist system research and practice is introduced. It shows that clinical pharmacist training base should be established, clinical pharmacist on job training mode should be explored and clinical pharmacist system should be built to give professional advice in clinical drug use.%从医院应当建立适宜的卫生人力资源、医院药学要转型,药师职责要转变、医院药师要参与临床用药,协同医师鉴别遴选药品等方面介绍了医院临床药师制体系建设的背景,阐述了临床药师制体系建设的研究与实践的主要内容,指出应建立临床药师培训试点基地,探索临床药师在职岗位培训模式,建立临床药师制,配备临床药师,全职(专职)参与临床药物治疗工作.

  17. Role of a Psychiatric Pharmacist in a Los Angeles “Skid-Row” safety-net clinic

    OpenAIRE

    Wang, Indriani; Dopheide, Julie Ann; Gregerson, Paul

    2011-01-01

    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...

  18. Positive interventions in clinical practice.

    Science.gov (United States)

    Rashid, Tayyab

    2009-05-01

    Mainstream psychotherapy has made huge strides in treating symptoms and disorders, but it has largely overlooked happiness as a therapeutic goal despite frequently hearing from clients, "Doctor, I want to be happy." This issue of Journal of Clinical Psychology: In Session describes a number of positive interventions for specific clinical problems, such as depression, anxiety, schizophrenia, loss, grief, and relationship distress. Although the name may suggest it, positive interventions do not imply that rest of psychotherapies are negative. Neither are negatives denied nor minimized. Distinct from self-help recipes proffering instant changes, positive psychology interventions refer to systematic approaches to overcome challenges by using clients' strengths and assets. A hybrid psychotherapy-coaching model and strength-based assessment can ask a client "What is right with you?" All articles are supplemented with rich case illustrations. PMID:19294745

  19. Bias in clinical intervention research

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte

    2006-01-01

    Research on bias in clinical trials may help identify some of the reasons why investigators sometimes reach the wrong conclusions about intervention effects. Several quality components for the assessment of bias control have been suggested, but although they seem intrinsically valid, empirical...

  20. Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

    Directory of Open Access Journals (Sweden)

    Hanna T

    2014-03-01

    Full Text Available Objective: To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods: Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG by three expert researchers. Results: In seven of nine scenarios (78%, the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency in the majority of scenarios. Due to this, only 47% (76/162 of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162 of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusion: Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

  1. Improving hypertension management through pharmacist prescribing; the rural alberta clinical trial in optimizing hypertension (Rural RxACTION: trial design and methods

    Directory of Open Access Journals (Sweden)

    Campbell Norman RC

    2011-08-01

    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.

  2. Improving hypertension management through pharmacist prescribing; the rural alberta clinical trial in optimizing hypertension (Rural RxACTION): trial design and methods

    OpenAIRE

    Campbell Norman RC; Kolber Michael R; Lewanczuk Richard; Cooney Dale; McAlister Finlay A; Charrois Theresa L; Rosenthal Meagen; Houle Sherilyn KD; Tsuyuki Ross T

    2011-01-01

    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 anti...

  3. Impact of clinical pharmacist collaboration in patients beginning insulin pump therapy: a retrospective and cross-sectional analysis*

    Science.gov (United States)

    Ledford, James L.; Hess, Rick; Johnson, Frank P.

    2013-01-01

    Objective To measure clinical and qualitative outcomes in patients with diabetes mellitus transitioning from intensive insulin therapy using multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) initiated and managed by clinical pharmacists under a collaborative practice agreement in a primary care setting without an endocrinologist. Research design and methods This study was a retrospective and cross-sectional analysis of data from an electronic medical record (EMR) and patient survey at a large primary care private practice. Patients with type 1 or type 2 diabetes who were ≥18 years old, started on CSII between 2007 and 2010, and had at least one follow-up visit post-CSII were analyzed. Mean HbA1c results were stratified across 3-month intervals post-CSII initiation and compared to pre-CSII levels. Body mass index (BMI), the number of diabetes-related clinic visits with the primary care physician (PCP), and non-insulin diabetes medication use was compared pre- and post-CSII initiation. Paper-based questionnaires were used to assess patient satisfaction with CSII vs MDI and pharmacist-led services. Results Twenty-five patients were included in the analysis. HbA1c decreased from 8.69 to 7.52% pre and post-CSII, respectively (p < 0.001). HbA1c also decreased across all 3-month intervals post-CSII. BMI decreased from 33.0 to 32.3 kg/m2 pre- and post-CSII, respectively (p = 0.085). Fewer diabetes-related PCP visits were completed post-CSII (5.09 vs 3.78 visits/year, p = 0.009), and less non-insulin diabetes medications were prescribed post-CSII (p < 0.001). Patients felt more comfortable controlling glycemic excursions and resultant insulin adjustments with CSII compared to MDI (p < 0.001). Conclusions Pharmacist-led CSII services appear to improve diabetes control in patients requiring intensive insulin therapy. Patients report greater comfort using CSII and strong confidence in the abilities of the pharmacist

  4. Pharmacist and clinical nutrition%药师与临床营养支持

    Institute of Scientific and Technical Information of China (English)

    梅丹; 李大魁; 张继春

    2001-01-01

    they dedicated to assuring that every patient receives optimal nutrition care,interdisciplinary,research-based,patient-centered clinical nutrition.Pharmacist would be one of the important roles in clinical nutrition.Guidelines for using parenteral and enteral nutrition in adult and pediatric patients and Medline were reviewed for this.For pharmacist is to identify problem areas in PN therapy specifically related to pharmacy practice and then will do his endeavors in safe practice for parenteral and enteral nutrition formulations,improving efficacy,reducing complications and facilitating efficient,cost-effective therapy.In this review,prescription,labeling PN formulations,extemporaneous compounding of them,the compounding technique and environment,quality assurance of the compounding process,stability and compatibility of PN formulations,in-line filtration of PN admixtures,the Y-site compatibility of medications and the influence of the type of bag were discussed.It is realized that these recommendations may result in significant changes in practice related to prescribing,compounding,labeling and administering PN.Pharmacist would play an important eole in the team.

  5. Characteristics of ambulatory care clinics and pharmacists in Veterans Affairs medical centers. IMPROVE investigators. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers.

    Science.gov (United States)

    Alsuwaidan, S; Malone, D C; Billups, S J; Carter, B L

    1998-01-01

    The type and extent of ambulatory care clinical pharmaceutical services in selected Veterans Affairs medical centers (VAMCs) were studied as part of a larger project. Questionnaires were sent to the 174 VAMCs to determine the extent of clinical pharmacy activity in ambulatory care clinics, characteristics of outpatient pharmacies and clinics, and characteristics of ambulatory care pharmacists in VAMCs and to identify sites for the IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) project. Fifty VAMCs responded to the survey. There were 512 ambulatory care clinics within these VAMCs. There was some pharmacist coverage in 75% of the clinics. The highest pharmacist coverage was in walk-in refill, therapeutic drug monitoring, and anticoagulation clinics. Clinical pharmacists at 68% of the VAMCs had prescribing privileges in ambulatory care clinics. Clinical pharmacists managed 29.9% of the clinics. The types of clinics most commonly managed by pharmacists were therapeutic drug monitoring, anticoagulation, walk-in refill, and lipid clinics. Nurse practitioners or physician assistants also were providing primary care in 41% of the clinics. There were 242 ambulatory care clinical pharmacy specialists practicing in the 50 VAMCs. Of these, 41.3% had three years or less of ambulatory care experience. Most pharmacists were in the clinic five days per week. A Pharm.D. degree was the highest degree obtained for 76.9%. Ambulatory care pharmaceutical services are common in VAMCs and are being provided by numerous clinical pharmacists. PMID:9437478

  6. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    OpenAIRE

    Angalakuditi M; Gomes J.

    2011-01-01

    Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR), pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription dat...

  7. Enhancing patient care via a pharmacist-managed rural anticoagulation clinic.

    Science.gov (United States)

    Jones, Cindy; Lacombe, Guy

    2009-01-01

    Integrating specialized pharmacist services and follow-up with the laboratory, home care nursing, retail pharmacy and physicians can ensure optimal outcomes for patients receiving anticoagulation, or "blood thinner," therapy. Improved patient education and discharge care planning can bridge disconnects, enable patients to better manage their care and ensure better patient outcomes and more effective use of health system resources. Specially trained pharmacists can provide safe and effective management of a high-alert medication to help prevent potentially life-threatening clots or bleeding. With advanced prescribing authorization, the pharmacist can seamlessly provide this service both locally in a community and via Telehealth to surrounding areas, potentially for any Albertan. Warfarin therapy may be lifelong or short-term (three to six months), but all patients require regular monitoring with blood tests. Many variables, both lifestyle and medication related, can impact therapy, and through extensive education and access via telephone to an "expert" for questions and follow-up of blood tests, patients are empowered to better regulate their anticoagulants. Anticoagulation pharmacists, as part of an AMS (anticoagulation management service), can provide a continuum of care for patients while in hospital, when discharged home, as an outpatient in the community or as a resident of a long-term care facility or seniors' home. PMID:20057253

  8. Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

    OpenAIRE

    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.

    2015-01-01

    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.

  9. Use of Six Sigma to improve pharmacist dispensing errors at an outpatient clinic.

    Science.gov (United States)

    Chan, Agnes L F

    2004-01-01

    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

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

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Kjeldsen, Lene Juel

    2013-01-01

    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...

  11. The role of Clinical Pharmacists in the improvement of a pharmacovigilance system: A review of the reported adverse drug reactions during 2004-2010 in Mazandaran Province of Iran

    Directory of Open Access Journals (Sweden)

    Elham Azhdari

    2013-02-01

    Full Text Available Background: Following establishment of Iranian Adverse Drug Reaction (ADR Monitoring Center in 1997, ADR committees were established in all hospitals of Mazandaran Province of Iran. Clinical pharmacists from Mazandaran University of Medical Sciences have been involved with these committees since 2007. The aim of this study was to compare the results of the pharmacovigilance system before and after active involvement of clinical pharmacists. Methods: This study included Yellow Cards filled out by healthcare providers in Mazandaran Province during 2004-2010. Frequency of Adverse Drug Reactions (ADRs, route of administration, reporters, number of reports in each years and damaged organs were focuses. Statistical analysis was performed by SPSS 16 software. P Results: A total of 793 yellow cards were completed during 2004 – 2010. Only 38 ADRs (4.8% were related to 2004-2007. Most of the reports generated by Nurses (49.3% followed by Pharmacists and Physicians (P Conclusion: Clinical pharmacists’ intervention regarding establishing ADR committees in the hospitals improved the output of the pharmacovigilance system, although under-reporting is still a major drawback of spontaneous reporting. Keywords: Pharmacovigilance, Adverse Drug Reaction, Mazandaran, Adverse Drug Reaction Reporting Systems

  12. Explore the Clinical Pharmacists of Clinical Pharmaceutical Thinking in Clinical Work%探讨临床药师参与临床工作的临床药学思维

    Institute of Scientific and Technical Information of China (English)

    万星灿

    2013-01-01

    目的:探讨临床药师建立临床药学思维的重要性。方法:结合临床药师在临床工作的特点,通过临床药师参与临床实践工作,对临床药学思维进行分析总结。结果:临床药师通过临床药学思维,能在临床上发现、识别并预防潜在的用药问题,可以与医师有效合作,使病人得到更加有效的治疗。结论:临床药师的临床药学思维能力的提高,对于临床药师能更好地开展药学服务,保障药物在临床使用过程中的安全及有效性具有重要意义。%Purpose: Explore the importance of the clinical pharmacists establishing clinical pharmaceutical thinking. Method:Combined with the features of the clinical pharmacists working in clinical work,Through the clinical pharmacists in clinical practice, thinking of clinical pharmacy are analyzed and summarized. Results:Clinical pharmacists in clinical pharmacy through thinking,can find,identify and prevent potential drug problems in clinical,can effectively cooperate with doctors,so that patients can get more effective treatment. Conclusion: The enhancement of the clinical pharmacists in clinical pharmacy of thinking ability,clinical pharmacists for better in pharmaceutical care,security in the process of using drugs in clinical safety and effective to have the important meaning.

  13. Adverse events in patients initiated on dabigatran etexilate therapy in a pharmacist-managed anticoagulation clinic

    Directory of Open Access Journals (Sweden)

    Donaldson M

    2013-06-01

    Full Text Available Background: Vitamin K antagonists have been the treatment of choice in preventing thromboembolic events, but problems such as frequent dose adjustment and monitoring of coagulation status, including multiple drug and food interactions, make their use difficult. Dabigatran etexilate is a new oral direct thrombin inhibitor not requiring routine monitoring and since its approval in the United States, many clinicians have been interested in utilizing this new therapy. Objective: This study documented adverse drug events (ADEs recorded in patients started on dabigatran therapy, including those who were previously controlled on warfarin and those who were anticoagulant naïve. Methods: In an outpatient pharmacist-managed anticoagulation clinic, a total of 221 patients were initiated on dabigatran therapy over an 18-month period. 43.0% of these patients were previously controlled on warfarin.Results: 54 of the 221 patients (24.4% developed an ADE while on dabigatran. The average time to event was 48.4 days. Nine of the fifty-four patients experienced a major bleeding ADE; six patients developed a serious non-bleeding ADE. Five of these fifteen patients died; one death was directly related to dabigatran therapy. The remaining thirty-nine of the fifty-four patients experienced a clinically relevant non-major ADE. Of the fifty-four patients who experienced an ADE, thirty were male. The average age was 73.8 years and the average weight was 92.8kg. Fifty-four percent of those who experienced an ADE were previously anticoagulant naïve.Conclusions: While many clinicians have been interested in utilizing the new direct thrombin inhibitor dabigatran etexilate, this new therapy is not without risks. This study documented adverse drug events in 24.4% of patients who were initiated on dabigatran etexilate therapy over an eighteen month period. ADEs were more common in patients who were anticoagulant naïve prior to dabigatran etexilate therapy and not those who

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

    Directory of Open Access Journals (Sweden)

    George J

    2011-05-01

    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.

  15. Medical and nursing staff highly value clinical pharmacists in the emergency department

    OpenAIRE

    Fairbanks, Rollin J.; Hildebrand, James M.; Kolstee, Karen E; Schneider, Sandra M.; Shah, Manish N.

    2007-01-01

    Despite the potential impact that emergency pharmacist (EPh) programmes could have on medication safety and quality of care in the emergency department (ED), very few programmes exist. This descriptive survey study aimed to assess staff perceptions of an EPh programme. A random sample of medical and nursing staff in an academic medical centre ED with a dedicated EPh programme received a 26‐item survey (82% return rate). 99% of respondents felt the EPh improves quality of care, 96% feel they a...

  16. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

    OpenAIRE

    Ma CSJ

    2014-01-01

    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 ex...

  17. Technical Support Role of Pharmacists in Clinical Drug Use%试论药师在临床用药中的技术支撑作用

    Institute of Scientific and Technical Information of China (English)

    吕健

    2015-01-01

    Objective To study the technical support role of pharmacists in clinical drug use.Methods The different professional divi-sion of labor and different professional requirements for clinical pharmacists and doctors were observed to define the clinical function of the clinical pharmacists.Results The clinical pharmacists′advantage in both clinical pharmacy knowledge and professional skills guaranteed their supporting function in the clinical medication.Conclusion The implementation of the Clinical Pharmacists System marks a great progress in the reform of China′s clinical system since the professional support from clinical pharmacists composes an irreplaceable part of clinical treatment.%目的:探索药师在临床用药中的技术支撑作用。方法考察临床治疗团队中对临床药师与临床医师的专业分工和专业要求,界定临床药师的临床作用。结果临床药师拥有临床药学专业知识和技能,在临床用药中起着专业技术支撑作用。结论临床药师制度的实施是我国临床制度改革的巨大进步,临床药师在临床用药中的专业技术支撑作用是实施临床治疗的重要组成部分。

  18. Repeat prescribing: a role for community pharmacists in controlling and monitoring repeat prescriptions.

    OpenAIRE

    Bond, C.; Matheson, C.; Williams, S; Williams, P.; Donnan, P

    2000-01-01

    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...

  19. Pharmacist-led implementation of a vancomycin guideline across medical and surgical units: impact on clinical behavior and therapeutic drug monitoring outcomes

    Directory of Open Access Journals (Sweden)

    Phillips CJ

    2015-10-01

    concentrations in target range rose from 33% to 44% (P=0.10, while potentially toxic concentrations decreased from 32% to 21% (P=0.05 post-implementation. Infection cure rates for patients increased from 85% to 96% (P=0.11 after the guideline was implemented. Conclusion: The implementation strategy employed in this study demonstrated potential effectiveness, and should prompt additional larger studies to optimize strategies that will translate into improved clinical practice using vancomycin. Keywords: antibiotics, Australia, behavioral medicine, clinical guidelines, implementation, intervention, pharmacists

  20. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

    Directory of Open Access Journals (Sweden)

    Ma CSJ

    2014-02-01

    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

  1. 临床药师在脑病科开展用药教育的体会%Experience of clinical pharmacist operating medical education in encephalopathy

    Institute of Scientific and Technical Information of China (English)

    张梅; 王成义

    2015-01-01

    本文探讨临床药师在临床科室开展患者用药教育的方法,提高药师服务患者的能力。临床药师应下临床开展患者用药教育,在工作中不断进行总结归纳。在开展用药教育过程中,临床药师要加强自身能力建设,主动、热情地投入工作。%In this paper,the author explored the methods of clinical pharmacists carry out patients medication education in clinical departments,in order to improve the service ability of pharmacists.Clinical pharmacists should develop drug education in the clinical,and continuously summary in the work. In the process of carrying out education,the clinical pharmacists should strengthen their own ability,and put into work with initiative and enthusiasm.

  2. 临床药师指导心血管科药物治疗的体会%Experience of clinical pharmacist guiding in medication of cardiovascular department

    Institute of Scientific and Technical Information of China (English)

    栗云明

    2013-01-01

    Objective To explore the effect of clinical pharmacists in clinical therapy.Methods The drug problems solved by clinical pharmacist in the cardiovascular department were summarized,and the process and methods of clinical pharmacist guiding in medication were described.Results The medication programs were improved through pharmaceutical guidance on doctors' drug treatment,the drug obedience and security were improved by pharmaceutical care for patients.Conclusion Participation of clinical pharmacists in cardiovascular department could improve the treatment effect,and protect the patients.%目的 探讨临床药师在临床治疗过程中的作用.方法 总结临床药师在心血管科遇到的用药问题,介绍临床药师指导药物治疗的过程与方法.结果 临床药师通过对医生的药学指导,完善了药物治疗方案;通过对患者的药学监护,提高了药物治疗依从性和安全性.结论 临床药师的参与对提高临床医疗水平、保障患者的生命安全具有重大意义.

  3. Practise of clinical pharmacists at hematology department%临床药师在血液科的工作实践

    Institute of Scientific and Technical Information of China (English)

    刘宇; 龚汉明; 段鹏程

    2014-01-01

    目的:探讨临床药师在血液科的药学服务模式,为临床药师工作提供参考。方法总结临床药师在血液科的工作经验及成效。结果临床药师发挥自身专业优势,协助解决临床用药问题,为医生、护士和患者提供药学服务。结论加强临床实践,找准切入点,协助临床解决用药中存在的问题,提高医疗质量。%Objective To explore the service mode at hematology department and set an example for clinical pharmacists in the respect of working mode .Methods To summarize the experience and achievements of clinical pharmacists in offering pharmaceutical service to doctors , nurses and patients at hematology depart-ment.Results The clinical pharmacists use their specialty to assist doctors and nurses in solving the dilemma of clinical prescription and guide patients in taking medicine .Conclusion A clinical pharmacists need to prac-tise more and find a breakthrough to serve doctors , nurses and patients better with their specialty .

  4. Family Planning and AIDS/HIV Intervention from a Cross-Cultural Perspective: Enhancing the Pharmacist's Role.

    Science.gov (United States)

    Day, Randal D.; And Others

    1993-01-01

    A study compared perceptions of pharmacy students in three different cultures (Malaysia, Thailand, United States) concerning pharmacist counseling about contraceptive use for family planning and AIDS prevention. Results indicate students in each culture, by gender, had different comfort levels with such counseling, implying need for different…

  5. Placebo interventions, placebo effects and clinical practice

    OpenAIRE

    Linde, Klaus; Fässler, Margrit; Meissner, Karin

    2011-01-01

    This article reviews the role of placebo interventions and placebo effects in clinical practice. We first describe the relevance of different perspectives among scientists, physicians and patients on what is considered a placebo intervention in clinical practice. We then summarize how placebo effects have been investigated in randomized controlled trials under the questionable premise that such effects are produced by placebo interventions. We further discuss why a shift of focus from the pla...

  6. 临床药师在静脉药物配置中心批次决策中的作用%Role of clinical pharmacists in batches decision making in pharmacy intravenous admixture services

    Institute of Scientific and Technical Information of China (English)

    秦娜; 魏立伟

    2015-01-01

    Reasonable batch decision-making of pharmacy intravenous admixture services (PIVAS) is a prerequisite for clinical rational drug use in the intravenous infusion. Clinical pharmacists in Luoyang Orthopedics Traumatological Hospital PIVAS draw up intravenous infusion batch rule according to the rational use of drug principle, and take manual intervention in special cases, which make the clinical PIVAS infusion delivery batches more scientific and reasonable, the clinical pharmacists play a decisive role in batches decision making.%静脉药物配置中心合理的批次决策能有效保障临床静脉输液合理用药。河南省洛阳正骨医院临床药师根据合理用药原则,制定静脉输液批次规则,在特殊情况下进行人工干预,使临床输液配送批次更加科学合理。临床药师在批次决策中起到举足轻重的作用。

  7. How to do"qualified full-time" clinical pharmacists%如何做合格的“专职”临床药师

    Institute of Scientific and Technical Information of China (English)

    常瑛; 冯娟; 赵培西; 田云; 乔逸; 文爱东

    2011-01-01

    在以患者为中心的药学服务阶段,结合我国临床药师的发展现况,认为培养专科临床药师切实可行,更利于我们药师和医院的同步发展,并探讨其工作主要任务和目标的六大方面,以及考核标准的六大方面;最终达到临床药师、医师、护师组成和谐团队,真正为患者提供最好的药学服务的观点.%In the patients as the center of pharmaceutical care stage, in combination with clinical pharmacists development of China, think training specialist clinical pharmacists feasible, more benefit at our hospital pharmacists and synchronous development, and discusses their work major tasks and goals of the six aspects, appraisal standards of six aspects. Finally achieve the clinical pharmacists, doctors, junior harmonious team, composed for patients with real provide the best pharmaceutical care point of view.

  8. Clinical Pharmacists'Pharmacy Practice in Pediatric Cardiac Intensive Care Unit%临床药师在儿童心脏病重症监护病房的药学实践

    Institute of Scientific and Technical Information of China (English)

    付强; 任艳丽; 郑磊; 郭华

    2015-01-01

    目的:探讨临床药师在儿童心脏病重症监护病房患者药物治疗中所发挥的作用。方法:结合典型案例,临床药师从药物配伍及滴注速度、抗感染药及肠外营养药合理应用等方面进行用药干预与监护,协助医师制定、调整用药方案。结果与结论:临床药师深入临床,开展药学监护工作,提高了药物疗效,减少了药品不良反应的发生。临床药师应发挥自身特长,促进了临床合理用药。临床药师应发挥自己的特长,不断提高专业素质、加强团队合作,在实践中积累经验,以便为临床治疗提供正确、全面的用药建议。%OBJECTIVE:To discuss the role of clinical pharmacists in treatment of patients in pediatric cardiac intensive care unit ( CICU ) . METHODS: Aimed at typical cases , clinical pharmacists carried out medication intervention and pharmaceutical care in aspects of drug compatibility , infusion rate , rational use of anti-infectives and parenteral nutrition , and helped physicians to develop and adjust dosage regimen .RESULTS&CONCLUSIONS:The clinical pharmacist carried out pharmaceutical care resulted in improvement in curative efficacy and reduction of the incidence of adverse drug reactions .Clinical pharmacists should bring their advantages into full play to promote clinical rational use of drug , meanwhile , they should bring into their advantages into full play and constantly improve their professional level , strengthen teamwork spirit and gain experience in practice in order to provide proper and comprehensive medication recommendations in clinical treatment .

  9. ASSESSMENT OF MEDICATION ADHERENCE AND FACTORS AFFECTING TO MEDIACTION ADHERENCE IN ASTHMA PATIENTS BY CLINICAL PHARMACIST

    Directory of Open Access Journals (Sweden)

    Hinchageri S. S

    2012-03-01

    Full Text Available Asthma is a major public health problem affecting a large number of individuals of all ages. The effectiveness of medications depends not only on the efficacy and appropriateness of the drugs used, but also on patient adherence to the intended regimen. Adherence with medication regimens is essential for attaining maximal therapeutic benefits. The main objective of the study was to assess the medication adherence and to identify the reasons for non-adherence to prescribed therapy. The medication adherence was assessed by using Morisky Medication Adherence Assessment questionnaires. Assessment of patient’s adherence from baseline to first follow up showed a mean increase in medication adherence level of 2.735 ± 0.1762 and P < 0.0001 which is statistically significant. Assessment of patient’s adherence from baselines to second follow up shows a mean increase of 3.211 ± 0.172 and P < 0.0001 which is statistically significant. The study concludes that pharmacist provided patient counseling found to have significant influence on improvement in the patient’s adherence to prescribed therapy.

  10. How to carry out pharmaceutical services of clinical pharmacists%临床药师如何开展药学服务

    Institute of Scientific and Technical Information of China (English)

    赵亚丽

    2016-01-01

    In this paper,the author discussed how to carry out pharmaceutical work in clinical pharmacists,and to make the clinical pharmacy services more effective.With the principles of safe,rational and economical in the use of drugs,we standardized the content and signiifcance of the speciifc work of clinical pharmacists in the clinical practice of pharmaceutical services.Clinical pharmacists should study the combination of clinical medicine and pharmacy,and enhance the ability of communication,to better serve the patients.%本文探讨临床药师如何开展药学工作,使临床药学服务更有效地服务患者。以患者安全、合理、经济用药为原则,规范临床药师在临床中开展药学服务的具体工作内容及意义,临床药师应学习临床医学知识,将其与药学结合,增强沟通能力。尽最大可能服务于患者。

  11. The Changing Roles Of Pharmacists In Society

    OpenAIRE

    Stephen Arthur Hudson; John Jackson Mc Anaw; Barbara Julienne Johnson

    2007-01-01

    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 ...

  12. 临床药师在糖尿病治疗中的药学服务%Pharmaceutical Care of Clinical Pharmacist in Treatment of Diabetic Patients

    Institute of Scientific and Technical Information of China (English)

    许恒忠

    2011-01-01

    Objective To study how the clinical pharmacist to provide the pharmaceutical care for diabetes patients for guiding patients with medication. Methods The clinical pharmacist used the pharmacological knowledge combined with the practice of pharmaceutical care and provided the pharmaceutical care to serve the diabetes patients. Results The clinical pharmacists providing the pharmaceutical services could improve the drug compliance of the diabetic patients, fully play the effect of drug treatment and enhance the patients' confidence to treatment. Conclusion The clinical pharmacy service has important significance to the diabetic patients for taking drugs rationally and controlling blood sugar, which also reflects the value of the clinical pharmacists.%目的 探讨临床药师如何为糖尿病患者提供药学服务.方法 临床药师应利用药学知识并结合药学服务实践,对糖尿病患者进行用药指导.结果 临床药师提供药学服务可提高糖尿病患者用药的依从性,更好地发挥药物疗效,增强患者对治疗的信心.结论 临床药学服务对糖尿病患者进行合理用药和控制血糖具有重要意义,同时也体现了临床药师的价值.

  13. Role of Clinical Pharmacist in Systemic Sclerosis Diagnosis%临床药师在系统性硬化症诊断中的作用

    Institute of Scientific and Technical Information of China (English)

    欧阳雁红; 李宝山

    2015-01-01

    Objective To discuss the role of of clinical pharmacist in systemic sclerosis diagnosis. Methods Clinical pharmacist discovered the problem through pharmaceutical care and pharmacy interrogation, and communicated with the clinical doctors, other symptoms of patient were considered. Results Two cases which were misdiagnosed many years got diagnosis correctly. Conclusion Clinical pharmacist can be an indispensable part of the treatment team through giving the full their advantage and cooperating with doc⁃tors efficiently.%目的:探讨临床药师在系统性硬化症诊断中的作用。方法临床药师通过临床药学监护及药学问诊,发现问题并及时与临床医师沟通,使患者的其他疾病体征得到重视。结果两例多年误诊为其他疾病的系统性硬化症患者得到确诊。结论临床药师充分发挥优势,与临床医师有效合作,可以成为治疗团队不可缺少的一部分。

  14. 临床药师参与45例癌症患者治疗的实践与分析%Practice and analysis of clinical pharmacists involved in 45 cases of treating cancer Huang Wei ZhangPiao GaoHuiThe people's hospital of yaan

    Institute of Scientific and Technical Information of China (English)

    黄伟; 张飘; 高慧

    2015-01-01

    目的:临床药师参与癌痛治疗效果分析评价。方法:选取我院收治45例癌症患者为研究对象,临床药师直接参与癌痛评估,对患者进行知识教育,对医生用药干预。观察比较干预前后效果。结果:干预后缓解率明显高于干预前,P<0.05,有显著差异,结论:疼痛治疗有药师参加效果更好。%effect Analysis and evaluation of clinical pharmacists involved in the treat of patients with cancer pain.Methods Select our hospital 45 cases of cancer patients for the study object, clinical pharmacists directly involved in pain assessment, providing patients with knowledge education,interventing in a doctor's medication.To compare the before and after effects of the intervention. Results:After the intervention, the remission rate was significantly higher than before intervention, P<0.05,having significant difference, conclusion:Pain treatment with Pharmacists participate work better.

  15. Fetal cardiac interventions: clinical and experimental research.

    Science.gov (United States)

    Yuan, Shi-Min; Humuruola, Gulimila

    2016-01-01

    Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block. The therapeutic options are advocated as prenatal aortic valvuloplasty, pulmonary valvuloplasty, creation of interatrial communication and fetal cardiac pacing. Experimental research on fetal cardiac intervention involves technical modifications of catheter-based cardiac clinical interventions and open fetal cardiac bypass that cannot be applied in human fetuses for the time being. Clinical fetal cardiac interventions are plausible for midgestation fetuses with the above-mentioned congenital heart defects. The technical success, biventricular outcome and fetal survival are continuously being improved in the conditions of the sophisticated multidisciplinary team, equipment, techniques and postnatal care. Experimental research is laying the foundations and may open new fields for catheter-based clinical techniques. In the present article, the clinical therapeutic options and experimental fetal cardiac interventions are described. PMID:27279868

  16. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    Directory of Open Access Journals (Sweden)

    Guy-Armel Bounda

    2013-01-01

    Conclusion: Chinese patients on warfarin therapy should benefit from periodic educational efforts reinforcing key medication safety information. Patient education is not a once-off procedure. A complete patient education program run by a clinical pharmacist in a Cardio-thoracic ward can considerably improve and enhance to reduce the hospital stays and significantly enlighten the role of the patient education in adherence to therapy.

  17. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    OpenAIRE

    Guy-Armel Bounda; Cosette Ngarambe; Wei Hong Ge; Feng Yu

    2013-01-01

    Background: Oral anticoagulation therapy with warfarin is used to prevent and to treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. Objective: This study aims to evaluate the clinical pharmacist-led in-patient warfarin′s knowledge education program and to assess a follow-up efficacy in a Chinese tertiary referral teaching hospital. Design and Setting: A cross-sectional and observational ...

  18. Perioperative medication management: expanding the role of the preadmission clinic pharmacist in a single centre, randomised controlled trial of collaborative prescribing

    OpenAIRE

    Hale, A.R.; Coombes, I D; Stokes, J.; D. McDougall; Whitfield, K; Maycock, E; Nissen, L

    2013-01-01

    Objectives Current evidence to support non-medical prescribing is predominantly qualitative, with little evaluation of accuracy, safety and appropriateness. Our aim was to evaluate a new model of service for the Australia healthcare system, of inpatient medication prescribing by a pharmacist in an elective surgery preadmission clinic (PAC) against usual care, using an endorsed performance framework. Design Single centre, randomised controlled, two-arm trial. Setting Elective surgery PAC in a ...

  19. 临床药师执业的困境及策略%Difficulties of clinical pharmacists practice and its corresponding strategies

    Institute of Scientific and Technical Information of China (English)

    吴洁芳

    2012-01-01

    To discuss clinical pharmacists' difficulties in practice in China and take measures to improve professional quality. Through analyzing the development status of clinical pharmacy in China and America, how to improve professional quality of clinical pharmacists in China is elaborated in this paper. Only taking doctors' professional weakness as the entry point, can their difficulties in practicing be resolved. Pharmacists should give full play to their professional pharmaceutical advantages, provide pharmaceutical services, guide rational drug use and become doctors' advisor on drug use and adapt to the new medical situation.%探讨目前中国临床药师的执业困境,明确提高职业素质的策略.本文通过分析中美两国临床药学的发展状况,阐明了中国临床药师应如何提高自身素质,应从医生的专业弱项作为切入点,才能化解执业困境,发挥药学专业优势,提供药学服务,指导合理用药,成为医生的用药顾问,适应新的医疗形势.

  20. Effects of pharmacists' interventions on appropriateness of prescribing and evaluation of the instruments' (MAI, STOPP and STARTs' ability to predict hospitalization--analyses from a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Ulrika Gillespie

    Full Text Available BACKGROUND: Appropriateness of prescribing can be assessed by various measures and screening instruments. The aims of this study were to investigate the effects of pharmacists' interventions on appropriateness of prescribing in elderly patients, and to explore the relationship between these results and hospital care utilization during a 12-month follow-up period. METHODS: The study population from a previous randomized controlled study, in which the effects of a comprehensive pharmacist intervention on re-hospitalization was investigated, was used. The criteria from the instruments MAI, STOPP and START were applied retrospectively to the 368 study patients (intervention group (I n = 182, control group (C n = 186. The assessments were done on admission and at discharge to detect differences over time and between the groups. Hospital care consumption was recorded and the association between scores for appropriateness, and hospitalization was analysed. RESULTS: The number of Potentially Inappropriate Medicines (PIMs per patient as identified by STOPP was reduced for I but not for C (1.42 to 0.93 vs. 1.46 to 1.66 respectively, p<0.01. The number of Potential Prescription Omissions (PPOs per patient as identified by START was reduced for I but not for C (0.36 to 0.09 vs. 0.42 to 0.45 respectively, p<0.001. The summated score for MAI was reduced for I but not for C (8.5 to 5.0 and 8.7 to 10.0 respectively, p<0.001. There was a positive association between scores for MAI and STOPP and drug-related readmissions (RR 8-9% and 30-34% respectively. No association was detected between the scores of the tools and total re-visits to hospital. CONCLUSION: The interventions significantly improved the appropriateness of prescribing for patients in the intervention group as evaluated by the instruments MAI, STOPP and START. High scores in MAI and STOPP were associated with a higher number of drug-related readmissions.

  1. 构建多元化的临床药师教学模式%Application of LBL, PBL and PLTL Teaching Methods in Clinical Pharmacist Training

    Institute of Scientific and Technical Information of China (English)

    汪震; 桂玲; 刘东; 杜光

    2014-01-01

    目的:提高在职临床药师培训教学质量。方法:根据在职药师及教学方法的特点,把传统教学模式( lecture-based learning,LBL)、问题为基础的教学方法(problem-based learning,PBL)与同伴主导的小组学习方法(peer-led team learning, PLTL)相结合,探索建立规范化的在职临床药师教学模式。结果:这种教学模式不仅提高了学生的学习积极性和主动性,还使学生掌握了解决问题的方法,增强了团队合作意识。结论:LBL、PBL和PLTL相结合的临床药师教学模式具有很好的教学效果。%Objective:To improve the teaching quality of in-service clinical pharmacist training. Methods:According to the traits of in-service pharmacists and teaching methods, combined with problem-based learning ( PBL), peer-led team learning(PLTL) and lecture-based learning ( LBL) , a standard teaching mode for in-service clinical pharmacists was explored and established. Results:The teaching mode could not only improve the study enthusiasm of students, but also let them master the study methods, and team co-operation consciousness was strengthened. Conclusion:An integrated teaching mode of LBL, PBL and PLTL has a good teaching effect on clinical pharmacist training.

  2. Placebo interventions for all clinical conditions

    DEFF Research Database (Denmark)

    Hróbjartsson, Asbjørn; Gøtzsche, Peter C

    2010-01-01

    Placebo interventions are often claimed to substantially improve patient-reported and observer-reported outcomes in many clinical conditions, but most reports on effects of placebos are based on studies that have not randomised patients to placebo or no treatment. Two previous versions of this...... review from 2001 and 2004 found that placebo interventions in general did not have clinically important effects, but that there were possible beneficial effects on patient-reported outcomes, especially pain. Since then several relevant trials have been published....

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

    Directory of Open Access Journals (Sweden)

    Box Margaret

    2011-10-01

    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

  4. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure

    NARCIS (Netherlands)

    R.N. Eggink; A.W. Lenderink (Albert); J.W. Widdershoven (Jos); P.M.L.A. van den Bemt (Patricia)

    2010-01-01

    textabstractObjective: Heart failure patients are regularly admitted to hospital and frequently use multiple medication. Besides intentional changes in pharmacotherapy, unintentional changes may occur during hospitalisation. The aim of this study was to investigate the effect of a clinical pharmacis

  5. Pharmacists' knowledge and the difficulty of obtaining emergency contraception.

    Science.gov (United States)

    Bennett, Wendy; Petraitis, Carol; D'Anella, Alicia; Marcella, Stephen

    2003-10-01

    This cross-sectional study was performed to examine knowledge and attitudes among pharmacists about emergency contraception (EC) and determine the factors associated with their provision of EC. A random systematic sampling method was used to obtain a sample (N = 320) of pharmacies in Pennsylvania. A "mystery shopper" telephone survey method was utilized. Only 35% of pharmacists stated that they would be able to fill a prescription for EC that day. Also, many community pharmacists do not have sufficient or accurate information about EC. In a logistic regression model, pharmacists' lack of information relates to the low proportion of pharmacists able to dispense it. In conclusion, access to EC from community pharmacists in Pennsylvania is severely limited. Interventions to improve timely access to EC involve increased education for pharmacists, as well as increased community request for these products as an incentive for pharmacists to stock them. PMID:14572889

  6. 临床药师参与感染性休克患者的药学监护实践%Clinical pharmacists providing pharmaceutical care for patient with septic shock

    Institute of Scientific and Technical Information of China (English)

    俞恩珠; 胡毅坚

    2013-01-01

    临床药师深入临床一线为感染性休克患者提供药学监护,对药物治疗方案进行分析、审核,为医生提供咨询,提出合理用药建议,对护士进行用药知识教育.临床药师参与解决临床药物治疗实际问题,可使患者更大限度受益.%Clinical pharmacists took part in inspection of ward and provided pharmaceutical care for patient with septic shock. Clinical pharmacists checked pharmaco - therapeutic programs with their professional knowledge, answered doctors' inquires, made recommendations on rational drug use, exerted drug knowledge education on nurses. It can benefit patients to a greater extent that clinical pharmacists resolve problems of clinical therapy.

  7. Retrospective analysis on participating in clinical medication related therapy of clinical pharmacists in 13 cases%回顾性分析本院临床药师参与临床药物治疗13例

    Institute of Scientific and Technical Information of China (English)

    俞恩珠

    2011-01-01

    Clinical pharmacists take part in inspection of wards, examine pharmaco - therapeutic programs and sometimes we put forward our proposals and suggestions to doctors. Our proposals are often adopted by doctors, therefore our jobs make pharmaco - therapeutic programs more perfect That clinical pharmacists participate in clinical medication related therapy by these methods is not only feasible but also effective.%临床药师参与查房,对药物治疗方案进行审核,必要时提出意见与建议.临床药师的建议经常被医师采纳,临床药师的工作使药物治疗方案更加完善.临床药师通过这种方式参与药物治疗不仅可行,而且有效.

  8. Developmental intervention: a pediatric clinical review.

    Science.gov (United States)

    Casey, P H; Bradley, R H; Caldwell, B M; Edwards, D R

    1986-08-01

    We have attempted to review developmental intervention for pediatricians in a way that is of clinical relevance to primary care pediatricians. In so doing, we chose not to evaluate certain topics such as therapeutic intervention for handicapped children or center-based educational programs because these have been adequately addressed elsewhere. It is clear that pediatricians have a unique and important role to play in developmental intervention for the following reasons: pediatricians have easy and routinely accepted access to infants and families in the prenatal, perinatal, and preschool periods: pediatricians possess a socially accepted role of authority; and pediatricians can integrate understanding of the child's health and developmental status within the context of the family and social environment to make clinical interpretation regarding the child's developmental status and prognosis. Pediatricians are thus in the best position to convince parents of their impact on their child's development. The following general roles have been identified for pediatricians. First, pediatricians should be aware of the child's biologic status and family environmental situation and the relative degree of risk for developmental problems. This clinical awareness, in combination with the use of appropriate screening instruments of the child's development and family environment, will allow clinical judgment regarding the frequency and type of child health supervision, the need for further diagnostic evaluation, and the need for referral to intervention programs and other resources. Second, the pediatrician should develop an approach for developmental intervention for all children, whatever their degree of biological risk. This review of medical, educational, and psychological literature demonstrate the following recurring important themes as goals for primary intervention: Improve parental understanding of normal child development and developmental expectations. Assist parent

  9. 临床药师开展药学监护工作方法之我见%The Way of Clinical Pharmacists to Promote Pharmaceutical Care

    Institute of Scientific and Technical Information of China (English)

    王虎军; 杨静; 杨燕燕

    2001-01-01

    OBJECTIVE: To discuss the problems to which clinical pharmacists should pay attention in promoting pharmaceutical care METHDOS: To summarize and analyze the present situation and existing problems in rational drug- use and pharmaceutical care RESULTS & CONCLUSION: Playing an important role in clinical treatment, clinical pharmacists should know medical knowledge well and can communicate with doctors in rational drug use, which is the prerequisite for pharmaceutic care%目的:探讨临床药师在药学监护工作中应注意的问题。方法:概述并分析了合理用药和药学监护工作的现状及存在的问题。结果与结论:临床药师已成为临床治疗中的重要角色,掌握必要的医学知识,在合理用药方面同医师相互沟通并掌握丰富的药学知识是药学监护的必要条件。

  10. Working Mode and Practice of Clinical Pharmacists Involved in Management of Inpatient Pharmacy%临床药师纳入病房药房管理的工作模式及实践

    Institute of Scientific and Technical Information of China (English)

    齐晓涟; 唐静; 刘宁; 褚燕琦; 王淑洁; 程红勤; 闫素英; 林晓兰; 王育琴

    2011-01-01

    目的:探索临床药师的工作模式.方法:结合我院工作实际,采用实证案例研究的方法,从临床药师与病房药房药师相互配合的角度,总结临床药师切实可行的工作模式.结果与结论:将临床药师的编制纳入病房药房中,临床药师采用每天在责任科室参与临床实践、积累临床用药经验的同时,对需要会诊的其他科室的病例给予用药监护和回访的工作方式,为医师、护士和患者提供全程化的药学服务,并将临床实践延伸到临床药学的教学和科研工作中,由此形成的临床药师工作模式有利于保证患者用药安全、有效,实现药师自身的工作价值.%OBJECTIVE: To explore the working mode of clinical pharmacists. METHODS: Based on the practice of our hospital, feasible working mode of clinical pharmacists was summarized in the view of cooperation between clinical pharmacists and pharmacists of wards and pharmacy by means of case study. RESULTS & CONCLUSIONS: The personnel posts of clinical pharmacists should be included in the management of inpatient pharmacy. Clinical pharmacists provide whole course pharmaceutical care for doctors, nurses and patients by means of participating in clinical practice of responsibility department, accumulating experience of clinical drug use, providing pharmaceutical care and returning visit for cases of other departments requiring consultations. Clinical practice is extended to teaching and research of clinical pharmacy. Established working mode of clinical pharmacists contributes to safe and effective drug use and the achievement of work value of clinical pharmacists.

  11. 国外临床药师药物重整工作简介%Introduction of Medication Reconciliation by Foreign Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    刘治军

    2012-01-01

      根据笔者6个月的美国临床药师培训工作的见闻,结合相关参考文献,对美国及其它相关的药物重整工作的情况进行简介,包括药物重整工作的定义、目的、发展情况和存在问题。供中国的临床工作者特别是临床药师在日常工作中学习和实践。%  Based on the 6-month clinical pharmacist training program at University of Illinois at Chicago (UIC) and the published literatures, the foreign medication reconciliation work was briefly introduced including the definition, aim, development and the existing questions. Chinese healthcare practitioners especially the clinical pharmacists can learn something and practice medication reconciliation in daily work.

  12. 临床药师会诊1例产后胎盘植入并感染浅析%Analysis of Clinical Pharmacist Participating in the Consultation for 1 Case of Postpartum Placenta Implantation Complicating with Infection

    Institute of Scientific and Technical Information of China (English)

    张忠元; 龙萍

    2011-01-01

    OBJECTIVE: To cultivate the thinking of clinical pharmacist gradually and discover the breakthrough point through summarizing from the consultation for a particular disease case by the clinical pharmacist, so as to become one member of the therapy team. METHODS: Clinical pharmacist participating in the consultation for a case of postpartum placenta implantation complicating with infection was analyzed retrospectively. RESULTS: Clinical pharmacist can provide the reasonable drug selection for clinical pharmacist and offer some necessary medication education to the patients. CONCLUSION: Clinical pharmacist can offer absolutely necessary help to the doctors and patients.%目的:通过总结分析临床药师在临床会诊的病例,逐渐培养临床药师的临床思维,找到在临床工作中药师的切入点,使之成为临床治疗团队中不可或缺的一员.方法:对临床药师参与会诊1例产后胎盘植入并感染进行回顾性分析.结果:通过会诊,临床药师不但给临床医师提供了合理的药物选择,同时也为患者提供了必要的用药教育.结论:临床药师可以在药物治疗学方面给予临床医师和患者不可或缺的帮助.

  13. Pharmaceutical Care for a Patient with Erlotinib Therapy by Clinical Pharmacists%临床药师对1例使用厄洛替尼患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    陈集志; 李刚; 徐小燕; 张静; 张增珠

    2012-01-01

    目的:探讨临床药师参与临床的切入点与开展药学监护的方法.方法:结合1例使用厄洛替尼患者的病例,临床药师从厄洛替尼的药理作用、药物相互作用、不良反应以及应采取的防范措施进行药学监护.结果:临床药师协助医师,确保患者顺利治疗,取得了明显的效果,提高了药物治疗水平.结论:临床药师通过参与临床实践,可协助医师提高药物治疗的安全性和有效性.%OBJECTIVE: To explore breakthrough point of clinical pharmacists participating in clinical practice and the methods of developing pharmaceutical care. METHODS: According to medical records of a patient receiving erlotinib, clinical pharmacists provided pharmaceutical care from pharmacological functions of erlotinib, drug interaction, adverse drug reactions and preventive measures. RESULTS: Clinical pharmacists assisted doctors to ensure smooth treatment for patients, obtain obvious effect and improve the level of drug treatment. CONCLUSION: Clinical pharmacists participate in clinical practice and assist physicians to improve the safety and efficacy of drug treatment.

  14. 临床药师对1例胆道感染患者的药学监护%Pharmaceutical Care of Clinical Pharmacist for One Patient with Biliary Tract Infection

    Institute of Scientific and Technical Information of China (English)

    李海燕; 胡斌

    2016-01-01

    Objective:To analyze the pharmaceutical care performed by clinical pharmacist for one patient with biliary tract infec -tion to investigate the role of clinical pharmacists in clinical treatment .Methods:The clinical pharmacist supervised the whole process of treatment for the patient and optimized the treatment regimen together with the clinical doctors to achieve good efficacy .Results:With the cooperation of clinical pharmacist , the clinical doctors changed the treatment drugs to avoid the potential adverse drug reac -tions until the patient was cured .Conclusion:The participation of clinical pharmacist in the pharmaceutical care for the patients with biliary tract infection can provide a new thought of working mode .%目的:分析临床药师对1例胆道感染患者抗感染治疗的药学监护,探讨临床药师如何在临床治疗中发挥作用。方法:临床药师监护患者用药全过程,协助医师优化给药方案。结果:临床药师建议医师及时换用恰当药物,避免了潜在药品不良反应的发生,并取得良好治疗效果。结论:为临床药师在胆道感染的药学监护中提供新思路。

  15. Clinical Pharmacist Participating in Pharmaceutical Care for a Patient with Acute Pancreatitis%临床药师参与1例急性胰腺炎的药学监护

    Institute of Scientific and Technical Information of China (English)

    姚高琼; 朱深银; 赵语; 邱峰; 张成志

    2012-01-01

    目的:通过临床药师对急性胰腺炎患者的药学服务,探讨临床药师如何在临床治疗中发挥作用.方法:临床药师在1例急性胰腺炎患者的治疗过程中,与临床医师共同制订治疗方案,监护患者用药全过程,针对患者病情变化提出合理换药.结果:在临床药师参与下,临床医师调整治疗方案,真正做到治疗个体化,使患者治愈出院.结论:临床药师通过药学监护,避免了不良反应的发生,优化了急性胰腺炎临床治疗方案,取得了良好的效果.%OBJECTIVE: To discuss pharmaceutical care for patients with acute pancreatitis by clinical pharmacists so as to investigate the role of clinical pharmacists in the clinical treatment. METHODS: The clinical pharmacists formulated the treatment plan with the clinical doctor and supervised the whole process of treatment for the patient, then changed drugs according to disease condition. RESULTS: With the cooperation of clinical pharmacists, the clinical doctor adjusted the treatment plan to individualize treatment. CONCLUSION: Clinical pharmacist participating in the pharmaceutical care for acute pancreatitis patients can avoid adverse drug reaction and optimize the treatment plan to achieve good efficacy.

  16. 我院临床药师开展儿科药学服务的经验与体会%Experience of Clinical Pharmacist Participating in Pharmaceutical Care in Pediatrics Department

    Institute of Scientific and Technical Information of China (English)

    王燕萍; 焦凯; 武新安

    2011-01-01

    目的:探讨临床药师在儿科开展药学服务的作用.方法:结合儿科工作经历和临床药学服务实践,介绍我院临床药师工作.结果与结论:临床药师应参与临床药物治疗团队的工作,与医师共同制订药物治疗方案,为提高临床治疗水平及保障患儿用药安全、有效起到促进作用.%OBJECTIVE: To discuss the effect of pharmaceutical care provided by clinical pharmacists in pediatrics department.METHODS: Based on the experience of clinical pharmacists and examples of pharmaceutical care for pediatrics, the work of clinical pharmacists in our hospital was introduced.RESULTS&CONCLUSIONS: Clinical pharmacists should participate in clinical treatment team and develop the treatment program together with doctors to improve medical treatment and ensure the safety and effectiveness of drug use in children patients.

  17. The Practice of Clinical Pharmacists'Participation in the Treatment of One Case with Nephrotic Syndrome%临床药师参与1例肾病综合征患者的治疗实践

    Institute of Scientific and Technical Information of China (English)

    马文明

    2015-01-01

    OBJECTIVE:To explore the effect of the clinic participation of pharmacists in the treatment of the patient with nephrotic syndrome .METHODS:Through participating in the treatment of a certain patient with nephrotic syndrome , pharmacists assisted the doctor to adjust the drug use program and analyze the rationality of the application of diuretics .RESULTS:The suggestions provided by clinical pharmacists were accepted by doctors , and the patient got better and discharged from the hospital .CONCLUSIONS:Clinical participation of pharmacists in the establishment of clinic treatment program can effectively solve the clinical problems and promoted rational drug use .%目的:探讨临床药师在临床药物治疗中所发挥的作用。方法:临床药师参与1例肾内科肾病综合征患者的临床治疗过程,参与药物治疗方案的调整,分析利尿剂应用的合理性。结果:临床药师的建议被医师采纳,患者病情好转出院。结论:临床药师参与临床药物治疗方案的制订,可有效解决临床问题,有利于促进合理用药。

  18. Clinical pharmacists in respiratory department pharmaceutical services%临床药师参与呼吸科药学服务的工作经验与体会

    Institute of Scientific and Technical Information of China (English)

    李佳鑫; 刘海楠

    2016-01-01

    目的:结合实例总结临床药师在呼吸科的工作经验与体会,探讨临床药师在呼吸科的工作切入点。方法本院药师查房采用了临床查房和药学查房相结合的模式,临床药师通过药学查房、协助医师优化治疗方案、关注药物不良反应、撰写药历、用药教育等全面参与临床诊疗。结果临床药师通过药学查房、协助医师优化治疗方案、关注药物不良反应、撰写药历、用药教育等参与临床治疗,运用自身优势协助医师解决用药问题,减少不良反应的发生,提高患者用药依从性。结论临床药师要精准把握呼吸内科的工作切入点,积极投身临床实践,以体现药师价值。%Objective To example and summarize experience of clinical pharmacists in respiratory department,to ex-plore the clinical pharmacists in respiratory work. Methods Our hospital pharmacists rounds by adopting the combination of the clinical ward round and pharmaceutical ward round model,clinical pharmacists through pharmaceutical ward round,assist doc-tors optimize treatment plan,pay attention to adverse drug reaction,writing drug database,such as drug education full partici-pation in the clinical diagnosis and treatment. Results Clinical pharmacists through pharmaceutical ward round,assist doctors optimize treatment plan,pay attention to adverse drug reaction,writing drug database,such as drug education full participation in the clinical diagnosis and treatment,using their own advantages to help doctors to solve medical problems,reduce the occur-rence of adverse reactions and improve the patients medication compliance. Conclusion Clinical pharmacists should accurately grasp the respiratory medicine work to start,active in clinical practice,in order to manifest the value of pharmacists.

  19. 临床药师参与治疗小儿重症化脓性胸膜炎的实践分析%Practical Analysis of Clinical Pharmacist Involved in Severe Pyothorax Treatment for Children

    Institute of Scientific and Technical Information of China (English)

    董懿珍; 胡晓红; 秦立忠

    2012-01-01

    Objective:To analyze the experience of clinical pharmacist involved in severe pyothorax treatment for children and discuss the role of clinical pharmacist in the clinical practice. Methods: Clinical pharmacist assisted physicians to develop effective treatments in children for specific cases, concerned about the effects of medication and drug safety issues during the treatment. Results; The pharmaceutical care developed by clinical pharmacists was accepted by doctors. The patients' conditions were promptly improved and all of them were cured. Conclusions; Clinical pharmacist should master the knowledge of pharmacy, and be involved in the clinical practice to improve the therapeutic effect and ensure drug safety in children patients.%目的:通过分析临床药师参与小儿重症化脓性胸膜炎的会诊与治疗,探讨其在临床治疗中的作用.方法:针对具体病例,协助医师制定有效的治疗方案,关注患儿治疗期间用药的疗效和安全性.结果:临床药师提供的治疗方案大部分被临床医师支持和采纳,使重症化脓性胸膜炎患儿的病情得到控制,取得了治愈的效果.结论:临床药师必须熟练掌握药学知识和临床相关知识,参与临床药物治疗,可提高疗效,确保患儿用药安全,使患儿受益.

  20. 临床药师参与1例布鲁菌病的治疗体会%Experience of Clinical Pharmacists Participating in the Treatment of One Case of Brucellosis

    Institute of Scientific and Technical Information of China (English)

    彭红艳; 周慧; 黄兴富; 刘灵敏; 李松

    2016-01-01

    目的::探讨临床药师参与布鲁菌感染患者实施药物治疗的方法与思路。方法:临床药师参与1例布鲁菌感染患者的会诊,针对患者的病情,详细询问患者病史、职业和接触史,调整药物治疗方案,对患者进行用药教育等方面进行综合分析。结果:临床药师在疾病治疗过程中提出的会诊意见和建议得到了临床认可,对协助医师合理用药发挥了重要的作用,明显提高了药物治疗效果。结论:临床药师参与患者个体化用药,协助临床医生优化抗感染治疗方案,提高患者用药的安全性、有效性。%Objective: To explore the approaches and ideas of clinical pharmacists participating in drug therapy of patients with brucellosis. Methods: Clinical pharmacists participated in the clinical consultation for one patient with brucellosis. Clinical pharmacists analyzed comprehensively by asking medical history, occupation and contact history in details, adjusting the treatment scheme and performing medical education etc. Results: The consultation comments and suggestions proposed by clinical pharmacists were recognized by clinics, which played an important role in assisting doctors in the rational drug use and significantly improved the medical treatment. Conclusion: Clinical pharmacists should participate in the individualized medication and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

  1. Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University.

    Science.gov (United States)

    Kitzmiller, Joseph P; Phelps, Mitch A; Neidecker, Marjorie V; Apseloff, Glen

    2014-01-01

    Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program - one of only nine accredited by the American Board of Clinical Pharmacology - that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions. PMID:25018660

  2. Delivery of patient adherence support: a systematic review of the role of pharmacists and doctors

    Directory of Open Access Journals (Sweden)

    Andersson M

    2014-06-01

    Full Text Available Malin Andersson,1,2 Sara Garfield,1,2 Lina Eliasson,3,4 Christina Jackson,3 David K Raynor5 1The Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, 2UCL School of Pharmacy, London, 3Atlantis Healthcare, London, 4Centre for Haematology, Imperial College London, Hammersmith Hospital, London, 5School of Healthcare, University of Leeds, Leeds, UK Abstract: We conducted a systematic review of adherence support programs involving doctors and pharmacists. We searched MEDLINE®, Embase, International Pharmaceutical Abstracts, PsycINFO®, and CINAHL using the keywords "pharmacist" or "doctor" and "adhere*" or "compli*" and "randomized controlled trials". We found 89 studies involving pharmacists; in contrast, only 14 studies involved doctors. The roles of pharmacists and doctors ranged from providing education and counseling to adjusting treatment. Most interventions that specified a patient group were carried out with patients with chronic conditions (n=79 and only six included short-term treatments. The majority of interventions improved adherence and clinical outcomes to some extent, although the size of effect size was sometimes small. Resource utilization (eg, hospitalization rates, visits to doctors did not change in the majority of studies that reported it. Few studies included cost analyses. All but one study had high risk of performance bias due to the nature of the interventions, which made it impossible to blind the participants. The majority of studies did not report tailoring the interventions to patient needs and the vast majority of papers did not report taking a concordant patient-centered approach or considering patients' own views and experiences when providing adherence support. In addition, the majority of studies did not describe training for the health care professionals involved in providing adherence support. Providing training for doctors and pharmacists to

  3. Mode Exploration of TCM Pharmacists Participating in Clinical Practice in Our Hospital%我院中药师参加临床实践的模式探讨

    Institute of Scientific and Technical Information of China (English)

    庄伟; 林晓兰; 高利; 郭景仙; 韩立新; 张鹏

    2012-01-01

    目的:探讨建立中药师参加临床实践的模式.方法:介绍我院中药师参加临床工作的实践与体会,探讨与中药师临床实践模式建立相关的问题.结果:中药师参加临床实践能够帮助医师、护士解决临床问题,促进患者安全、有效、经济使用中药.结论:建立中药师临床实践工作模式任重道远,面临的挑战十分严峻.%OBJECTIVE: To explore the mode of TCM pharmacists participating in clinical practice in our hospital. METHODS: By introducing practice and experience of TCM pharmacist participating in clinical practice in our hospital, the related problems about the establishment of clinical pharmacist practice model were investigated. RESULTS: TCM pharmacists can assist doctors and nurses to resolve problems to promote safe, effective and economical drug use in patients. CONCLUSION: There are severe challenges to establish standardization clinical practicing mode.

  4. 临床药师参与多药耐药不动杆菌抗感染治疗的体会%Experience of clinical pharmacists participating in antiinfective therapy

    Institute of Scientific and Technical Information of China (English)

    田泾; 王卓; 高申

    2015-01-01

    目的:探讨临床药师参与药物治疗方案的制订与药学监护的方法。方法临床药师参与了1例患者的抗感染治疗,通过学习文献和指南,分析评价治疗方案,提出用药建议,开展药学服务。结果临床药师的建议被采纳,患者病情好转出院。结论临床药师可协助医师制订更为安全有效的治疗方案,对患者康复有促进作用。%Objective To explore the method of clinical pharmacists participating in designing therapy regimens and car-rying out pharmaceutical care .Methods The clinical pharmacists participated in antiinfective therapy of one patient through learning literature and guidelines ,analyzing the regimen ,offering suggestion and providing pharmaceutical care .Results The suggestion provided by clinical pharmacists was accepted by doctors and the patient was cured and discharged from the hospital . Conclusion Participation of clinical pharmacists is helpful for doctors to make safe and effective medication .

  5. Pharmacist Computer Skills and Needs Assessment Survey

    OpenAIRE

    Robert M. Balen; Jewesson, Peter J

    2004-01-01

    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...

  6. Explore the pharmacist intervention on quality of hospital outpatient prescriptions%探讨药师干预对我院门诊处方质量的影响

    Institute of Scientific and Technical Information of China (English)

    吴福建

    2015-01-01

    目的:了解药师干预对医院门诊处方质量的影响效果。方法本院自2011年开始门诊处方受药师干预,随机抽取200张处方进行检查点评,设为观察组,另随机选取本院2010年药师干预前门诊处方200张,设为对照组。对2组处方质量进行平行比较与分析。结果相对于药师干预前,干预后处方的合格率、药物使用方面等均有显著改善,对比有明显优越性,差异具统计学意义(P<0.05)。结论药师干预让我院门诊处方在审核和点评方面更加完善,能够及时发现不合理的地方并通过点评结果对处方进行干预,对于我们门诊处方的质量提高有重要作用,可以在一定程度纠正医生开处方时的不良用药习惯,需要不断加强干预力度,确保医院门诊处方出现错误的概率不断下降,保障患者用药安全。%Objective To understand the pharmacist intervention on outpatient prescription quality affect the results. Methods The hospital outpatient prescriptions since 2011 by pharmacist intervention, randomly selected 200 prescriptions for inspection comments, set in the observation group, another randomly selected hospital pharmacist intervention before 2010 outpatient prescription 200, set in the control group. Quality prescription for two parallel group comparison and analysis. Results:Compared with the previous pharmacist intervention were significantly improved after the intervention pass rate of prescription of drugs use, etc., there are obvious advantages contrast, the difference statistically significant (P<0.05). Conclusion Pharmacist intervention outpatient prescription let me be more perfect in terms of audits and reviews, the ability to detect unreasonable and reviews the results of the prescription through intervention, for us to improve the quality of outpatient prescriptions have an important role, the doctor can be corrected to some extent bad habit of prescribing

  7. The regular work,the innovative work and the pioneering work of clinical pharmacists%临床药师的常规工作、创新工作与开拓工作

    Institute of Scientific and Technical Information of China (English)

    谭喜莹; 蔡映云; 叶晓芬

    2011-01-01

    Objective:To introduce the outstanding clinical pharmacist who would not only complete the regular work but also carry out the scientific research on clinical pharmacy and the teaching reform. Methods: The contents of regular work, the innovative work and the pioneering work of clinical pharmacists. and the examination systems and the training systems are introduced. Results:The outstanding clinical pharmacist should have the pioneering spirit to promote development of the knowledge and to extend the influence on other pharmacists and doctors, and enable themselves to become the pharmaceutical talents with comprehensive skills and knowledge. Conclusion:Clinical pharmacists should gradually carry out above three kinds of work.%目的:介绍一名优秀的临床药师不但要在临床做好常规工作,而且要开展临床药学科研和临床药学教学改革.方法:从常规工作、创新工作和开拓工作的工作内容、考核方法及如何进行三个方面的工作进行介绍.结果:临床药师要具有开拓能力,推动学科发展,不断扩大影响,成为素质高、能力强、知识精的医教研全面发展的人才.结论:临床药师在工作中应逐步开展上述三项工作.

  8. 临床药师参与布鲁菌感染患者1例会诊实践%Consultation practice of clinical pharmacist in a Brucella infection case

    Institute of Scientific and Technical Information of China (English)

    李晓平

    2016-01-01

    Objective To introduce the clinical pharmacist consultation practice in a Brucella infection case and ex-plore the clinical pharmacist role in the process of drug treatment. Methods Clinical pharmacist involved in the drug treat-ment for a Brucella infection case was retrospectively analyzed. Results Clinical pharmacist helped doctors provide the best treatment options for patient on the basis of professional knowledge,the infection of the patient was effectively controlled. Con-clusion Clinical pharmacists can improve the efficacy and safety of drugs by participating in drug treatment and carry out pharmaceutical care.%目的:通过介绍我院临床药师参与布鲁菌病患者1例会诊的情况,总结临床药师参与药物治疗的作用。方法回顾性分析我院临床药师参与1例布鲁菌感染会诊治疗的案例。结果临床药师以专业特长参与临床治疗,配合医师为患者选择最佳用药方案,患者感染得到有效控制。结论临床药师参与药物治疗,及时进行药学监护,可提高患者用药的有效性及安全性。

  9. Clinical analysis of interventional therapy for adenomyosis

    International Nuclear Information System (INIS)

    Objective: To assess clinical effects of transcatheter uterine arterial embolization (TUAE) on adenomyosis. Methods: From Oct. 1999 to Jun. 2001, TUAE was performed on 46 cases with adenomyosis whose clinical symptoms could not be controlled by drugs. By using Seldinger's method, iodine oil and PVA were injected in double uterine arteries. High pressure sterilized gelfoam particles were used to embolize the arteries. Results: After interventional treatment, the volume of menstruation decreased 30%-70% for all patients. Mean decreasing value was (54.2 +- 20.2)%, t test value 5.85 (P 3 to (129.3 +- 56.6) cm3 (30% - 66%). t test value is 2.86 (P 3 to (48.2 +- 18.7) cm3 (32.1% - 98.6%). t test value is 3.9 (P < 0.01). The blood flow within the uterine focus decreased obviously which was detected by colour Doppler flow imaging. Conclusion: TUAE is proved to be therapeutically effective for adenomyosis in short-term

  10. 药师干预对华法林抗凝患者治疗认知度的影响研究%Influence of pharmacist intervention on patients′knowledge of anticoagulation therapy with warfarin

    Institute of Scientific and Technical Information of China (English)

    蒋捷; 谢秋芬; 向倩; 王梓凝; 霍东波; 曹利佳; 周双; 周颖; 崔一民

    2015-01-01

    ;Objective To investigate the influence of pharmacist inter-vention on patients′knowledge of anticoagulation therapy with warfarin . Methods Two hundred sixteen patients who were admitted to cardiovas-cular wards and were prescribed anticoagulation therapy with warfarin from October 2013 to August 2014 were included in the study .According to the ward they stayed , patients were divided into control group ( Cardiology ward No1.) and intervention group ( Cardiology ward No 2.) . In the control group , physicians and nurses introduced anticoagulation knowledge for the patients as usual , while intervention group received medication education and guidance on warfarin use by pharmacists .All patients of two groups filled out an assessment questionnaire about warfa-rin anticoagulation at discharge ( outpoint =13 ) .If any answer to the questions was wrong , pharmacists would educate them again .The score of the questionnaire were compared between the two groups . Results The intervention group enrolled 112 patients while the control group enrolled 104 patients. Scores of assessment questionnaire at discharge of the intervention group and the control group were (10.50 ±2.24) vs (8.08 ±2.61) respectively,with statistical difference ( P <0.05 ) .Conclusion Knowledge of warfarin therapy was much better in patients who received pharmacist intervention than patients who received usual care . Integrated management model with pharmacist interventions can improve patients′cognition in anticoagulation therapy with warfarin .%目的:探讨药师干预对华法林抗凝患者治疗认知度的影响。方法选取2013年10月至2014年8月在我院心血管内科病房住院的口服华法林抗凝患者216例为研究对象,按照病区分为对照组(心内科一病房)和干预组(心内科二病房),对照组由医师及护士介绍华法林抗凝知识,干预组接受药师关于华法林抗凝的用药教育和指导。在出院时,2组患者均填

  11. Pharmacist specialty certification.

    Science.gov (United States)

    Durfee, Sharon M

    2012-03-01

    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

  12. Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University

    Directory of Open Access Journals (Sweden)

    Kitzmiller JP

    2014-06-01

    Full Text Available Joseph P Kitzmiller,1,4 Mitch A Phelps,2 Marjorie V Neidecker,3 Glen Apseloff41Center for Pharmacogenomics, Colleges of Medicine and of Engineering, The Ohio State University Medical Center, 2Colleges of Pharmacy and Medicine, Pharmacoanalytic Shared Resources Laboratory, The Ohio State University, 3Colleges of Medicine, Nursing, and Pharmacy, The Ohio State University, 4Department of Pharmacology, The Ohio State University College of Medicine, Columbus, OH, USAAbstract: Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program – one of only nine accredited by the American Board of Clinical Pharmacology – that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions.Keywords: clinical pharmacology education, clinical pharmacology fellowship

  13. Impact of Pharmacists and Student Pharmacists in Educating and Screening Low-Income Women for Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro, PharmD, MPH

    2012-01-01

    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.

  14. Implementation of sequential therapy programmes--a pharmacist's view.

    Science.gov (United States)

    Cairns, C

    1998-07-01

    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

  15. Clinical Prediction Rules for Physical Therapy Interventions: A Systematic Review

    OpenAIRE

    Beneciuk, Jason M.; Bishop, Mark D; George, Steven Z.

    2009-01-01

    Background and Purpose: Clinical prediction rules (CPRs) involving physical therapy interventions have been published recently. The quality of the studies used to develop the CPRs was not previously considered, a fact that has potential implications for clinical applications and future research. The purpose of this systematic review was to determine the quality of published CPRs developed for physical therapy interventions.

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

    Directory of Open Access Journals (Sweden)

    Horace AE

    2015-08-01

    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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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....

  18. 临床药师开展用药教育对老年高血压合并高胆固醇血症患者的影响%The Effect of Medication Education from Clinical Pharmacists on the Elderly Hypertension Patients with Hypercholesterolemia

    Institute of Scientific and Technical Information of China (English)

    孙艳萍; 王烨; 李影影; 邢玉晶; 蔡郁

    2013-01-01

    目的:探讨临床药师开展用药教育对老年高血压合并高胆固醇血症患者用药依从性及治疗达标率的影响。方法:依据是否实施用药教育将老年高血压合并高胆固醇血症患者分为试验组和对照组,分别在用药教育前和教育后半年对2组患者进行用药依从性和治疗达标率的调查。结果:临床药师通过用药教育可提高老年高血压合并高胆固醇血症患者的用药依从性和降压调脂治疗达标率。结论:影响老年高血压合并高胆固醇血症患者用药依从性的因素是多方面的,临床药师可通过个体化的用药指导,提高药物治疗的依从性及治疗达标率。%Objective: To discuss the effect of medication education from clinical pharmacists on medication compliance and therapeutic efficiency of hypercholesterolemia and hypertension treatment for the elderly hypertension patients. Methods: Elderly hypertension patients with hypercholesterolemia were randomly divided into intervention group and control group. The intervention group was given medication education, while control group was not. Medication compliance and the rate of patient reaching the treatment standard were investigated before the intervention and 0.5 year after the intervention. Results:Medication education from clinical pharmacists couldsignificantly enhance medication compliance and increase the rate of patient reaching the standard of blood pressure and lipid lowering therapy. Conclusion:There were many influential factors which could affect medication compliance of the elderly hypertension patients with hypercholesterolemia. Clinical pharmacists could improve patient medication compliance and therapeutic efficiency with individual medication education.

  19. Present situation and thinking of pharmacists in the clinical treatment in hospital%浅谈临床药师在医院临床治疗活动中的现状及思考

    Institute of Scientific and Technical Information of China (English)

    刘德连; 姜培芹

    2013-01-01

    Objective To promote the construction of the clinical pharmacists system,improve the service level of pharmacy,strengthen the rational drug use. Methods To investigate and analyze the developing conditions of clinical pharmacists in the hospital at now. Results Clinical pharmacists now in hospital are mainly engaged in the working such as assessing doctors around,drug analyzing,drug economics and pharmacokinetic researching,drug consulting,adverse reactions detection and reporter. Conclusion Clinical treatment activities are impacted heavily by the traditional treatment orders. The subordinate position of clinical pharmacists in clinical treatment activities are not changed fundamentally.%目的:促进临床药师制度建设,提升药学服务水平,强化合理用药。方法调查分析现阶段医院临床药师开展情况。结果临床药师在医院主要从事跟随医师查房、医院用药分析、药物经济学及药动学研究、药品咨询、不良反应检测及上报等工作。结论临床治疗活动受到传统治疗秩序的影响较重,临床药师在临床治疗活动中的从属地位没有得到根本改观。

  20. Exploration of working mode of clinical pharmacists to promote chemotherapy medication safety%临床药师促进化疗药物用药安全的工作模式探讨

    Institute of Scientific and Technical Information of China (English)

    张美玲

    2015-01-01

    目的:探讨临床药师参与肿瘤科临床工作的切入点和工作模式。方法临床药师通过参与肿瘤科临床查房,修订化疗药物管理制度、标准流程,协助软件工程师编写化疗药物管理模块,整理药品说明书相关知识点,编辑高危药物手册等,为医生、护士、患者的合理用药提供个性化服务。结果与结论我院临床药师在促进化疗药物用药安全、有效方面发挥重要作用,取得明显效果。促进化疗药物安全合理使用可作为临床药师参与肿瘤科临床工作的切入点,并以此为工作模式。%Objective To explore the breakthrough point and working mode of clinical pharmacists participating in clinical work of oncology de-partment.Methods Clinical pharmacists provided personalized service for doctors , nurses and patients by participating in ward round , reviewing the management system and standard process of chemotherapy medica-tion, helping the software engineers write the management module of chemotherapy medication , summarizing knowledge points from medicine instructions and editing the handbook of high -risk drug , etc.Results and Conclusion Clinical pharmacists played an important role and obtained obvious effect in promoting chemotherapy medication safely and effectively.Promoting safe and rational administration of chemotherapy medication can serve as the starting points and working mode of clinical pharmacists participating in clinical work.

  1. On the Contents of Clinical Pharmacists' Prescribing Authority and Its Realization in China%论我国临床药师处方权的内容及其实现

    Institute of Scientific and Technical Information of China (English)

    黄姝颖; 沈春明

    2011-01-01

    OBJECTIVE: To redefine what is prescribing authority, and to discuss what kind of special prescribing authority (or limited prescribing authority) the clinical pharmacists can get and how to get it, in order to provide a reference for modifying the relevant policies and regulations on the consideration of the clinical pharmacist's participation in prescription. METHODS: On the basis of new comments about the prescribing authority, the qualifications for a clinical pharmacist in China to obtain it were demonstrated, and we defined the contents of clinical pharmacists' special prescribing authority in China by consulting international prescribing models. RESULTS&CONCLUSIONS: Clinical pharmacists should obtain the special prescribing authority gradually in 3 phases. To achieve this goal, we should provide prescribing training, establish the rules or regulations of hospitals, develop relevant policies, promote the legislation of the pharmacist, and modify relevant laws or regulations.%目的:从临床药师参与处方角度出发,重新定义什么是处方权,探讨我国临床药师可以获得怎样的特别处方权(或限定处方权)及如何获得,从而给相关政策和法规的修订提供参考.方法:在对处方权作出新诠释的基础上,就临床药师获得处方权的资格进行论述,然后参照国际处方模式对我国临床药师特别处方权的内容进行界定.结果与结论:我国临床药师应分3个阶段逐步获得特别处方权,并通过处方培训、设立医院规章制度、制定相关政策、推动药师立法及修改相应法律法规,最终使临床药师处方权在我国得以实现.

  2. Admission Privileges and Clinical Responsibilities for Interventional Radiologists

    International Nuclear Information System (INIS)

    Although clinical involvement by interventional radiologists in the care of their patients was advocated at the inception of the specialty, the change into the clinical paradigm has been slow and patchy for reasons related to pattern of practice, financial remuneration or absence of training. The case for the value of clinical responsibilities has been made in a number of publications and the consequences of not doing so have been manifest in the erosion of the role of the interventional radiologists particularly in the fields of peripheral vascular and neuro intervention. With the recent recognition of interventional radiology (IR) as a primary specialty in the USA and the formation of IR division in the Union of European Medical Specialists and subsequent recognition of the subspecialty in many European countries, it is appropriate to relook at the issue and emphasize the need for measures to promote the clinical role of the interventional radiologist

  3. Admission Privileges and Clinical Responsibilities for Interventional Radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [The American University of Beirut Medical Center, IR Division, The Department of Diagnostic Radiology (Lebanon)

    2015-04-15

    Although clinical involvement by interventional radiologists in the care of their patients was advocated at the inception of the specialty, the change into the clinical paradigm has been slow and patchy for reasons related to pattern of practice, financial remuneration or absence of training. The case for the value of clinical responsibilities has been made in a number of publications and the consequences of not doing so have been manifest in the erosion of the role of the interventional radiologists particularly in the fields of peripheral vascular and neuro intervention. With the recent recognition of interventional radiology (IR) as a primary specialty in the USA and the formation of IR division in the Union of European Medical Specialists and subsequent recognition of the subspecialty in many European countries, it is appropriate to relook at the issue and emphasize the need for measures to promote the clinical role of the interventional radiologist.

  4. 我国临床药师参与临床药物治疗会诊现状文献分析%Analysis of Clinical Pharmacists Particpating in the Clinical Drug Treatment Consultation in China

    Institute of Scientific and Technical Information of China (English)

    刘建昆; 苏红艳; 曾小燕; 何洪静

    2015-01-01

    目的:关注我国临床药师参与药物治疗会诊现状。方法:以“临床药师”“药物治疗”“会诊”等为关键词,组合检索中国医院知识总库、万方数据库及中国生物医学文献服务系统中文题录数据库,对我国临床药师参与临床会诊的现状进行归纳与总结。结果:共查询到文献186篇,其中有效文献114篇。临床药师参与药物治疗会诊病例2606例,全部或部分采纳临床药师建议2257例,临床医师对临床药师会诊意见的执行度达93.02%。执行临床药师的会诊意见,患者的病情好转或治愈的达2290例,有效率为94.47%。结论:我国临床药师参与临床会诊取得了一定的成效,但其工作方法和模式有待进一步探讨和规范。%OBJECTIVE:To focus on the situation of clinical pharmacists particpating in the clinical drug treatment consulta-tion in China. METHODS:With the keywords of“clinical pharmacists”,“consultation”and others,retrieved from China Hospital Knowledge Database (CHKD),Wanfang Database and China BioMedical Literature Service System (SinoMed),the situation of clinical pharmacists particpating in the clinical drug treatment consultation in China was concluded and summarized. RESULTS:A total of 186 literatures were included,invloving 114 effective literatures. 2 606 cases were clinical pharmacists particpating in the clinical drug treatment consultation,2 257 cases were all or part of adoption of clinical pharmacists’suggestions,the execution lev-el of clinicians for clinical pharmacists’consultation suggestions reached 93.02%. After carrying out the clinical pharmacists’con-sultation suggestions,patients’condition improved or cured reached 2 290 cases,with the effective rate of 94.47%. CONCLU-SIONS:Clinical pharmacists participating in the clinical consultation has certain function,however,the working method and mode need to be further explored and standarized.

  5. Clinical applications: percutaneous coronary intervention - a review

    International Nuclear Information System (INIS)

    Following a brief review of the early days of coronary angiography, this article traces the development of percutaneous coronary intervention from the pioneering work of Dotter and Gruentzig up to the latest procedures for coronary angioplasty. (orig.)

  6. Clinical applications: percutaneous coronary intervention - a review

    Energy Technology Data Exchange (ETDEWEB)

    Meier, B. [Swiss Cardiovascular Center Bern, Univ. Hospital, Bern (Switzerland)

    2006-07-01

    Following a brief review of the early days of coronary angiography, this article traces the development of percutaneous coronary intervention from the pioneering work of Dotter and Gruentzig up to the latest procedures for coronary angioplasty. (orig.)

  7. A systematic review of pharmacists performing obstructive sleep apnea screening services.

    Science.gov (United States)

    Cawley, Michael J; Warning, William J

    2016-08-01

    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

  8. Farmacevtske kognitivne storitve pri zdravljenju z zdravili - pogled farmacevta svetovalca v ambulanti: Pharmaceutical cognitive services in pharmacotherapy - pharmacist's consultant perspective at an ambulance:

    OpenAIRE

    Premuš Marušič, Alenka

    2013-01-01

    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...

  9. Safe medication use based on knowledge of information about contraindications concerning cross allergy and comprehensive clinical intervention

    Directory of Open Access Journals (Sweden)

    Li W

    2013-02-01

    Full Text Available Wei Li,1 Ling-Ling Zhu,2 Quan Zhou31Division of Medical Affairs, 2Cadre Department, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of ChinaBackground: An investigation of safety issues regarding information on contraindications related to cross allergy was conducted to promote clinical awareness and prevent medical errors in a 2200-bed tertiary care teaching hospital.Methods: Prescribing information on contraindications concerning cross allergy was collected from an information system and package inserts. Data mining and descriptive analysis were performed. A risk register was used for project management and risk assessment. A Plan, Do, Check, Act cycle was used as part of continuous quality improvement. Records of drug counseling and medical errors were collected from an online reporting system. A pharmacist-led multidisciplinary team initiated an intervention program on cross allergy in August 2008.Results: Four years of risk management at our hospital achieved successful outcomes, ie, the number of medical errors related to cross allergies decreased by 97% (10 cases monthly before August 2008 versus three cases yearly in 2012 and risk rating decreased significantly [initial risk rating:25 (high-risk before August 2008 versus final risk rating:6 (medium-risk in December 2012].Conclusion: We conclude that comprehensive clinical interventions are very effective through team cooperation. Medication use has potential for safety risks if sufficient attention is not paid to contraindications concerning cross allergy. The potential for cross allergy involving drugs which belong to completely different pharmacological classes is easily overlooked and can be dangerous. Pharmacists can play an important role in reducing the risk of cross allergy as well as recommending therapeutic alternatives.Keywords: clinical pharmacy, contraindications, cross allergy

  10. Literature Review on the Effect of Paediatric Clinical Pharmacists Participating in Medical Treatment All Over the World%国内外儿科临床药师干预患者药物治疗效果研究的文献评价

    Institute of Scientific and Technical Information of China (English)

    张川; 黄亮; 张伶俐

    2011-01-01

    OBJECTIVE: To evaluate the effect of paediatric clinical pharmacists participating in medical treatment all over the world so as to provide reference for the study in China.METHODS: Retrieved from National Library of Medicine, Cochrane library, CNKI and VIP (deadline of Feb.2010), 12 relevant literatures were included.Information on the type of hospital, quality of paediatric pharmacist, designs of the studies, standards of intervention provided by paediatric clinical pharmacists and results of study were analyzed descriptively.RESULTS: Researches on effect of paediatric clinical pharmacists were usually conducted in large general affiliated hospital of universities offering paediatrics major (8 hopitals) or paediatric hospitals (4 hospitals).33% of literatures required that pharmacists must be licensed or experienced pharmacist.Study design included 6 before and after controlled studies, 4 prospective studies and 2 non-randomized clinical trials.Work of clinical pharmacists included collecting patient data,checking patient's medical history, providing counseling for discharged patients and drug information for doctors and nurses, monitoring plasma concentration of patients.Results of study included adoption rates of pharmacists' recommendation, severity of potential problems of drugs found by pharmacists, effect of drugs on treatment-related variables and so on.CONCLUSIONS: Researches on the effect of paediatric clinical pharmacists participating in medical treatment are observational studies.Thus, there is a lack of high-quality randomized controlled trial.It is suggested to conduct randomized controlled trials in China.%目的:评价国内、外儿科临床药师干预患者药物治疗效果的研究,为我国开展此类研究提供借鉴和参考.方法:检索美国国立医学图书馆(1960年起)、Cochrane图书馆(1981年起)英文数据库(1 109篇)和中国期刊全文数据库(1983年起)、维普数据库(1996年起)中文全文数据库(87

  11. Pharmacist independent prescribing in secondary care: opportunities and challenges.

    Science.gov (United States)

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

    2016-02-01

    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

  12. Clinical pharmacist participates in the magnesium sulfate therapy and pharmaceutical practice in obstetric ward%临床药师参与产科硫酸镁应用的监护模式与实践

    Institute of Scientific and Technical Information of China (English)

    顾寅明; 于锋; 葛卫红

    2012-01-01

    AM To introduce the clinical pharmacist participating in the magnesium sulfate therapy and pharmaceutical practice in obstetric ward in our hospital and compare die status of magnesium sulfate used in obstetric between China and abroad. METHODS The clinical pharmacist participated in the process of drug treatment and established safety-use procedures of magnesium sulfate infusion in obstetric and drip-rate dose conversion table. RESULTS Through educating the maternal and monitoring serum magnesium concentration for preventing the adverse drug reactions, clinical pharmacist ensured die security and efficiency of magnesium sulfate therapy. CONCLUSION Clinical pharmacists participating in magnesium sulfate therapy greatly improve the satisfaction of the doctors, patients and their families.%目的 介绍我院临床药师参与产科硫酸镁安全用药的模式探讨及监护实践,并对比国内外产科硫酸镁使用的现况.方法 临床药师参与产科硫酸镁用药并建立硫酸镁静滴安全监护流程及滴速剂量换算表.结果 临床药师通过对使用硫酸镁的孕产妇进行用药教育,监测血镁浓度,预防药物不良反应,获得了较好的效果,为患者的安全、合理用药提供了保障.结论 临床药师的参与在很大程度上提高了医师、患者和家属对硫酸镁治疗的满意度.

  13. The pharmaceutical care on the infected patients after trauma by clinical pharmacists%临床药师对创伤感染病例的药学监护

    Institute of Scientific and Technical Information of China (English)

    毛璐

    2011-01-01

    目的:探讨临床药师在创伤重症感染病例救治中的作用.方法:临床药师通过参与创伤骨科两例重症感染病例的救治工作,对抗感染药物的选择以及药品不良反应监测等方面提出具体意见,为病人制定个体化的给药方案,并对创伤感染病例的特点及药学监护方向进行了分析总结.结果:重症感染的病人得到及时控制和治疗.结论:临床药师参与临床治疗,有利于提高临床治疗水平,促进合理用药.%Objective: To investigate the role of clinical pharmacists in the treatment of the severe infected patients after trauma. Methods: The clinical pharmacists take part in the therapy team to treat two cases of severe infected patients after trauma. Pharmacists helped the doctors to choose anti-infective drugs, gave a bit of advice on monitoring adverse drug reactions, made individualized drug therapy scheme for the patients,summarized and analyzed characteristics of infection after trauma and the direction of pharmaceutical care for these patients. Results: The patients with severe infection were treated in time. Conclusion: The participation of clinical pharmacists in clinical treatment can improve the therapeutic level and promote the rational use of drugs.

  14. Importance of training on clinical thinking and clinical competence to interventional radiologists

    International Nuclear Information System (INIS)

    Although the history of Interventional Radiology is no longer than 50 years, interventional techniques have been dramatically developed. Interventional radiologists have been responsible for much of the medical innovations and development of the minimally invasive procedures that are commonplace today to treat many complicated diseases as physicians. But the education backgrounds of interventional radiologist in China are different. Therefore, we should be aware that the job of an interventional radiologist is totally different from that of a diagnostic radiologist. It is very important to train interventional radiologists for improving their clinical thinking and clinical competence. Herein, we propose our suggestions on how to improve the clinical thinking and clinical competence of interventional radiologists. In this paper we also systemically introduce the accurate and proper treatment procedures which should be strictly followed in clinical work and,meanwhile, the perioperative patients care is emphasized. (authors)

  15. Practice and Experience of Clinical Pharmacists Participating in Drug Therapy of Ovarian Cancer Patient%临床药师参与1例卵巢癌患者药物治疗的实践与体会

    Institute of Scientific and Technical Information of China (English)

    蒋倩; 蒋刚

    2011-01-01

    目的:探讨肿瘤专科医院临床药师病房工作方法.方法:参与1例卵巢癌患者的治疗,在实践中与医护人员协作,最终使患者顺利完成本周期治疗,并通过实践总结出目前的工作模式.结果与结论:临床药师参与临床药物治疗实践,有利于提高药物治疗水平.%OBJECTIVE: To investigate the work methods of clinical pharmacist in cancer hospital. METHODS: Clinical pharmacists participated in the treatment for 1 case of ovarian cancer and cooperated with doctors and nurses so that the patient succeeded in finishing this cycle of therapy, the working mode can be summarized by practicing.. RESULTS&CONCLUSION: Clinical pharmacists participating in drug therapy could improve the level of treatment.

  16. 临床药师参与1例难治性颅内感染患者的治疗实践%Practice of Clinical Pharmacist Participating in the Treatment of One Patient with Severe Intracranial Infection

    Institute of Scientific and Technical Information of China (English)

    周至品; 唐秀能; 叶晓雪

    2016-01-01

    Objective:To investigate the role of clinical pharmacist in the treatment of patients with severe infection. Methods:Clinical pharmacist participated in the consultations for a patient with severe intracranial infection after craniocerebral operation in neurosurgery. According to the conditions of the patient and the results of antibiotic susceptive test,clinical pharmacist made an individualized medication for the patient,and the regimen included cefoperazone/ sulbactam,meropenem, vancomycin and Angong Niuhuang Wan. Results:The intracranial infection in the patient was improved gradually and controlled finally. Conclusion:Based on self professional knowledge,clinical pharmacist can participate in the clinical treatment of patients with severe infection,and assist doctors to develop treatment regimen in order to improve treatment effects. It will help clinical pharmacist preferably blend in clinical treatment team.%目的:探讨临床药师在重症感染患者中的作用。方法:以临床药师参与神经外科1例颅脑术后并发颅内感染患者的会诊工作为例,临床药师结合患者的病情,细菌学培养药敏结果,为患者制定最佳的个体治疗方案,先后给予注射用头孢酮钠/舒巴坦钠、注射用美罗培南、注射用盐酸万古霉素和安宫牛黄丸等药物抗感染治疗。结果:患者颅内感染情况逐渐好转,最后得到了有效控制。结论:临床药师利用自身的专业知识,积极参与重症感染患者的临床治疗,协助医生制定治疗方案,提高临床治疗效果,使临床药师更好地融入到临床治疗团队中。

  17. Investigation and analysis of clinical pharmacist training%我国临床药师培养现状调查与分析

    Institute of Scientific and Technical Information of China (English)

    杨红; 赵丽红; 郭享; 刘小艳; 冯欣

    2014-01-01

    药信息资料、药品不良反应监测、建立药历、参与临床药物治疗、参加临床会诊、处方(医嘱)审核临床药学服务项目的 了解程度分别是88.3%(53/60)、96.7%(58/60)、71.7%(43/60)、81.7%(49/60)、68.3%(41/60)、63.3%(38/60)、41.7%(25/60)、36.7%(22/60)、91.7%(55/60);不太了解程度分别为6.7%(4/60),1.7%(1/60),15.0%(9/60),18.3%(11/60),30.0%(18/60),25.0%(15/60),50.0%(30/60),38.3%(23/60),8.3%(5/60);完全不了解程度分别为5.0%(3/60),1.7%(1/60),13.3%(8/60),1.7%(1/60),1.7%(1/60),11.7%(7/60),6.7%(4/60),26.7%(16/60),1.7%(1/60);患者对患者用药教育、患者药物咨询、提供用药信息资料、药品不良反应监测、建立药历、参与临床药物治疗、参加临床会诊、处方(医嘱)审核等临床药学服务项目的 了解程度分别是17%(51/300)、20%(60/300)、14%(42/300)、9%(27/300)、8%(24/300)、11%(33/300).结论 各高校临床药师培养目标、课程设置不统一,差异大;临床药师在职培养专业还不能满足医院的实际需求.%Objective To observe the current situation of clinical pharmacist training in our country. Methods Document research and questionnaire were adopted in this study.Clinical pharmacist training objectives, curriculum, training quantity and ratio and professional clinical pharmacist training arrangement and clinical staff, patients on medical service satisfaction in 15 colleges and universities were investigated and analyzed. Results Most colleges and universities clinical pharmacy curriculums were still based on traditional pharmacy, where medicinal chemistry, pharmaceutical analysis, the proportion of pharmacology, pharmacy administration (hospital pharmacy), science and other drug treatment programs offered were 86.7%(13/15), 86.7%(13/15), 80.0%(12/15), 93.3%(14/15), 80.0%(12/15); clinical practice courses as well as humanitarian courses are not enough, including diagnostics, internal medicine, clinical introduction, surgery, gynecology

  18. Clinical application of interventional therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Objective: To study the safety and efficiency of interventional therapy of hyperthyroidism. Methods: 70 cases of hyperthyroidism were selected and treated with embolization of the thyroid gland artery. The efficacy and complications of the therapy were observed. Results: The therapy was effect in 60 of all the 70 patients, while failed in 1 patient and relapsed in 9 cases. Specifically speaking, 2 of them hyperthyroidism crisis occurred in 2 cases, hypoparathyroidism occurred in 1 case and hypothyroidism occurred in 2 cases. Conclusion: Intervention therapy of hyperthyroidism is of advantage such as good effect, safety, microtrauma, little complication. (authors)

  19. Choosing a control intervention for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Djulbegovic Benjamin

    2003-04-01

    Full Text Available Abstract Background Randomised controlled clinical trials are performed to resolve uncertainty concerning comparator interventions. Appropriate acknowledgment of uncertainty enables the concurrent achievement of two goals : the acquisition of valuable scientific knowledge and an optimum treatment choice for the patient-participant. The ethical recruitment of patients requires the presence of clinical equipoise. This involves the appropriate choice of a control intervention, particularly when unapproved drugs or innovative interventions are being evaluated. Discussion We argue that the choice of a control intervention should be supported by a systematic review of the relevant literature and, where necessary, solicitation of the informed beliefs of clinical experts through formal surveys and publication of the proposed trial's protocol. Summary When clinical equipoise is present, physicians may confidently propose trial enrollment to their eligible patients as an act of therapeutic beneficence.

  20. Talking to the Pharmacist (For Parents)

    Science.gov (United States)

    ... 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 ...

  1. Exploration of cooperation mode between clinical pharmacists and medical team in the Department of Oncology%肿瘤专科临床药师与医护团队协作模式探讨

    Institute of Scientific and Technical Information of China (English)

    王伟兰; 郭代红; 朱曼; 陈超

    2013-01-01

    目的:探讨肿瘤专科临床药师与医护团队协作,共同促进合理用药的工作模式.方法:解放军总医院肿瘤中心的临床药师与医护团队实施协作4年多来,开展特色全程化药学服务,深入临床为医师、护士和患者提供用药咨询,开设系列药学专题讲座、对患者进行用药教育、编写肿瘤专科实用药物手册,并协助制订医嘱,处理药品不良反应.结果和结论:肿瘤专科的医、药、护团队协作工作模式促进了合理用药,提高了临床药学服务水平.%Objective:To explore the cooperation mode between clinical pharmacists and medical team in the Department of Oncology,so as to elevate the level of rational medication of drugs.Methods:Clinical pharmacists and the medical team in the tumor center of General Hospital of PLA experienced cooperation for over 4 years,during which clinical pharmacists carried out integrated specific pharmaceutical care,provided consultation for doctors,nurses as well as patients concerning medication of drugs,conducted a series of pharmaceutical lectures,gave lectures to patients on medication,compiled a practical medical handbook,helped doctors to prescribe medical advices and cope with adverse drug reactions.Results and Conclusion:The cooperation mode between pharmacists,the medical and nursing teams in the Department of Oncology promoted rational medication of drugs and elevated the level of pharmaceutical care.

  2. Pharmacy students' attitudes towards physician-pharmacist collaboration: Intervention effect of integrating cooperative learning into an interprofessional team-based community service.

    Science.gov (United States)

    Wang, Jun; Hu, Xiamin; Liu, Juan; Li, Lei

    2016-09-01

    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

  3. Review of Clinical Pharmacists Participating in Therapy for Severe Hand-foot-mouth Disease in Primary Hospital%基层医院临床药师参与救治重症手足口病患者回顾

    Institute of Scientific and Technical Information of China (English)

    张岚

    2011-01-01

    OBJECTIVE: To promote and improve the rational use of drugs in the clinic. METHODS: Taking clinical pharmacist participating in the clinical consultation and rescue for 1 case of severe hand-foot-mouth disease as example, the roles of clinical pharmacist assiting physicians prescribe drugs were descriped in detail. RESULTS: The clinical use of drugs involved wide variety of drugs, and the time and energy of physicians were so limited as to be ignorant of indications and contraindications of each drug. Moreover, the daily work of nurses was to perform clinical orders in primary hospital and didn't know the indications, dosage and usage of many drugs. Clinical medication was more or less unreasonable, the participation of clinical pharmacists could very well make up for these deficiencies. CONCLUSION: Clinical pharmacists participate in clinical consultation medication to improve safe, rational and effective drug use.%目的:探讨基层医院临床药师参与临床会诊用药的作用,促进合理用药.方法:以临床药师参与1例重症手足口病患者临床会诊和抢救过程为例,具体描述临床药师对医师处方、用药的辅助作用.结果:基层医院医师的时间和精力有限,而基层医院中的护士对一些药品的适应证和用法用量知之甚少,临床用药存在或多或少的不合理性,临床药师的参与可以弥补这些不足.结论:基层医院临床药师参与临床会诊用药,对提高临床诊疗水平和保障患者用药安全、合理、有效有很大的帮助和促进作用.

  4. Medication problems are frequent and often serious in a Danish emergency department and may be discovered by clinical pharmacists

    DEFF Research Database (Denmark)

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

    2012-01-01

    Transferring a patient from one health-care sector to another implies a risk of medication errors. It is of interest to evaluate whether a specialist in clinical pharmacy is beneficial for the patients in the emergency departments (ED). The aim of the present study was to report the incidence, ca...

  5. Embedding clinical interventions into observational studies.

    Science.gov (United States)

    Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

    2016-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

  6. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    OpenAIRE

    Saw PS; Nissen LM; Freeman C; Wong PS; Mak V

    2015-01-01

    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, Ma...

  7. Can community retail pharmacist and diabetes expert support facilitate insulin initiation by family physicians? Results of the AIM@GP randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Harris Stewart B

    2013-02-01

    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

  8. 深圳市龙岗区妇幼保健院临床药师参与会诊的总结与体会%Experiences of Pharmacist Participating in Clinical Consultations

    Institute of Scientific and Technical Information of China (English)

    朱丽萍; 程晓莉

    2012-01-01

    目的:探讨临床药师参与临床会诊的效果.方法:回顾性分析深圳市龙岗区妇幼保健院临床药学室262例会诊记录,探讨临床药师参与临床会诊的效果.结果:262例会诊病例中,55.73%要求设计抗感染治疗方案,27.49%要求推荐治疗替代药物,8.40%要求了解药物配伍禁忌.科室常规会诊占67.18%,全院大型病例讨论占25.95%,科室急诊会诊占6.87%.全院要求会诊的科室中产科最多,占35.11%,妇科28.24%,外科18.32%,儿科8.40%,其他科室9.92%.临床医师对会诊用药建议全部采纳占85.50%,部分采纳14.50%.会诊后采取新的用药方案治疗的患者有19.08%痊愈,77.10%好转,3.82%死亡.结论:临床药师参与临床会诊,和临床医师共同制定用药方案,可弥补专科医师专业知识的缺陷,对提高临床治疗效果有重要意义.%Objective: To research clinical effects of pharmacist participating in clinical consultations. Methods: Retrospectively analyze 262 cases of clinical consultation record in the Maternal and Child Health Hospital of Longgang, and research effects of clinical pharmacist consultation. Results: Rate of pharmacists required to take part in designed antimicrobial therapy program in 262 cases was 55.73%. Rate of pharmacists asked to recommend alternative drug treatment was 27. 49%. Rate of clinical faculty requiring understanding drug incompatibility was 8.4%. Office routine consultations accounted for 67. 18% , all departments of hospital consultations accounted for 25. 95% , and emergency consultations accounted for 6. 87%. The rates of each department requiring consultations were maternity department 35. 11% , gynecology department 28. 24% , surgical 18. 32% , pediatrics 8. 4% , and other departments 9. 92%. The 85.5% consultation recommendations were adopted thoroughly, and 14.5% were adopted partially. After clinical pharmacist consultations, 19. 08% cases were healed, 77. 1% were improved, and 3

  9. 医院临床药师全面质量管理体系的建立%Establishment of the clinical pharmacist working model based on the total quality management in hospital

    Institute of Scientific and Technical Information of China (English)

    潘常青; 李晓宇; 王理伟; 李群

    2016-01-01

    Transformation and quality improvement of clinical pharmacy is key to assuring quality of care for public hospital reform.The clinical pharmacist working model has been established after years of exploration in China,which plays a positive role in promoting such quality and optimizing the allocation of medical resources.However,with the advance of the health care reform,the original working model and methods of clinical pharmacists need to be further improved to meet emerging demands.This paper puts forward a new model of clinical pharmacist development based on the concept of hospital total quality management,which involves the clinical pharmacists′ duty,the work model from the “Pay a visit to bedside”to “Stay by bedside”in clinic,professional development training and performance evaluation.The reform provides a feasible way for the transformation and development of clinical pharmacists in public hospitals.%临床药学工作转型与质量提高对于公立医院改革中医疗质量的保证具有重要意义。我国经过多年探索逐渐建立了临床药师制工作,在推进医疗质量、优化改善国家医疗资源分配中起到了积极作用。但随着医改的推进,临床药师原有的工作模式和方法需要进一步改进以适应新形势下需要。文章提出了基于医院全面质量管理理念的临床药师发展新模式,涉及临床药师职责定位、工作模式由“下临床”转变为“驻临床”、职业发展培训及绩效考核多方面,为公立医院临床药师转型发展改革提供了一条可行之路。

  10. Pharmaceutical Care of Clinical Pharmacists Participating in a Case of AECOPD Combined With Liver and Kidney Function Damage%临床药师参与1例AECOPD合并肝肾功能损害的药学监护

    Institute of Scientific and Technical Information of China (English)

    钱鑫; 张庆; 黄妙婵

    2016-01-01

    Objective: To investigate the role of clinical pharmacist in drug therapy.Methods: Clinical pharmacists participated in a case of AECOPD combined with liver and kidney function damage with pharmaceutical care, clinical pharmacists help doctors adjust drug treatment plan.Results: The drug treatment plan and the proposed method of clinical pharmacists have been adopted by the doctors.Conclusions: Clinical pharmacists use clinical thinking to participate in drug treatment analysis, to assist in the optimization of clinical treatment plan, to ensure the safety and effectiveness of drug treatment.%目的:探讨临床药师在药物治疗中的作用。方法:临床药师参与1例AECOPD合并肝肾功能损害患者的药学监护,针对患者住院过程中出现的肝肾功能损害,帮助医生调整药物治疗方案。结果:临床药师对药物治疗方案的干预与建议得到医师采纳,取得较好的疗效。结论:临床药师运用临床思维参与药物治疗分析,协助临床优化治疗方案,保证了药物治疗的安全性与有效性。

  11. Analysis of 61 Cases Of Clinical Pharmacists Intervening Medical order about Drug Usage%临床药师干预医师用药61例分析

    Institute of Scientific and Technical Information of China (English)

    李文军; 吴燕子; 张淑兰

    2011-01-01

    目的:提高临床药师干预医师用药的成功率.方法:分析2008年10月-2009年10月期间临床药师干预医师用药61例情况,包括干预方式、医师接受程度、干预失败所涉及的用药问题和原因分析.结果:临床药师干预医师用药成功率为85.25%(52/61),与医师面对面讨论后干预用药成功率提高(95.00%),医师较主治医师及以上者接受度高,干预成功率分别为88.37%、77.78%;干预失败所涉及用药问题中药物选择方面(药物选择违反相关规定+无依据联合用药)比例较高(52.94%),其次是用药疗程过长(35.29%);分析干预失败原因:医师不重视药师意见、过分相信自己的临床经验.结论:应加强对医师尤其是高年资医师用药相关知识的宣教,提高其合理用药的认知度;药师应提高其自身业务素质,以提升其在用药方面的权威性;临床药师及时、主动干预医师用药值得推广实践.%OBJECTIVE: To improve the success rate of clinical pharmacists intervening medical order about drug usage.METHODS: 61 cases of clinical pharmacists intervening medical order about drug usage during Oct. 2008-Oct. 2009 were analyzed, including the means of intervening, doctor acceptance, analysis of the reasons for intervening failure. RESULTS: The success rate of clinical pharmacists intervening medical order about use of drug was 85.25% (52/61), the success rate was increased after face to face discussion (95.00%). There was better acceptance in physicians than physicians in charge or above, and the successrates were 88.37% and 77.78%. Intervening failure was mainly caused by drug choice (52.94%), followed by over-long medication time (35.29%). The reasons for intervening failure were that doctor set little attention to the advice of clinical pharmacists and trust themselves too much. CONCLUSIONS: Medication education for physicians should be strengthened especially in veteran physicians. The cognition of physicians

  12. 临床药师参与1例淋巴肉瘤白血病患者的药物治疗实践%Clinical Pharmacists Participating in Drug Therapy for a Patient with Lymphosarcoma Leukemia

    Institute of Scientific and Technical Information of China (English)

    张毅

    2012-01-01

    OBJECTIVE: To explore the proper treatment for diseases under the cooperation of doctors and pharmacists. METHODS: Through participating in drug treatment for a case of lymphosarcoma leukemia, clinical pharmacist assisted medical workers in developing drug treatment scheme and provided pharmaceutical care in the following aspects: the choice of anti-infective agents in the early and middle stages, the supply of electrolyte, the choice of diuretics, the designation of the individualized anti-tumor treatment plan and the proper protection for stomach. RESULTS: Patients had successfully finished the course of treatment to prolong the life expectancy cycle of tumor patients. CONCLUSION: The participation of clinical pharmacists in the practice of clinical drug therapy would improve the level of drug therapy.%目的:探讨医师药师联合模式下对疾病的合理治疗.方法:临床药师参与1例淋巴肉瘤白血病患者的药物治疗,在实践中与医护人员共同制订治疗方案,在患者入院初、中期抗感染药物的选择、电解质补充、利尿药选用、抗肿瘤个体化方案制订、合理护胃等方面提供药学服务.结果:患者顺利完成本周期治疗,延长了患者的生存期.结论:临床药师参与临床药物治疗实践,有利于提高药物治疗水平.

  13. Clinical experience of surgical intervention for severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Xu Yuan; Shao Qinshu; Yang Jin; Yu Xiaojun; Xu Ji

    2014-01-01

    Background The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century.Even now surgical procedures play a decisive role in the treatment of SAP,especially in managing the related complications,but the rational indications,timing,and approaches of surgical intervention for SAP are still inconclusive.Methods Clinical data of 308 SAP patients recruited during January 2000-January 2013,including 96 conservatively treated cases plus 212 surgically intervened cases,were comparatively analyzed.Based on the initial surgical intervention time,the surgical intervention group was split into two:early intervention group (within 2 weeks) 103 cases,and late intervention group (after 2 weeks) 109 cases.Results In the conservative treatment group,the cure rate was 82.29% (79/96),the death rate was 13.54% (13/96),and 4 cases self-discharged,while in the surgical intervention group,the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged.The difference was of no statistical significance between these two groups (P >0.05).In surgical intervention group,the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109),and the difference was statistically significant (P <0.05).Conclusions Both conservative treatment and surgical intervention play important roles in the treatment of SAP,and the indication,timing,and procedure should be strictly followed.Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications,such as multiple organ failure,which does not improve despite active treatment,and in those who develop abdominal compartment syndrome.

  14. A brief simulation intervention increasing basic science and clinical knowledge

    Directory of Open Access Journals (Sweden)

    Maria L. Sheakley

    2016-04-01

    Full Text Available Background: The United States Medical Licensing Examination (USMLE is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose: To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods: This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515 and the intervention group received lecture plus a simulation exercise (nl+s=1,066. Assessment included summative exam questions (n=4 that were scored as pass/fail (≥75%. USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results: Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003. Discussion: Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

  15. 临床药师参与药物热会诊的实践和体会%Practice and Experience of Clinical Pharmacist Participating in Consultation for Drug Fever

    Institute of Scientific and Technical Information of China (English)

    刘宪军

    2016-01-01

    Objective To provide references for identifying drug fever with infectious disease and rational use of drugs. Methods The process data of clinical pharmacists involving in analysis of medical consultation and treatment for drug fever were analyzed. Results Drug fever disappeared after the drug fever was identified with infectious disease and withdrawing related drugs. Conclusion Clinical pharmacist participating in medical consultation can promote clinical rational drug use and ensure safety usage.%目的:为临床鉴别药物热和感染性疾病及促进临床合理用药提供参考。方法对临床药师参与药物热会诊的资料进行分析。结果临床药师将药物热和感染性疾病进行鉴别后,停用相关药物,药物热消失。结论临床药师参与临床会诊可促进临床合理用药,保证患者用药安全。

  16. Practice of medication reconciliation services by clinical pharmacists of nephrolo-gy department%肾内科临床药师在药物整合服务中的实践探索

    Institute of Scientific and Technical Information of China (English)

    张晓荧; 张四喜; 周微; 宋燕青

    2015-01-01

    Objective To discuss the important role of clinical pharmacists in medication reconciliation through the prac‐tice of clinical pharmacists of nephrology department .Methods The medication reconciliation serviced for the patients newly admitted to nephrology department was carried out through the way of interrogation .The difference and the causes between the results of pharmacist′s interrogation and the doctors′were analyzed .Results 20 patients were enrolled .The quantity was not consistent with what hospital doctor′s advice rate (60% ) ,drugs produced in different areas (55% ) ,different producing areas pharmacist had higher accuracy .Conclusion It had certain effect on medication management and could reduce the ADR .Clinical pharmacists and doctors should pay more attention on the medication reconciliation ,strengthen the ability of interrogation to im‐prove patient compliance and establish a complete medication reconciliation system .%目的:通过临床药师在肾内科对药物整合(medication reconciliation)的实践,探讨临床药师在药物整合中的重要作用。方法对2014年1月18日-2月18日入院的20名患者进行药物整合,主要通过询问患者近1年内的用药情况,对比入院医嘱和药师询问结果,分析存在差异的原因。结果药品数量与入院医嘱不相符率占60%,药品产地不同占55%,药师问诊的准确率更高。结论临床药师在药物整合中起到重要的作用,通过加强医生和患者对药物整合的重视,以及加强医院系统网络建设等措施可以更好地帮助医务工作者实行药物整合服务,减少用药差错的产生。

  17. 临床药师对1例重度烧伤患者的药学监护%Pharmaceutical Care for One Patient with Severe Burn by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    钱先中; 唐美莲; 王冬雪; 谢文忠; 任传路; 仵利军; 徐立平

    2015-01-01

    Objective:To investigate the content and mode of pharmaceutical care for the patients with severe burn and promote the rational use of drugs. Methods:Taking the treatment for one patient with severe burn as example,pharmacists provided pharmaceu-tical care in respects of anti-infection therapy,organ preservation,nutritional support, drug interactions, drug precautions, drug incom-patibility, adverse drug reactions and the effect evaluation . Results:The program of rational drug use was provided for clinics through the implementation of pharmaceutical care. The vital signs of the patient were stable, and then the patient left on pass and continued to be treated with rehabilitation therapy. Conclusion:It is necessary for clinical pharmacists to perform pharmaceutical care for the pa-tients with severe burn,reduce the abuse of drugs and improve the medication safety and effectiveness. Meanwhile, the collaborative service of doctors,pharmacists,nurses and inspectors to patients reflects the value of clinical pharmacists.%目的::探讨对重度烧伤患者药学监护,促进药物合理使用。方法:以1例重度烧伤患者的救治过程为例,药师针对抗感染治疗,器官保护,营养支持以及用药过程中的药物相互作用、注意事项、配伍禁忌、不良反应进行了药学监护,并进行效果评价。结果:通过实施药学监护,为临床提供了合理用药方案;患者的各项生命体征平稳,脱离了危险期,进入康复期继续巩固治疗。结论:临床药师对重度烧伤患者的药学监护非常必要,减少了药物的滥用,提高了药物治疗安全性和有效性,同时,“医、药、护、检”相互协作服务于患者,体现了临床药师的价值。

  18. Investigation and analysis of how to promote the clinical reasonable medication from doctors, clinical pharmacists and patients%从医生、临床药师和患者方面探讨如何促进临床合理用药的调查分析

    Institute of Scientific and Technical Information of China (English)

    蔡帆; 张建华

    2015-01-01

    目的:从医生、临床药师和患者方面探讨临床合理用药的方法。方法以问卷的形式对广州市六所医院的医生、临床药师和患者展开调查,分析数据并得出结论。结果影响临床合理用药的因素并非单一,医生与患者的用药习惯、医生与患者对临床药师的认知以及临床药师自身的知识水平等都会对临床合理用药产生影响。结论合理用药必须把安全放在第一位。改善医生、临床药师和患者的沟通,是促进临床合理用药的关键。%Objective To investigate the method of clinical reasonable medication from the doctor, clinical pharmacists and patients. Methods Questionnaire method was used to make a investigation, and the date of the investigation was analyzed to get a conclusion. Results Clinical reasonable medication was affected by many factors, such as doctor and patient's drug habits, doctor and patient's cognition of clinical pharmacists, clinical pharmacists' own knowledge level and so on. Conclusion Reasonable clinical medication must put safety above all. Improvement of communications among doctors, clinical pharmacists and patients is the key to promote the clinical rational drug use.

  19. Development and implementation of a pharmacist-managed inpatient anticoagulation monitoring program.

    Science.gov (United States)

    Wellman, Jessica C; Kraus, Peggy S; Burton, Bradley L; Ensor, Christopher R; Nesbit, Todd W; Ross, Patricia A; Thomas, Michelle L; Streiff, Michael B

    2011-05-15

    PURPOSE. A stepwise approach to development and implementation of a program to standardize and increase pharmacists' involvement in anticoagulation therapy at a large academic medical center is described. SUMMARY. In response to the Joint Commission's national goal of improved patient safety in anticoagulation therapy, a work group of pharmacy administrators, educators, clinical specialists, and decentralized pharmacists at the hospital developed the structure for a comprehensive inpatient anticoagulation program (IAP); the work group also developed a list of required competencies, educational materials, assessment methods, and mechanisms for eliciting feedback from IAP pharmacists and other patient care staff. After completion of training that included structured case-review sessions, a one-on-one shadowing experience, and competency assessment, IAP pharmacists began reviewing clinical and laboratory data on patients receiving warfarin and low-molecular-weight heparins and providing recommendations to physicians, nurse practitioners, and other health care team members. Feedback from other clinicians was generally positive, with a majority of those surveyed indicating that increased pharmacist involvement in anticoagulation monitoring and dosage adjustment resulted in improved patient care; about 80% indicated that they concurred with pharmacists' recommendations at least 75% of the time. Results of a survey of IAP pharmacists indicated increased satisfaction with their daily duties but also a need for improved pharmacist-to-pharmacist communication. CONCLUSION. Case-based advanced training and implementation of an IAP in a tertiary care hospital increased pharmacists' involvement in the management of inpatients receiving anticoagulants. PMID:21546645

  20. Worksite Physical Activity Intervention for Ambulatory Clinic Nursing Staff.

    Science.gov (United States)

    Tucker, Sharon; Farrington, Michele; Lanningham-Foster, Lorraine M; Clark, M Kathleen; Dawson, Cindy; Quinn, Geralyn J; Laffoon, Trudy; Perkhounkova, Yelena

    2016-07-01

    Health behaviors, including physical activity (PA), of registered nurses (RNs) and medical assistants (MAs) are suboptimal but may improve with worksite programs. Using a repeated-measures crossover design, the authors explored if integrating a 6-month worksite non-exercise activity thermogenesis (NEAT) intervention, with and without personalized health coaching via text messaging into workflow could positively affect sedentary time, PA, and body composition of nursing staff without jeopardizing work productivity. Two ambulatory clinics were randomly assigned to an environmental NEAT intervention plus a mobile text message coaching for either the first 3 months (early texting group, n = 27) or the last 3 months (delayed texting group, n = 13), with baseline 3-month and 6-month measurements. Sedentary and PA levels, fat mass, and weight improved for both groups, significantly only for the early text group. Productivity did not decline for either group. This worksite intervention is feasible and may benefit nursing staff. PMID:27143144

  1. Clinical Pharmacist Participating in the Treatment of Hemorrhage Induced by Warfarin Therapy in a Patient with Mechanical Heart Valve Prostheses%临床药师参与心脏机械瓣膜术后华法林致出血的治疗

    Institute of Scientific and Technical Information of China (English)

    郭婷婷

    2015-01-01

    Objective To explore the modes and ideas of clinical pharmacists' participation in clinical drug treatment. Methods Clinical pharmacist participated in the whole treatment process of hemorrhage induced by oral warfarin pa tient with mechanical heart valve prostheses, and provided recommendations on rational drug use for doctors, gave phar-maceutical care and drug knowledge education on patient. Results Clinical pharmacist made treatment program more reasonable and reduced the incidence of adverse drug reactions. Conclusion Clinical pharmacist can further promote the safe, effective and reasonable drug use in clinic by providing clinical pharmacy services.%目的:探索临床药师参与临床药物治疗的工作模式及思路。方法临床药师参与心脏瓣膜术后口服华法林致患者出血的治疗全过程,为医生提供合理用药建议,并对患者进行药学监护及用药教育。结果临床药师的参与使治疗方案更为合理,减少了药品不良反应的发生。结论临床药师为临床提供药学服务,进一步促进临床用药安全、有效、合理。

  2. Practice of Clinical Pharmacists Participating in the Treatment of Infectious Fever in a Patient with Jejunum Cancer during Postoperative Adjuvant Chemotherapy%临床药师参与1例空肠癌患者术后辅助化疗中感染发热的治疗实践

    Institute of Scientific and Technical Information of China (English)

    陈伦; 祁佳; 李莉霞

    2013-01-01

    目的:探讨临床药师参与药物治疗方案的制订以及提供药学服务的方法.方法:临床药师参与1例空肠癌患者术后辅助化疗中出现感染发热的治疗过程,通过分析肿瘤患者发热的原因,建议医师选择合适的抗菌药物,并根据药物的临床疗效和病情变化及时调整用药方案,提供个体化的药学服务.结果:临床药师的建议被采纳,提高了临床治疗效果,减少了药品不良反应.结论:临床药师参与医师查房,可以协助医师制订安全、有效的治疗方案,在临床药物合理使用中发挥重要作用.%OBJECTIVE: To investigate clinical pharmacists participating in the formulation of drug treatment program and how to provide pharmaceutical care. METHODS: Clinical pharmacists participated in the treatment of infectious fever in a patient with jejunum cancer during postoperative adjuvant chemotherapy. Clinical pharmacists recommended doctors to choose appropriate antibacterial drugs by analyzing reasons of fever, made the adjustment of medication regimen timely and provided individualized pharmaceutical care according to clinical efficacy and circadian clinical feature. RESULTS: The recommendations of clinical pharmacists were adopted to improve clinical outcomes and reduce adverse drug reactions. CONCLUSIONS: Clinical pharmacists participating in medical rounds can help doctors to develop safe and effective treatment programs and play an important role in rational use of drugs in the clinic.

  3. 临床药师在1例ICU重症患者抗感染药物治疗中的作用%Role of Clinical Pharmacists in Anti-infective Drug Therapy for a Severe Patient in ICU

    Institute of Scientific and Technical Information of China (English)

    陈燕; 王婧; 陆瑶华; 李颖川; 周明; 郭澄

    2012-01-01

    OBJECTIVE: To investigate the role of clinical pharmacists in the determining of drug therapy for ICU severe patients. METHODS: One case of intestinal obstruction patient with septic shock was analyzed descriptively in terms of disease course, drug therapy and outcome. The empirical anti-infective therapeutic strategies for the sepsis induced by the abdominal infection with unsatisfactory anti-infection and undetected pathogen were analyzed. Pharmaceutical care mainly concerned about the change of the routine blood test, biochemical function and other laboratory index, especially the specific inflammatory markers. RESULTS: In the course of therapy, clinical pharmacists identified the intraperitoneal drug-resistant E. coli infection was the main problem and selected a broad-spectrum carbapenem antibiotic for the treatment. De-escalation therapy was performed after controlling severe infection, and then the individual anti-infective program was formulated in the course of antibiotic therapy to promote disease condition. CONCLUSION: Clinical pharmacists should participate in the health care team, and help clinicians to adjust drug treatment programs. This attempt may enhance the effect of drug therapy.%目的:探讨临床药师在ICU重症患者药物治疗方案确定中的作用.方法:描述性分析1例肠梗阻术后休克患者的病程发展、药物治疗情况及转归,分析腹腔感染引起脓毒症、感染控制不佳、病原体不明确时的经验治疗策略.药学监护重点关注血常规、生化功能等实验室指标趋势,特别是特异性炎性指标.结果:临床药师针对多部位的耐药菌感染,明确腹腔大肠埃希菌感染为需解决的主要矛盾,选用耐酶广谱的碳青霉烯类及时控制感染后降阶梯治疗,制订个体化抗感染方案,使得病情好转.结论:临床药师参与医疗团队,协助医师调整药物治疗方案,有利于提升患者的药物治疗效果.

  4. Revisão dos estudos de intervenção do farmacêutico no uso de medicamentos por pacientes idosos A literature review on pharmacists' interventions in the use of medication by elderly patients

    Directory of Open Access Journals (Sweden)

    Nicolina Silvana Romano-Lieber

    2002-12-01

    Full Text Available No Brasil, os idosos representavam 9,05% em 1999 e, em 2020, poderão totalizar 13% da população. Nessa faixa etária as doenças crônicas e degenerativas são comuns e freqüentemente se utiliza muitos medicamentos. A prescrição e o uso inadequado dos mesmos podem levar a resultados indesejados, acarretando internações hospitalares evitáveis e elevando os custos do sistema de saúde. O objetivo deste trabalho foi conhecer os estudos de intervenção do farmacêutico e sua influência no uso de medicamentos pelo paciente idoso, listados em cinco bases de dados, no período entre 1970 e 1999. Foram localizados 76 artigos, resultando em 15 trabalhos para análise e discussão. Os estudos sobre o tema são escassos e limitados aos países de economia avançada. De uma forma geral, as intervenções apresentaram resultado positivo. A maioria das intervenções limitou-se ao aconselhamento ao usuário e/ou ao prescritor, notando-se falta de ações que levem à adequação do medicamento ao usuário.The total proportional geriatric population in Brazil is projected to increase from 9.05% in 1999 to approximately 13% in 2020. Non-communicable diseases are common in this age group, and medication is used frequently. Inadequate prescription and improper use of drugs can produce undesirable outcomes, leading to avoidable hospitalization and increasing health care costs. The objective of this paper was to conduct a literature review of pharmacists' interventions and their influence on use of medication by elderly patients, based on five databases from 1970 to 1999. The sample consisted of 76 studies, of which 15 were analyzed and discussed. Research on this subject is scarce, and limited to developed countries. In general, the interventions presented favorable outcomes. Most actions were limited to counseling patients and their physicians, and there was a lack of interventions to adjust the medication to the user.

  5. Clinical study of interventional therapy for acute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficacy and safety of interventional therapy for acute cerebral infarction. Method: Using urokinase, 35 patients with acute cerebral infarction within 24 hours were treated by intra-artery thrombolytic therapy. Europe stroke scale (ESS), Barthel index (BI) were used to evaluate the recovery of neurological functions. Result: ESS score increase rapidly after thrombolytisis, and there were significant difference between the two teams. Thirteen of 13 cases treated within 6 hours from onset showed complete/partial recanalization in cerebral angiography and intraparenchymal hemorrhagic rate were 0%, twenty-six of 35 cases treated within 24 hours showed complete/partial recanalization and intraparenchymal hemorrhagic rate were 5.71%. Conclusion: Interventional therapy for acute cerebral infarction within 6h were safe and effective. (authors)

  6. Role and Work Mode of Clinical Pharmacists in the Multidisciplinary Pain Management Team%临床药师在多学科疼痛管理团队中的作用及工作模式

    Institute of Scientific and Technical Information of China (English)

    谢菡; 马正良; 陈正香; 仇毓东; 葛卫红

    2015-01-01

    Taking effective analgesic measures actively to relieve pain, improve patient comfort and quality of life is the important content of pain management. To achieve the goal, the hospital must be able to perform enough analgesia with a capa-ble pain management team. Our hospital estab-lished a multidisciplinary cooperation pain manage-ment team by referencing domestic and foreign ad-vanced experience and combining with our clinical situation. The clinical pharmacists as an important member of the team have carried out a series of work. In this paper, we will summarily report the function and working mode of clinical pharmacists in the multidisciplinary pain management team.%积极采取有效的镇痛措施缓解疼痛,提高患者的舒适度和生活质量,是疼痛管理工作的重要内容。要达到这个目标,医院必须具备完善的镇痛能力和疼痛管理团队。我院通过借鉴国内外先进经验,结合本院临床现状,成立了多学科合作的疼痛管理团队,并将临床药师作为团队重要成员参与用药教育、用药方案的制定与调整以及监测药物治疗情况等临床药学相关工作,形成了临床药师在多学科疼痛管理团队中的初步工作模式。

  7. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Directory of Open Access Journals (Sweden)

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  8. Primary Care Physician-Pharmacist Collaborative Care Model: Strategies for Implementation.

    Science.gov (United States)

    Carter, Barry L

    2016-04-01

    The Collaboration Among Pharmacists and Physicians To Improve Outcomes Now (CAPTION) trial recently found that a pharmacist intervention for hypertension could be implemented in diverse medical offices. In this issue of Pharmacotherapy, the article by Brian Isetts and colleagues discusses the complexity of the patient population, the specific functions the pharmacists performed, and the time estimates from billing records used to quantify time spent during face-to-face patient encounters. This invited commentary will discuss findings from the CAPTION trial and provide recommendations for strategies to implement similar interventions for patients with other chronic medical conditions seen in primary care practices. PMID:26931738

  9. Prospects for a clinical science of mindfulness-based intervention.

    Science.gov (United States)

    Dimidjian, Sona; Segal, Zindel V

    2015-10-01

    Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological science. Utilizing the National Institutes of Health stage model (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), we map the evidence base for mindfulness-based cognitive therapy and mindfulness-based stress reduction as exemplars of MBIs. From this perspective, we suggest that important gaps in the current evidence base become apparent and, furthermore, that generating more of the same types of studies without addressing such gaps will limit the relevance and reach of these interventions. We offer a set of 7 recommendations that promote an integrated approach to core research questions, enhanced methodological quality of individual studies, and increased logical links among stages of clinical translation in order to increase the potential of MBIs to impact positively the mental health needs of individuals and communities. PMID:26436311

  10. Study of two-dimensional barcode prescription system for pharmacists' activities of NHI contracted pharmacy.

    Science.gov (United States)

    Wang, Wei-Ling; Lin, Chyi-Hong

    2008-01-01

    To lower the cost and enhance the quality of healthcare service, the Taiwan government launched National Health Insurance (NHI) in 1995 and the System of Separation of Medicine and Pharmacy in 1997. After the separation of dispensing and prescribing (SDP), pharmacists in NHI-contracted pharmacies have the right to fill prescriptions from a clinic. This means that pharmacists in NHI-contracted pharmacies have four more activities than previously. How to improve the additional activities remains an issue to be solved. Today, in most countries, patients deliver a written prescription to the pharmacy of their choice. The pharmacist validates the prescription and dispenses the drug. In this paper, we describe an automatic data collection system, the two-dimensional barcode prescription system (2DBPS) for pharmacists. The system allows patients to deliver a paper prescription with a 2D barcode issued by a clinic to the pharmacy of their choice. The pharmacist scans in the 2D barcode, validates the prescription, and dispenses the drug. Evaluation of the 2DBPS showed that most pharmacists use it to execute additional activities and it was more efficient than before. Moreover, the easy-to-use 2DBPS is accepted and appreciated by pharmacists. We can thus conclude that the aim of the 2DBPS is to reduce the workload of pharmacist in data processing. It will help pharmacists to expand their role beyond simple dispensing and data processing to providing pharmaceutical care services. PMID:18176063

  11. Case analysis of clinical pharmacists participated in anti-infective treatment of severe hospital-acquired pneumonia%临床药师参与医院获得性肺炎病人抗感染治疗病例分析

    Institute of Scientific and Technical Information of China (English)

    张晋萍; 葛卫红; 戴令娟

    2012-01-01

    Objective: To explore the method of clinical pharmacists participating in designing therapy regimens and carrying out pharmaceutical care. Methods: The clinical pharmacists participated in therapy of a patient with severe hospital-acquired pneumonia, analyzed the regimen, offered suggestion and provided pharmaceutical care. Results: The suggestion provided by clinical pharmacists was accepted by doctors. Finally,the patient was cured and discharged from the hospital. Conclusion: Clinical pharmacists' participation is helpful for doctors to make safe and effective medication.%目的:探讨临床药师参与药物治疗方案的制定与药学监护的方法.方法:临床药师参与了呼吸科1例医院获得性肺炎病人的治疗,分析评价治疗方案,提出药学建议,并进行药学服务.结果:临床药师的建议被采纳,病人的病情好转出院.结论:临床药师的参与可以协助医师制订安全、有效的治疗方案.

  12. 临床药师参与1例门冬胰岛素诱发自身免疫性低血糖的治疗分析%Clinical Pharmacists'Participation in Drug Treatment Analysis on 1 Case of Insulin Aspart-induced Autoimmune Hypoglycemia

    Institute of Scientific and Technical Information of China (English)

    于恒彩; 计成

    2015-01-01

    Objective:To provide reference for clinical pharmacists' participation in treatment of drug-induced autoimmune hypo-glycemia. Methods:Clinical pharmacists participated in drug treatment of a case of insulin aspart-induced autoimmune hypoglycemia, analyzed treatment and provided suggestion and pharmaceutical care. Results:Clinical pharmacists' suggestion was accepted and the patient was cured and discharged from the hospital. Conclusion: Clinical pharmacists' participation could help doctors to make safe and effective medication, provide good pharmaceutical care and medication education for patients.%目的:为临床药师参与治疗药物致自身免疫性低血糖提供参考. 方法: 临床药师参与了1例门冬胰岛素诱发自身免疫性低血糖的治疗,分析治疗方案并提出建议,提供药学服务. 结果: 临床药师的建议被采纳,患者病情好转出院. 结论:临床药师能协助医师制定安全、有效的治疗方案,给患者提供良好的药学监护与用药教育.

  13. 临床药师医嘱审核在静脉药物集中配置中的作用%Clinical pharmacists orders audit role in intravenous drug centralized configuration

    Institute of Scientific and Technical Information of China (English)

    曾爱民

    2014-01-01

    Objective:To analyze the circumstances of hospital intravenous drug concentration, to explore the pharmacist review through the doctor's advice in the intravenous drugs allocation centre (PIVAS), promote the hospital clinical rational use of drugs. Methods:Focusing on PIVAS work for medical ward, in accordance with the principle of a random sample, Every 4, 000 inpatient medication orders from July to December in 2013 (group A) and from January to June in 2014 (group B), respectively, analysis and statistics. Results:The unqualified medical advice about 377 (9.43%) in group A, in the hospital drug use in the pharmacist's advice, the unqualified medical advice was about 94 (2.35%) in group B. Conclusion:Through the doctor's advice, pharmacists in PIVAS, can control irrational drugs use level, promote the clinical rational drug use, improve the medical quality of hospital modernization.%目的:分析医院静脉药物集中配置情况,探讨临床药师通过医嘱审核在静脉药物配置中心(PIVAS)的作用,促进了临床合理用药。方法:针对医院PIVAS为内科病房开展工作,按照随机抽样原则,分别抽取2013年7~12月(A组)及2014年1~6月(B组)的住院用药医嘱中各抽取4000份,进行分析和统计。结果:A组不合格医嘱有377份(占医嘱9.43%),B组住院用药医嘱中,不合格医嘱有94份(占医嘱2.35%)。结论:通过医嘱审核,临床药师在PIVAS的工作中,将控制不合理用药关口前移,促进了临床合理用药,提高了医院的现代化医疗质量。

  14. Pharmacist involvement in a diabetic education centre.

    Science.gov (United States)

    Kanitz, J; Birken, B; Ward, V

    1982-01-01

    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

  15. Applying the guidelines for pharmacists integrating into primary care teams

    Science.gov (United States)

    Barry, Arden R.; Pammett, Robert T.

    2016-01-01

    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.

  16. The clinical practice of interventional radiology: a European perspective.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-05-01

    The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management\\'s refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

  17. The Clinical Practice of Interventional Radiology: A European Perspective

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management's refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

  18. Chronotherapy in practice: the perspective of the community pharmacist.

    Science.gov (United States)

    Kaur, Gagandeep; Gan, Yuh-Lin; Phillips, Craig L; Wong, Keith; Saini, Bandana

    2016-02-01

    Background Optimising the time of drug administration in alignment with circadian rhythms to enhance the clinical effect or minimise/avoid adverse effects is referred to as chronotherapy. Pharmacists have a key role in providing medicine related information, including counselling about the optimal time for medication administration. Where applicable, the principles of chronotherapy should underlie this aspect of medication counselling. Despite significant developments in the science of chronotherapy for specific pharmacological treatments, the perspective of pharmacists about their understanding and application of these principles in practice has not been explored. Objective To explore community pharmacist's viewpoints about and experience with the application of chronotherapy principles in practice. Setting Community pharmacies within metropolitan Sydney in New South Wales, Australia. Methods Semi-structured, face to face interviews with a convenience sample of community pharmacists were conducted. All interviews were audio-recorded, transcribed verbatim and thematically analyzed using a 'grounded theory' approach, given the novelty of this area. Main outcome measure Community pharmacists' awareness, current practice and future practice support requirements about the principles of chronotherapy. Results Twenty-five semi-structured interviews were conducted. Most participants reported encountering cases where clinical decision making about suggesting appropriate times of drug administration to patients was needed. Their approach was mainly pragmatic rather than based on theoretical principles of circadian variation in drug disposition or on current or emerging evidence; thus there was an evidence practice chasm in some cases. However, most participants believed they have an important role to play in counselling patients about optimal administration times and were willing to enact such roles or acquire skills/competence in this area. Conclusion Community pharmacists

  19. Extending role by Japanese pharmacists after training for performing vital signs monitoring

    Directory of Open Access Journals (Sweden)

    Hasegawa F

    2014-09-01

    Full Text Available Background: In Japan, the circumstances in which pharmacists work are changing. Pharmacists are expected to assess conditions of patients subject to medication to ensure proper use of pharmaceutical products. To ensure fulfilment of these roles, there have already been pharmacists’ efforts in performing vital signs monitoring. Objective: To clarify the necessity and related issues, by investigating the state of vital sign monitoring in clinical field by pharmacists who have been trained in vital sign monitoring. Method: A web survey was conducted from 4th October to 3rd December 2012, subjecting 1,026 pharmacists who completed the vital signs training hosted by The Japanese Association of Home Care Pharmacies (JAHCP. Survey items were 1 basic information of a respondent, 2 situation of homecare conducted by pharmacists, 3 seminar attendance status, and 4 vital signs monitoring status after the seminar. Results: The number of valid respondents was 430 and the response rate was 41.9%. As a result of the present research, it was revealed that 168 pharmacists (41.4%, had the opportunity to perform vital signs monitoring. By conducting vital sign monitoring, effects such as 1 improved motivation of pharmacists and better communication with patients, 2 proper use of medication, and 3 cost reduction were confirmed. Conclusion: Judging from the results of the survey, pharmacists can improve medication therapy for patients by attaining vital sign skills and conduct vital sign monitoring. Pharmacists who perform vital sign monitoring should share cases where they experienced positive patient outcomes.

  20. The importance of pharmacist providing patient education in oncology.

    Science.gov (United States)

    Avery, Mia; Williams, Felecia

    2015-02-01

    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

  1. Rational drug use and the role of clinical pharmacists in PIVAS of a cancer hospital%肿瘤专科医院PIVAS合理用药及临床药师的作用

    Institute of Scientific and Technical Information of China (English)

    文柳静

    2011-01-01

    Objective To analyze the use of drugs and clinical pharmacists' role in safe medication in a Hospital Pharmacy Intravenous Admixture Service (PIVAS). Methods The situation of drug use of year-round and each quarter in the hospital PIVAS in 2010 was analyzed. The situation of infusion orders of 562 915 group was checked. Results Plant-based antitumor drug sales amount accounted for 55. 50% ,in which paclitaxel drugs were the first,and brucea oil sales were increased consistently. In 679 groups,the selection of drugs,dosage and solvent were unreseasonable. Conclusion Pharmacists can play important role on PIVAS platform to ensure the intravenous drugs use safety.%目的 分析医院静脉药物配置中心(PIVAS)药物的使用情况与临床药师在安全用药中的作用.方法 对医院2010年度PIVAS全年用药及各季度用药进行分析,并对562 915组输液医嘱进行审核.结果 植物类抗肿瘤药物销售金额占55.50%,紫杉醇类药物各季度均占销售首位,鸦胆子油销售数量持续增加,其中679组医嘱存在溶媒选择、用量和给药剂量不当等不合理用药现象.结论 药师可凭借PIVAS平台,积极开展临床药学工作,确保静脉用药安全.

  2. The Comprehensive Management of Anticoagulation: Ochsner Coumadin Clinic

    OpenAIRE

    Barrios, Annette C.; Ventura, Hector O.; Milani, Richard V.

    2002-01-01

    Clinical privileging of pharmacists and the effective use of support staff and information technology have helped create an efficient pharmacist-operated anticoagulation clinic at Ochsner Clinic Foundation that will support future growth efforts for improved patient care. Developed by Ochsner's Department of Cardiology, the pharmacist-operated anticoagulation clinic cares for 2000 patients with a clinical pharmacist, staff pharmacist, registered nurse, and medical assistants. Patients are man...

  3. Vellykket implementering af farmaceutisk intervention på Akut Modtage Afdeling

    DEFF Research Database (Denmark)

    Grønkjær, Louise Smed; Jensen, Mia Lolk; Madsen, Hanne;

    2011-01-01

    We document the process of implementing a clinical pharmacist service at the acute medical admission unit at Odense University Hospital. During the period December 2009 through April 2010 we reviewed 915 medication lists, which resulted in 628 interventions with generic substitution as the most f...

  4. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  5. Student Pharmacists’ Clinical Interventions in Advanced Pharmacy Practice Experiences at a Community Nonteaching Hospital

    OpenAIRE

    Shogbon, Angela O.; Lundquist, Lisa M.

    2014-01-01

    Objective. To assess student pharmacists’ clinical interventions in advanced pharmacy practice experiences (APPEs) at a community nonteaching hospital and evaluate completed interventions based on the type of documentation method used.

  6. Clinical exercise interventions in pediatric oncology: a systematic review.

    Science.gov (United States)

    Baumann, Freerk T; Bloch, Wilhelm; Beulertz, Julia

    2013-10-01

    Studies in pediatric oncology have shown a positive effect of physical activity on disease- and treatment-related side effects. Although several reviews have approved the benefits of therapeutic exercise for adult cancer patients, no systematic review exists summarizing the evidence of physical activity in pediatric oncology. We identified a total of 17 studies using the PubMed database and Cochrane library. To evaluate the evidence, we used the evaluation system of the Oxford Center for Evidence-Based Medicine 2001. The findings confirm that clinical exercise interventions are feasible and safe, especially with acute lymphoblastic leukemia (ALL) patients and during medical treatment. No adverse effects have been reported. Positive effects were found on fatigue, strength, and quality of life. Single studies present positive effects on the immune system, body composition, sleep, activity levels, and various aspects of physical functioning. Child-specific aspects such as cognitive abilities, growth, adolescence, and reintegration into peer-groups, school, and sports have barely been taken into consideration. The evidence for exercise interventions in pediatric oncology is rated level "3." Although the results are very promising, future research of high methodological quality and focusing on child-specific aspects is needed to establish evidence-based exercise recommendations, particularly for childhood cancer patients. PMID:23857296

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

    Directory of Open Access Journals (Sweden)

    P Kapur

    2009-12-01

    Full Text Available

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

  8. Practice of Clinical Pharmacists Participating in Treatment for Gouty Nephropathy Patients with Renal Hypertension%临床药师参与痛风性肾病合并肾性高血压患者治疗的药学实践

    Institute of Scientific and Technical Information of China (English)

    宋香清; 阎敏; 尹桃

    2013-01-01

    OBJECTIVE: To explore the role of clinical pharmacists in clinical rational drug use of gouty nephropathy patients with renal hypertension. METHODS: Through participating in treatment for a patient with gouty nephropathy complicating with renal hypertension, clinical pharmacists suggested that doctors should select appropriate drugs for the patient, the regimen should be promptly adjusted according to clinical efficacy of drugs and patient' s conditions, and the patient should be provided with individualized pharmaceutical care. RESULTS: The patient's compliance and clinical outcomes were improved, and adverse drug reactions were decreased through pharmaceutical care provided by clinical pharmacists. CONCLUSIONS: Clinical pharmacists have their own advantages in providing individualized pharmaceutical care for patients. They play an important role in the rational use of drugs.%目的:探讨临床药师在痛风性肾病合并肾性高血压患者合理用药中的作用.方法:临床药师通过参与1例痛风性肾病合并肾性高血压患者的治疗过程,建议医师选择合适的药物,并根据药物的临床疗效和病情变化及时调整用药方案,提供个体化的药学服务.结果:临床药师为患者提供药学服务,提高了患者治疗依从性和临床治疗效果,减少了药品不良反应的发生.结论:临床药师在为患者提供个体化药学服务方面具有自身的优势,能在合理用药中发挥重要作用.

  9. The clinical study of interventional therapy in thrombo angitis obliterans

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical feasibility and validity of interventional therapy in thrombo angitis obliterans. Methods: 13 patients with thrombo angitis obliterans were treated with percutaneous left subclavian artery port-catheter system implantation. The catheter external iliac artery with perfusion of prostaglandin E1 (PGE1) 100 μg, urokinase (UK) 200, 000U and mailuoning 20 ml every day. Each treatment lasted for 7-10 days. Results: 13 patients with angiographic demonstration showed occlusions of 1 case in the middle segment of superficial femoral artery, 9 cases of complete occlusion in popliteal artery and same for 3 cases in anterior tibial artery, the end of the peroneal artery and posterior tibial artery. After treatment, 3 patients had to undergo amputation due to gangrene in foot and 10 patients with no gangrene showed skin temperature rising up in the lower limb. Intermittent claudication and rest pain were relieved obviously accompanied by increasing step distance over 500 m with the Fontain grade improvement of twice at least. Follow up angiography one year later showed large quantity of vasculogenesis in the lower limb. Conclusion: The treatment of trans-port-catheter system is excellent and practical for improving the clinical status of patients with thrombo angitis obliterans. (authors)

  10. 临床药师参与1例难治性凝固酶阴性葡萄球菌患者会诊的探讨%Clinical pharmacists involved in one case consultation of a patient with refractory staphylococcal infection

    Institute of Scientific and Technical Information of China (English)

    钱春艳; 谢云芬; 王明丽

    2013-01-01

    Objective: To provide references for clinical pharmacists who attend case consultation. Methods: Clinical pharmacists participated in a case consultation of a patient after coronary angiography complicated with sepsis. The blood culture showed the growing of hemolytic staphylococci and saprophytic staphylococci, and drug sensitive test hinted vancomycin-sensitive. According to the analysis of clinical pharmacists, the doctor applied vancomycin but the drug was not effective. The outer-court consultant advised using daptomycin and the anti-infection treatment was successful. Results and Conclusion: Clinical pharmacists should pay attention to the accumulation of knowledge, and concern the updating of therapy guidelines. Hospital consultation is not only the valuable embodied way of clinical pharmacists, but also is necessary practice for clinical pharmacists to grow up quickly.%目的:为临床药师参与院内会诊提供参考.方法:临床药师参与1例冠状动脉造影术后并发败血症的会诊,血培养显示溶血性葡萄球菌及腐生葡萄球菌生长,两者均属于凝固酶阴性葡萄球菌,药敏试验提示对万古霉素敏感.临床药师根据病情分析用药后给出用药建议,医生采纳,使用万古霉素治疗但疗效不佳,经外院专家会诊后使用达托霉素抗感染治疗成功.结果与结论:临床药师要注重知识的积累,关注专业领域的治疗指南更新,参与院内会诊是临床药师价值的体现的途径,也是促进临床药师尽快成长的必经之路.

  11. 卫生部抗感染专业临床药师培训模式及实施中问题的探讨%Investigation of Training Mode of Clinical Pharmacists in Anti-infection Area by Ministry of Health

    Institute of Scientific and Technical Information of China (English)

    雷宇; 万瑞融; 朱子辉; 曾尚勇

    2011-01-01

    OBJECTIVE: To study the advantages and disadvantages of training mode of clinical pharmacists in anti-infection area by Ministry of Health. METHODS: According to training method, training content and training requirement of clinical pharmacists in anti-infection area by Ministry of Health, training mode of clinical pharmacists was analyzed and summarized through the practice of writer. RESULTS: Training mode of clinical pharmacists in anti-infection area by Ministry of Health had advantages, and also had disadvantages. CONCLUSIONS: It needs everyone to consummate the training mode of clinical pharmacists in anti-infection area by Ministry of Health. Fine training mode could raise level of clinical pharmacist to be one of treatment team. Patients, doctors and nurses can obtain all round pharmaceutical care.%目的 探讨卫生部抗感染专业临床药师培训模式的优点与不足,为临床药师培养模式的丰富、完善提供参考.方法 根据卫生部临床药师抗感染专业的培训方法、内容和要求,通过笔者亲身实践进行分析总结.结果 目前卫生部抗感染专业临床药师培训模式有优点,也存在弊端,如培训时间短,要求高,学员难以在规定时间内高质量完成培训任务;学员临床知识缺乏,难以在实际操作中给临床医师做好辅助工作.结论 卫生部抗感染专业临床药师培训模式仍需进一步完善,如改进培训方法,加强药历书写训练,提高沟通、交流能力等,让患者、医师、护士真正得到全面的药学服务.

  12. Obtaining a critical care pharmacist position: a marketing case study.

    Science.gov (United States)

    Stratton, T P; Wu, B; Nakagawa, R S

    1993-06-01

    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

  13. Rationale and clinical data supporting nutritional intervention in Alzheimer's disease.

    Science.gov (United States)

    Engelborghs, S; Gilles, C; Ivanoiu, A; Vandewoude, M

    2014-01-01

    Adequate nutrition plays an important role in the maintenance of cognitive function, particularly during aging. Malnutrition is amongst the risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Epidemiological studies have associated deficiencies in some nutrients with a higher risk of cognitive dysfunction and/or AD. Cognitive decline in AD is correlated with synaptic loss and many of the components required to maintain optimal synaptic function are derived from dietary sources. As synapses are part of the neuronal membrane and are continuously being remodelled, the availability of sufficient levels of nutritional precursors (mainly uridine monophosphate, choline and omega-3 fatty acids) to make the phospholipids required to build neuronal membranes may have beneficial effects on synaptic degeneration in AD. In addition, B-vitamins, phospholipids and other micronutrients act as cofactors to enhance the supply of precursors required to make neuronal membranes and synapses. Despite this, no randomized controlled trial has hitherto provided evidence that any single nutrient has a beneficial effect on cognition or lowers the risk for AD. However, a multi-target approach using combinations of (micro)nutrients might have beneficial effects on cognitive function in neurodegenerative brain disorders like AD leading to synaptic degeneration. Here we review the clinical evidence for supplementation, based on a multi-target approach with a focus on key nutrients with a proposed role in synaptic dysfunction. Based on preclinical evidence, a nutrient mixture, Souvenaid(®) (Nutricia N.V., Zoetermeer, The Netherlands) was developed. Clinical trials with Souvenaid(®) have shown improved memory performance in patients with mild AD. Further clinical trials to evaluate the effects of nutritional intervention in MCI and early dementia due to AD are on-going. PMID:24635394

  14. Clinical outcomes resulting from telemedicine interventions: a systematic review

    Directory of Open Access Journals (Sweden)

    Kraemer Dale

    2001-11-01

    Full Text Available Abstract Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis. All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.

  15. 我院呼吸科临床药师的培养和开展药学服务工作的体会%Cultivation of Clinical Pharmacists and Experience of the Development of Pharmaceutical Care in Respiratory Department of Our Hospital

    Institute of Scientific and Technical Information of China (English)

    陈进兵; 金桂兰; 姚远兵

    2012-01-01

    OBJECTIVE: To explore the cultivation of clinical pharmacists and development of pharmaceutical care in respiratory department. METHODS: Relative works of pharmaceutical care were summarized through analyzing 2 cases of clinical pharmacy practice in which clinical pharmacist participated. RESULTS: Clinical pharmacists could fulfill their specialty and perform important responsibilities in the clinical work of the safety maintenance of drug use and ADR monitoring, etc. CONCLUSION: Clinical pharmacists should keep raising the level of the basic knowledge of medicine and pharmacy, assist doctor to use drugs rationally and avoid the occurrence of ADR, so that they can provide high-quality and brand-new pharmaceutical care for patients.%目的:探讨呼吸科临床药师的培养及开展药学服务的相关工作.方法:通过分析2例临床药师参与临床药学服务的实践情况,归纳开展临床药学服务的相关工作.结果:临床药师在维护用药安全、药品不良反应监测等临床工作中能够发挥自身的专业特长,并履行了重要职责.结论:临床药师应不断提高药学和医学专业知识水平,协助医师做到合理用药,避免不良反应的发生,为患者提供高质量的、全新的药学技术服务.

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

    Directory of Open Access Journals (Sweden)

    Sebastiaan Rothmann

    2011-03-01

    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.

  17. Designing Clinical Trials of Intervention for Mobility Disability: Results from the Lifestyle Interventions and Independence for Elders (LIFE) Pilot Trial

    Science.gov (United States)

    Clinical trials to assess interventions for mobility disability are critically needed, however data for efficiently designing such trials are lacking. Our results are described from the LIFE pilot clinical trial, in which 424 volunteers aged 70-89 years were randomly assigned to one of two intervent...

  18. Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities.

    Science.gov (United States)

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2016-09-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers-particularly middle managers-also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions. PMID:26647411

  19. Knowledge and attitude of Iranian community pharmacists about the pharmaceutical care for epileptic females

    International Nuclear Information System (INIS)

    This study was designed to evaluate the knowledge and attitude of a cohort of Iranian community pharmacists about the pharmaceutical care indexes and drug therapy in female epileptic patients. Methodology: This cross-sectional study was conducted in Iran (2011) and one hundred and twenty two community pharmacists were randomly selected using clustering method for sampling. A self-administered questionnaire which was originally made by a clinical pharmacy focus group was used. This questionnaire had 10 true/false questions for knowledge assessing (Spearman-Brown coefficient, 0.65) and 19 attitude statements (with Likert scale) about the intention of pharmacists for providing pharmaceutical care for epileptic females (Croanbach's alpha, 0.802). Face and content validity for both parts of the questionnaire were performed before the study. Results: There was a significant inverse relationship between pharmacists' knowledge on pharmaceutical care for epileptic females and the time elapsed from their graduation date. Considering the minimum passing score of 5, 85% of pharmacists did not have enough knowledge. The range of pharmacists' attitude scores was 35 to 64 and its mean was 46.09. Regarding the minimum passing score of 45, 63.3% of pharmacists had positive attitude to AEDs in epileptic females. Conclusion: It seems that the pharmaceutical care for epileptic females is a missing part of Pharmacy education. It is highly recommended to pay special attention to this topic in continuing education programs for Iranian pharmacists. (author)

  20. 临床药师参与2例产ESBLs大肠埃希菌抗感染治疗病例分析%Clinical pharmacists participating in Anti-infective treatment:Analysis of two gynecological cases of patients with ESBLs-producing bacte-ria-Escherichia coli infection

    Institute of Scientific and Technical Information of China (English)

    桂洪芹; 宁颖

    2016-01-01

    目的:探讨临床药师如何在妇产科产超广谱β-内酰胺酶(ESBLs)大肠埃希菌抗感染治疗中发挥作用。方法临床药师参与剖宫产术后切口感染及子宫次全切除术后宫颈残端感染各1例治疗过程,协助医生调整抗感染治疗方案。结果临床药师建议被采纳,2例患者均痊愈出院。结论临床药师利用药学专业知识协助妇产科医师多次调整用药方案,对治疗效果进行评估,提高治疗成功率。%Objective To investigate the clinical pharmacists how to play a role in anti-infection treatment. Methods Clinical pharmacists participate in treatment process of two cases of patients with ESBLs-producing bacteria-Escherichia coli infection,and one was incision infection after cesarean section,the other was cervical stump infection after subtotal hysterectomy. And in the treatment,Clinical pharmacists helped the doctor to adjust the drug use of anti-in-fection treatment. Results Clinical pharmacists proposals are adopted,and two patients were recovered. Conclusion Clinical pharmacists’pharmaceutical professional knowledge could help the doctor to adjust the drug use of anti-infection treatment and improve the treatment effecacy.

  1. Analysis of Clinical Pharmacist Participating in Diagnosis and Treatment of a Case of Invasive Pulmonary Fungal Infection and Drug Use of It%临床药师参与1例肺部侵袭性真菌病患者的诊治和用药实践分析

    Institute of Scientific and Technical Information of China (English)

    金海英; 邓再春

    2012-01-01

    目的:为临床药师与临床医师参与肺部侵袭性真菌感染治疗提供参考.方法:回顾性分析临床药师参与1例肺部侵袭性真菌感染患者的诊断和药物治疗情况.结果与结论:临床药师与临床医师专业互补,两者密切配合,临床药师可在药物的药效学、药动学、药物经济学及药品不良反应和应用注意事项等方面为临床医师提供参考,协助医师制订个体化治疗方案.%OBJECTIVE: To provide reference for clinical pharmacists participating in the therapy for invasive pulmonary fungal infection. METHODS: The clinical pharmacist participating in the diagnosis and the drug use of a case of invasive pulmonary fungal infection were analyzed retrospectively. RESULTS&CONCLUSION: Cooperated closely with the doctor, the clinical pharmacist can provide reference on pharmacodynamics, pharmacokinetics, pharmacoeconomics, adverse drug reactions and clinical cautions for the doctors, and assist the doctor with setting individualized treatment.

  2. 临床药师参与治疗1例产单核细胞李斯特菌致脑干脑炎患者的案例分析%Analysis of Clinical Pharmacist Participating in the Treatment for a Patient with Brainstem Encephalitis Caused by Listeria monocytogenes

    Institute of Scientific and Technical Information of China (English)

    温悦; 秦秀兰; 黄金柱

    2013-01-01

    OBJECTIVE:To provide reference for clinical pharmacist and doctor to treat brainstem encephalitis caused by Listeria monocytogenes.METHODS:The process of clinical pharmacists participating in drug treatment for a case of brainstem encephalitis caused by L.monocytogenes was analyzed retrospectively.Pharmaceutical care was provided in the field of anti-infective drugs,hemorrhage of digestive tract and nutritional support,etc.RESULTS:The patient finally recovered and discharged from hospital.CONCLUSIONS:The participation of clinical pharmacists in clinical treatment to develop individual nutritional therapy can improve therapeutic level and promote rational drug use.%目的:为临床药师参与治疗产单核细胞李斯特菌致脑干脑炎患者提供参考.方法:回顾性分析临床药师参与1例产单核细胞李斯特菌致脑干脑炎患者的药物治疗情况,从抗感染药、消化道出血、营养支持等方面进行药学监护.结果:最终患者病情好转出院.结论:临床药师参与临床治疗,协助制订个体化的治疗方案,有利于提高临床治疗水平,促进合理用药.

  3. Clinical pharmacist’s contribution to medication reconciliation on admission to hospital in Ireland

    LENUS (Irish Health Repository)

    Galvin, Mairead

    2012-10-08

    Background Medication reconciliation has been mandated by the Irish government at transfer of care. Research is needed to determine the contribution of clinical pharmacists to the process. Objective To describe the contribution of emergency department based clinical pharmacists to admission medication reconciliation in Ireland. Main Outcome Measure Frequency of clinical pharmacist\\'s activities. Setting Two public university teaching hospitals. Methodology Adults admitted via the accident and emergency department, from a non-acute setting, reporting the use of at least three regular prescription medications, were eligible for inclusion. Medication reconciliation was provided by clinical pharmacists to randomly-selected patients within 24-hours of admission. This process includes collecting a gold-standard pre-admission medication list, checking this against the admission prescription and communicating any changes. A discrepancy was defined as any difference between the gold-standard pre-admission medication list and the admission prescription. Discrepancies were communicated to the clinician in the patient\\'s healthcare record. Potentially harmful discrepancies were also communicated verbally. Pharmacist activities and unintentional discrepancies, both resolved and unresolved at 48-hours were measured. Unresolved discrepancies were confirmed verbally by the team as intentional or unintentional. A reliable and validated tool was used to assess clinical significance by medical consultants, clinical pharmacists, community pharmacists and general practitioners. Results In total, 134 patients, involving 1,556 medications, were included in the survey. Over 97 % of patients (involving 59 % of medications) experienced a medication change on admission. Over 90 % of patients (involving 29 % of medications) warranted clinical pharmacy input to determine whether such changes were intentional or unintentional. There were 447 interventions by the clinical pharmacist regarding

  4. Education of pharmacists in Canada.

    Science.gov (United States)

    Austin, Zubin; Ensom, Mary H H

    2008-12-15

    In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada. PMID:19325948

  5. Independent pharmacist prescribing in Canada

    OpenAIRE

    Law, Michael R.; Ma, Tracey; Fisher, Judith; Sketris, Ingrid S

    2012-01-01

    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.

  6. Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP therapy for HIV prevention

    Directory of Open Access Journals (Sweden)

    Clauson KA

    2009-03-01

    Full Text Available With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies. They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an “evening before pill”. The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy

  7. Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP) therapy for HIV prevention.

    Science.gov (United States)

    Clauson, Kevin A; Polen, Hyla H; Joseph, Shine A; Zapantis, Antonia

    2009-01-01

    With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP) is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies). They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an "evening before pill". The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy, and developing policy

  8. Addressing the Issue of Chronic, Inappropriate Benzodiazepine Use: How Can Pharmacists Play a Role?

    Directory of Open Access Journals (Sweden)

    Helen C. Gallagher

    2013-09-01

    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.

  9. 临床药师参与足部G+粗大杆菌混合G-杆菌感染治疗体会%Experience of Clinical Pharmacists' Participation in the Drug Treatment of Foot G+ Gross Coli Mixed G- Bacillus Infections

    Institute of Scientific and Technical Information of China (English)

    邢颖; 高杰; 毛璐; 甄健存

    2012-01-01

    Objective: To investigate the effect of clinical pharmacists participation in the treatment of foot G+ gross coli mixed G- coli infections. Method: Clinical pharmacists took part in the therapy of a patient with foot G+ gross coli mixed G- coli infection. Pharmacists helped doctors choose anti-infective drugs under the consideration of the guide, drug susceptibility results, characteristics of drugs, self medication experience and drug adverse reactions. Result: The patients with gas gangrene and mixed infection was cured successfully by the operation and rational drug therapy. Conclusion: The participation of clinical pharmacists in the treatment of surgical infections can supplement the deficiency of antimicrobial drug knowledge in the surgeons. It is beneficial to improve the levels of clinical treatment and rational drug use.%目的:探讨临床药师在治疗足部G+粗大杆菌混合G-杆菌感染病例中的作用.方法:临床药师通过参与1例足G+粗大杆菌混合感染患者的救治工作,发挥自身药学特长,结合指南、药敏结果、药物特点、用药经验及药物不良反应等方面知识帮助临床医生合理选择抗菌药物,处理不良反应.结果:通过手术及合理的用药方案成功治疗气性坏疽及感染.结论:临床药师参与外科感染的治疗,可以弥补外科医生对抗菌药物知识的不足,有利于提高临床治疗水平,促进合理用药.

  10. Antibacterial Agent Adjustment Performed by Clinical Pharmacists in the Treatment of One Case of Hospi-tal-acquired Pneumonia%临床药师参与1例医院获得性肺炎患者抗菌药物调整

    Institute of Scientific and Technical Information of China (English)

    张金莲; 李莉霞

    2014-01-01

    目的::小结临床药师在协同查房中调整抗菌药物治疗的工作。方法:临床药师参入1例医院获得性肺炎病例查房,与医生共同确定、抗菌药选择并实行药学服务。结果:临床药师协同查房,关注病程发展,病史,用药史,选用正确的抗菌药覆盖可疑病原菌及时控制感染。结论:临床药师参与药物治疗,主动提出抗菌药使用建议,为患者和医师提供药学服务提高药物治疗质量。%Objective:To summary the antibacterial agent therapy adjustment performed by clinical pharmacists in the collabora-tive rounds. Methods:Combined with physicians, clinical pharmacists participated in the ward round and antibacterial agent selection for one case of hospital-acquired pneumonia, meanwhile, pharmaceutical care was performed for the patient. Results:Clinical pharma-cists chose appropriate antibacterial agents for the patient to cover the suspected pathogens and control the infection in time through par-ticipating in the ward round and paying attention to the disease course progress, medical history and medication history. Conclusion:Clinical pharmacists can enhance the quality of drug therapy through participating in the drug therapy, providing the proposal for the antibacterial agent use and performing pharmaceutical service for physicians and patients.

  11. Measuring the quality of life of the elderly in health promotion intervention clinical trials.

    OpenAIRE

    Kutner, N G; Ory, M G; Baker, D. I.; Schechtman, K B; Hornbrook, M C; Mulrow, C D

    1992-01-01

    The Multicenter Trials of Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) is a series of clinical trials of biomedical, behavioral, and environmental interventions to reduce the risks of frailty and injury among the elderly. Reliable assessment of the quality of life reported by the subjects is a central issue in evaluating the interventions. An intervention may have a significant impact on an elderly person's sense of well-being, even though significant improvem...

  12. The Team Education and Adherence Monitoring (TEAM) trial: pharmacy interventions to improve hypertension control in blacks.

    Science.gov (United States)

    Svarstad, Bonnie L; Kotchen, Jane Morley; Shireman, Theresa I; Crawford, Stephanie Y; Palmer, Pamela A; Vivian, Eva M; Brown, Roger L

    2009-05-01

    Recent studies suggest that involving pharmacists is an effective strategy for improving patient adherence and blood pressure (BP) control. To date, few controlled studies have tested the cost-effectiveness of specific models for improving patient adherence and BP control in community pharmacies, where most Americans obtain prescriptions. We hypothesized that a team model of adherence monitoring and intervention in corporately owned community pharmacies can improve patient adherence, prescribing, and BP control among hypertensive black patients. The Team Education and Adherence Monitoring (TEAM) Trial is a randomized controlled trial testing a multistep intervention for improving adherence monitoring and intervention in 28 corporately owned community pharmacies. Patients in the 14 control pharmacies received "usual care," and patients in the 14 intervention pharmacies received TEAM Care by trained pharmacists and pharmacy technicians working with patients and physicians. Data collectors screened 1250 patients and enrolled 597 hypertensive black patients. The primary end points were the proportion of patients achieving BP control and reductions in systolic and diastolic BP measured after 6 and 12 months. Secondary end points were changes in adherence monitoring and intervention, patient adherence and barriers to adherence, prescribing, and cost-effectiveness. Researchers also will examine potential covariates and barriers to change. Involving pharmacists is a potentially powerful means of improving BP control in blacks. Pharmacists are in an excellent position to monitor patients between clinic visits and to provide useful information to patients and physicians. PMID:20031847

  13. Educating the clinical trainer: professional gain for the trainee? A controlled intervention study in general practice

    OpenAIRE

    Jochemsen-van der Leeuw, H.G.A. Ria; van Dijk, Nynke; de Jong, Wilfried; Wieringa-de Waard, Margreet

    2014-01-01

    The aim of this study was to establish whether a ‘teach-the-trainer’ course leads to improvements in, firstly, the knowledge and attitude of clinical trainers and their trainees, and, secondly, the role model behaviour of the clinical trainers. A controlled intervention study was performed with GP trainers and GP trainees from four training institutes in the Netherlands. Clinical trainers in the two intervention institutes received two 3-h training sessions on weight management, focusing on k...

  14. Case Analysis of the Participation of Clinical Pharmacist in Antifungal Drug Treatment of New Type Crypto-coccal Meningitis%临床药师参与1例新型隐球菌性脑膜炎抗真菌治疗的病例分析

    Institute of Scientific and Technical Information of China (English)

    孙闻续; 徐珽

    2015-01-01

    OBJECTIVE:To explore the method of pharmaceutical care for antifungal drug treatment of new type crypto-coccal meningitis by clinical pharmacist. METHODS:Clinical pharmacist participated in the drug treatment process for a pa-tient with new type cryptococcal meningitis. Clinical pharmacist provided pharmaceutical care in following aspects:assisting doctor to optimize antifungal drugs treatment plan,providing patients pharmaceutical monitoring and medication education, etc. During amphotericin B treatment,the patient developed refractory hypokalemia. Clinical pharmacists suggested doctors to reduce the dose of amphotericin B and additionally use voriconazole for antifungal treatment. RESULTS:The patient devel-oped refractory hypokalemia no more after the plan was adjusted. After 11 weeks of systematic antifungal treatment,the pa-tient was on the mend. CONCLUSIONS:The participation of clinical pharmacist in antifungal treatment of new type cryptococ-cal meningitis indicates that following the instructions,but not lost flexible disposal;providing service actively,and details is guarantee of safety.%目的:探讨临床药师在新型隐球菌性脑膜炎患者抗真菌治疗中的药学服务方法。方法:临床药师参与1例新型隐球菌性脑膜炎患者的药物治疗过程,从协助医师优化抗真菌药物治疗方案、对患者进行药学监护、不良反应处理及用药教育等方面提供药学服务。使用两性霉素B期间,患者出现顽固性低钾血症,临床药师建议医师降低两性霉素B剂量,加用伏立康唑抗真菌治疗。结果:调整抗真菌治疗方案后,患者未再出现低血钾;经系统抗真菌治疗11周后,患者病情较前明显好转。结论:临床药师参与新型隐球菌性脑膜炎抗真菌治疗的心得是:遵循指南,但不失灵活处理;主动服务,细节保障用药安全。

  15. Impact of diabets on clinical outcomes following multivessel percutaneous interventions

    Institute of Scientific and Technical Information of China (English)

    乔岩

    2013-01-01

    Objective To compare the rates of mortality,mycardial infarction (MI) ,repeat revascularization and stent thrombosis after percutaneous coronary intervention (PCI) with implantation of stents for diabetics versus nondiabetics with multivessel disease to evaluate the im-

  16. Pharmacist's Role in Diabetes Care

    Centers for Disease Control (CDC) Podcasts

    2008-05-19

    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.

  17. Impact of clinical pharmacy services in a short stay unit of a hospital emergency department in Qatar.

    Science.gov (United States)

    Abdelaziz, Hani; Al Anany, Rasha; Elmalik, Ashraf; Saad, Mohammad; Prabhu, Kirti; Al-Tamimi, Haleema; Salah, Salem Abu; Cameron, Peter

    2016-08-01

    Background The presence of a clinical pharmacist in a hospital's Emergency Department (ED) is important to decrease the potential for medication errors. To our knowledge, no previous studies have been conducted to evaluate the impact of implementing clinical pharmacy services in the ED in Qatar. Objective To characterize the contributions of clinical pharmacists in a short stay unit of ED in order to implement and scale-up the service to all ED areas in the future. Methods A retrospective study conducted for 7 months in the ED of Hamad General Hospital, Qatar. The intervention recommendations were made by clinical pharmacists to the physician in charge during medical rounds. Results A total of 824 documented pharmacist recommendations were analyzed. The interventions included the following: Providing information to the physician (24.4 %) and recommending medication discontinuation (22.0 %), dose adjustment (19.3 %), medication addition (16.0 %), changes in frequency of medications (7.6 %), medication resumption (5.7 %), and patient education (5.0 %). Conclusion Clinical pharmacists in the ED studied play an important role in patient care. PMID:27033505

  18. Impact of Pharmacist Facilitated Discharge Medication Reconciliation

    Directory of Open Access Journals (Sweden)

    Todd M. Super

    2014-07-01

    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.

  19. The changing nature of prescribing: pharmacists as prescribers and challenges to medical dominance.

    Science.gov (United States)

    Weiss, Marjorie C; Sutton, Jane

    2009-04-01

    This paper investigates the potential threat to medical dominance posed by the addition of pharmacists as prescribers in the UK. It explores the role of prescribing as an indicator of professional power, the legitimacy and status of new pharmacist prescribers and the forces influencing professional jurisdictional claims over the task of prescribing. It draws upon 23 interviews with pharmacist supplementary prescribers. Data suggest that the legitimacy of pharmacists as prescribers, as experienced in the workplace, has been aided by: (1) blurred definitions of prescribing; (2) the emphasis on new prescribers' competence urging pharmacist prescribers to limit their areas of clinical practice; and (3) a team approach to patient management. Competence, self-limitation on practice and the benefits of team working as part of the ideology of patient safety were thus an important influence on pharmacists' jurisdictional claim over prescribing. While pharmacists have successfully negotiated a role for themselves as prescribers, medicine has retained its high status, relative to other health professionals and with patients; it controls the knowledge base relevant for prescribing practice and has managed to develop an 'overseer' role over the process of prescribing. Prescribing, as an indicator of medicine's autonomy of control over their work and professional status, has changed. Yet the extent to which new prescribers have been able to threaten the professional dominance of medicine is debatable. PMID:19055585

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

    Science.gov (United States)

    Bilsen, Johan; Bauwens, Marc; Bernheim, Jan; Stichele, Robert Vander; Deliens, Luc

    2005-03-01

    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 = 359). Most of the pharmacists who responded felt that patients have the right to end their own life (73%), and that under certain conditions physicians may assist the patient in dying (euthanasia: 84%; physician-assisted suicide: 61%). Under the prevailing restrictive legislation, a quarter of the pharmacists were willing to dispense lethal drugs for euthanasia versus 86% if it were legalized, but only after being well informed by the physician. The respondents-favour guidelines for pharmacists drafted by their own professional organizations (95%), and enforced by legislation (90%) to ensure careful end-of-life practice. Over the last two years, 7.3% of the responding pharmacists have received a medical prescription for lethal drugs and 6.4% have actually dispensed them. So we can conclude that community pharmacists in East Flanders were not adverse to physician-assisted death, but their cooperation in dispensing lethal drugs was conditional on clinical information about the specific case and on protection by laws and professional guidelines. PMID:15810755

  1. Job Sharing for Women Pharmacists in Academia

    OpenAIRE

    Rogers, Kelly C.; Finks, Shannon W.

    2009-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Hatah E

    2013-09-01

    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.

  3. Effectiveness of pharmacist dosing adjustment for critically ill patients receiving continuous renal replacement therapy: a comparative study

    Directory of Open Access Journals (Sweden)

    Jiang SP

    2014-06-01

    Full Text Available Sai-Ping Jiang,1 Zheng-Yi Zhu,2 Xiao-Liang Wu,3 Xiao-Yang Lu,1 Xing-Guo Zhang,1 Bao-Hua Wu1 1Department of Pharmacy, the First Affiliated Hospital, 2Department of Pharmacy, Children’s Hospital, College of Medicine, Zhejiang University, Hangzhou, 3Intensive Care Unit, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China Background: The impact of continuous renal replacement therapy (CRRT on drug removal is complicated; pharmacist dosing adjustment for these patients may be advantageous. This study aims to describe the development and implementation of pharmacist dosing adjustment for critically ill patients receiving CRRT and to examine the effectiveness of pharmacist interventions. Methods: A comparative study was conducted in an intensive care unit (ICU of a university-affiliated hospital. Patients receiving CRRT in the intervention group received specialized pharmacy dosing service from pharmacists, whereas patients in the no-intervention group received routine medical care without pharmacist involvement. The two phases were compared to evaluate the outcome of pharmacist dosing adjustment. Results: The pharmacist carried out 233 dosing adjustment recommendations for patients receiving CRRT, and 212 (90.98% of the recommendations were well accepted by the physicians. Changes in CRRT-related variables (n=144, 61.81% were the most common risk factors for dosing errors, whereas antibiotics (n=168, 72.10% were the medications most commonly associated with dosing errors. Pharmacist dosing adjustment resulted in a US$2,345.98 ICU cost savings per critically ill patient receiving CRRT. Suspected adverse drug events in the intervention group were significantly lower than those in the preintervention group (35 in 27 patients versus [vs] 18 in eleven patients, P<0.001. However, there was no significant difference between length of ICU stay and mortality after pharmacist dosing adjustment, which

  4. Clinical observation of interventional treatment for tubal pregnancy

    International Nuclear Information System (INIS)

    Objective: To investigate a new method to of conservative treatment of treat tubal pregnancy. Methods: 20 cases of tubal pregnancy were treated by two conservative methods. Among them, 10 cases received single dose 5-fluorouracil perfusion through the super selective catheterization for uterus artery. Others took RU486 orally and received intra-muscular injection of testosterone. Results: Hospitalization was shorter, less salpingectomy was recommended, and blood HCG decreased faster in interventional group, than in control group. Conclusion: The 5-fluorouracil interventional treatment had its advantages for tubal pregnancy

  5. Reiki as a clinical intervention in oncology nursing practice.

    Science.gov (United States)

    Bossi, Larraine M; Ott, Mary Jane; DeCristofaro, Susan

    2008-06-01

    Oncology nurses and their patients are frequently on the cutting edge of new therapies and interventions that support coping, health, and healing. Reiki is a practice that is requested with increasing frequency, is easy to learn, does not require expensive equipment, and in preliminary research, elicits a relaxation response and helps patients to feel more peaceful and experience less pain. Those who practice Reiki report that it supports them in self-care and a healthy lifestyle. This article will describe the process of Reiki, review current literature, present vignettes of patient responses to the intervention, and make recommendations for future study. PMID:18515247

  6. Intervention effects on negative affect of CPS-referred children: results of a randomized clinical trial.

    Science.gov (United States)

    Lind, Teresa; Bernard, Kristin; Ross, Emily; Dozier, Mary

    2014-09-01

    Exposure to early adversity places young children at risk for behavioral, physiological, and emotional dysregulation, predisposing them to a range of long-term problematic outcomes. Attachment and Biobehavioral Catch-up (ABC) is a 10-session intervention designed to enhance children's self-regulatory capabilities by helping parents to behave in nurturing, synchronous, and non-frightening ways. The effectiveness of the intervention was assessed in a randomized clinical trial, with parents who had been referred to Child Protective Services (CPS) for allegations of maltreatment. Parent-child dyads received either the ABC intervention or a control intervention. Following the intervention, children from the ABC intervention (n=56) expressed lower levels of negative affect during a challenging task compared to children from the control intervention (n=61). PMID:24814751

  7. Impact of Pharmacy Student Interventions in an Urban Family Medicine Clinic

    OpenAIRE

    Ginzburg, Regina

    2014-01-01

    Objectives. To determine the number of interventions made by pharmacy students at an urban family medicine clinic and the acceptance rate of these recommendations by the healthcare providers. The secondary objective was to investigate the cost avoidance value of the interventions.

  8. A Marginal Structural Model Analysis for Loneliness: Implications for Intervention Trials and Clinical Practice

    Science.gov (United States)

    VanderWeele, Tyler J.; Hawkley, Louise C.; Thisted, Ronald A.; Cacioppo, John T.

    2011-01-01

    Objective: Clinical scientists, policymakers, and individuals must make decisions concerning effective interventions that address health-related issues. We use longitudinal data on loneliness and depressive symptoms and a new class of causal models to illustrate how empirical evidence can be used to inform intervention trial design and clinical…

  9. Scale Development of a Measure to Assess Community-Based and Clinical Intervention Group Environments

    Science.gov (United States)

    Wilson, Patrick A.; Hansen, Nathan B.; Tarakeshwar, Nalini; Neufeld, Sharon; Kochman, Arlene; Sikkema, Kathleen J.

    2008-01-01

    Though group interventions are widely used in community-based and clinical settings, there are few brief instruments for assessing the group environment. Two studies on the development of a brief measure to assess intervention group environments are described, and psychometric properties of the new scale are presented. The new measure is based on…

  10. From cell culture to population enquiry: Experimental, clinical and epidemiological studies on restenosis post coronary intervention

    NARCIS (Netherlands)

    A.G. Violaris (Andonis)

    1998-01-01

    textabstractPercutaneous coronary intervention is widely used in the treatment of coronaty artery disease but currently limited by restenosis in a proportion of cases. We investigated the restenosis problem using complimentary experimental, clinical and epidemiological approaches.

  11. Case analysis of the of clinical pharmacists participating in the treatment of severe hypoglycemia caused by xiaokewan%临床药师参与消渴丸所致重度低血糖治疗的病例分析

    Institute of Scientific and Technical Information of China (English)

    郭燕波; 付登聪

    2015-01-01

    目的:探讨临床药师参与患者药物治疗的作用。方法对1例消渴丸所致重度低血糖的病例进行分析,临床药师从专业角度识别药物不良反应,协助医生制订合理、有效的治疗方案。结果经治疗患者低血糖症状消失,血糖稳定在5~9mmol/ L。结论在临床实践中,临床药师参与不良反应因果关系的判断,对患者进行药学监护,充分发挥了临床药师的价值。%Objective To investigate the effect of clinical pharmacists participating in drug treatment of patients. Methods By analyzing one case of severe hypoglycemia caused by xiaokewan,the clinical pharmacists identify adverse reaction from the professional point of view,and assist doctors in formulating a reasonable and effective treatment plan. Results After the treatment,the symptoms of hypoglycemia disappeared for patients,blood glucose maintained at 5 ~ 9mmol/ L. Conclusion In clinical practice,clinical pharmacists judge the causality of the adverse reactions and provided pharmaceutical care for pa-tient,which played a role in the clinical practice.

  12. Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jakobsen, Lars; Niemann, Troels; Thorsgaard, Niels;

    2012-01-01

    The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood.......The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood....

  13. An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice

    Directory of Open Access Journals (Sweden)

    Cresswell Kathrin M

    2012-06-01

    Full Text Available Abstract Background There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER intervention, which substantially reduced the risk of clinically important errors in medicines management in primary care. Methods Data were collected at two geographical locations in central England through a combination of one-to-one longitudinal semi-structured telephone interviews (one at the beginning of the trial and another when the trial was well underway, relevant documents, and focus group discussions following delivery of the PINCER intervention. Participants included PINCER pharmacists, general practice staff, researchers involved in the running of the trial, and primary care trust staff. PINCER pharmacists were interviewed at three different time-points during the delivery of the PINCER intervention. Analysis was thematic with diffusion of innovation theory providing a theoretical framework. Results We conducted 52 semi-structured telephone interviews and six focus group discussions with 30 additional participants. In addition, documentary data were collected from six pharmacist diaries, along with notes from four meetings of the PINCER pharmacists and feedback meetings from 34 practices. Key findings that helped to explain the success of the PINCER intervention included the perceived importance of focusing on prescribing errors to all stakeholders, and the credibility and appropriateness of a pharmacist-led intervention to address these shortcomings. Central to this was the face-to-face contact and relationship building between pharmacists and a range of practice staff, and pharmacists’ explicitly designated role as a change agent

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

    Directory of Open Access Journals (Sweden)

    Maria Rubio-Valera

    2014-10-01

    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.

  15. Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia

    Science.gov (United States)

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

    2016-01-01

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

  16. Subclinical hepatic encephalopathy: diagnosis, clinical implications, and intervention

    NARCIS (Netherlands)

    J.C. Guero Guillen

    1997-01-01

    textabstractHepatic encephalopathy (HE) is traditionally graded into four clinical stages of severity, ranging from lethargy, sleep and memory disturbances (grade 1) to coma (grade 4). In addition to the clinical grading of HE, a subclinical stage has been described. In subclinical hepatic encephalo

  17. 临床药师参与治疗鲍曼不动杆菌颅内感染患儿的药学实践%Clinical pharmacists participated in the treatment of Acinetobacter baumannii in- tracranial infections in children

    Institute of Scientific and Technical Information of China (English)

    何霜霜; 刘腾

    2015-01-01

    Objective To provide reference for clinical pharmacist and physicians working together to treat se-vere refractory Acinetobacter baumanniii ntracranial infections in children. Methods The process of clinical pharmacist participating indrug therapy for the patient suffering from Acinetobacter baumannii intracranial infections in children was retrospectively analyzed. The clinical pharmacist can closely cooperate with the physicians by using their pharma-ceutical knowledge and the evidence-based literatures. Results The children was finally cured and discharged from hospital. Conclusion Clinical pharmacists′ participation is helpful for doctors to make safe and effective medication.%目的:为临床救治重症难治性鲍曼不动杆菌颅内感染患儿提供用药参考。方法通过分析临床药师参与救治我院1例鲍曼不动杆菌颅内感染患儿提供的药学服务,根据患者的病情变化,临床药师结合药物的药理药化知识,查阅相关文献资料,与临床医师共同协商,制定出最优的药物治疗方案。结果通过临床医师及临床药师的共同努力,最终成功救治该患儿。结论临床药师的参与可以协助医师制订安全、有效的治疗方案。

  18. 药师参与日本乙型脑炎合并肺部感染治疗实践1例%Clinical Practice of Pharmacist in the Treatment of One Patient with Japanese B Encephalitis Complicated with Pulmonary Infection

    Institute of Scientific and Technical Information of China (English)

    闫成; 薛洪源; 刘建芳

    2014-01-01

    Objective:To explore the value of clinical pharmacist in clinical treatment through the pharmaceutical care on a patient with Japanese B encephalitis complicated with pulmonary infection. Methods:Clinical pharmacist participated in the whole treatment process and gave suggestions on the selection,dosage and course of the drugs prescribed for anti-virus, anti-epilepsy and anti-infection by focusing on the drug interactions and adverse reactions. Results:The treatment course of the patient was smooth, and the pathoge-netic condition was brought under control gradually while no obvious adverse drug reactions occurred. Conclusion:The work of clinical pharmacist can help to optimize treatment programs to ensure the safety and effectiveness of medication.%目的:通过临床药师参与1例日本乙型脑炎合并肺部感染患者的治疗实践,探讨药师在临床发挥的作用。方法:临床药师积极参与该患者的整个治疗过程,围绕抗病毒、抗癫痫、抗感染等方面开展药学监护,对治疗药物的选择、剂量、疗程提出合理化建议,关注药物相互作用及不良反应。结果:患者治疗过程顺利,病情逐步得到控制,整个治疗过程中未见明显药品不良反应。结论:临床药师参与疾病治疗工作,旨在优化治疗方案,确保患者用药安全、有效。

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

    Directory of Open Access Journals (Sweden)

    Adepu R

    2006-01-01

    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

  20. Consumer Perception and Expectation of Community Pharmacist

    Directory of Open Access Journals (Sweden)

    Sekar T. Hutami

    2013-09-01

    Full Text Available The aims of the study are to determine consumer perception and expectation of community pharmacist in Yogyakarta. This research was a non-experimental descriptive study. One hundred respondents were taken from five pharmacies with purposive sampling technique. Data were collected by survey using a questionnaire and were analysed with descriptive statistical analysis using frequency statistics. The results showed that 62% of respondents were able to distinguish pharmacists with other staffs in the pharmacy and 75% of respondents understood that they could consult with pharmacist about medications that they were taking. Respondents received drug information less from community pharmacist than from physician (-0.27 and placed pharmacists at the second place in the ranking of the most reliable health provider after physician. The highest respondent expectation of pharmacist service developments were willingness to be contacted outside office hours (80.00% and monitoring drug therapy (73.25%. In pharmacy services development, respondents expected two important services which are 24 hours pharmacy services (87.25% and completeness of offered drug (92.25%. Although consumers have not already put pharmacists as the first drug information provider, but the consumers have begun to understand the role of pharmacist as drug information source.

  1. Genetics, pathogenesis and clinical interventions in type 1 diabetes

    Science.gov (United States)

    Bluestone, Jeffrey A.; Herold, Kevan; Eisenbarth, George

    2016-01-01

    Type 1 diabetes is an autoimmune disorder afflicting millions of people worldwide. Once diagnosed, patients require lifelong insulin treatment and can experience numerous disease-associated complications. The last decade has seen tremendous advances in elucidating the causes and treatment of the disease based on extensive research both in rodent models of spontaneous diabetes and in humans. Integrating these advances has led to the recognition that the balance between regulatory and effector T cells determines disease risk, timing of disease activation, and disease tempo. Here we describe current progress, the challenges ahead and the new interventions that are being tested to address the unmet need for preventative or curative therapies. PMID:20432533

  2. Pharmaceutical Care for 1 Case of Chemotherapy-induced Febrile Neutropenla by Clinical Pharmacist%临床药师对1例化疗所致发热性中性粒细胞缺乏患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    惠红岩

    2012-01-01

    目的:探讨临床药师参与化疗所致发热性中性粒细胞缺乏患者的药学监护切入点.方法:回顾性分析临床药师参与1例急性非淋巴细胞白血病患者大剂量阿糖胞苷化疗所致发热性中性粒细胞缺乏的药物治疗过程.结果与结论:临床药师从抗感染和支持治疗用药选择、药学监护和患者教育方面,积极配合医师,为患者提供了合理的用药方案,使患者粒细胞缺乏得以明显改善,并避免了严重不良反应的发生,最终提高了治疗效果和患者生活质量.%OBJECTIVE: To explore the approaches for clinical pharmacist participating in pharmaceutical care for a patient with febrile neutropenia after chemotherapy. METHODS: The treatment course of clinical pharmacists participated in the treatment for 1 case of acute non-lymphocytic leukemia patient with febrile neutropenia after having large dose of cytarabine chemotherapy was analyzed retrospectively. RESULTS&CONCLUSION: Through drug selection for anti-infection and supportive treatment, phar-maceutical care and patient education, clinical pharmacists help physician to provide reasonable medication to improve neutropenia significantly and avoid severe adverse drug reaction so as to improve therapeutic efficacy and life quality of the patient.

  3. Pharmacist-managed oral anticoagulation therapy in the community setting.

    Science.gov (United States)

    Bouwmeester, Carla; Chim, Christine

    2013-05-01

    Pharmacists are at the forefront when caring for patients requiring anticoagulation resulting from chronic conditions, complex medications therapy, or at risk for drug interactions. As a consequence, there is a greater need for pharmacist-managed anticoagulation clinics in the community setting. This article will review special considerations for oral anticoagulant therapy in the elderly, collaborative therapy management, establishment of policies and procedures, documentation of patient visits, patient counseling, and barriers to successful anticoagulation management. It will also discuss evidence-based guidelines for the use of oral anticoagulants and compare the agents currently approved by the Food and Drug Administration. Finally, barriers to anticoagulation management will be examined, including issues with adherence and communication with patients and health care providers. PMID:23649677

  4. Pharmaceutical Care of Medication Schedule for Elderly Diabetes Patients with Merge Complications by Clinical Pharmacists%临床药师为老年糖尿病合并多种并发症患者合理安排用药时间的药学监护

    Institute of Scientific and Technical Information of China (English)

    王丽; 卜一珊; 张丹

    2015-01-01

    OBJECTIVE:To explore the approach of pharmaceutical care for elderly diabetes patients with merge complications by clinical pharmacists.METHODS:Through the principles of chronopharmacology,drug and food and interactions between drugs,to introduce the rational adjustment of medication schedule in patients and the process of medication guidance for one elderly diabetes patient with merge complications by the clinical pharmacists.RESULTS:The patients adjusted the medication schedule via the"indicator diagram of medication time" formulated by the clinical pharmacists,the treatment efficacy of drugs and medication compliance were significantly improved.After adjustment,the blood glucose and pressure levels were perfectly controlled,levels of Scr and UA deceased obviously,the patient had discharged from the hospital with normal conditions.CONCLUSIONS:The communication between patients and clinical pharmacists,serious medication guidance and the improvement of medication compliance in patients all play important roles in the promotion of rational drug use and contribution of fully developing the drugs curative effect.%目的:探索临床药师为老年糖尿病合并多种并发症患者提供药学服务的途径.方法:介绍临床药师根据时辰药理学、药物与食物、药物与药物间的相互作用等原理,为1 例老年糖尿病合并多种并发症患者的服药时间进行合理调整并进行用药指导的过程.结果:患者按照临床药师制订的“服药时间指示图”调整服药时间,提高了药物的治疗效果,同时也提高了患者的用药依从性.经调整后患者血糖、血压控制理想,血肌酐、尿酸水平明显下降,病情稳定出院.结论:临床药师与患者良好的沟通,认真的用药指导,提高患者用药的依从性,对促进合理用药、最大程度发挥药物疗效具有重要作用.

  5. Prime time: 18-month violence outcomes of a clinic-linked intervention.

    Science.gov (United States)

    Sieving, Renee E; McMorris, Barbara J; Secor-Turner, Molly; Garwick, Ann W; Shlafer, Rebecca; Beckman, Kara J; Pettingell, Sandra L; Oliphant, Jennifer A; Seppelt, Ann M

    2014-08-01

    Prime Time, a youth development intervention, aims to reduce multiple risk behaviors among adolescent girls seeking clinic services who are at high risk for pregnancy. The purpose of the current study was to examine whether Prime Time involvement produced changes in relational aggression, physical violence, and related psychosocial and behavioral outcomes. Qualitative case exemplars illustrated social contexts of intervention participants with differing longitudinal patterns of relational aggression and physical violence. Data were from a randomized efficacy trial with 13-17 year-old girls (n = 253) meeting specified risk criteria. Intervention participants were involved in Prime Time and usual clinic services for 18 months, control participants received usual clinic services. Participants in the current study completed self-report surveys at baseline and 18 months following enrollment. Outcomes analyses revealed significantly lower levels of relational aggression perpetration in the intervention group versus controls. In contrast, Prime Time involvement did not result in significant reductions in physical violence. Exploratory dose-response analyses indicated that reductions in relational aggression may have been most pronounced among girls actively involved in Prime Time case management and peer leadership activities. Qualitative findings suggested that the intervention's emphasis on modeling and building supportive relationships contributed to reductions in relational aggression. This study contributes to what has been a very limited evidence base regarding effective approaches to preventing violence among high-risk adolescent girls. Findings suggest that offering youth development interventions through clinic settings hold promise in reducing violence risk among vulnerable youth. PMID:23543359

  6. Documentation of pharmacotherapeutic interventions of pharmacy students

    Directory of Open Access Journals (Sweden)

    King ED

    2007-06-01

    Full Text Available During patient care rounds with the medical team, pharmacy students have made positive contributions for the benefit of the patient. However, very little has been documented regarding the impact these future healthcare professionals are making while on clinical rotations.The objective of this study was to assess the impact that clinical interventions made by 6th year pharmacy students had on overall patient outcome. Using a special program for a personal digital assistant (PDA, the students daily recorded the pharmacotherapeutic interventions they made. The interventions ranged from dosage adjustments to providing drug information. Data was collected over a 12-week period from various hospitals and clinics in the Jacksonville, Florida area.In total, there were 89 pharmaceutical interventions performed and recorded by the students. Fifty interventions involved drug modification and fifty-four interventions were in regards to drug information and consulting. Of the drug information and consulting interventions, 15 were drug modification.This study shows the impact pharmacy students make in identifying, recommending, and documenting clinical pharmacotherapeutic interventions. Similar to pharmacists, pharmacy students can also have a positive contribution towards patient care.

  7. Assessing the relationship between pharmacists' job satisfaction and over-the-counter counselling at community pharmacies.

    Science.gov (United States)

    Urbonas, Gvidas; Kubilienė, Loreta

    2016-04-01

    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

  8. Evaluation of Community Pharmacists Performance in Management of Cough, Diarrhea and Common Cold using OTC Medication Requests in Hamadan in 2015

    Directory of Open Access Journals (Sweden)

    A. Rashidi

    2016-07-01

    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

  9. Postgraduate Clinical Psychology Students' Perceptions of an Acceptance and Commitment Therapy Stress Management Intervention and Clinical Training

    Science.gov (United States)

    Pakenham, Kenneth I.; Stafford-Brown, Johanna

    2013-01-01

    Background: Research into stress management interventions for clinical psychology trainees (CPTs) is limited, despite evidence indicating that these individuals are at risk for elevated stress, which can negatively impact personal and professional functioning. This study explored: (1) CPTs' perceptions of a previously evaluated Acceptance and…

  10. The Analysis of Pharmaceutical Care to Clinical Pharmacists Through Involvement in One Case of Drug-induced Liver Injury%临床药师参与1例药物性肝损伤药学服务分析

    Institute of Scientific and Technical Information of China (English)

    刘歌明

    2015-01-01

    临床药师全程参与1例女性药物性肝损伤患者药物治疗过程协助医生查找肝损伤原因,筛选可能导致肝损伤的药物,制定药物治疗方案,给予患者药学监护,针对患者情况制定合理的出院用药计划,临床药师利用自己的专业优势保障了临床较好的治疗效果.%Clinical pharmacists through involvement in 1 case of female patients with drug-induced liver injury drug treatment process ,to assist the doctor investigate the cause of liver damage,screening of drugs may lead to liver damage,for drug treatment plan,for patients with pharmaceutical care,a reasonable plan to discharge medication for patients,clinical pharmacists to use their own professional advantage to ensure better clinical therapeutic effect.

  11. Analysis and Pharmaceutical Care Performed by Clinical Pharmacist for 2 Cases of Drug-induced Acute Kidney Injury%临床药师参与2例药物所致急性肾损伤的分析与药学监护

    Institute of Scientific and Technical Information of China (English)

    李丹; 韩静静; 吴杰; 郭咸希; 雷嘉川; 宋金春

    2015-01-01

    Objective: To provide some experience and help for the pharmaceutical care for drug-induced acute kidney injury through analysis and pharmaceutical care performed by clinical pharmacist for two cases of drug-induced acute kidney injury. Meth-ods:Clinical pharmacist analyzed the mechanism of drug-induced acute kidney injury, provided some suggestions for the medication, helped doctors select hormone drugs reasonably and performed medical education in the patients. Results:The kidney function of the two patients was recovered during the hospitalization after the reasonable treatment and care by doctors and pharmacists. Conclusion:The drug-induced acute kidney injury should be paid high attention, and the medical education should be strengthened in the patients.%目的:临床药师通过对2例药物所致急性肾损伤的分析总结及药学监护,期望为药物所致的急性肾损伤的药学监护提供一些经验和帮助. 方法:药师通过分析药物所致急性肾损伤的机制并给出用药建议,协助医师合理选用激素并对患者进行用药教育和指导. 结果:在医师的合理治疗和药师的悉心监护下,2例患者肾功能在住院期间恢复. 结论: 应加强患者的用药教育,药物所致的急性肾损伤应引起高度重视.

  12. Role of community pharmacists in the use of antipsychotics for behavioural and psychological symptoms of dementia (BPSD): a qualitative study

    Science.gov (United States)

    Aston, Lydia; Hilton, Andrea; Iqbal, Naveed; Child, Anne; Shaw, Rachel

    2016-01-01

    Objective This study aimed to use qualitative methodology to understand the current role of community pharmacists in limiting the use of antipsychotics prescribed inappropriately for behavioural and psychological symptoms of dementia. Design A qualitative study employing focus groups was conducted. Data were analysed using thematic analysis. Setting 3 different geographical locations in the England. Participants Community pharmacists (n=22). Results The focus groups identified an array of factors and constraints, which affect the ability of community pharmacists to contribute to initiatives to limit the use of antipsychotics. 3 key themes were revealed: (1) politics and the medical hierarchy, which created communication barriers; (2) how resources and remit impact the effectiveness of community pharmacy; and (3) understanding the nature of the treatment of dementia. Conclusions Our findings suggest that an improvement in communication between community pharmacists and healthcare professionals, especially general practitioners (GPs) must occur in order for community pharmacists to assist in limiting the use of antipsychotics in people with dementia. Additionally, extra training in working with people with dementia is required. Thus, an intervention which involves appropriately trained pharmacists working in collaboration with GPs and other caregivers is required. Overall, within the current environment, community pharmacists question the extent to which they can contribute in helping to reduce the prescription of antipsychotics. PMID:26983947

  13. Clinic-based intervention projects: STD and family planning programs get involved. Intervention model.

    Science.gov (United States)

    Finger, W R

    1991-06-01

    The sexually transmitted disease (STD) program in Udorn, a popular Thai tourist city, has worked closely with 750 prostitutes for 15 years, incorporating the concerns of brothel managers and prostitutes into service delivery. The program in Udorn is part of a nationwide network of STD clinics. The level of person-to-person interaction was increased once it was determined by 1989 that HIV had infected 6% of prostitutes in the city's brothels. Outreach educators were recruited and trained to ensure that all prostitutes in Udorn had the basic facts about HIV and AIDS. Over the last 2 years, the STD program has trained outreach educators to work in 8 brothels, started a local AIDS prevention foundation supported by local businessmen, and taken other steps to incorporate AIDS prevention into its clinic structure. Such clinic-based programs are an important way of targeting groups at high risk of HIV transmission. PMID:12316886

  14. Prime Time: 18-Month Violence Outcomes of a Clinic-Linked Intervention

    OpenAIRE

    Sieving, Renee E.; McMorris, Barbara J.; Secor-Turner, Molly; Garwick, Ann W.; Shlafer, Rebecca; Beckman, Kara J.; Pettingell, Sandra L.; Oliphant, Jennifer A.; Seppelt, Ann M.

    2014-01-01

    Prime Time, a youth development intervention, aims to reduce multiple risk behaviors among adolescent girls seeking clinic services who are at high risk for pregnancy. The purpose of the current study was to examine whether Prime Time involvement produced changes in relational aggression, physical violence and related psychosocial and behavioral outcomes. Qualitative case exemplars illustrated social contexts of intervention participants with differing longitudinal patterns of relational aggr...

  15. Texting Teens in Transition: The Use of Text Messages in Clinical Intervention Research

    OpenAIRE

    Rempel, Gwen R; Ballantyne, Ross T; Magill-Evans, Joyce; Nicholas, David B; Mackie, Andrew S

    2014-01-01

    Background The rapidly growing population of young adults living with congenital heart disease (CHD), currently challenging ill-prepared cardiac care systems, presents a novel population in which to consider the use of mHealth. This methodological study was part of a larger study that tested the effectiveness of a clinic-based nursing intervention to prepare teens for transfer from pediatric to adult cardiology care. The intervention included creation of a MyHealth Passport and subsequently S...

  16. Development of Detailed Clinical Models for Nursing Assessments and Nursing Interventions

    OpenAIRE

    Park, Hyeoun-Ae; Min, Yul Ha; Kim, Younglan; Lee, Myung Kyung; Lee, Youngji

    2011-01-01

    Objectives The aim of this study was to develop and validate Detailed Clinical Models (DCMs) for nursing assessments and interventions. Methods First, we identified the nursing assessment and nursing intervention entities. Second, we identified the attributes and the attribute values in order to describe the entities in more detail. The data type and optionality of the attributes were then defined. Third, the entities, attributes and value sets in the DCMs were mapped to the International Cla...

  17. 基层医院临床药师用药管理对促进临床合理用药的价值%Strengthening Primary Hospital Clinical Pharmacist Medication Manage-ment and Rational Use of Drugs for Clinical Value

    Institute of Scientific and Technical Information of China (English)

    李华

    2015-01-01

    目的:探讨基层医院临床药师用药管理对促进临床合理用药的价值。方法该研究按照数字表法随机分为对照组和研究组,每组各550例,其中对照组采用常规用药管理,而研究组则由临床药师对患者用药全过程进行适时管理,比较两组患者用药不安全事件及患者满意度。结果研究组患者的不安全用药事件发生率(0.73%)较对照组(2.91%)明显下降,且差异有统计学意义(字2=7.33,P<0.05)。研究组患者用药满意度(90.18%)明显优于对照组(72.55%),且差异有统计学意义(字2=56.41,P<0.05)。结论临床药师在临床治疗过程中具有重要的价值,应从各个方面不断提高强化药师的业务能力和综合素质,规范临床用药的合理性和安全性,保证人们的身体健康。%Objective To investigate the value of clinical pharmacists in drug management of the primary hospital to promote ra-tional drug use in the clinic. Methods In this study, were randomly divided into control group and study group, 550 cases in each group, the control group was treated with conventional therapy, while the study group by clinical pharmacists in the whole process of the drug in patients with timely management, compared two groups of patients with medication safety events and patients' satis-faction. Results The incidence of unsafe medication events of patients in the study group (0.73%) than in the control group (2.91%) was significantly decreased, and the difference was statistically significant (χ²=7.33,P<0.05). Satisfaction study group pa-tients (90.18%) was significantly better than the control group (72.55%), and the difference was statistically significant (χ²=56.41, P<0.05). Conclusion Clinical pharmacists can play an important role in the process of clinical treatment, to strengthen their opera-tional capacity, improve their overall quality, from the aspects of improving himself, so as to standardize the clinical

  18. Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention

    Directory of Open Access Journals (Sweden)

    Ozayr H. Mahomed

    2015-02-01

    Full Text Available Background: Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases.Objectives: The aim of this study was to establish if the implementation of a structured clinical record (SCR as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level.Method: A quasi-experimental study (before and after study with a comparison group was conducted across 30 primary health care clinics (PHCs located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS method was used to determine the number of records required to be reviewed per diagnostic condition per facility.Results: There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes.Conclusions: A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

  19. Student Pharmacists as Tuberculosis Screeners.

    Science.gov (United States)

    McKennon, Skye A; Arnold, Jennifer

    2016-03-25

    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

  20. Investigation on situation of potentially inappropriate medication before and after pharmacist intervention in elderly patients in Beijing primary health care institutions%北京地区基层医疗机构药师干预前后老年患者潜在不适当用药情况调查

    Institute of Scientific and Technical Information of China (English)

    李星炜; 沈芊; 李晓玲; 刘琛; 王雅葳; 王育琴

    2015-01-01

    Objective To explore the impact of pharmacist intervention on the potentially inappropriate drug application in the elderly patients in the primary health care institutions. Methods Twenty four primary health care institutions in Beijing were selected. The researchers selected 15 kinds of potentially inappropriate drugs according to the Beers criteria and lists of potentially inappropriate drugs of USA,UK,and Japanese and organized a training of medication safety for pharmacists in above primary health care institutions. From February 10th,2014 to February 20th,2014,education on the risks of potentially inappropriate drug application in the elderly patients was carried out among the doctors in above mentioned institutions and relevant documents were distributed. Prescriptions for the elderly outpatients in the 24 primary health care institutions before(from June 3,2013 to June 7,2013)and after(from March 12,2014 to March 16,2014)the intervention were collected and the proportions of prescriptions containing 15 kinds of potentially inappropriate drugs in the prescriptions containing the appropriate diagnosis before and after the intervention were calculated and compared. Results The number of collected prescriptions in the elderly patients before and after the intervention was 12 243 and 11 571, respectively. Before the intervention,there were 10 kinds of inappropriate drugs, including estazolam, diazepam, ibuprofen, diclofenac, belladonna, theophylline, aminophylline, chlorpheniramine, digoxin, compound reserpine triamterene,and glyburide. After pharmacist intervention,the proportions of prescriptions of 5 kinds of potentially inappropriate drugs in the elderly patients decreased significantly,including ibuprofen(5. 92% vs. 27. 43%),diclofenac(5. 92% vs. 13. 17%),chlorpheniramine(1. 08% vs. 4. 86%),digoxin(2. 40% vs. 7. 56%)and glyburide(1. 61% vs. 8. 03%),all P<0. 001. Conclusion Pharmacist intervention has a positive effect on improving the potentially

  1. 临床药师参与肿瘤患者医院感染的会诊分析%Consultation Analysis of Clinical Pharmacist on the Hospital Infection of Patients with Cancer

    Institute of Scientific and Technical Information of China (English)

    潘勇; 何鸽飞; 廖德华

    2015-01-01

    目的:探讨临床药师在临床合理用药中的作用。方法回顾性分析某院2008年1月至2013年12月的92例会诊病例的资料。结果年龄≥65岁者54例,占58.69%;患者身体基础差,肝功能或肾功能损害者43例,占46.74%;感染病原菌以革兰氏阴性菌为主,真菌感染相对较少。肠杆菌科细菌中肺炎克雷伯菌、大肠埃希菌产 ESBLs 分别为66.67%和71.43%,金黄色葡萄球菌中耐甲氧西林耐药株(MRSA)的检出率为58.82%,凝固酶阴性葡萄球菌耐甲氧西林耐药株(MRCNS)的检出率为66.67%。铜绿假单胞菌对美罗培南、亚胺培南的敏感率分别为66.67%、73.33%,鲍曼不动杆菌仅对复方新诺明和头孢哌酮-舒巴坦敏感率高;会诊意见被医师全部采纳的有65例(70.65%),部分采纳的有15例(16.30%),未采纳的有12例(13.04%),采纳情况与预后情况呈显著性相关。结论临床药师参与肿瘤患者医院感染会诊,给医生提供合理化建议,提高了患者应用抗菌药物的安全性和有效性,有助于医院感染肿瘤患者的治疗。%Objective To investigate the importance of clinical pharmacist in rational drug use. Methods A retrospec-tive survey was performed on the consultation data of 92 cases in our hospital between January 2008 and December 2013. Results Of the 92 cases, 54 of them were 65 years or older, accounting for 58.69%. Hepatic or renal function damage was observed in 43 cases, accounting for 46.74%. Gram negative bacteria were the major pathogen, and fungal infection was relatively rare. ESBLs-producing Klebsiella pneumonia and Escherichia coli accounted for 66.67% and 71.43% respectively in Enterobacteriaceae. The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) was 58.82%, and that of methicillin-resistantin coagulase negative staphylococci (MRCNS) was 66.67%. The sensitive rate of Pseudomonas aerugi-nosa to

  2. Recent advances of ventilation-perfusion scintigraphy in clinical diagnosis and interventional treatment of pulmonary embolism

    International Nuclear Information System (INIS)

    Ventilation-perfusion scintigraphy can reflect the pulmonary function of ventilation and perfusion, then, indirectly assess the distribution of embolism. This technique is especially valuable in evaluating hemodynamic stability in patients with suspected pulmonary embolism. Ventilation-perfusion scintigraphy is superior to other imaging means in clinical practice as it is non-invasive and carries high specificity in detecting sub-segmental embolism. Furthermore, the advantages of interventional therapy are of significant clinical value in treating pulmonary embolism. This paper aims to make a comprehensive review for the ventilation-perfusion scintigraphy diagnosis, as well as the interventional treatment, of pulmonary embolism. (authors)

  3. Impact of an educational intervention on steroid prescribing and dosing effect on patient outcomes in COPD exacerbations

    Directory of Open Access Journals (Sweden)

    Hope NH

    2010-09-01

    Full Text Available The increasing number of patients affected by chronic obstructive pulmonary disease (COPD and associated exacerbations has led to both rising hospital admissions and significant economic impact. Evidence-based guidelines have been formulated for COPD management recommending the use of low dose, oral corticosteroid therapy in the treatment of exacerbations. However, fewer than 50% of physicians’ prescribing practices appropriately reflect the published clinical guidelines on the use of systemic corticosteroids in these patients. Objective. The purpose of this study was to evaluate the impact of a pharmacist-led educational intervention on prescribing practices and patient outcomes when using systemic corticosteroids in patients with COPD exacerbations. Methods. This retrospective case-control study included patients admitted to an inpatient family medicine service with a COPD exacerbation who received systemic corticosteroids. Two pharmacist-led educational interventions were delivered to prescribers to review current guidelines for managing COPD exacerbations with systemic corticosteroids. Patients were retrospectively identified over a three month span prior to and following the educational intervention. Data was collected via chart review to evaluate prescribing practices prior to and following the educational sessions. In addition, data was collected to evaluate the effects of an educational intervention on length of stay, adverse events, and cost of treatment.Results. A total of 23 pre-intervention patients and 18 post-intervention patients met inclusion criteria. After pharmacist-led interventions, guidelines were not more likely to be adhered to by prescribers when compared to guideline adherence in the pre-intervention patients. Because no statistically significant change in guideline adherence was observed, there was no impact on secondary outcomes.Conclusion. Pharmacist-led didactic educational interventions and guideline

  4. Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions

    Science.gov (United States)

    Légaré, France; Robitaille, Hubert; Gane, Claire; Hébert, Jessica; Labrecque, Michel; Rousseau, François

    2016-01-01

    Background Knowledge translation (KT) interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties. Objective We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing. Methods We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153) published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC) and Consumers and Communication. Results We retrieved 2473 unique trials of which we retained only 28 (1%). Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1) and educational outreach (n = 1). Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15), communication of DNA-based disease risk estimates (n = 7), personalized risk communication (n = 3) and mobile phone messaging (n = 1). Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective. Conclusions More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations. PMID:26938633

  5. The Impact of Nationally Coordinated Pharmacy-Based Asthma Education Intervention

    OpenAIRE

    Shelley Anne Diamond; Kenneth Ross Chapman

    2001-01-01

    OBJECTIVE: To assess the impact of a nationally coordinated pharmacy-based educational intervention on self-management behaviour and markers of asthma control in self-referred patients with asthma.DESIGN: An asthma clinic day was set up by a national chain of community pharmacies whereby pharmacists used a structured questionnaire to assess asthma control and self-care among self-referred patients with doctor-diagnosed asthma. In a one-on-one counselling session, each patient's educational ne...

  6. Helicobacter pylori eradication in dyspeptic primary care patients: a randomized controlled trial of a pharmacy intervention

    OpenAIRE

    STEVENS, Victor J; Shneidman, Robert J; Johnson, Richard E; Boles, Myde; Steele, Paul E.; Lee, Nancy L

    2002-01-01

    Objective To determine the effectiveness of structured adherence counseling by pharmacists on the eradication of Helicobacter pylori when using a standard drug treatment regimen. Design Randomized controlled clinical trial. Setting Nonprofit group-practice health maintenance organization (HMO). Participants HMO primary care providers referred 1,393 adult dyspeptic patients for carbon 14 urea breath testing (UBT). Interventions Those whose tests were positive for H pylori (23.3%) were provided...

  7. Clinical application of virtual US-CT or MRI fusion navigation system in interventional radiology

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of virtual US-CT or MRI navigation system for guidance of interventional procedures. Methods: Virtual US-CT or MRI fusion navigation system was applied on 47 cases for guiding various interventional procedures. The operating method, success rate, clinical outcome, and complication of the navigating interventional technique were retrospectively analyzed. Thirtyeight cases of hepatic tumors underwent percutaneous needle biopsy and / or radiofrequency ablation (RFA); 4 cases of hepatic abscess underwent percutaneous abscess rainage, 5 cases of musculoskeletal diseases underwent biopsy, RFA or RFA with cementoplasty. Results: For 38 cases of hepatic tumors who underwent RFA, 27 acquired complete ablation in one session, no recurrence after 3.0-6.0 months (median time 4.8 months) follow-up; while the other 11 cases present with no significant change. Five cases of musculoskeletal diseases improved significantly after interventional therapy and pathological diagnoses were also acquired. Four cases of hepatic abscesses were cured after drainage. All cases were free of significant complication, except one local skin thermal damage. Conclusion: Virtual US-CCT or MRI navigation guiding technique provides mutual aid to different imaging modalities for guiding interventional procedure. After application of navigation system, those interventional procedures may become more convenient, more effective and safer. (authors)

  8. Chronicles of a primary care practice pharmacist

    Directory of Open Access Journals (Sweden)

    Freeman CR

    2012-11-01

    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

  9. Adherence to yoga and exercise interventions in a 6-month clinical trial

    Directory of Open Access Journals (Sweden)

    Haas M

    2007-11-01

    Full Text Available Abstract Background To determine factors that predict adherence to a mind-body intervention in a randomized trial. Design We analyzed adherence data from a 3-arm trial involving 135 generally healthy seniors 65–85 years of age randomized to a 6-month intervention consisting of: an Iyengar yoga class with home practice, an exercise class with home practice, or a wait-list control group. Outcome measures included cognitive function, mood, fatigue, anxiety, health-related quality of life, and physical measures. Adherence to the intervention was obtained by class attendance and biweekly home practice logs. Results The drop-out rate was 13%. Among the completers of the two active interventions, average yoga class attendance was 77% and home practice occurred 64% of all days. Average exercise class attendance was 69% and home exercise occurred 54% of all days. There were no clear effects of adherence on the significant study outcomes (quality of life and physical measures. Class attendance was significantly correlated with baseline measures of depression, fatigue, and physical components of health-related quality of life. Significant differences in baseline measures were also found between study completers and drop-outs in the active interventions. Adherence was not related to age, gender, or education level. Conclusion Healthy seniors have good attendance at classes with a physically active intervention. Home practice takes place over half of the time. Decreased adherence to a potentially beneficial intervention has the potential to decrease the effect of the intervention in a clinical trial because subjects who might sustain the greatest benefit will receive a lower dose of the intervention and subjects with higher adherence rates may be functioning closer to maximum ability before the intervention. Strategies to maximize adherence among subjects at greater risk for low adherence will be important for future trials, especially complementary

  10. Costs, Quality and Value in Cardiovascular Interventions: Implications for clinical decision-making and policy development

    OpenAIRE

    Osnabrugge, Ruben

    2015-01-01

    markdownabstract__Abstract__ The aim of this thesis is to study the clinical, economic and quality-of-life considerations for clinical decision-making and policy development in cardiovascular interventions. More specifi cally the goals are: 1. To investigate the disease prevalence, adoption trends, quality of life, and economic aspects associated with therapies of aortic stenosis. 2. To explore the economic and policy aspects of alternative revascularization therapies for coronary artery dise...

  11. Sex, Age, Race and Intervention Type in Clinical Studies of HIV Cure: A Systematic Review

    OpenAIRE

    Johnston, Rowena E.; Heitzeg, Mary M.

    2015-01-01

    This systematic review was undertaken to determine the extent to which adult subjects representing sex (female), race (nonwhite), and age (>50 years) categories are included in clinical studies of HIV curative interventions and thus, by extension, the potential for data to be analyzed that may shed light on the influence of such demographic variables on safety and/or efficacy. English-language publications retrieved from PubMed and from references of retrieved papers describing clinical studi...

  12. A Clinical Algorithm for Early Identification and Intervention of Cervical Muscular Torticollis.

    Science.gov (United States)

    Nichter, Stephanie

    2016-06-01

    Congenital muscular torticollis (CMT) is a common newborn pediatric muscular deformity of the neck. The purpose of this article is to suggest a clinical algorithm for pediatric clinicians to promote prompt identification and intervention for infants with CMT. Early intervention for a child with CMT at less than 1 month of age yields a 98% success rate by 2.5 months of age, with the infant achieving near normal range of motion. Intervention initiated at 6 months of age or later can require 9 to 10 months of therapy with less success in achieving full range of motion of the cervical musculature. The clinical algorithm proposed here incorporates the American Physical Therapy Association guideline for CMT to optimize outcomes for the child and reduce health care expenditures. Current evidence and guidelines demonstrate that primary care providers are the primary diagnostic clinicians, while physical therapists are the preferred provider for the treatment of CMT. PMID:26307184

  13. The importance of pre-clinical animal testing in interventional cardiology.

    Science.gov (United States)

    Suzuki, Yoriyasu; Yeung, Alan C; Ikeno, Fumiaki

    2008-11-01

    The treatment of cardiovascular disease has changed dramatically over the past 2 decades, allowing patients to live longer and better quality lives. The introduction of new therapies has contributed much to this success. Nowhere has this been more evident than in interventional cardiology, where percutaneous cardiovascular intervention has evolved in the past 2 decades from a quirky experimental procedure to a therapeutic cornerstone for patients with symptomatic cardiovascular disease. The development of these technologies from the earliest stages requires preclinical experiments using animal models. Once introduced into the clinical arena, an understanding of therapeutic mechanisms of these devices can be ascertained through comparisons of animal model research findings with clinical pathological specimens. This review provides an overview of the emerging role, results of preclinical studies and development, and evaluation of animal models for percutaneous cardiovascular intervention technologies for patients with symptomatic cardiovascular disease. PMID:19142381

  14. Optimizing transition of care through the facilitation of a pharmacist-managed deep vein thrombosis treatment program.

    Science.gov (United States)

    Davis, Kyle A; Miyares, Marta A; Price-Goodnow, Venessa S

    2013-08-01

    A pharmacist-managed deep vein thrombosis (DVT) treatment program was put into operation at Jackson Memorial Hospital in Miami, Florida to provide appropriate transition of care to the outpatient setting for patients diagnosed with DVT. A postgraduate year 1 pharmacy practice resident partnered with a clinical pharmacist to establish and implement the DVT pilot program in the emergency department (ED). Once contacted, the pharmacy resident or the clinical pharmacist communicated with the ED physician and made recommendations regarding appropriate anticoagulation. The pharmacist met with the patient to obtain informed consent and provide counseling regarding the anticoagulants. A timely outpatient appointment at the pharmacy-managed warfarin clinic was arranged for the patient and contact information was exchanged between the patient and the pharmacist. On average, patients enrolled in the DVT program from the ED were released 18.29 hours (±7.06) following the time of arrival. Following release from the hospital, 91% of patients attended their outpatient follow-up appointment at the warfarin clinic. Since the initiation of the DVT program, 1 patient experienced a recurrent DVT and major bleed during their treatment course. Due to successful implementation of this pharmacist-managed DVT program in the ED, the services were subsequently extended to inpatients with DVT. PMID:23172896

  15. Evaluation of the Impact of a Physical Assessment Course on the Practice of Institutional Pharmacists

    Directory of Open Access Journals (Sweden)

    Rene R. Breault

    2014-09-01

    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.

  16. From computer-assisted intervention research to clinical impact: The need for a holistic approach.

    Science.gov (United States)

    Ourselin, Sébastien; Emberton, Mark; Vercauteren, Tom

    2016-10-01

    The early days of the field of medical image computing (MIC) and computer-assisted intervention (CAI), when publishing a strong self-contained methodological algorithm was enough to produce impact, are over. As a community, we now have substantial responsibility to translate our scientific progresses into improved patient care. In the field of computer-assisted interventions, the emphasis is also shifting from the mere use of well-known established imaging modalities and position trackers to the design and combination of innovative sensing, elaborate computational models and fine-grained clinical workflow analysis to create devices with unprecedented capabilities. The barriers to translating such devices in the complex and understandably heavily regulated surgical and interventional environment can seem daunting. Whether we leave the translation task mostly to our industrial partners or welcome, as researchers, an important share of it is up to us. We argue that embracing the complexity of surgical and interventional sciences is mandatory to the evolution of the field. Being able to do so requires large-scale infrastructure and a critical mass of expertise that very few research centres have. In this paper, we emphasise the need for a holistic approach to computer-assisted interventions where clinical, scientific, engineering and regulatory expertise are combined as a means of moving towards clinical impact. To ensure that the breadth of infrastructure and expertise required for translational computer-assisted intervention research does not lead to a situation where the field advances only thanks to a handful of exceptionally large research centres, we also advocate that solutions need to be designed to lower the barriers to entry. Inspired by fields such as particle physics and astronomy, we claim that centralised very large innovation centres with state of the art technology and health technology assessment capabilities backed by core support staff and open

  17. Positive Family Intervention for Severe Challenging Behavior I: A Multisite Randomized Clinical Trial

    Science.gov (United States)

    Durand, V. Mark; Hieneman, Meme; Clarke, Shelley; Wang, Mo; Rinaldi, Melissa L.

    2013-01-01

    The present study was a multisite randomized clinical trial assessing the effects of adding a cognitive-behavioral intervention to positive behavior support (PBS). Fifty-four families who met the criteria of (a) having a child with a developmental disability, (b) whose child displayed serious challenging behavior (e.g., aggression, self-injury,…

  18. A Randomized Clinical Trial of Alternative Stress Management Interventions in Persons with HIV Infection

    Science.gov (United States)

    McCain, Nancy L.; Gray, D. Patricia; Elswick, R. K., Jr.; Robins, Jolynne W.; Tuck, Inez; Walter, Jeanne M.; Rausch, Sarah M.; Ketchum, Jessica McKinney

    2008-01-01

    Research in psychoneuroimmunology suggests that immunosuppression associated with perceived stress may contribute to disease progression in persons with HIV infection. While stress management interventions may enhance immune function, few alternative approaches have yet been tested. This randomized clinical trial was conducted to test effects of…

  19. The matching quality of experimental and control interventions in blinded pharmacological randomised clinical trials

    DEFF Research Database (Denmark)

    Bello, Segun; Wei, Maoling; Hilden, Jørgen;

    2016-01-01

    BACKGROUND: Blinding is a pivotal method to avoid bias in randomised clinical trials. In blinded drug trials, experimental and control interventions are often designed to be matched, i.e. to appear indistinguishable. It is unknown how often matching procedures are inadequate, so we decided to sys...

  20. Clinical prediction of the need for interventions for the control of myopia.

    Science.gov (United States)

    McMonnies, Charles W

    2015-11-01

    The prevalence of myopia is increasing in Western populations but in East Asian countries, it is increasing to epidemic levels, where there are also markedly increased rates of progression to pathological myopia. Measures to more effectively control the development and progression of myopia are urgently needed. Notwithstanding a large volume of research, especially regarding the different mechanisms for the development of myopia and the efficacy of particular methods of intervention, there is still a great need and scope for improvements in clinical efforts to prevent and/or control myopic progression. Too often clinical efforts may involve only one method of intervention; however, the heterogenous nature of myopia suggests that clinical intervention may be more successful when interventions are employed in combination. The decision to prescribe interventions for the control of myopia in children, especially prior to onset, may be better framed by a comprehensive estimation of the degree of risk for the development and/or progression of myopia. For example, rather than ascribing equal weight to any degree of parental myopia, more accurate estimates may be obtained, if risk is judged to increase with the degree of parental myopia and the extent of any associated degenerative pathology. Risk estimates may be limited to broad mild, moderate and severe classifications due to lack of accurate weighting of risk factors. Nevertheless, comprehensive assessment of risk factors appears likely to better inform a prognosis and discussions with parents. Consideration of numerous environmental influences, for example, such as continuity and intensity of near work and time spent outdoors, may contribute to better risk estimation. Family-based practice appears to be ideally suited for risk estimation and the clinical application of approaches to control myopia. A proactive approach to estimating risk of developing myopia prior to its onset may be beneficial. Earlier implementation

  1. Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

    Science.gov (United States)

    Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

    2016-01-01

    Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148

  2. 临床药师对1例膜性肾病合并药物性肝损伤患者的药学监护%Pharmaceutical Care of Clinical Pharmacist for One Patient with Membranous Nephropathy Complicated with Drug-induced Liver Injury

    Institute of Scientific and Technical Information of China (English)

    刘静; 朱全刚; 徐熠; 徐玲玲

    2016-01-01

    目的:探讨临床药师在膜性肾病合并药物性肝损伤患者的合理用药中的作用。方法:对1例膜性肾病合并肝损伤患者的用药过程进行分析,对糖皮质激素、保肝药、抗凝药、降压药物的应用进行药学监护,提出用药注意事项和建议。结果:临床药师深入临床,直接为医师、护士及患者提供药学服务,可有效提高药物的治疗效果,减少药物的不良反应。结论:通过参加临床实践,临床药师为合理用药提供了帮助,使患者得到了更好的药学服务。%Objective:To explore the effects of clinical pharmacist on the rational drug use in the patients with membranous ne -phropathy complicated with drug-induced liver injury .Methods:The whole drug treatment process of one patient with membranous ne-phropathy complicated with drug-induced liver injury was analyzed , pharmaceutical care on the use of glucocorticoids , hepatoprotective agents, anticoagulants and antihypertensive drugs was performed , and the precautions and suggestions on the drug use were put for-ward.Results:Clinical pharmacist participated in the clinical treatment and provided the pharmaceutical service for doctors , nurses and patients directly , which could enhance the therapeutic efficacy and reduce the adverse drug reaction .Conclusion: Through the participation in clinical practice , clinical pharmacist plays an important role in the rational drug use , which provides better pharmacy service for patients .

  3. 临床药师药学干预呼吸内科抗生素使用的研究%Influence of clinical pharmacists’pharmaceutical intervention on reasonable use of antibiotics in department of respiratory medicine

    Institute of Scientific and Technical Information of China (English)

    朱惠新

    2015-01-01

    目的:探讨临床药师药学干预对呼吸内科合理使用抗生素的影响。方法随机抽取临床药师药学干预前后呼吸内科病例资料各300份,比较干预前后抗生素使用情况、抗感染效果、合理使用等差异。结果干预后抗生素使用率明显低于干预前(71.3%VS 95.7%,P=0.000);单联抗生素使用率明显高于干预前(28.7%VS 19.0%,P =0.028),三联及以上抗生素明显低于干预前(20.0%VS 43.3%,P =0.000);平均住院费用明显少于干预前[(1965.7±265.7) VS (2600.8±316.5)元,P<0.01];抗生素使用不合理性明显低于干预前(20.1%VS 34.2%,P<0.01)。结论临床药师药学干预可促进呼吸内科合理使用抗生素,指导医生用药行为。%Objective To investigate the effect of clinical pharmacists ’pharmaceutical intervention on reasonable use of antibi-otics in department of respiratory medicine .Methods The clinical data of 300 cases before and after clinical pharmacists ’pharmaceuti-cal intervention were randomly collected .The differences in application of antibiotics ,anti-infection effect and reasonable use before and after intervention were compared.Results After the intervention,antibiotics usage were significantly lower (71.3% vs 95.7%,P =0.000),single union antibiotics usage was significantly higher (28.7%vs 19.0%,P =0.028) and sanlian and above antibiotics were significantly lower(20.0%vs 43.3%,P =0.0001) when compared to before the intervention .The hospitalization cost was also signifi-cantly less than before intervention(1965.7 ±265.7)yuan vs (2600.8 ±316.5 yuan)].The irrational antibiotic use was significantly lower than before intervention(20.1% vs 34.2%).Conclusion Clinical pharmacists’pharmaceutical intervention can promote rea-sonable use of antibiotics ,and regulate behavior of doctor ’s medication .

  4. Exploration and Reflection of Clinical Pharmacists Participating in Antico-agulant Therapy in the Department of Orthopedics%临床药师参与骨科抗凝治疗的探索与思考

    Institute of Scientific and Technical Information of China (English)

    周玲; 吴晓丽; 吴甜; 贝宇飞

    2016-01-01

    药师参与骨科创伤病人静脉血栓风险筛查,预防深静脉血栓的形成,提供合理的用药治疗方案,其工作得到医护患的认可。%Pharmacists participated in risk screening, assisted doctors on assessing the risk of throm-boembolism and screening the contraindication for traumatic patients. They assisted anticoagulant therapy in the department of orthopedics. Their work was gradually accepted and affirmed by doctors, nurses and pa-tients.

  5. Medication Safety Systems and the Important Role of Pharmacists.

    Science.gov (United States)

    Mansur, Jeannell M

    2016-03-01

    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

  6. Interventional treatment of biliary stent restenosis: recent progress in clinical management

    International Nuclear Information System (INIS)

    Malignant obstructive jaundice is biliary obstruction disorders which are caused by various malignant tumors. Usually the disease is at its advanced stage and is inoperable when the diagnosis is confirmed. At present, percutaneous transhepatic biliary drainage (PTCD) and endoscopic or interventional implantation of plastic or self-expanding metal stent (SEMS) are the main managements in clinical practice. Due to the improved survival time, biliary stent restenosis has become a quite common clinical problem. Photodynamic therapy (PDT) and biliary tract radiofrequency ablation (RFA) have provided new therapeutic means for clinical use. Especially, with its development in technology and equipment, RFA has played more and more important role in treating biliary stent restenosis. (authors)

  7. Bioeconomic modeling of intervention against clinical mastitis caused by contagious pathogens

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq

    2012-01-01

    The objective of this study was to assess the epidemiologic and economic consequences of intervention against contagious clinical mastitis during lactation. A bioeconomic model of intramammary infections (IMI) was used to simulate contagious spread of Staphylococcus aureus, Streptococcus uberis......, and Streptococcus dysgalactiae, and an environmental spread of Escherichia coli IMI in a 100-cow dairy herd during 1 quota year. The costs of clinical IMI, subclinical IMI, and intervention were calculated into the total annual net costs of IMI during lactation per scenario and compared with a default...... transmission, number of IMI cases, and persistent subclinical IMI cases. Nonetheless, the high associated costs of culling bacteriologically unrecovered clinical IMI cows made the other scenarios with a long and intensive antibiotic treatment, but without culling, the most cost effective. The model was...

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

    Directory of Open Access Journals (Sweden)

    Kennie-Kaulbach Natalie

    2012-03-01

    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.

  9. Interventional therapy of lower limb ischemic diseases: a clinical therapeutic analysis

    International Nuclear Information System (INIS)

    Objective: To assess the value of angiography in diagnosing lower limb ischemic diseases and to discuss the therapeutic results of interventional therapy for lower limb ischemic diseases. Methods: Lower limb artery DSA was performed in 75 patients with lower limb ischemic diseases. The angiographic findings were evaluated, and both the length and the stenotic rate of the diseased vessels were measured. Thirty of the total 75 patients, with 39 diseased lower limbs, agreed to receive interventional therapy (study group). Percutaneous balloon dilation was employed in the patients of study group, and self-expandable stent placement was carried out for patients with severe arterial stenosis. The remaining 45 patients who refused to accept interventional treatment (total of 60 lower limbs with symptomatic ischemia) were treated with internal conservative measures (control group). Clinical follow-up for 6 to 36 months was made. Observations on the arterial reopen and the improvement of ischemic symptoms were carefully taken. The results were compared between the two groups. Results: The technical success rate and the clinical effective rate of the study group were 100% and 90.0%, respectively. The one-year amputation rate was 10.0%. The clinical effective rate and the one-year amputation rate of the control group were 62.2% and 37.8%, respectively. The difference in clinical effective rate between the two groups was statistically significant (P<0.05). The 3-year patency rate and amputation rate in the study group were 57.7% and 23.1%, respectively. Conclusion: Interventional treatment can markedly improve the clinical symptoms of lower limb ischemic diseases and increase the clinical effective rate. Therefore, this technique is an effective therapy for lower limb ischemic diseases. (authors)

  10. Randomised controlled trials for evaluating the prescribing impact of information meetings led by pharmacists and of new information formats, in General Practice in Italy

    Directory of Open Access Journals (Sweden)

    Magnano Lucia

    2007-09-01

    Full Text Available Abstract Background Suboptimal translation of valid and relevant information in clinical practice is a problem for all health systems. Lack of information independent from commercial influences, limited efforts to actively implement evidence-based information and its limited comprehensibility are important determinants of this gap and may influence an excessive variability in physicians' prescriptions. This is quite noticeable in Italy, where the philosophy and methods of Evidence-Based Medicine still enjoy limited diffusion among practitioners. Academic detailing and pharmacist outreach visits are interventions of proven efficacy to make independent and evidence-based information available to physicians; this approach and its feasibility have not yet been tested on a large scale and, moreover, they have never been formally tested in Italy. Methods/Design Two RCTs are planned: 1 a two-arm cluster RCT, carried out in Emilia-Romagna and Friuli Venezia Giulia, will evaluate the effectiveness of small group meetings, randomising about 150 Primary Care Groups (corresponding to about 2000 GPs to pharmacist outreach visits on two different topics. Physicians' prescriptions (expressed as DDD per 1000 inhabitants/day, knowledge and attitudes (evaluated through the answers to a specific questionnaire will be compared for target drugs in the two groups (receiving/not receiving each topic. 2 A three-arm RCT, carried out in Sardinia, will evaluate both the effectiveness of one-to-one meetings (one pharmacist visiting one physician per time and of a 'new' information format (compared to information already available on changing physicians' prescription of specific drugs. About 900 single GPs will be randomised into three groups: physicians receiving a visit supported by "traditional" information material, those receiving a visit with "new" information material on the same topic and those not receiving any visit/material. Discussion The two proposed RCTs aim

  11. Measures of clinical malaria in field trials of interventions against Plasmodium falciparum

    Directory of Open Access Journals (Sweden)

    Smith Thomas A

    2007-05-01

    Full Text Available Abstract Background Standard methods for defining clinical malaria in intervention trials in endemic areas do not guarantee that efficacy estimates will be unbiased, and do not indicate whether the intervention has its effect by modifying the force of infection, the parasite density, or the risk of pathology at given parasite density. Methods Three different sets, each of 500 Phase IIb or III malaria vaccine trials were simulated corresponding to each of a pre-erythrocytic, blood stage, and anti-disease vaccine, each in a population with 80% prevalence of patent malaria infection. Simulations considered only the primary effects of vaccination in a homogeneous trial population. The relationships between morbidity and parasite density and the performance of different case definitions for clinical malaria were analysed using conventional likelihood ratio tests to compare incidence of episodes defined using parasite density cut-offs. Bayesian latent class models were used to compare the overall frequencies of clinical malaria episodes in analyses that did not use diagnostic cut-offs. Results The different simulated interventions led to different relationships between clinical symptoms and parasite densities. Consequently, the operating characteristics of parasitaemia cut-offs in general differ between vaccine and placebo arms of the simulated trials, leading to different patterns of bias in efficacy estimates depending on the type of intervention effect. Efficacy was underestimated when low parasitaemia cut-offs were used but the efficacy of an asexual blood stage vaccine was overestimated when a high parasitaemia cut-off was used. The power of a trial may be maximal using case definitions that are associated with substantial bias in efficacy. Conclusion Secondary analyses of the data of malaria intervention trials should consider the relationship between clinical symptoms and parasite density, and attempt to estimate overall numbers of clinical

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

    Directory of Open Access Journals (Sweden)

    Kerry Wilbur

    2010-04-01

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

  13. Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention.

    Science.gov (United States)

    Zhang, Yanhang; Barocas, Victor H; Berceli, Scott A; Clancy, Colleen E; Eckmann, David M; Garbey, Marc; Kassab, Ghassan S; Lochner, Donna R; McCulloch, Andrew D; Tran-Son-Tay, Roger; Trayanova, Natalia A

    2016-09-01

    Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications. PMID:27138523

  14. Case Analysis of Clinical Pharmacists Participating in the Treatment of Asthma Exacerbation Induced by Bisoprolol in a Patient with Hypertension Complicating with Chronic Obstructive Pulmonary Disease%临床药师参与治疗1例高血压伴慢性阻塞性肺疾病患者服用比索洛尔致哮喘加重的病例分析

    Institute of Scientific and Technical Information of China (English)

    许懿; 谢继青; 牟燕; 舒鹤; 孙成春

    2013-01-01

    OBJECTIVE: To explore the method of clinical pharmacists participating in designing therapy regimens and carrying out pharmaceutical care. METHODS: The clinical pharmacists participated in therapy for a patient with hypertension complicating with chronic obstructive pulmonary disease, and analyzed reasons for asthma exacerbation, pharmacological action of bisoprolol, indication, caution and ADR. RESULTS: Asthma exacerbation from which patients suffered after admission was associated with bisoprolol. Clinical pharmacists provided pharmaceutical suggestions that bisoprolol was continued to be used and β2 receptor agonist was given additionally. The suggestion provided by clinical pharmacists was accepted by doctors. Finally, the patient was cured and discharged from the hospital. CONCLUSIONS: Clinical pharmacists' participation is helpful for doctors to make safe and effective medication.%目的:探讨临床药师参与药物治疗方案的制订与药学监护的方法.方法:介绍临床药师参与心血管内科1例高血压伴慢性阻塞性肺疾病患者的治疗,分析患者住院期间呼吸症状加重的诱因和比索洛尔的药理作用、适应证、禁忌证及不良反应.结果:发现患者入院后所出现的哮喘加重与其一直服用比索洛尔降压有关.提出药学建议,即不停用比索洛尔,加用β2受体激动药.临床药师的建议被采纳,患者的呼吸系统症状明显好转,病情得到有效控制.结论:临床药师的参与可以协助医师制订安全、有效的治疗方案.

  15. [Pharmacists contribute to the safety of medicines].

    Science.gov (United States)

    Nishihara, Shigeki

    2011-01-01

    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

  16. Designing a Clinical Framework to Guide Gross Motor Intervention Decisions for Infants and Young Children with Hypotonia

    Science.gov (United States)

    Darrah, Johanna; O'Donnell, Maureen; Lam, Joyce; Story, Maureen; Wickenheiser, Diane; Xu, Kaishou; Jin, Xiaokun

    2013-01-01

    Clinical practice frameworks are a valuable component of clinical education, promoting informed clinical decision making based on the best available evidence and/or clinical experience. They encourage standardized intervention approaches and evaluation of practice. Based on an international project to support the development of an enhanced service…

  17. Clinical trials in Huntington's disease: Interventions in early clinical development and newer methodological approaches.

    Science.gov (United States)

    Sampaio, Cristina; Borowsky, Beth; Reilmann, Ralf

    2014-09-15

    Since the identification of the Huntington's disease (HD) gene, knowledge has accumulated about mechanisms directly or indirectly affected by the mutated Huntingtin protein. Transgenic and knock-in animal models of HD facilitate the preclinical evaluation of these targets. Several treatment approaches with varying, but growing, preclinical evidence have been translated into clinical trials. We review major landmarks in clinical development and report on the main clinical trials that are ongoing or have been recently completed. We also review clinical trial settings and designs that influence drug-development decisions, particularly given that HD is an orphan disease. In addition, we provide a critical analysis of the evolution of the methodology of HD clinical trials to identify trends toward new processes and endpoints. Biomarker studies, such as TRACK-HD and PREDICT-HD, have generated evidence for the potential usefulness of novel outcome measures for HD clinical trials, such as volumetric imaging, quantitative motor (Q-Motor) measures, and novel cognitive endpoints. All of these endpoints are currently applied in ongoing clinical trials, which will provide insight into their reliability, sensitivity, and validity, and their use may expedite proof-of-concept studies. We also outline the specific opportunities that could provide a framework for a successful avenue toward identifying and efficiently testing and translating novel mechanisms of action in the HD field. PMID:25216371

  18. For Better Heart Care, Get a Pharmacist on Your Team

    Science.gov (United States)

    ... 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. ...

  19. Ask Your Pharmacist | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn Javascript on. Feature: Taking Medicines Safely Ask Your Pharmacist Past Issues / Summer 2013 Table of ... bottle. If the label is hard to read, ask your pharmacist to use larger type. Check that ...

  20. Balanced intervention for adolescents and adults with language impairment: a clinical framework.

    Science.gov (United States)

    Fallon, Karen A; Katz, Lauren A; Carlberg, Rachel

    2015-02-01

    Providing effective intervention services for adolescents and adults who struggle with spoken and written language presents a variety of unique challenges. This article discusses the 5S Framework (skills, strategies, school, student buy-in, and stakeholders) for designing and implementing balanced spoken and written language interventions for adolescents and adults. An in-depth case illustration highlights the usefulness of the framework for targeting the language and literacy skills of adolescents and young adults. By describing and illustrating the five key components of the intervention framework, the article provides a useful clinical tool to help guide clinicians and educators who serve the needs of adolescents and adults who struggle with spoken and written language. PMID:25633140

  1. Expanding the scope and relevance of health interventions: Moving beyond clinical trials and behavior change models

    Directory of Open Access Journals (Sweden)

    Khary K. Rigg

    2014-07-01

    Full Text Available An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.

  2. Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

    International Nuclear Information System (INIS)

    Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

  3. Isoniazid Completion Rates for Latent Tuberculosis Infection among College Students Managed by a Community Pharmacist

    Science.gov (United States)

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

    2009-01-01

    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…

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  5. Clinical pharmacy in a multidisciplinar team for chronic pain in adults.

    Science.gov (United States)

    Bauters, T G M; Devulder, J; Robays, H

    2008-01-01

    The aim of this study was to evaluate the role and the impact of a clinical pharmacist as a member of a multidisciplinary pain team. Although physicians have a good knowledge of pharmacotherapy in the field of pain medication, pharmacy interventions were necessary to enhance the quality of prescribing. On a population of 93 patients, a total of 120 interventions were recorded. The different types of interventions included: provision of information (10.0%), clinical intervention (89.2%) and the provision of a specific product (0.8%). Out of the 107 clinical interventions, a total of 95.3 % interventions were accepted by the physicians. The results highlight the clinical importance of the pharmacy in optimizing drug therapy for adult patients with chronic pain. PMID:19048702

  6. Pharmaceutical Care for a Brain Trauma Patient with Mixed Infection of Multiple Pathogenic Microorganisms by Clinical Pharmacists%临床药师参与1例脑外伤后多种微生物混合感染患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    任彤; 丁建强; 朱军; 王军

    2013-01-01

    OBJECTIVE:To explore how the clinical pharmacists work best on pharmaceutical care for brain trauma patient,so as to provide reference for anti-infection treatment of the patients with mixed infection of multiple pathogenic microorganisms.METHODS:Clinical pharmacists participated in therapy for a brain trauma patient with mixed infection of multiple pathogenic microorganisms and provided advices on the formulation of anti-infection therapy scheme.Combination treatment strategy of fosfomycin and piperacillin/tazobactam was used,which was time difference attack therapy and amphotericin B ultrasonic atomizing inhalation.RESULTS:Clinical pharmacists provided reasonable therapy scheme and obtained good curative effect.The body temperature and routine blood test of the patient returned to normal and spontaneous breathing was maintained.Pharmaceutical care was enhanced for allergic shock induced by fosfomycin and nephrotoxicity of amphotericin B.CONCLUSIONS:Time difference attack therapy and amphotericin B ultrasonic atomizing inhalation of piperacillin/tazobactam combined with fosfomycin provide a choice for the treatment of mixed infection after severe brain trauma.Through clinical pharmacists provide pharmaceutical care and optimize therapy scheme,the effect of clinical treatment have been improved,the bacterial drug resistance and adverse drug reactions have been reduced.%目的:探讨临床药师在脑外伤患者的药学监护中如何发挥作用,为多种微生物混合感染患者的抗感染治疗提供参考.方法:临床药师参与1例脑外伤后多种微生物混合感染患者的联合治疗,对抗感染药物治疗方案的制订提出了具体意见,采取磷霉素联合哌拉西林/他唑巴坦时间差攻击疗法和两性霉素B超声雾化的治疗方案.结果:临床药师提供的合理治疗方案取得了良好的治疗效果,患者体温、血常规恢复正常,自主呼吸.治疗的同时加强对磷霉素可能导致过敏性休克、两性

  7. An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice

    OpenAIRE

    Cresswell Kathrin M; Sadler Stacey; Rodgers Sarah; Avery Anthony; Cantrill Judith; Murray Scott A; Sheikh Aziz

    2012-01-01

    Abstract Background There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER) intervention, which substantially reduced the risk of clinically important errors in medicines ma...

  8. An expanded prescribing role for pharmacists - an Australian perspective

    OpenAIRE

    Kreshnik Hoti; Jeffery Hughes; Bruce Sunderland

    2011-01-01

    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...

  9. Pharmacy Student Perceptions of Pharmacist Prescribing: A Comparison Study

    OpenAIRE

    Charrois, Theresa L; Meagen Rosenthal; Kreshnik Hoti; Christine Hughes

    2013-01-01

    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...

  10. [Vaccination by the pharmacist: practical guidelines].

    Science.gov (United States)

    Freney, J

    2012-11-01

    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

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

    Directory of Open Access Journals (Sweden)

    Lewis NJW

    2014-06-01

    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

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

    Directory of Open Access Journals (Sweden)

    Emmerton Lynne M

    2012-06-01

    PAMS provided pharmacists an opportunity to become involved in an innovative service delivery model, supported by the researchers, yet trained and empowered to implement the clinical service throughout the trial period and beyond. The balance between support and independence appeared crucial in the pharmacists’ engagement with the trial. Their feedback was overwhelmingly positive, while useful suggestions were identified for future academic trials.

  13. [Alzheimer's disease and pharmacists in contact with the public].

    Science.gov (United States)

    Dreux, C

    2009-03-01

    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

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

    LENUS (Irish Health Repository)

    Gallagher, Ruth M

    2012-05-01

    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.

  15. A pharmacist-led follow-up program for patients with established coronary heart disease in North Norway – a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Garcia BH

    2015-06-01

    Full Text Available Objectives: The aim of the study was twofold; 1 to develop a clinical pharmacist-led 12 month lasting follow-up program for patients with established coronary heart disease (CHD discharged from the University Hospital of North Norway, and 2 to explore the impact of the program with regards to adherence to a medication assessment tool for secondary prevention of CHD and change in biomedical risk factors. Methods: A total of 102 patients aged 18-82 years were enrolled in a non-blinded randomized controlled trial with an intervention group and a control group. The intervention comprised medication reconciliation, medication review and patient education during three meetings; at discharge, after three months and after twelve months. The control group received standard care from their general practitioner. Primary outcomes were adherence to clinical guideline recommendations concerning prescription, therapy goal achievement and lifestyle education defined in the medication assessment tool for secondary prevention of CHD (MAT-CHDSP. Secondary outcomes included changes in the biomedical risk factors cholesterol, blood pressure and blood glucose. Results: Ninety-four patients completed the trial, 48 intervention group patients and 46 controls. Appropriate prescribing was high, but therapy goal achievement was low in both groups. Overall adherence to MAT-CHDSP criteria increased in both groups and was significantly higher in the intervention group at study end, 78.4% vs. 62.0%, p<0.001. The difference was statistically significant for the documented lifestyle advices in intervention group patients. No significant improvements in biomedical risk factors were observed in favor of the intervention group. Conclusions: The study showed an increased guideline adherence in both study groups. This indicates that attention to clinical practice guideline recommendations in itself increases adherence – which may be a clinical pharmacist task. A larger adequately

  16. Contributions to clinical Occupational Therapy in the area of early intervention in interdisciplinary team

    Directory of Open Access Journals (Sweden)

    Dani Laura Peruzzolo

    2015-07-01

    Full Text Available Introduction: Specialized care for infants considers that the sooner the intervention in risk and symptoms occurs, the greater the possibility of obtaining better results. Aims: To describe the process of early intervention provided by an extension program of graduate studies in Occupational Therapy and Hearing, Speech and Languages Science courses and also discuss the theoretical and practical paths in the care for infants and in the Occupational Therapy area. Method: Case report with convenience sample. The study was carried out through an assessment interpreted in light of psychomotor, occupational therapeutic, and speech, hearing and language contributions. The intervention was under the responsibility of an occupational therapist supported by an interdisciplinary team. It occurred once a week from August 2011 to January 2012 and from March 2012 to July 2012. Data analysis was carried out by comparing the entry assessment test and the final assessment test. Results: The boy had not developed concepts of body schema and body image that could sustain his relationship with objects, space and other persons. He presented little linguistic evolution. Considering the contributions of occupational therapy in psychomotor clinic, the boy reconstructed his family place in early intervention. The possibility of language functioning connected to the boy’s demands allowed access to symbolism. Conclusion: The proposal of early occupational therapy intervention with a single therapist supported by an interdisciplinary team was able to overcome the structural and instrumental obstacles to the boy’s development.

  17. Redefining the Role of the Pharmacist: Medication Therapy Management

    Science.gov (United States)

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

    2012-01-01

    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…

  18. Bibliometric Analysis: Mirror Therapy as an Occupational Therapy Intervention Strategy in the Clinical Setting

    OpenAIRE

    Elvis Siprián Castro Alzate; Karen Aguía Rojas; Leidy Vanessa Linares Murcia; Laura Yanquén Castro; Vanessa Reyes Villanueva

    2016-01-01

    Objective: To determine the national and international scientific evidence regarding the use of mirror therapy, as an occupational therapy intervention tool in the clinical setting, in order to acquire knowledge and implement this strategy in professional practice. Materials and methods: A descriptive study was conducted in which the research strategy was held through medical subject headings (MeSH), such as “mirror neuron”, ”occupational therapy”, “physical rehabilitation” and “motor imagery...

  19. Improving the Dictation in Attention Deficit Hyperactivity Disorder by Using Computer Based Interventions: A Clinical Trial

    OpenAIRE

    Mahdi Tehranidoost; Anahita Basirnia; Shervin Assari; Mohammad Reza Mohammadi; Mostafa Najafi; Javad Alaghband-rad

    2006-01-01

    Objective: The aim of the current study was to assess the impact of computer games and computer-assisted type instruction on dictation scores of elementary school children with attention deficit – hyperactivity disorder (ADHD). Method: In this single-blind clinical trial, 37 elementary school children with ADHD, selected by convenience sampling and divided into group I (n=17) and group II (n=20), underwent eight one-hour sessions (3 sessions per week) of intervention by computer games versus ...

  20. Cognitive Behavioral Interventions with Older Adults: Integrating Clinical and Gerontological Research

    OpenAIRE

    Satre, Derek; Knight, Bob G.; David, Steven

    2006-01-01

    Psychotherapeutic interventions utilizing cognitive–behavioral strategies have been used widely with older adults. To appropriately adapt these techniques, characteristics unique to older adults must be taken into account. These factors include aspects of the social environment, cohort effects, cognitive changes with aging, personality, and emotional development, which have been described in an emerging body of research literature from the field of gerontology. In addition, clinical studies h...

  1. The Effect of Educational and Modifying Intervention on Asthma Control among Adolescents: a Randomized Clinical Trial

    OpenAIRE

    Zarei, Soheila; Valizadeh, Leila; BILAN, Nemat

    2013-01-01

    Introduction: Controlling over allergens and environmental irritants is one of the essential elements of controlling asthma. Asthma control in adolescents is a challenge. The current study was performed with the goal of investigating the effect of an educational and modifying intervention about asthma triggers on asthma control among adolescents. Methods: The current study was a randomized clinical trial. 60 adolescents of 12-18 years of age participated in this study. The p...

  2. Smoking cessation, physicians, and medical office staff. Clinical tobacco intervention in Prince Edward Island.

    OpenAIRE

    Rowan, M S; Coambs, R. B.; Jensen, P.; Balderston, M.; MacKenzie, D; Kothari, A.

    1998-01-01

    OBJECTIVE: To assess attitudes and self-reported behaviours of physicians and medical office staff in Prince Edward Island concerning clinical tobacco intervention (CTI). DESIGN: Mail survey of PEI primary care physicians and their medical office staff. Most surveys were not mailed back but picked up in person by research staff. SETTING: Primary care settings in PEI. PARTICIPANTS: All active primary care physicians in PEI identified in the Canadian Medical Association database and medical off...

  3. Clinical Efficiency of Interventional Radiological Therapy in the Treatment of Obstructed Hemodialysis Shunts

    Directory of Open Access Journals (Sweden)

    Hadi Zomorrodian

    2011-05-01

    Full Text Available Background/Objective: Analysis of the clinical"neffectiveness of endovascular radiological interventions"nin the treatment of dysfunctional dialysis shunts."nPatients and Methods: During a 3 year period, 459"ninterventional radiological procedures were performed"nin hemodialysis shunt dysfunctions in 222 patients"n(123 men, 99 women; mean age, 68.7±9.7 years. 72.1%"n(n=160 of the patients had an autologous venous graft"nand 27.9% (n=62 of the patients had a PTFE graft. In"na retrospective analysis, the primary technical success"nrate, clinical success rate, complication rate and postinterventional"npatency rates were calculated with a"nfollow-up period ranging from 0.5 to 11 years."nResults: Endovascular shunt treatments were"ntechnically successful in 98% and clinically successful"nin 97%. Minor complications occurred in 1.9% and"nmajor complications in 1.2%. Six (12 months after"ntreatment 35% (15% of the shunts were still patent"n(primary postinterventional patency rate. The"nsecondary postinterventional patency rate (including"nrepetitive interventions was 60% after 12 months and"n28% after 24 months following the first time shunt"ntreatment. The cumulative patency rate was 81%"nafter12 months, 63% after 24 months and 44% after 36"nmonths following the implantation of the shunt graft."nHence, radiological intervention allowed doubling of"nthe functional life of dysfunctional shunts."nConclusion: Radiological shunt intervention"nsignificantly increased the functional life of"ndysfunctional shunts. High technical and clinical"nsuccess rates allowed the use of almost all shunts"nfor hemodialysis immediately after treatment. The"ninterventional endovascular procedure is an effective"nand safe treatment method in the life-threatening"nsituation of a shunt dysfunction.

  4. Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice

    Directory of Open Access Journals (Sweden)

    Macneil Craig A

    2012-09-01

    Full Text Available Abstract While diagnosis has traditionally been viewed as an essential concept in medicine, particularly when selecting treatments, we suggest that the use of diagnosis alone may be limited, particularly within mental health. The concept of clinical case formulation advocates for collaboratively working with patients to identify idiosyncratic aspects of their presentation and select interventions on this basis. Identifying individualized contributing factors, and how these could influence the person's presentation, in addition to attending to personal strengths, may allow the clinician a deeper understanding of a patient, result in a more personalized treatment approach, and potentially provide a better clinical outcome.

  5. Clinical Trials Infrastructure as a Quality Improvement Intervention in Low- and Middle-Income Countries.

    Science.gov (United States)

    Denburg, Avram; Rodriguez-Galindo, Carlos; Joffe, Steven

    2016-06-01

    Mounting evidence suggests that participation in clinical trials confers neither advantage nor disadvantage on those enrolled. Narrow focus on the question of a "trial effect," however, distracts from a broader mechanism by which patients may benefit from ongoing clinical research. We hypothesize that the existence of clinical trials infrastructure-the organizational culture, systems, and expertise that develop as a product of sustained participation in cooperative clinical trials research-may function as a quality improvement lever, improving the quality of care and outcomes of all patients within an institution or region independent of their individual participation in trials. We further contend that this "infrastructure effect" can yield particular benefits for patients in low- and middle-income countries (LMICs). The hypothesis of an infrastructure effect as a quality improvement intervention, if correct, justifies enhanced research capacity in LMIC as a pillar of health system development. PMID:27216089

  6. The status of hypnosis as an empirically validated clinical intervention: a preamble to the special issue.

    Science.gov (United States)

    Nash, M R

    2000-04-01

    In his introductory remarks to this Journal's special issue on the status of hypnosis as an empirically supported clinical intervention, the editor briefly describes the dawn of clinical hypnosis research, the logic of the natural science model, the importance of an inspired but tough-minded clinical science, and the auspicious confluence of practice and research purpose in this enterprise. The progenitor of this effort was indeed the Report of the Royal Commission coauthored by Benjamin Franklin and Antoine Lavoisier, among others, more than 215 years ago--a report noted as one of the most important documents in the history of human reason. The ethos and logic of this special issue is grounded on the legacy of that document. Eschewing the conflicting mental health agendas of managed-care, government, patient rights, and professional guild interests, this special issue seeks to present a frank, evenhanded, informed, and dispassionate assessment of what science knows and does not know about clinical hypnosis. PMID:10769979

  7. Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review.

    Directory of Open Access Journals (Sweden)

    Maria B Ospina

    Full Text Available BACKGROUND: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD. We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. METHODS AND FINDINGS: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlled trials favoured developmental approaches based on initiative interaction compared to contingency interaction in the amount of time spent in stereotyped behaviours and distal social behaviour, but the effect sizes were not clinically significant. No statistically significant differences were found for: Lovaas versus special

  8. A role for pharmacists in community-based post-discharge warfarin management: protocol for the 'the role of community pharmacy in post hospital management of patients initiated on warfarin' study

    Directory of Open Access Journals (Sweden)

    Bereznicki Luke RE

    2011-01-01

    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

  9. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Stemer Gunar

    2011-07-01

    Full Text Available Abstract Background Chronic kidney disease (CKD and end-stage renal disease (ESRD represent worldwide health problems with an epidemic extent. Therefore, attention must be given to the optimisation of patient care, as gaps in the care of CKD and ESRD patients are well documented. As part of a multidisciplinary patient care strategy, clinical pharmacy services have led to improvements in patient care. The purpose of this study was to summarise the available evidence regarding the role and impact of clinical pharmacy services for these patient populations. Methods A literature search was conducted using the Medline, Embase and International Pharmaceutical Abstracts databases to identify relevant studies on the impact of clinical pharmacists on CKD and ESRD patients, regarding disease-oriented and patient-oriented outcomes, and clinical pharmacist interventions on drug-related problems. Results Among a total of 21 studies, only four (19% were controlled trials. The majority of studies were descriptive (67% and before-after studies (14%. Interventions comprised general clinical pharmacy services with a focus on detecting, resolving and preventing drug-related problems, clinical pharmacy services with a focus on disease management, or clinical pharmacy services with a focus on patient education in order to increase medication knowledge. Anaemia was the most common comorbidity managed by clinical pharmacists, and their involvement led to significant improvement in investigated disease-oriented outcomes, for example, haemoglobin levels. Only four of the studies (including three controlled trials presented data on patient-oriented outcomes, for example, quality of life and length of hospitalisation. Studies investigating the number and type of clinical pharmacist interventions and physician acceptance rates reported a mean acceptance rate of 79%. The most common reported drug-related problems were incorrect dosing, the need for additional

  10. Clinical application of percutanously interventional therapeusis in patients with hepatocellular carcinoma accompanied with bile duct thrombosis

    International Nuclear Information System (INIS)

    Objective: To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis. Methods: Sixteen cases bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed. According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents. Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The patients were followed up within 2 years. Results: The PTBD was successfully performed in 16 cases. Permanent external drainage, temporary internal drainage and imalantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively. TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2 ± 80.5) μmol/L averagely from (261.9 ± 77.2) μmol/L before the treatments. All the patients died before the end of followed-up. The average survival time was 204 days (30 to 391 d) and the median survival time was 200 days. Bleeding and infection were the main complications, which could be controlled successfully by routine treatments. Conclusion: With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis. (authors)

  11. Beyond clinical engagement:a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities

    OpenAIRE

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2015-01-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a...

  12. Effect of Three Interventions on Contact Lens Comfort in Symptomatic Wearers: A Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Maria Navascues-Cornago

    Full Text Available To investigate whether carrying out various interventions part way through the day influences comfort in symptomatic daily disposable (DD contact lens wearers.A subject-masked, randomized, controlled clinical trial was conducted in thirty symptomatic soft lens wearers who wore their habitual DD contact lenses bilaterally for 12 h on two separate days. Five hours after lens application, one of the following three interventions or a control was performed on each eye: replacing the existing lens with a new lens; removing and reapplying the same lens; performing a 'scleral swish'; and no action (control. Comfort scores were recorded using SMS text messages every hour following lens application using a 0 (causes pain to 100 (excellent comfort scale. Comfort scores before lens application, at 6 mins post-application, and at 6 mins post-intervention were also recorded.There was a significant reduction in comfort from pre-lens application to 6 mins post-application for all groups (all p0.05. After the intervention, comfort continued to decline (p<0.0001 with slightly lower mean scores for the control group compared to the new lens group (p = 0.003. Change in comfort relative to pre-intervention (5 h was similar for all groups (p = 0.81. There was no difference in comfort at 12 h between groups (p = 0.83.This work has confirmed that comfort shows a continual and significant decline over a 12-h wearing period in symptomatic DD contact lens wearers. None of the interventions investigated had any significant impact on end-of-day comfort. These data suggest discomfort in lens wearers is more heavily influenced by changes to the ocular environment rather than to the lens itself.Controlled-Trials.com ISRCTN10419752 http://www.controlled-trials.com/ISRCTN10419752.

  13. Can teaching agenda-setting skills to physicians improve clinical interaction quality? A controlled intervention

    Directory of Open Access Journals (Sweden)

    Rogers William H

    2008-01-01

    Full Text Available Abstract Background Physicians and medical educators have repeatedly acknowledged the inadequacy of communication skills training in the medical school curriculum and opportunities to improve these skills in practice. This study of a controlled intervention evaluates the effect of teaching practicing physicians the skill of "agenda-setting" on patients' experiences with care. The agenda-setting intervention aimed to engage clinicians in the practice of initiating patient encounters by eliciting the full set of concerns from the patient's perspective and using that information to prioritize and negotiate which clinical issues should most appropriately be dealt with and which (if any should be deferred to a subsequent visit. Methods Ten physicians from a large physician organization in California with baseline patient survey scores below the statewide 25th percentile participated in the agenda-setting intervention. Eleven physicians matched on baseline scores, geography, specialty, and practice size were selected as controls. Changes in survey summary scores from pre- and post-intervention surveys were compared between the two groups. Multilevel regression models that accounted for the clustering of patients within physicians and controlled for respondent characteristics were used to examine the effect of the intervention on survey scale scores. Results There was statistically significant improvement in intervention physicians' ability to "explain things in a way that was easy to understand" (p = 0.02 and marginally significant improvement in the overall quality of physician-patient interactions (p = 0.08 compared to control group physicians. Changes in patients' experiences with organizational access, care coordination, and office staff interactions did not differ by experimental group. Conclusion A simple and modest behavioral training for practicing physicians has potential to positively affect physician-patient relationship interaction quality

  14. Falls Assessment Clinical Trial (FACT: design, interventions, recruitment strategies and participant characteristics

    Directory of Open Access Journals (Sweden)

    Lawton Beverley

    2007-07-01

    Full Text Available Abstract Background Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care. Methods Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used – waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels. Results 312 participants were recruited (69% women. Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05. Mean age of all participants was 81 years (SD 5. On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics with a median of 2 falls (interquartile range 1, 3 in the previous year. Conclusion The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a

  15. Increase in prophylaxis of glucocorticoid-induced osteoporosis by pharmacist feedback : a randomised controlled trial

    OpenAIRE

    Klop, C.; de Vries, F.; Vinks, T; Kooij, M. J.; Van Staa, T. P.; Bijlsma, J.W.J.; Egberts, A C G; Bouvy, M.L.

    2014-01-01

    Summary The aim of this study was to determine whether feedback by pharmacists to prescribers of patients eligible for glucocorticoid-induced osteoporosis prophylaxis would stimulate the prescribing of osteoporosis prophylaxis. The intervention did not significantly increase the prescribing of bisphosphonates in the total study population, but a significant increase was seen in men and in the elderly. However, the proportion of bisphosphonate-treated patients remained low. Introduction The ai...

  16. Educating the clinical trainer: professional gain for the trainee? A controlled intervention study in general practice.

    Science.gov (United States)

    Jochemsen-van der Leeuw, H G A Ria; van Dijk, Nynke; de Jong, Wilfried; Wieringa-de Waard, Margreet

    2014-12-01

    The aim of this study was to establish whether a 'teach-the-trainer' course leads to improvements in, firstly, the knowledge and attitude of clinical trainers and their trainees, and, secondly, the role model behaviour of the clinical trainers. A controlled intervention study was performed with GP trainers and GP trainees from four training institutes in the Netherlands. Clinical trainers in the two intervention institutes received two 3-h training sessions on weight management, focusing on knowledge and attitudes towards obesity, and on conveying the correct professional competency as a positive role model for trainees. This was measured using questionnaires on knowledge, attitude, and role model behaviour (the role model apperception tool; RoMAT). GP trainers showed an increase in knowledge and several characteristics could be identified as being related to positive role model behaviour. A small correlation was found between the trainer's score on the RoMAT and the attitude of the trainee. A teach-the-trainer course in which knowledge, attitudes, and role modelling are integrated proved to be a first step toward improving the knowledge of clinical trainers, but did not result in a measurably better professional outcome for the trainee, maybe due to a more objective level of assessment. PMID:25338922

  17. Antibiotics: Pharmacists Can Make the Difference

    Centers for Disease Control (CDC) Podcasts

    2015-04-16

    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.

  18. Effects of prescription adaptation by pharmacists

    Directory of Open Access Journals (Sweden)

    Marra Carlo A

    2010-11-01

    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.

  19. Interventional radiology as clinical specialty and how this affects the radiology specialty as a whole

    International Nuclear Information System (INIS)

    Full text: Interventional Radiologists (IRs) are medical doctors who are trained in imaging but have undergone additional specialist training in highly demanding image-guided techniques. For this reason they play an increasingly important clinical role which is expanding beyond IR/angiography suite. As IR practice is fundamentally different from diagnostic imaging, the Radiology departments should be adapted to facilitate this special task. Interventional Radiologists should be able to fulfil their task as patient’s primary doctor and exert direct clinical responsibility for the patient under their care. They should be able to clinically assess and counsel patients before a procedure, inform them about the risks of the procedure and possible alternative treatment options, obtain valid consent and follow-up them after the procedure. they should also effectively communicate with referring physicians and develop strategies to deal with complex clinical situations and difficult clinical scenarios. In this context it is imperative for IRs to participate regularly in multidisciplinary clinical meetings and multidisciplinary forums to ensure optimum care. As clinicians, IR’s must be involved with the day to day management of their patients’ care to ensure optimal outcomes for patients. This may involve shared care with a broad range of specialists, however IR’s should aim to have direct access to inpatients beds where they can admit and discharge patients as necessary, with sufficient time allocated for this activity. As the number and demand of IR day cases steadily increases, IR units should organize day case facilities staffed with nursing and clerical staff which can result in major cost savings to hospitals. In this context the Head of Radiology department should convince hospital authorities to establish outpatient clinic facilities with nursing and clerical support where referred patients can be counselled and reviewed in a quiet environment. In order to

  20. Retesting for genital Chlamydia trachomatis among visitors of a sexually transmitted infections clinic: Randomized intervention trial of home- versus clinic-based recall

    NARCIS (Netherlands)

    H.M. Götz (Hannelore); M.E.G. Wolfers (Mireille); A. Luijendijk (Ad); I.V.F. van den Broek (Ingrid)

    2013-01-01

    textabstractBackground: Reinfections of Chlamydia trachomatis (Ct) are common. In a two-armed intervention study at an urban STI clinic in the Netherlands, heterosexual Ct-positive visitors received an invitation for retesting after 4-5 months. Interventions were either home-based sampling by mailed

  1. Retesting for genital Chlamydia trachomatis among visitors of a sexually transmitted infections clinic : randomized intervention trial of home- versus clinic-based recall

    NARCIS (Netherlands)

    Gotz, Hannelore M.; Wolfers, Mireille E. G.; Luijendijk, Ad; van den Broek, Ingrid V. F.

    2013-01-01

    Background: Reinfections of Chlamydia trachomatis (Ct) are common. In a two-armed intervention study at an urban STI clinic in the Netherlands, heterosexual Ct-positive visitors received an invitation for retesting after 4-5 months. Interventions were either home-based sampling by mailed test-kit, o

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

    Directory of Open Access Journals (Sweden)

    Niquille A

    2010-03-01

    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

  3. School based oral health promotional intervention: Effect on knowledge, practices and clinical oral health related parameters

    Directory of Open Access Journals (Sweden)

    Arjun Gauba

    2013-01-01

    Full Text Available Background: No organized school oral health program is existent in India. Aim: The aim of this study is to test the feasibility and efficacy of an economical school oral health promotional intervention with educational and preventive components. Settings and Design: School oral health promotional intervention carried out in one of the randomly selected school and evaluated through short duration prospective model. Materials and Methods: A total of 100 children with an age range of 10-12 years with no previous history of dental intervention were enrolled. Interventions comprised of oral health education (delivered through lecture and demonstrations by an undergraduate dental student and topical antibacterial therapy (fluoride varnish and povidone iodine. Outcomes consisted of Knowledge and practices (KAP regarding oral health, clinical oral health related parameters such as plaque index (PI, gingival index (GI and caries activity as per Modified Snyder′s test. These were reported at baseline, 3 weeks and 6 months follow-up examination by a calibrated examiner. Statistical Analysis: McNemar Bowker′s test, Student′s t-test, Pearson Chi-square tests were used. Results: Highly significant (P < 0.001 improvements in KAP scores, PI scores, GI scores and caries activity were reported at 3 weeks and 6 months follow-up examination. Conclusion: This small economical school oral health program positively influenced oral health related practices and parameters of oral health such as oral cleanliness, gingival health and caries activity.

  4. Interventional management of spine eosinophilic granuloma in children: preliminary investigation of its clinical value

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of interventional management in treating spine eosinophilic granuloma in children. Methods: Interventional therapies, including per cutaneous biopsy and percutaneous vertebroplasty (PVP), were carried out in three child patients with five pathologically-proved eosinophilic granuloma lesions, which were localized in the vertebrae. The clinical data were retrospectively analyzed. Visual analogue pain scale (VAS) and Oswesty disability index (ODI) were assessed before and after operation. Results: A total of four operations were successfully carried out in all of three patients. The mean VAS score reduced from 7 before treatment of 1 after treatment. The mean ODI decreased from preoperative 52.5% to postoperative 10.5%. During procedures no significant complications occurred except for cement leakage in some cases. Pain relief and daily activity were remarkably improved after treatment. All patients were followed up for 3 months to 5 years. Conclusion: For the treatment of spine eosinophilic granuloma in children, interventional techniques are mini-invasive, safe and effective therapeutic methods. (authors)

  5. Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges

    Directory of Open Access Journals (Sweden)

    Bajorek B

    2016-06-01

    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.

  6. The transjugular portosystemic stent shunt (TIPSS) as an intervention in clinical complication of portal hypertension

    International Nuclear Information System (INIS)

    Most frequent complications in patients with liver cirrhosis are due to portal hypertension. Beside ascites circumvent vessles formate with vasodilatation. Due to counterregulation a secondary hyperaldosteronism develops with release of vasocontrictive agents. If conservative and endoscopic methods fail, indication for building a portosystemic shunt is given. The TIPSS procedure is less invasive than the surgical method of Warren-Shunt, so the radiological intervention has replaced surgery. Reducing the portal pressure by the shunt, the clinical complications change for the better. Still problems are defined as hepatic encephalopathy and right ventricular heart failure. Regular follow up investigations have to be performed to detect complications in the shunt. Using regular clinical and radiological check up TIPSS is of clinical benefit with good long term results. (orig.)

  7. Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting

    OpenAIRE

    Eapen, Valsamma; Črnčec, Rudi; Walter, Amelia

    2013-01-01

    Background Available evidence indicates that early intervention programs, such as the Early Start Denver Model (ESDM), can positively affect key outcomes for children with Autism Spectrum Disorder (ASD). However, programs involving resource intensive one-to-one clinical intervention are not readily available or deliverable in the community, resulting in many children with ASD missing out on evidence-based intervention during their early and most critical preschool years. This study evaluated ...

  8. Clinical effect and necessity of interventional treatment in diabetic foot before and after amputation

    International Nuclear Information System (INIS)

    Objective: To assess the clinical effect and necessity of interventional treatment in diabetic foot before and after amputation. Methods: Combined intravascular angioplasty with intraarterial medicine perfusing were carried out in fourteen patients with diabetic foot including 10 patients treated before amputation and 4 after amputation involving superficial femoral, deep femoral, tibial and fitular arteries. Among them seventeen vessels with irregular stenosis and obstruction were treated by intravascular angioplasty through balloon dilation. Results: The technical successful rate was 100%, no complication happened. The symptoms were relieved in all patients after treatment, including promotion of lower extremity arterial blood perfusion, reducing range of amputation and wound healing after amputation. Conclusions: Intravascular interventional treatment is safe, effective and valuable in diabetic foot before and after amputation. (authors)

  9. European clinical guidelines for Tourette syndrome and other tic disorders. Part III: behavioural and psychosocial interventions

    DEFF Research Database (Denmark)

    Verdellen, Cara; van de Griendt, Jolande; Hartmann, Andreas;

    2011-01-01

    This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to...... obtain an update on the efficacy of BPI for tics. Relevant studies were identified using computerised searches of the Medline and PsycINFO databases and the Cochrane Library for the years 1950-2010. The search identified no meta-analyses, yet twelve (systematic) reviews and eight randomised controlled...... trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both...

  10. Clinical Pharmacists'Participation in Pharmaceutical Practice of Radioactive Iodine Therapy in One Patient with Allergic Constitution%临床药师参与1例过敏体质患者放射碘的治疗实践

    Institute of Scientific and Technical Information of China (English)

    刘杨从; 李妍; 张耕

    2016-01-01

    OBJECTIVE:To provide reference for the clinic to evaluate the benefits and risks for radioactive iodine therapy in allergic constitution patients .METHODS:To introduce the process of pharmaceutical practice and clinical decision-making provided by clinical pharmacists for one patient with moderate recurrent risk after the surgery of thyroid cancer and who were allergic to many kinds of foods (peanuts, seafood, etc.), drugs[levothyroxine sodium (euthyrox), methylprednisolone, etc.] and chemicals ( nitrite, benzene mixture, etc.).RESULTS: Through the collection of adverse reactions history of the patient , the clinical pharmacists found that lots of the adverse reactions were mild and mainly associated with iodine-related foods and drugs such as fish , seaweed and iodine contrast agents , etc.There were no discomforts for the patient after 24 hours of iodine absorption rate .Since there were low risk of severe adverse reactions for patients with radioactive iodine therapy , the benefits of the therapy were more than the risks.Meanwhile, the allergen skin test suggested that the patient had a severe allergies with levothyroxine sodium ( euthyrox );through consulted the related literature and data , the clinical pharmacists thought the patient was allergic to accessories, who was advised to change levothyroxine sodium (letrox) for skin allergy test again, finally, the result was negative , and then the replacement therapy was suggested .The clinicians took the clinical pharmacists 'suggestions so that the radioactive iodine therapy had a successful completion , and there were no adverse drug events in the follow-up after discharge of 7 days.CONCLUSIONS:The clinical pharmacists play an essential role in the process of adverse drug reactions evaluation and disposal when as a part of the clinical treatment team .%目的:为临床评估过敏体质患者进行放射碘治疗获益风险提供参考.方法:通过报道1例对多种食物(花生、海鲜等)、药物[左甲

  11. Acute interventional diagnosis and treatment of upper gastrointestinal arterial hemorrhage: its clinical value and influence factors

    International Nuclear Information System (INIS)

    Objective: To evaluate emergent angiography and interventional management in treating massive upper gastrointestinal (GI) arterial hemorrhage, and to discuss the factors influencing the angiographic bleeding signs and the interventional therapeutic results. Methods: The clinical data of 56 patients with massive upper GI arterial hemorrhage, who underwent diagnostic arteriography and interventional management with trans-catheter vasopressin infusion and embolization, were retrospectively analyzed. Systolic blood pressure of both pre-and post-interventional therapy was recorded and statistically analyzed. The arteriographic positive rates were separately calculated according to the catheter tip's location, being placed at the 2nd grade branch or at the 3 rd -4 th grade branch of the artery, and the relation of the positive rate with the tip's location was analyzed. A comparison of the hemostatic effect between trans-catheter vasopressin infusion and trans-catheter embolization was made. Results: The average systolic blood pressure of pre-and post-procedure was (93.14 ± 18.63) mmHg and (11.64 ± 13.61) mmHg respectively, with a significant difference (P = 0.023). The angiographic bleeding signs were demonstrated in 12 cases (21.4%) with the catheter's tip at the 2nd grade branch and in 56 cases (100%) with the catheter's tip at the 3 rd -4 th grade branch,the difference between the two was of statistically significance (P < 0.05). The technical success rate and the clinical hemostasis rate of via catheter vasopressin infusion was 80% (16 / 20) and 55% (11/20) respectively. Of nine re-bleeding cases, seven were successfully controlled with embolization therapy by using microcatheter and two had to receive surgery because of arterial rupture which was proved by angiography. The technical and the clinical rates of success for transcatheter embolization therapy were 93% (42 / 45) and 89% (40 / 45) respectively. Recurrence of bleeding was seen in two patients who got

  12. Implementation of a drug therapy monitoring clinic in a primary-care setting.

    Science.gov (United States)

    Yanchick, J K

    2000-12-15

    The development and implementation of a drug therapy monitoring clinic in the primary-care clinics of a military hospital are described. To improve patient care and decrease costs associated with treating chronic diseases, in August 1995 the pharmacy department established a drug therapy monitoring clinic. The clinic was responsible for initiating and monitoring treatment plans for patients with chronic diseases, implementing clinical guidelines, providing educational programs, collecting and analyzing outcome data, and handling requests for medication extensions. Treatment followed existing national standards and Department of Defense guidelines modified for the institution. The clinic began with one clinical pharmacy specialist, and within a year it added another clinical pharmacist and a technician. The clinic first obtained patients via consultations from providers in primary care; this was soon extended to all departments. In addition, the pharmacist was available to see walk-in patients needing medication extensions. Later, referrals came for inpatients and patients seen in the emergency room for asthma or diabetes mellitus, as well as for inpatients receiving oral anticoagulation therapy. For fiscal year 1999, the clinic saw 104 (+/- 44.3) patients per month seeking medication extensions. It also handled 24,873 clinical interventions that year, resulting in projected annual savings of $1,085,560. Chart review indicated that compliance with national standards improved dramatically for patients with diabetes mellitus or asthma followed by pharmacists compared with physician monitoring during the same period and before the clinic began. The wait time for reviewing laboratory results and for patients receiving anticoagulation therapy was eliminated, and doses were changed immediately, if needed. A comprehensive pharmacist-managed drug therapy monitoring clinic for outpatients with chronic diseases can result in positive patient outcomes and more cost

  13. Optimizing Drug Prescribing in Managed Care Populations: Improving Clinical and Economic Outcomes

    OpenAIRE

    Rachel Czubak; Jasmine Tucker; Zarowitz, Barbara J.

    2004-01-01

    Managed care presents interesting opportunities to optimize clinical and economic outcomes related to drug prescribing. There are very few randomized controlled trials that have evaluated methods to educate or incentivize physicians, implement formulary management or guideline tools, profile physicians, and implement pharmacist interventions to ensure optimal drug prescribing. Single methods of optimizing medication outcomes have not been shown to be as effective as multifaceted approaches. S...

  14. From orphan drugs to adopted therapies: Advancing C3-targeted intervention to the clinical stage.

    Science.gov (United States)

    Mastellos, Dimitrios C; Reis, Edimara S; Yancopoulou, Despina; Hajishengallis, George; Ricklin, Daniel; Lambris, John D

    2016-10-01

    Complement dysregulation is increasingly recognized as an important pathogenic driver in a number of clinical disorders. Complement-triggered pathways intertwine with key inflammatory and tissue destructive processes that can either increase the risk of disease or exacerbate pathology in acute or chronic conditions. The launch of the first complement-targeted drugs in the clinic has undeniably stirred the field of complement therapeutic design, providing new insights into complement's contribution to disease pathogenesis and also helping to leverage a more personalized, comprehensive approach to patient management. In this regard, a rapidly expanding toolbox of complement therapeutics is being developed to address unmet clinical needs in several immune-mediated and inflammatory diseases. Elegant approaches employing both surface-directed and fluid-phase inhibitors have exploited diverse components of the complement cascade as putative points of therapeutic intervention. Targeting C3, the central hub of the system, has proven to be a promising strategy for developing biologics as well as small-molecule inhibitors with clinical potential. Complement modulation at the level of C3 has recently shown promise in preclinical primate models, opening up new avenues for therapeutic intervention in both acute and chronic indications fueled by uncontrolled C3 turnover. This review highlights recent developments in the field of complement therapeutics, focusing on C3-directed inhibitors and alternative pathway (AP) regulator-based approaches. Translational perspectives and considerations are discussed, particularly with regard to the structure-guided drug optimization and clinical advancement of a new generation of C3-targeted peptidic inhibitors. PMID:27353192

  15. Mega clinical trials which have shaped the RAS intervention clinical practice.

    Science.gov (United States)

    Düsing, Rainer

    2016-06-01

    Following extensive clinical research, drugs affecting the renin-angiotensin system have been used for the treatment of patients with congestive heart failure, myocardial infarction, hypertension, diabetic nephropathy, chronic renal failure and for reducing the risk of developing major cardiovascular (CV) events. This review examines all mega trials (those involving >1000 patients) and smaller pivotal trials involving angiotensin-converting enzyme inhibitors (ACE-Is; 25 mega trials) and angiotensin receptor blockers (ARBs; 27 mega trials) to provide perspective on the huge database of evidence that has accumulated on the use of these drugs. Our review demonstrates that ACE-Is and ARBs are generally as effective as conventional therapies in the treatment of hypertension, but offer additional cardioprotective benefits in patients with heart failure, and in those who have experienced myocardial infarction. Also, both ACE-Is and ARBs are capable of renal protection in addition to their blood-pressure-lowering effects. Although ACE-Is and ARBs provide major benefits to CV patients, doubts remain over the concept of blood-pressure-independent CV protection offered by both classes of drugs. ACE-Is and ARBs appear to be equally effective with respect to morbidity and mortality endpoints, but ARBs are better tolerated. Considering the available evidence, the combined use of an ACE-I and ARB should be avoided and full doses of either ACE-I or ARB should be aimed for as evidence suggests they provide a greater prognostic benefit. PMID:27271312

  16. Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders

    DEFF Research Database (Denmark)

    Gross, Douglas P; Armijo-Olivo, Susan; Shaw, William S; Williams-Whitt, Kelly; Shaw, Nicola T; Hartvigsen, Jan; Qin, Ziling; Ha, Christine; Woodhouse, Linda J; Steenstra, Ivan A

    2016-01-01

    Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying...... the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research...

  17. Usual Care as the Control Group in Clinical Trials of Nonpharmacologic Interventions

    OpenAIRE

    Thompson, B Taylor; Schoenfeld, David

    2007-01-01

    We discuss the pros and cons of including usual care as a control arm in clinical trials of nonpharmacologic interventions. Usual care is a term used to describe the full spectrum of patient care practices in which clinicians have the opportunity (which is not necessarily seized) to individualize care. The decision to use usual care as the control arm should be based on the nature of the research question and the uniformity of usual-care practices. The use of a usual-care arm in a two-arm tri...

  18. Alzheimer’s disease multiple intervention trial (ADMIT: study protocol for a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Callahan Christopher M

    2012-06-01

    Full Text Available Abstract Background Given the current lack of disease-modifying therapies, it is important to explore new models of longitudinal care for older adults with dementia that focus on improving quality of life and delaying functional decline. In a previous clinical trial, we demonstrated that collaborative care for Alzheimer’s disease reduces patients’ neuropsychiatric symptoms as well as caregiver stress. However, these improvements in quality of life were not associated with delays in subjects’ functional decline. Trial design Parallel randomized controlled clinical trial with 1:1 allocation. Participants A total of 180 community-dwelling patients aged ≥45 years who are diagnosed with possible or probable Alzheimer’s disease; subjects must also have a caregiver willing to participate in the study and be willing to accept home visits. Subjects and their caregivers are enrolled from the primary care and geriatric medicine practices of an urban public health system serving Indianapolis, Indiana, USA. Interventions All patients receive best practices primary care including collaborative care by a dementia care manager over two years; this best practices primary care program represents the local adaptation and implementation of our prior collaborative care intervention in the urban public health system. Intervention patients also receive in-home occupational therapy delivered in twenty-four sessions over two years in addition to best practices primary care. The focus of the occupational therapy intervention is delaying functional decline and helping both subjects and caregivers adapt to functional impairments. The in-home sessions are tailored to the specific needs and goals of each patient-caregiver dyad; these needs are expected to change over the course of the study. Objective To determine whether best practices primary care plus home-based occupational therapy delays functional decline among patients with Alzheimer’s disease compared

  19. Training-Based Interventions in Motor Rehabilitation after Stroke: Theoretical and Clinical Considerations

    Directory of Open Access Journals (Sweden)

    Annette Sterr

    2004-01-01

    Full Text Available Basic neuroscience research on brain plasticity, motor learning and recovery has stimulated new concepts in neurological rehabilitation. Combined with the development of set methodological standards in clinical outcome research, these findings have led to a double-paradigm shift in motor rehabilitation: (a the move towards evidence-based procedures for the assessment of clinical outcome & the employment of disablement models to anchor outcome parameters, and (b the introduction of practice-based concepts that are derived from testable models that specify treatment mechanisms. In this context, constraint-induced movement therapy (CIT has played a catalytic role in taking motor rehabilitation forward into the scientific arena. As a theoretically founded and hypothesis-driven intervention, CIT research focuses on two main issues. The first issue is the assessment of long-term clinical benefits in an increasing range of patient groups, and the second issue is the investigation of neuronal and behavioural treatment mechanisms and their interactive contribution to treatment success. These studies are mainly conducted in the research environment and will eventually lead to increased treatment benefits for patients in standard health care. However, gradual but presumably more immediate benefits for patients may be achieved by introducing and testing derivates of the CIT concept that are more compatible with current clinical practice. Here, we summarize the theoretical and empirical issues related to the translation of research-based CIT work into the clinical context of standard health care.

  20. Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Awad Abdelmoneim

    2012-10-01

    counseling obese patients by pharmacists were positively correlated with their perceived comfort with counseling and perceived effectiveness of obesity management aspects. The most anticipated barriers to obesity counseling were lack of patient awareness about pharmacists' expertise in counseling 76.2% (95% CI: 69.7-81.7 and pharmacists’ opinions that obese patients lack willpower and are non-adherent to weight reduction interventions 71.8% (95% CI: 65.1-77.8. Conclusions Strengths, weaknesses and barriers related to obesity counseling by pharmacists in Kuwait were identified, and suggestions were provided to strengthen that role.

  1. Clinical significance of post-interventional cerebral hyperdensities after endovascular mechanical thrombectomy in acute ischaemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Nikoubashman, Omid [Uniklinik Aachen, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany); Uniklinik Aachen, Klinik fuer Neurologie, Aachen (Germany); Reich, Arno; Gindullis, Mirco; Schulz, Joerg B. [Uniklinik Aachen, Klinik fuer Neurologie, Aachen (Germany); Frohnhofen, Katharina; Pjontek, Rastislav; Brockmann, Marc-Alexander; Wiesmann, Martin [Uniklinik Aachen, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany)

    2014-01-15

    This study aims to investigate the clinical significance of post-interventional cerebral hyperdensities (PCHD) after endovascular mechanical thrombectomy in acute ischaemic stroke. Data of 102 consecutive patients who received post-interventional CT scans within 4.5 h after mechanical thrombectomy were analysed retrospectively. Sixty-two of 102 patients (60.8 %) had PCHD on their post-interventional CT scans. The most common site of PCHD was the basal ganglia. PCHD were persisting in 13 of 62 patients (21.0 %), and transient in the remaining 49 patients (79.0 %) within 24 h. Four patients with PCHD and four patients without PCHD suffered from parenchymal haemorrhage. Neither ASA nor Clopidogrel, Tirofiban or rtPA were risk factors for PCHD. Final infarction size was congruent with or bigger than areas of PCHD in 93.3 % of cases in our series. PCHD was not a risk factor for parenchymal haemorrhage in our series. The occurrence of PCHD was strongly related to the prior presence of infarction. PCHD was also a strong predictor for final infarction size. (orig.)

  2. [The pharmacist: health professional and citizen].

    Science.gov (United States)

    Rozenfeld, Suely

    2008-04-01

    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

  3. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

    Directory of Open Access Journals (Sweden)

    Yahya Dadjoo

    2013-03-01

    Full Text Available Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI. Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4% had cardiac problem and the other 2 (2.9% died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6% and those with LAD ST-elevation myocardial infarction (5% died after one year (P= 0.263 and P= 0.319 respectively. However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161, but there was no reported mortality in those with single vessel disease.

  4. Gender differences among suicide attempters attending a Crisis Intervention Clinic in South India

    Directory of Open Access Journals (Sweden)

    Vikas Menon

    2015-01-01

    Full Text Available Background and Objectives: Studying gender differences among suicide attempters is important for identifying gender-specific risk factors and for planning management and prevention. Our objective was to delineate gender differences among a well-defined group of suicide attempters. Materials and Methods: This record-based study was conducted among patients presenting to a Crisis Intervention Clinic in a Tertiary Care Hospital in South India. Information was gathered regarding sociodemographic and clinical characteristics. Hopelessness was measured using Beck Hopelessness Scale (BHS, and stress was evaluated using Presumptive Stressful Life Events Scale (PSLES. Results: The sample comprised of 162 males and 137 females. Males were significantly older and were more likely to be employed as compared to females. Alcohol use was significantly more in males and number of men who attempted suicide under intoxication was significantly higher. Females had a greater proportion of attempts with the use of plant poisons and medication overdose. There was no significant difference between two genders on BHS though differences were noted on types of stresses reported on PSLES. Conclusion: Gender-specific differences were noted with regard to substance use, mode of attempt and types of stressors experienced. Identifying these factors might help us to design targeted interventions to prevent further attempts.

  5. Improving the Dictation in Attention Deficit Hyperactivity Disorder by Using Computer Based Interventions: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mahdi Tehranidoost

    2006-07-01

    Full Text Available Objective: The aim of the current study was to assess the impact of computer games and computer-assisted type instruction on dictation scores of elementary school children with attention deficit – hyperactivity disorder (ADHD. Method: In this single-blind clinical trial, 37 elementary school children with ADHD, selected by convenience sampling and divided into group I (n=17 and group II (n=20, underwent eight one-hour sessions (3 sessions per week of intervention by computer games versus computer-assisted type instruction, respectively. 12 school dictation scores were considered: 4 scores preintervention, 4 scores during interventions, and 4 scores post-intervention. Dictation test was taken during each session. Data was analyzed using repeated measure ANOVA. Results: Two groups were matched for age, gender, school grade, medication, IQ, parent’s and teacher’s Conners’ scale scores, having computer at home, history of working with computer, and mean dictation scores. There was no significant difference in dictation scores before and after interventions and also between the study groups. The improvement in school dictation scores had no significant correlation with age, gender, Ritalin use, owning a computer at home and past history of computer work, baseline dictation scores, Ritalin dose, educational status, IQ, and the total score of parent’s and teacher’s Conners’ rating scale. Conclusion: Absence of significant improvement in dictation scores in study groups may be due to the confounding effect of other variables with known impact on dictation scores. Further studies in this field should also assess the change of attention and memory.

  6. Family Commitment and Work Characteristics among Pharmacists

    Directory of Open Access Journals (Sweden)

    Paul O. Gubbins

    2015-12-01

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

  7. Job sharing for women pharmacists in academia.

    Science.gov (United States)

    Rogers, Kelly C; Finks, Shannon W

    2009-11-12

    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

  8. Virtual Pharmacist: A Platform for Pharmacogenomics.

    Directory of Open Access Journals (Sweden)

    Ronghai Cheng

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

  9. Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada

    Directory of Open Access Journals (Sweden)

    Laliberté Marie-Claude

    2012-03-01

    provision of these services in current practice were lack of: time (86.1%, coordination with other health care professionals (61.1%, staff or resources (57.2%, financial compensation (50.8%, and clinical tools (45.5%. Conclusions Although community pharmacists think they should play a significant role in health promotion and prevention, they recognize a wide gap between their ideal and actual levels of involvement. The efficient integration of primary-care pharmacists and pharmacies into public health cannot be envisioned without addressing important organizational barriers.

  10. Patients Perception of Community Pharmacist in Bosnia and Herzegovina

    OpenAIRE

    Catic, Tarik; Jusufovic, Fatima Insanic; Tabakovic, Vedad

    2013-01-01

    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...

  11. A collaborative cardiologist-pharmacist care model to improve hypertension management in patients with or at high risk for cardiovascular disease

    OpenAIRE

    Irons BK; Meyerrose G; Laguardia S; Hazel K; Seifert CF

    2012-01-01

    Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigorous goals of therapy. Objective: The purpose of this project was to evaluate this type of care model in a high c...

  12. Survey of pharmacists and physicians on drug interactions between combined oral contraceptives and broad-spectrum antibiotics

    Directory of Open Access Journals (Sweden)

    Masters KP

    2009-09-01

    Full Text Available Objective: To evaluate physician and pharmacist knowledge on potential drug interactions between combined oral contraceptives (COC and broad-spectrum antibiotics and determine if any difference exists between responses.Methods: Two hundred licensed retail pharmacists and 200 licensed family practice physicians in the states of Virginia, West Virginia, and Maryland were mailed an anonymous survey between August 2007 and November 2007. The survey consisted of 3 short questions asking practitioners about their current opinion on drug interactions with COCs and whether an alternative form of contraception is needed for patients taking COC and concomitant broad-spectrum antibiotics. The main outcome measure of the survey included: identifying how physicians and pharmacists handle prescribing or dispensing COCs along with broad-spectrum antibiotics. Gender, educational degree, and years in practice were also collected. Results: A total of 182 participants returned the surveys (57% were physicians and 43% were pharmacists. When asked if broad-spectrum antibiotics have a clinically significant interaction with COCs, 82.7% of physicians and 88.5% of pharmacists answered, “yes”. Of the respondents, 84.6% stated that the drug interaction warrants the patient to be advised to use back-up contraception. A total of 90.1% stated that they currently instruct patients to use back-up contraception when prescribing or dispensing antibiotics to a patient who is on COC, with no statistically significant difference existing between the responses of the pharmacists and the physicians.Conclusion: Physicians and pharmacists believe that broad-spectrum antibiotics decrease the effectiveness of COCs. These practitioners warn their patients of this interaction and advise the use of back-up contraception. More education should be provided to practitioners regarding the data concerning COCs and broad spectrum antibiotics and lack of a proven interaction.

  13. Pharmacist-led minor ailment programs: a Canadian perspective.

    Science.gov (United States)

    Taylor, Jeff Gordon; Joubert, Ray

    2016-01-01

    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

  14. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    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.

  15. Evaluation of Prescriber Responses to Pharmacist Recommendations Communicated by Fax in a Medication Therapy Management Program (MTMP)

    Science.gov (United States)

    Perera, Prasadini N.; Guy, Mignonne C.; Sweaney, Ashley M.; Boesen, Kevin P.

    2016-01-01

    BACKGROUND As defined by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, medication therapy management programs (MTMPs) must be designed to decrease adverse drug events and improve patient outcomes by promoting appropriate medication use. WellPoint Inc. contracted with the pharmacist-run University of Arizona College of Pharmacy Medication Management Center (UA MMC) to provide a pilot telephone-based MTMP to approximately 5,000 high-risk beneficiaries from among its nearly 2 million Medicare prescription drug plan (PDP) beneficiaries. Eligibility for the program was determined by a minimum of 2 of 6 chronic diseases (dyslipidemia, cardiovascular disease, depression, diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease; at least 1 of the latter 2 diseases must be present), at least 3 Part-D covered medications, and greater than $4,000 per year in predicted drug spending. In addition to these criteria, WellPoint Inc. used the Johns Hopkins adjusted clinical groups (ACG) predictive model to identify the high-risk beneficiaries to be enrolled in the program. Medication therapy reviews were conducted for these patients. If any medication-related problems (MRPs) were identified, the patient’s prescribers were contacted via a fax communication with recommendation(s) to resolve these MRPs. The UA MMC fax interventions were categorized as cost saving, guideline adherence, or safety concerns. OBJECTIVES To (a) determine prescriber responses to pharmacist-initiated recommendations in an MTMP for the 3 intervention categories, (b) compare prescriber responses between intervention categories, and (c) compare prescriber response by prescriber type (primary care physician [PCP] vs. specialist) within each intervention category. METHODS A retrospective analysis of pharmacist-initiated interventions from August through December 2008 was performed using data collected from the UA MMC database. Data were collected on

  16. Pharmacists’ Interventions in A Paediatric Haematology-Oncology Pharmacy: Do They Matter to Minimise Medication Misadventure?

    Directory of Open Access Journals (Sweden)

    Hesty U. Ramadaniati

    2016-03-01

    Full Text Available Paediatric patients with cancer are a high-risk patient population for medication misadventures. This study aimed to document and evaluate the role of pharmacists’ interventions during dispensing-related activities in minimising the occurrence of medication misadventure in haematology-oncology patients. The primary investigator observed and documented all clinical interventions during dispensing-related activities performed by clinical pharmacists in a haematology-oncology pharmacy during 33-day. A total of 359 interventions were performed for 1028 patients. The rates of intervention were 20.04 per 100 medication orders and 34.92 per 100 patients. Provision of drug information was the most common interventions constituting more than three quarters of all interventions. According to therapeutic groups, cytotoxic antineoplastics made up more than half of all interventions. Of all interventions, 22 involved recommendations leading to changes in patients’ treatment (active interventions, and all recommendations were accepted. The top three medication errors were due to inappropriate dosing, labelling error, and unfulfilled indication. Clinical pharmacists’ intervention during dispensing in a paediatric haematology-oncology pharmacy improved medication safety and patient care by minimising the incidence of medication misadventures.

  17. Development and Delivery of a Physical Activity Intervention for People With Huntington Disease: Facilitating Translation to Clinical Practice

    Science.gov (United States)

    Quinn, Lori; Trubey, Rob; Gobat, Nina; Dawes, Helen; Edwards, Rhiannon Tudor; Jones, Carys; Townson, Julia; Drew, Cheney; Kelson, Mark; Poile, Vincent; Rosser, Anne; Hood, Kerenza

    2016-01-01

    Background and Purpose: We studied the development and delivery of a 14-week complex physical activity intervention for people with Huntington disease, where detailed information about the intervention was fully embedded in the trial design process. Methods: Intervention Development: The intervention was developed through a series of focus groups. The findings from the focus groups informed the development of a logic model for the physical activity intervention that was broadly consistent with the framework of self-determination theory. Intervention Delivery: Key components underpinning the delivery of the intervention were implemented including a defined coach training program and intervention fidelity assessment methods. Training of coaches (physical therapists, occupational therapists, research nurses, and exercise trainers) was delivered via group and 1:1 training sessions using a detailed coach's manual, and with ongoing support via video calls, and e-mail communication as needed. Detailed documentation was provided to determine costs of intervention development and coach training. Results: Intervention delivery coaches at 8 sites across the United Kingdom participated in the face-to-face training. Self-report checklists completed by each of the coaches indicated that all components of the intervention were delivered in accordance with the protocol. Mean (standard deviation) intervention fidelity scores (n = 15), as measured using a purpose-developed rating scale, was 11 (2.4) (out of 16 possible points). Coaches' perceptions of intervention fidelity were similarly high. The total cost of developing the intervention and providing training was £30,773 ($47,042 USD). Discussion and Conclusions: An important consideration in promoting translation of clinical research into practice is the ability to convey the detailed components of how the intervention was delivered to facilitate replication if the results are favorable. This report presents an illustrative

  18. Engaging Nurses in Research for a Randomized Clinical Trial of a Behavioral Health Intervention

    Directory of Open Access Journals (Sweden)

    Lona Roll

    2013-01-01

    Full Text Available Nurse involvement in research is essential to the expansion of nursing science and improved care for patients. The research participation challenges encountered by nurses providing direct care (direct care nurses include balancing patient care demands with research, adjusting to fluctuating staff and patient volumes, working with interdisciplinary personnel, and feeling comfortable with their knowledge of the research process. The purpose of this paper is to describe efforts to engage nurses in research for the Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART study. SMART was an NIH-funded, multisite, randomized, behavioral clinical trial of a music therapy intervention for adolescents/young adults (AYA undergoing stem cell transplant for an oncology condition. The study was conducted at 8 sites by a large multidisciplinary team that included direct care nurses, advanced practice nurses, and nurse researchers, as well as board-certified music therapists, clinical research coordinators, and physicians. Efforts to include direct care nurses in the conduct of this study fostered mutual respect across disciplines in both academic and clinical settings.

  19. Percutaneous coronary intervention in asians- are there differences in clinical outcome?

    Directory of Open Access Journals (Sweden)

    Chua Terrance S

    2011-05-01

    Full Text Available Abstract Background Ethnic differences in clinical outcome after percutaneous coronary intervention (PCI have been reported. Data within different Asian subpopulations is scarce. We aim to explore the differences in clinical profile and outcome between Chinese, Malay and Indian Asian patients who undergo PCI for coronary artery disease (CAD. Methods A prospective registry of consecutive patients undergoing PCI from January 2002 to December 2007 at a tertiary care center was analyzed. Primary endpoint was major adverse cardiovascular events (MACE of myocardial infarction (MI, repeat revascularization and all-cause death at six months. Results 7889 patients underwent PCI; 7544 (96% patients completed follow-up and were included in the analysis (79% males with mean age of 59 years ± 11. There were 5130 (68% Chinese, 1056 (14% Malays and 1001 (13.3% Indian patients. The remaining 357 (4.7% patients from other minority ethnic groups were excluded from the analysis. The primary end-point occurred in 684 (9.1% patients at six months. Indians had the highest rates of six month MACE compared to Chinese and Malays (Indians 12% vs. Chinese 8.2% vs. Malays 10.7%; OR 1.55 95%CI 1.24-1.93, p Conclusion These data indicate that ethnic variations in clinical outcome exist following PCI. In particular, Indian patients have higher six month event rates compared to Chinese and Malays. Future studies are warranted to elucidate the underlying mechanisms behind these variations.

  20. The Radiologist Will See You Now: Patients' Perceptions of an Outpatient Interventional Clinic.

    Science.gov (United States)

    Abboud, Salim; Partovi, Sasan; Nakamoto, Dean; Azar, Nami

    2016-01-01

    Patient satisfaction is becoming an increasingly important part of America's healthcare system. Patient satisfaction is now a metric assessed for value-based incentive payments by the Center for Medicare and Medicaid Services, and the healthcare market is becoming increasingly consumer-driven as patients are provided with more options regarding where they receive care as well as improved access to medical information. Radiologists, while less involved with direct patient care than other medical specialties, are not immune to the changing medical landscape and need to adapt to a progressively value- and patient-oriented healthcare system. At our institution, first-year radiology residents take an active role in our outpatient interventional radiology clinic by performing clinical histories and physical exams in a dedicated radiology clinic examination rooms. Stressing the various opportunities for patient interaction and the potential benefits of patient- centered radiology in the evolving healthcare system may increase its perceived value among both radiology residents as well as practicing radiologists. ​Directly engaging patients may be unfamiliar territory for the practicing radiologist and an unexpected prospect for current residents, but available data suggests that patients do value direct interaction with radiologists during the course of their care. PMID:26596560

  1. Engaging nurses in research for a randomized clinical trial of a behavioral health intervention.

    Science.gov (United States)

    Roll, Lona; Stegenga, Kristin; Hendricks-Ferguson, Verna; Barnes, Yvonne J; Cherven, Brooke; Docherty, Sharron L; Robb, Sheri L; Haase, Joan E

    2013-01-01

    Nurse involvement in research is essential to the expansion of nursing science and improved care for patients. The research participation challenges encountered by nurses providing direct care (direct care nurses) include balancing patient care demands with research, adjusting to fluctuating staff and patient volumes, working with interdisciplinary personnel, and feeling comfortable with their knowledge of the research process. The purpose of this paper is to describe efforts to engage nurses in research for the Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study. SMART was an NIH-funded, multisite, randomized, behavioral clinical trial of a music therapy intervention for adolescents/young adults (AYA) undergoing stem cell transplant for an oncology condition. The study was conducted at 8 sites by a large multidisciplinary team that included direct care nurses, advanced practice nurses, and nurse researchers, as well as board-certified music therapists, clinical research coordinators, and physicians. Efforts to include direct care nurses in the conduct of this study fostered mutual respect across disciplines in both academic and clinical settings. PMID:24102024

  2. [Clinical implication of urinary protein markers in diabetic nephropathy and interventional effects of Chinese herbal medicine].

    Science.gov (United States)

    Shi, Xi-Miao; Meng, Xian-Jie; Wan, Yi-Gang; Shen, Shan-Mei; Luo, Xun-Yang; Gu, Liu-Bao; Yao, Jian

    2014-07-01

    In clinic, some urinary protein makers can dynamically and noninvasively reflect the degree of renal tubular injury in patients with diabetic nephropathy (DN). These urinary biomarkers of tubular damage are broadly divided into two categories. One is newfound, including kidney injury molecule-1 (Kim-1), neutrophil getatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP) and cystatin C (CysC); the other one is classical, including beta2 microglobulin (beta2-MG), retinal binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG). It is reported that, the increases in urinary protein markers are not only closely related to the damage of tubular epithelial cells in DN patients, but also can be ameliorated by the treatment with Chinese herbal compound preparations or Chinese herbal medicine. Recently, although urinary proteomics are used in the protein separation and identification, the traditional associated detection of urinary protein markers is more practical in clinic. At present, it is possible that the associated detection of urinary biomarkers of glomerular and tubular damages may be a feasible measure to reveal the clinical significance of urinary protein markers in DN patients and the interventional effects of Chinese herbal medicine. PMID:25272479

  3. Patient And phaRmacist Telephonic Encounters (PARTE in an underserved rural population with asthma: methods and rationale

    Directory of Open Access Journals (Sweden)

    Henry N. Young, PhD

    2011-01-01

    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

  4. A brief conversation analytic communication intervention can change history-taking in the seizure clinic.

    Science.gov (United States)

    Jenkins, Laura; Cosgrove, Jeremy; Ekberg, Katie; Kheder, Ammar; Sokhi, Dilraj; Reuber, Markus

    2015-11-01

    Question design during history-taking has clear implications for patients' ability to share their concerns in general and their seizure experiences in particular. Studies have shown that unusually open questions at the start of the consultation enable patients to display interactional and linguistic markers which may help with the otherwise challenging differentiation of epileptic from nonepileptic seizures (NES). In this study, we compared the problem presentation approach taken by trainee neurologists in outpatient encounters with new patients before and after a one-day conversation analytic training intervention in which doctors were taught to adopt an open format of question design and recognize diagnostically relevant linguistic features. We audio/video-recorded clinical encounters between ten doctors, their patients, and accompanying persons; transcribed the interactions; and carried out quantitative and qualitative analyses. We studied 39 encounters before and 55 after the intervention. Following the intervention, doctors were significantly more likely to use nondirective approaches to soliciting patient accounts of their presenting complaints that invited the patient to describe their problems from their own point of view and gave them better opportunity to determine the initial agenda of the encounter. The time to first interruption by the doctor increased (from 52 to 116 s, p<.001). While patients were given more time to describe their seizure experiences, the overall appointment length did not increase significantly (19 vs 21 min, n.s.). These changes gave patients more conversational space to express their concerns and, potentially, to demonstrate the interactional and linguistic features previously found to help differentiate between epilepsy and NES, without impacting the length of the consultations. PMID:26409131

  5. Clinical investigation study on occupational exposure of operators during cardiovascular intervention

    International Nuclear Information System (INIS)

    Objective: To investigate the personal effective dose of the operator in cardiovascular intervention. Methods: Lithium fluoride (LiF) thermoluminescent dosimeters (TLD) were used to carry out personal dose monitoring for the operator. Effective doses of the operator were evaluated in 28 clinical operations. Results: The average fluoroscopy time for 24 Coronary angiography (CA), percutaneous transluminal coronary angioplasty (PTCA) and percutaneous intracoronary arterial stenting (PICAS) procedures was 19.2±6.3 min, and the average effective dose of the operator per procedure was 4.1±0.9 μSv (under protection) and 52.2±15.5 μSv (without protection). However, for 4 PT procedures, average fluoroscopy time was 14.1±4.6 min, and the average effective dose of the operator per operation was 5.5±1.4 μSv (under protection) and 220±42 μSv (without protection). Conclusions: Reducing fluoroscopy time, femoral artery access to the patients are recommended during interventional procedures. In order to decrease the radiation risk to the lowest level, more advanced equipment should be applied and radiation protection should be fully managed. (authors)

  6. Clinical Use of an Autovideography Intervention to Support Recovery in Individuals with Severe Mental Illness.

    Science.gov (United States)

    Linz, Sheila; Hanrahan, Nancy P; DeCesaris, Marissa; Petros, Ryan; Solomon, Phyllis

    2016-05-01

    The current authors introduced an innovative autovideography intervention asking mental health consumers to use video cameras for 1 month to tell about their recovery. The research approach was based on a participatory research model with workers and consumers of a recovery education center fully involved with the study design and implementation. Twelve individuals who had graduated from a recovery program participated. The participant-produced videos were qualitatively analyzed using thematic analysis. The use of autovideography was found to be feasible and can be used clinically to support the process of recovery by providing opportunities for reciprocity, self-reflection, and advocacy. Consumer-produced videos provide a voice to inform others with and without mental illness about the concerns of individuals with mental illness and the process of recovery. [Journal of Psychosocial Nursing and Mental Health Services, 54(5), 33-40.]. PMID:27135892

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

    OpenAIRE

    SHARMA, H; Jindal, D.; Aqil, M.; Alam, M. S.; Karim, S.; Kapur, P.

    2009-01-01

    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...

  8. Bibliometric Analysis: Mirror Therapy as an Occupational Therapy Intervention Strategy in the Clinical Setting

    Directory of Open Access Journals (Sweden)

    Elvis Siprián Castro Alzate

    2016-01-01

    Full Text Available Objective: To determine the national and international scientific evidence regarding the use of mirror therapy, as an occupational therapy intervention tool in the clinical setting, in order to acquire knowledge and implement this strategy in professional practice. Materials and methods: A descriptive study was conducted in which the research strategy was held through medical subject headings (MeSH, such as “mirror neuron”, ”occupational therapy”, “physical rehabilitation” and “motor imagery”. Through the use of the bolean and combinations in five different databases were performed: Embase, Ebsco, OTseeker, Science Direct and Medline. The analysis was elaborated by establishing frequencies of different variables such as journal, country, study type and publish­ing year. Conclusions: In the evidence analysis it was found that mirror therapy is an interven­tion modality recently used by different rehabilitation professionals. Since 2004, an increase in the generation of high impact scientific evidence about this subject has been recognized, due in part to the reported effectiveness in clinical practices, mainly the treatment of health conditions secondary to stroke, limb amputations, chronic pain syndromes, and post-surgical rehabilitation. During the reviewed period, an increase in high level academic evidence was observed: 35.7 % of the analyzed publications correspond to randomized controlled trials and 42.9 % are system­atic reviews. The use of mirror therapy in occupational therapy is an intervention modality that facilitates functional rehabilitation processes, promotes independence in performing activities of daily living (adl and allows social participation and environment adaptation processes to happen.

  9. Health-related restrictions of choices and choosing: implications for quality of life and clinical interventions

    Directory of Open Access Journals (Sweden)

    Barry J Gurland

    2010-08-01

    Full Text Available Barry J Gurland1, Huai Cheng2, Mathew S Maurer31Columbia University Department of Psychiatry, Stroud Center for Study of Quality of Life, New York, NY, USA; 2Anderson Cancer Center, Houston, TX, USA; 3Columbia Presbyterian Medical Center, New York, NY, USABackground: The process of “accessing choices and choosing among them” (c-c has been proposed as a model for understanding, evaluating, and assisting a patient’s management of quality of life. If desired choices are freely accessible, and the act of choosing is efficient and unconstrained, then the outcome is optimized quality of life. The c-c model fits many clinical situations where improved quality of life is a goal, and interventions may be aimed at relieving health-related restrictions of the patient’s desired activities. Aims: To determine the impact of health restrictions of choices and choosing on indicators and outcomes reflecting quality of life. Method: Secondary analysis of a community-based health survey of three ethnic groups, 65 years and older (n = 2,130, repeated after 18 months, with mortality over 6 years. Findings: Complaints of health restrictions of desired activities accounted for about half the variance of all determinants of a quality of life proxy indicator, and had a high frequency. Such complaints also predicted declines in mood and function, higher death rates, and increased service use.Conclusions: Clinical trials are warranted of the efficacy for quality of life improvement of interventions that focus on the relief of health-induced restrictions of desired activities.Keywords: choice, quality of life, aging, health restrictions

  10. Prescription Writing in Small Groups as a Clinical Pharmacology Educational Intervention: Perceptions of Preclerkship Medical Students.

    Science.gov (United States)

    James, Henry; Tayem, Yasin I Y; Al Khaja, K A J; Veeramuthu, Sindhan; Sequeira, Reginald P

    2016-08-01

    Medical students do not perform well in writing prescriptions, and the 3 variables-learner, teacher, and instructional method-are held responsible to various degrees. The objective of this clinical pharmacology educational intervention was to improve medical students' perceptions, motivation, and participation in prescription-writing sessions. The study participants were second-year medical students of the College of Medicine and Medical Sciences of the Arabian Gulf University, Bahrain. Two prescription-writing sessions were conducted using clinical case scenarios based on problems the students had studied as part of the problem-based learning curriculum. At the end of the respiratory system subunit, the training was conducted in small groups, each facilitated by a tutor. At the end of the cardiovascular system subunit, the training was conducted in a traditional large-group classroom setting. Data were collected with the help of a questionnaire at the end of each session and a focus group discussion. A majority of the students (95.3% ± 2.4%) perceived the small-group method better for teaching and learning of all aspects of prescription writing: analyzing the clinical case scenario, applying clinical pharmacology knowledge for therapeutic reasoning, using a formulary for searching relevant prescribing information, and in writing a complete prescription. Students also endorsed the small-group method for better interaction among themselves and with the tutor and for the ease of asking questions and clarifying doubts. In view of the principles of adult learning, where motivation and interaction are important, teaching and learning prescription writing in small groups deserve a serious consideration in medical curricula. PMID:26677798

  11. Antibiotics dispensing for URTIs by community pharmacists and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients

    OpenAIRE

    Alabid, Alamin Hassan M.A.; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi

    2014-01-01

    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...

  12. Approach of pharmacists and herbalists while offering guidance on potentially malignant oral lesions: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Abhishek Gouraha

    2014-01-01

    Conclusion: Apart from pharmacists, the new probable off-clinical counselors (herbalists and pharmacy assistants have been identified as potential factors of patient diagnostic delay in oral cancer. Educational strategies to improve advice and referral for these identified groups should be designed.

  13. Interdisciplinary collaboration in the provision of a pharmacist-led discharge medication reconciliation service at an Irish teaching hospital.

    LENUS (Irish Health Repository)

    Holland, Deirdre M

    2015-04-01

    Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.

  14. Outcome analysis of a pharmacist-managed anticoagulation service.

    Science.gov (United States)

    Wilt, V M; Gums, J G; Ahmed, O I; Moore, L M

    1995-01-01

    The primary objective of this study was to determine if a pharmacist-managed anticoagulation monitoring service (AMS) improved the outcomes of patients receiving warfarin in a family practice setting and was cost effective in treating and preventing thromboembolic disorders. A retrospective chart review was performed on all patients at the University of Florida's Family Practice Residency Program who received warfarin pharmacotherapy between October 1, 1988, and December 15, 1993. The outcomes of patients followed by AMS were compared with those of a control group consisting of patients receiving warfarin but followed only by their physician. Outcomes were evaluated based on the number of thromboembolic and hemorrhagic events, as well as unplanned clinic visits, emergency room visits, and hospital admissions. Cost of hospital admissions, emergency room visits, and participation in the AMS were analyzed. During 28 person-years of treatment, control subjects sustained 12 thromboembolic events (2 pulmonary embolisms, 1 cerebrovascular accident, and 9 deep venous thromboses) and 2 minor and 5 major hemorrhagic events. The study group reported two minor hemorrhagic events during a total of 60 person-years. The control group was 20 times more likely than the study group to experience any event (rate ratio 20, 95% CI 5-87). In addition, hospitalization and emergency room charges indicated an actual cost of $119,074.95 for the control group's events. The cost to this group for 28 person-years of participation in the AMS would have been $5040.00. A potential cost avoidance of $4072.68 per person-year of follow-up may have been possible if these patients had been followed by the AMS. A pharmacist-managed AMS in a family practice setting can result in improved outcomes for patients receiving warfarin and is cost effective. PMID:8602380

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

    Directory of Open Access Journals (Sweden)

    Katoue MG

    2016-06-01

    communication and conducting TPN-research research. Conclusion: TPN pharmacists in Kuwait are confined to performing TPN manufacturing processes. There are promising avenues for future development of their role in patient care. This can be achieved by overcoming the barriers to pharmaceutical care practice and providing pharmacists with educational opportunities to equip them with the clinical competencies needed to practise as nutrition support pharmacists with patient-centred roles.

  16. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available At the Research Clinic for Holistic Medicine in Copenhagen, 43 patients who presented with low or very low self-esteem were treated with psychodynamic short-term therapy complemented with bodywork. They received an average of 20 sessions at a cost of 1,600 EURO. The bodywork helped the patients to confront old emotional pain from childhood trauma repressed to the body-mind. Results showed that 60.5% recovered from low selfesteem (95% CI: 44.41–75.02%. Calculated from this, we have NNT = 1.33–2.25. Almost all aspects of life improved at the same time (p < 0.01: physical health, mental health, quality of life, and ability to function in a number of important areas (partner, friends, sexually, and socially. This indicated that we had successfully induced existential healing (Antonovsky salutogenesis. The strategy of improving self-esteem can be the key to a new life for patients presenting with low quality of life, poor health (physical and/omental, and poor ability to function. The patients were strongly motivated and willing to endure strong emotional pain provoked by the therapy. The rate of recovery is comparable to the most successful interventions with psychological and psychiatric treatment. Clinical holistic treatment has many advantages: efficiency, low cost, lack of negative side effects, lasting results, lack of use of psychopharmacological drugs (often with side effects, and an important preventive dimension.

  17. Lower 1,5-anhydroglucitol is associated with adverse clinical events after percutaneous coronary intervention.

    Science.gov (United States)

    Fujiwara, Takayuki; Yoshida, Masashi; Akashi, Naoyuki; Yamada, Hodaka; Tsukui, Takunori; Nakamura, Tomohiro; Sakakura, Kenichi; Wada, Hiroshi; Arao, Kenshiro; Katayama, Takuji; Umemoto, Tomio; Funayama, Hiroshi; Sugawara, Yoshitaka; Mitsuhashi, Takeshi; Kakei, Masafumi; Momomura, Shin-Ichi; Ako, Junya

    2016-06-01

    Diabetes mellitus and impaired glucose tolerance are well-known risk factors for coronary artery disease (CAD) and adverse clinical events after percutaneous coronary intervention (PCI). Postprandial hyperglycemia is an important risk factor for CAD and serum 1,5-anhydroglucitol (1,5-AG) reflects postprandial hyperglycemia more robustly than hemoglobin (Hb)A1c. We aimed to clarify the relationship between serum 1,5-AG level and adverse clinical events after PCI. We enrolled 141 patients after PCI with follow-up coronary angiography. We evaluated associations between glycemic biomarkers including HbA1c and 1,5-AG and cardiovascular events during follow-up. Median serum 1,5-AG level was significantly lower in patients with any coronary revascularization and target lesion revascularization (TLR) [13.4 µg/ml (first quartile, third quartile 9.80, 18.3) vs. 18.7 (12.8, 24.2), p = 0.005; 13.4 µg/ml (10.2, 16.4) vs. 18.7 (12.9, 24.2), p = 0.001, respectively]. Multivariate logistic analysis showed lower 1,5-AG was independently associated with any coronary revascularization and TLR (odds ratio 0.93, 95 % confidence interval 0.86-0.99, p = 0.04; 0.90, 0.81-0.99, p = 0.044, respectively), whereas higher HbA1c was not. Postprandial hyperglycemia and lower 1,5-AG are important risk factors for adverse clinical events after PCI. PMID:25921916

  18. Benefits of Pharmacist's Participation on Hospitalist Team.

    Science.gov (United States)

    Mahdikhani, Simin; Dabaghzadeh, Fatemeh

    2016-02-01

    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

  19. Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials

    OpenAIRE

    Gonçalves, J. P. B.; G. Lucchetti; Menezes, P. R.; Vallada, H.

    2015-01-01

    Background. Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs). Method. A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use o...

  20. Developing interprofessional communication skills for pharmacists to improve their ability to collaborate with other professions.

    Science.gov (United States)

    Luetsch, Karen; Rowett, Debra

    2016-07-01

    Successful communication between health professionals is a prerequisite for collaborative practice. Clinical pharmacists completed a learning and practice module introducing them to a framework for successful interprofessional communication (IPC) in the course of their postgraduate studies. A face-to-face discussion of a contemporary clinical topic with a health professional was then scheduled, mainly with junior doctors, in their practice setting. An exploratory case study methodology was employed to investigate pharmacists' written reflections on their experience applying their newly acquired IPC skills. Thematic analysis of reflections developed five categories relating to interprofessional collaboration, learning, and education. Themes describing pharmacists' preconceptions about the health professional and scheduled interprofessional encounter, how it allowed them to learn about doctors' and other health professionals' practice and build collaborative relationships were identified. Reflections also elaborated that applying the communication framework and strengthening of collaboration created opportunities for IPE, with added observations about these increasing potential impact on patient care and change of practice. Analysis of anonymous feedback provided by the health professionals yielded similar themes and was integrated for triangulation. Applying successful IPC skills in healthcare settings may increase interprofessional collaboration and create practice models which facilitate interprofessional learning in health profession programmes. PMID:27191638

  1. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Lindsay J. L. Forbes

    2012-01-01

    Full Text Available Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2. Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  2. Cultural adaptation of an intervention to reduce sexual risk behaviors among patients attending a STI clinic in St. Petersburg, Russia.

    Science.gov (United States)

    Grau, Lauretta E; Krasnoselskikh, Tatiana V; Shaboltas, Alla V; Skochilov, Roman V; Kozlov, Andrei P; Abdala, Nadia

    2013-08-01

    Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed. PMID:23322231

  3. PRIME – PRocess modelling in ImpleMEntation research: selecting a theoretical basis for interventions to change clinical practice

    Directory of Open Access Journals (Sweden)

    Pitts Nigel

    2003-12-01

    Full Text Available Abstract Background Biomedical research constantly produces new findings but these are not routinely translated into health care practice. One way to address this problem is to develop effective interventions to translate research findings into practice. Currently a range of empirical interventions are available and systematic reviews of these have demonstrated that there is no single best intervention. This evidence base is difficult to use in routine settings because it cannot identify which intervention is most likely to be effective (or cost effective in a particular situation. We need to establish a scientific rationale for interventions. As clinical practice is a form of human behaviour, theories of human behaviour that have proved useful in other similar settings may provide a basis for developing a scientific rationale for the choice of interventions to translate research findings into clinical practice. The objectives of the study are: to amplify and populate scientifically validated theories of behaviour with evidence from the experience of health professionals; to use this as a basis for developing predictive questionnaires using replicable methods; to identify which elements of the questionnaire (i.e., which theoretical constructs predict clinical practice and distinguish between evidence compliant and non-compliant practice; and on the basis of these results, to identify variables (based on theoretical constructs that might be prime targets for behaviour change interventions. Methods We will develop postal questionnaires measuring two motivational, three action and one stage theory to explore five behaviours with 800 general medical and 600 general dental practitioners. We will collect data on performance for each of the behaviours. The relationships between predictor variables (theoretical constructs and outcome measures (data on performance in each survey will be assessed using multiple regression analysis and structural equation

  4. "Do I Know What I Need to Do?" A Social Communication Intervention for Children with Complex Clinical Profiles

    Science.gov (United States)

    Timler, Geralyn R.; Olswang, Lesley B.; Coggins, Truman E.

    2005-01-01

    Purpose: Speech-language pathologists frequently address social communication difficulties in children with diverse clinical profiles. The purpose of this study was to investigate the feasibility of a social communication intervention for a school-age child with a complex cognitive and behavioral profile secondary to diagnosis of a fetal alcohol…

  5. Care and feeding of the endocannabinoid system: a systematic review of potential clinical interventions that upregulate the endocannabinoid system.

    Directory of Open Access Journals (Sweden)

    John M McPartland

    Full Text Available BACKGROUND: The "classic" endocannabinoid (eCB system includes the cannabinoid receptors CB1 and CB2, the eCB ligands anandamide (AEA and 2-arachidonoylglycerol (2-AG, and their metabolic enzymes. An emerging literature documents the "eCB deficiency syndrome" as an etiology in migraine, fibromyalgia, irritable bowel syndrome, psychological disorders, and other conditions. We performed a systematic review of clinical interventions that enhance the eCB system--ways to upregulate cannabinoid receptors, increase ligand synthesis, or inhibit ligand degradation. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed for clinical trials, observational studies, and preclinical research. Data synthesis was qualitative. Exclusion criteria limited the results to 184 in vitro studies, 102 in vivo animal studies, and 36 human studies. Evidence indicates that several classes of pharmaceuticals upregulate the eCB system, including analgesics (acetaminophen, non-steroidal anti-inflammatory drugs, opioids, glucocorticoids, antidepressants, antipsychotics, anxiolytics, and anticonvulsants. Clinical interventions characterized as "complementary and alternative medicine" also upregulate the eCB system: massage and manipulation, acupuncture, dietary supplements, and herbal medicines. Lifestyle modification (diet, weight control, exercise, and the use of psychoactive substances--alcohol, tobacco, coffee, cannabis also modulate the eCB system. CONCLUSIONS/SIGNIFICANCE: Few clinical trials have assessed interventions that upregulate the eCB system. Many preclinical studies point to other potential approaches; human trials are needed to explore these promising interventions.

  6. Development of a Multilevel Intervention to Increase HIV Clinical Trial Participation among Rural Minorities

    Science.gov (United States)

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Shandor Miles, Margaret; Roman Isler, Malika

    2013-01-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using intervention mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people…

  7. The First Intervention Study in Elder Self-Neglect: A Randomized Clinical Trial to Improve Vitamin D Levels

    Science.gov (United States)

    Burnett, Jason; Hochschild, Ann; Smith, Scott M.; Diamond, Pam; Stotts, Angela; Dyer, Carmel

    2011-01-01

    Despite high mortality rates, elder self-neglect is characterized by refusal of medical and social interventions. To date there have been no tested clinical interventions in elders who self-neglect. Previous research from the TEAM Institute has shown significantly low vitamin D levels in this population. This study aimed to determine the feasibility of a clinical intervention. Replacement of vitamin D was chosen because of its ease of administration and favorable safety profile. Methods: A randomized clinical trial using directly observed therapy of vitamin D was conducted using 50 elders, >65 years of age, with Adult Protective Services (APS) validated self-neglect. A staggered intervention with waiting controls was used to maximize statistical power. One-third (n=17) of the group was administered 50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder (n=33) were administered 400 IU monthly. Serum 25-OH vitamin D was assessed at baseline and 5-months. Results: 69% agreed to participate in the study and of those n=40 (80%) remained at 5-months. At baseline, 12% (n=7) were deficient in vitamin D (<30nmol/L) and approximately 38% (n=22) had inadequate vitamin D levels (<50nmol/L). The baseline 25-OH vitamin D level was 59 nmol/L +25 (mean SD), and increased significantly to 72nmol/L +21 nmol/L at 5-months. Conclusion: These data are the first to provide evidence that clinical interventions are feasible in elders who self-neglect. The increase in vitamin D levels confirmed that the study personnel were able to successfully intervene community-dwelling elders with self-neglect. This study sets the precedent for future intervention and prevention studies

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

    Directory of Open Access Journals (Sweden)

    Waddell Gordon

    2007-01-01

    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

  9. Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects

    Directory of Open Access Journals (Sweden)

    Ruggiero Laurie

    2006-07-01

    Full Text Available Abstract Background Despite a growing literature on the efficacy of behavioral weight loss interventions, we still know relatively little about the long terms effects they have on HRQL. Therefore, we conducted a study to investigate the immediate post-intervention (6 months and long-term (12 and 24 months effects of clinically based weight management programs on HRQL. Methods We conducted a randomized clinical trial in which all participants completed a 6 month clinical weight loss program and were randomized into two 6-month extended care groups. Participants then returned at 12 and 24 months for follow-up assessments. A total of 144 individuals (78% women, M age = 50.2 (9.2 yrs, M BMI = 32.5 (3.8 kg/m2 completed the 6 month intervention and 104 returned at 24 months. Primary outcomes of weight and HRQL using the SF-36 were analyzed using multivariate repeated measures analyses. Results There was complete data on 91 participants through the 24 months of the study. At baseline the participants scored lower than U.S. age-specific population norms for bodily pain, vitality, and mental health. At the completion of the 6 month clinical intervention there were increases in the physical and mental composite measures as well as physical functioning, general health, vitality, and mental health subscales of the SF-36. Despite some weight regain, the improvements in the mental composite scale as well as the physical functioning, vitality, and mental health subscales were maintained at 24 months. There were no significant main effects or interactions by extended care treatment group or weight loss group (whether or not they maintained 5% loss at 24 months. Conclusion A clinical weight management program focused on behavior change was successful in improving several factors of HRQL at the completion of the program and many of those improvements were maintained at 24 months. Maintaining a significant weight loss (> 5% was not necessary to have and maintain

  10. 10 CFR 35.55 - Training for an authorized nuclear pharmacist.

    Science.gov (United States)

    2010-01-01

    ... 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...

  11. Pharmacist, general practitioner, and nurse perceptions, experiences, and knowledge of medication dosage form modification

    Directory of Open Access Journals (Sweden)

    Nguyen TMU

    2013-12-01

    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

  12. Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders: A Scoping Review.

    Science.gov (United States)

    Gross, Douglas P; Armijo-Olivo, Susan; Shaw, William S; Williams-Whitt, Kelly; Shaw, Nicola T; Hartvigsen, Jan; Qin, Ziling; Ha, Christine; Woodhouse, Linda J; Steenstra, Ivan A

    2016-09-01

    Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research crosses multiple disciplines, we searched health care, computing science and business databases. Results Our search resulted in 4605 manuscripts. Titles and abstracts were screened for relevance. The reliability of the screeni