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Sample records for clinical pharmacist intervention

  1. Clinical pharmacist interventions to support adherence to thrombopreventive therapy

    DEFF Research Database (Denmark)

    Hedegaard, Ulla

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

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

    Directory of Open Access Journals (Sweden)

    LeMay KS

    2015-03-01

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

  3. 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

  4. Improvement of knowledge, attitude and perception of healthcare workers about ADR, a pre- and post-clinical pharmacists' interventional study

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chen M

    2016-11-01

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

  6. Quasi experimental designs in pharmacist intervention research.

    Science.gov (United States)

    Krass, Ines

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Tan Edwin

    2012-08-01

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

  8. Effect of critical care pharmacist's intervention on medication errors: A systematic review and meta-analysis of observational studies.

    Science.gov (United States)

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

    2015-10-01

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

  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

    2014-10-01

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

    OpenAIRE

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

    2014-01-01

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

  11. [Consideration of the Work Content of the Clinic Pharmacist and Its Usefulness].

    Science.gov (United States)

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

    2016-12-01

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

  12. The role of a clinical pharmacist in a multidisciplinary amyotrophic lateral sclerosis clinic.

    Science.gov (United States)

    Jefferies, Kristen A; Bromberg, Mark B

    2012-02-01

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

  13. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists

    Science.gov (United States)

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

    2016-01-01

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

  14. Clinical skill development for community pharmacists.

    Science.gov (United States)

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

    1996-09-01

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

  15. 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

  16. Contribution of a liaison clinical pharmacist to an inpatient palliative care unit.

    Science.gov (United States)

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

    1997-05-01

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

  17. Pharmacists

    Science.gov (United States)

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

  18. 临床药师对抗生素相关性腹泻治疗的药学干预要点%The point of pharmaceutical intervention for antibiotic - associated diarrhea treatment by clinical pharmacists

    Institute of Scientific and Technical Information of China (English)

    宋征; 郑翠翠; 苟春霞; 高新富

    2015-01-01

    Objective To investigate the point of pharmaceutical intervention for clinical pharmacists providing phar-maceutical care for patient with antibiotic - associated diarrhea. Methods Clinical pharmacists provided pharmaceutical intervention for two kinds of patients with antibiotic - associated diarrhea in drug treatment,and analyzed the improper meth-ods during in treatment of antibiotic associated diarrhea. Results There are some unreasonable points in the process of drug treatment of antibiotic - associated diarrhea. Conclusion In the process of drug treatment for the patients with antibiotic -associated diarrhea,clinical pharmacists should focus on the key content,such as the diagnosis of different types of antibiotic associated diarrhea,the choice of main drugs,drug dose and indications of other auxiliary medication.%目的:探讨抗生素相关性腹泻药物治疗的干预要点。方法临床药师分别对两例不同类型抗生素相关性腹泻患者进行药学干预,分析临床在抗生素相关性腹泻药物治疗过程中不当之处。结果在抗生素相关性腹泻药物治疗过程中存在一些不合理之处。结论在抗生素相关性腹泻患者药物治疗过程中,临床药师应关注不同类型抗生素相关性腹泻的诊断,主要治疗药物的选择、药物应用剂量以及其他辅助用药的适应症等重点内容。

  19. Outcomes assessment of a pharmacist-directed seamless care program in an ambulatory oncology clinic.

    Science.gov (United States)

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

    2014-02-01

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

  20. Analysis of ADR Reports in Our Hospital before and after Clinical Pharmacist Intervention%临床药师干预前后我院药品不良反应报告情况分析

    Institute of Scientific and Technical Information of China (English)

    王红程; 王芬; 刘华强; 孙福生

    2012-01-01

    目的:分析临床药师干预前、后我院药品不良反应(ADR)报告情况,探讨临床药师干预对ADR监测工作的影响.方法:将我院2008年(临床药师干预前)和2009年(临床药师干预后)上报的ADR报告,按报告人、给药途径、患者的年龄与性别、引起ADR的药品品种等进行分析、评价、比较.结果:2008年共上报ADR报告697份,其中新的严重的ADR 98例,药师上报395例,临床医师上报92例,引起ADR最常见的药物为抗感染药,共375例,其中喹诺酮类药物113例;2009年共上报ADR报告599例,其中新的严重的ADR 155例,药师上报327例,临床医师上报102例,引起ADR最常见的药物为抗感染药,共314例,其中喹诺酮类药物59例.结论:ADR监测工作可以促进临床安全、合理用药;临床药师在ADR监测工作中发挥着重要作用.%OBJECTIVE: To analyze ADR reports in our hospital before and after clinical pharmacist intervention, and to explore the impact of clinical pharmacist intervention on ADR monitoring. METHODS: ADR reports of our hospital in 2008 (before intervention) and 2009 (after intervention) were analyzed and evaluated comparatively in respects of reporter, route of administration, patient's age, sex and ADR-inducing drugs. RESULTS: A total of 697 ADR cases were submitted in 2008, including 98 new/ serious ADR reports, 395 cases reported by pharmacists, 92 cases reported by clinician; the most common ADR-inducing drug was anti-infective drag, a total of 375 cases, of which 113 cases by quinolones. A total of 599 ADR cases were reported in 2009, including 155 new/serious ADR reports, 327 cases reported by pharmacists, 102 cases reported by clinician; the most common ADR-inducing drug was anti-infective drag, a total of 314 cases, of which 59 cases by quinolones. CONCLUSION: ADR monitoring can promote the rational safe use of drugs in the clinic; clinical pharmacists play an important role in ADR monitoring.

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

    Science.gov (United States)

    Murante, Lori J.; Moffett, Lisa M.

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinazari

    2013-07-01

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

  3. 临床药师在干预万古霉素血药浓度监测的作用研究%Role of Clinical Pharmacist Intervention in Therapeutic Drug Monitoring of Vancomycin

    Institute of Scientific and Technical Information of China (English)

    白向荣; 褚燕琦

    2015-01-01

    目的:研究临床药师在万古霉素血药浓度监测干预中的作用,为临床合理用药提供参考。方法对我院2011~2013年进行万古霉素血药浓度监测的患者进行分组:不达标组(浓度20μg·mL-1)。同时对临床药师的建议进行统计分析。结果不达标组:剂量增加比例为3%(3/35);达标组:剂量无调整比例91%(48/53);超过有效范围组:剂量减少比例为12.5%(3/24)。结论临床药师在对万古霉素血药浓度达标组的建议,临床医生采纳较高,对于未达标组和超过有效范围组,临床医生的采纳较低。临床药师加强与临床医生的合作,保证临床的安全、有效用药。%Objective To study the role of clinical pharmacists in serum vancomycin concentration monitoring, so as to provide references for rational use of drug service in clinical settings practice. Methods We collected the patients data with vancomycin concentration monitoring from 2011~2013. Based on the characteristics of these patients, we divided the samples into three groups:no-target group (concentration20 μg·mL-1). Results The proportion of dose increase in the no-target group was 3%(3/35).The ratio of no dose adjustment in target group was 91%(48/53), but the ratio of dose reduction in over-target group accounts for 12.5% (3/24). Conclusion There was no statistics difference in three group. The clinicians seem to adopt pharmacist intervention in target group. Clinical pharmacists should cooperate with clinicians to ensure effective medication usage.

  4. Treatment Considerations and the Role of the Clinical Pharmacist Throughout Transitions of Care for Patients With Acute Heart Failure.

    Science.gov (United States)

    McNeely, Elizabeth B

    2016-04-28

    Heart failure is associated with increased risk of morbidity and mortality, resulting in substantial health-care costs. Clinical pharmacists have an opportunity to reduce health-care costs and improve disease management as patients transition from inpatient to outpatient care by leading interventions to develop patient care plans, educate patients and clinicians, prevent adverse drug reactions, reconcile medications, monitor drug levels, and improve medication access and adherence. Through these methods, clinical pharmacists are able to reduce rates of hospitalization, readmission, and mortality. In addition, care by clinical pharmacists can improve dosing levels and adherence to guideline-directed therapies. A greater benefit in patient management occurs when clinical pharmacists collaborate with other members of the health-care team, emphasizing the importance of heart failure treatment by a multidisciplinary health-care team. Education is a key area in which clinical pharmacists can improve care of patients with heart failure and should not be limited to patients. Clinical pharmacists should provide education to all members of the health-care team and introduce them to new therapies that may further improve the management of heart failure. The objective of this review is to detail the numerous opportunities that clinical pharmacists have to improve the management of heart failure and reduce health-care costs as part of a multidisciplinary health-care team.

  5. 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

  6. 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)

  7. 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.

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

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    David O Riordan

    2016-06-01

    Full Text Available Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid, Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect, ClinicalTrials.gov, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America. Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of

  9. 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

  10. Optimizing hepatitis C virus treatment through pharmacist interventions: Identification and management of drug-drug interactions

    Science.gov (United States)

    Langness, Jacob A; Nguyen, Matthew; Wieland, Amanda; Everson, Gregory T; Kiser, Jennifer J

    2017-01-01

    AIM To quantify drug-drug-interactions (DDIs) encountered in patients prescribed hepatitis C virus (HCV) treatment, the interventions made, and the time spent in this process. METHODS As standard of care, a clinical pharmacist screened for DDIs in patients prescribed direct acting antiviral (DAA) HCV treatment between November 2013 and July 2015 at the University of Colorado Hepatology Clinic. HCV regimens prescribed included ledipasvir/sofosbuvir (LDV/SOF), paritaprevir/ritonavir/ombitasvir/dasabuvir (OBV/PTV/r + DSV), simeprevir/sofosbuvir (SIM/SOF), and sofosbuvir/ribavirin (SOF/RBV). This retrospective analysis reviewed the work completed by the clinical pharmacist in order to measure the aims identified for the study. The number and type of DDIs identified were summarized with descriptive statistics. RESULTS Six hundred and sixty four patients (83.4% Caucasian, 57% male, average 56.7 years old) were identified; 369 for LDV/SOF, 48 for OBV/PTV/r + DSV, 114 for SIM/SOF, and 133 for SOF/RBV. Fifty-one point five per cent of patients were cirrhotic. Overall, 5217 medications were reviewed (7.86 medications per patient) and 781 interactions identified (1.18 interactions per patient). The number of interactions were fewest for SOF/RBV (0.17 interactions per patient) and highest for OBV/PTV/r + DSV (2.48 interactions per patient). LDV/SOF and SIM/SOF had similar number of interactions (1.28 and 1.48 interactions per patient, respectively). Gastric acid modifiers and vitamin/herbal supplements commonly caused interactions with LDV/SOF. Hypertensive agents, analgesics, and psychiatric medications frequently caused interactions with OBV/PTV/r + DSV and SIM/SOF. To manage these interactions, the pharmacists most often recommended discontinuing the medication (28.9%), increasing monitoring for toxicities (24.1%), or separating administration times (18.2%). The pharmacist chart review for each patient usually took approximately 30 min, with additional time for more complex

  11. 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

    prescription practice. Prescriptions not following good practice in these intervention areas were defined as "sub-optimal prescriptions," and then discussed between a physician and a clinical pharmacist. The primary parameter was the difference in the number of days with a sub-optimal prescription (Mann...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  12. 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

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    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

  13. The effect of a clinical pharmacist-led training programme on intravenous medication errors : a controlled before and after study

    NARCIS (Netherlands)

    Nguyen, Huong; Pham, Hong-Tham; Vo, Dang-Khoa; Nguyen, Tuan-Dung; van den Heuvel, Edwin R.; Haaijer-Ruskamp, Flora M.; Taxis, Katja

    2014-01-01

    Background Little is known about interventions to reduce intravenous medication administration errors in hospitals, especially in low-and middle-income countries. Objective To assess the effect of a clinical pharmacist-led training programme on clinically relevant errors during intravenous medicatio

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

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    Ann M. Fugit, Pharm.D., BCPS

    2013-01-01

    Full Text Available Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: Types of interventions documented during the patient-pharmacist visit, categorized as medication review, patient education, or adherence monitoring. Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%, patient education (23.3%, and adherence monitoring (9.8%. Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS (P = 0.01, have current or history of opportunistic infection (OI (P=0.01, and have current or history of OI prophylaxis (P = 0.03. Adherence monitoring was less common amongst the non-Hispanics (7.1% compared to the Hispanic sub-population (16.5%, (P = 0.04. Conclusion: The role of ambulatory care pharmacists in a free and bilingual clinic goes beyond adherence monitoring. Pharmacists can be a valuable part of the patient care team by providing medication review and patient education for HIV and other co-morbidities within free clinics. Further research is warranted to assess outcomes and to further explore the underlying barriers to early HIV diagnosis and adherence within the Hispanic population.

  15. Implementation of a School-wide Clinical Intervention Documentation System

    OpenAIRE

    Stevenson, T. Lynn; Fox, Brent I.; Andrus, Miranda; Carroll, Dana

    2011-01-01

    Objective. To evaluate the effectiveness and impact of a customized Web-based software program implemented in 2006 for school-wide documentation of clinical interventions by pharmacy practice faculty members, pharmacy residents, and student pharmacists.

  16. Impact of pharmacist interventions in older patients: a prospective study in a tertiary hospital in Germany

    Directory of Open Access Journals (Sweden)

    Cortejoso L

    2016-09-01

    significance, and 7.2% were clinically serious.Conclusion: Our findings show the importance of clinical pharmacist involvement in the optimization of pharmacotherapy in older adults, ensuring that they receive effective, safe, and efficient drug therapy. Keywords: older adults, medication errors, pharmacist interventions

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  18. NEED OF CLINICAL PHARMACIST FOR RATIONALIZATION OF PRESCRIPTION

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    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.

  19. Spanish-speaking patients' satisfaction with clinical pharmacists' communication skills and demonstration of cultural sensitivity.

    Science.gov (United States)

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

    2014-01-01

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

  20. 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.

  1. Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists

    Science.gov (United States)

    Fois, Romano A.; McLachlan, Andrew J.; Chen, Timothy F.

    2017-01-01

    Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns’ patient safety attitudes. However, other factors likely influenced their attitudes in the longer term. PMID:28289295

  2. The role of the clinical pharmacist in the care of patients with cardiovascular disease.

    Science.gov (United States)

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

    2015-11-10

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

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

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    Abdulkareem M Albekairy

    2015-07-01

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

  4. A feasibility study of a combined nurse/pharmacist-led chronic pain clinic in primary care.

    Science.gov (United States)

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

    2008-01-01

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

  5. Impact of pharmacist and clinician dual intervention on prescribed benzodiazepines in prisoner patients: a retrospective study.

    Science.gov (United States)

    Lerat, Marie-Cecile; Cabelguenne, Delphine; Lassia, Jerome; Meunier, Frederic; Zimmer, Luc

    2011-12-01

    High-dose benzodiazepine (BDZs) represents an important risk factor for dependence, particularly in a prison environment. In Lyon's prison, BDZs and/or opioid maintenance treatment are often prescribed to patients with mental disorders. The aim of this retrospective study was to assess the impact of psychiatrist and pharmacist collaboration on reducing the BDZs dose prescribed to prisoner patients. Since 2001, clinicians and pharmacists have been holding monthly meetings to develop prescribing guidelines and discuss those patients receiving high-dose BDZs. All prescribed psychotropic drugs were noted for each included patient in the control (before guidelines) and intervention groups. Criteria used to define each patient profile included age, diagnosis (mental disorder), and concomitant treatment (opioids, antidepressants). To compare each group, the daily dose of prescribed BDZs was used as a quantitative variable and expressed in diazepam equivalent. Four hundred and seventy-three patients were included, 222 in the control group and 251 in the intervention group. The two groups showed no difference in terms of diagnosis. The daily dose of BDZ was higher in the control group when all patients were considered (mean(CONTROL GROUP) = 46 mg in diazepam equivalent vs. mean(INTERVENTIION GROUP) = 34 mg) and for each of the following patient categories: 'mental disorder' (48 mg vs. 30 mg), 'no opioid treatment' (44 mg vs. 31 mg), 'buprenorphin treatment' (58 mg vs. 63 mg), 'no antidepressant treatment' (41 mg vs. 29 mg), and 'antidepressant treatment' (53 mg vs. 38 mg). The results of this retrospective study show the positive impact of multidisciplinary intervention on reducing the prescribed daily dose of BDZs. This experience confirms the positive impact that pharmacist feedback on prescriptions and the development of treatment guidelines by clinician and pharmacist collaboration have on improving the prescribing practice in a prison environment.

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. Clinical Pharmacist Intervention Effect of Prophylactic Use of Antibiotics for Type I Incision Operation in Department of General Surgery%临床药师干预对普外科I类切口手术预防性使用抗生素的影响

    Institute of Scientific and Technical Information of China (English)

    张毅丰

    2015-01-01

    Objective To evaluate and analysis the effect of the intervention of clinical pharmacists on prophylactic uses of antibacterial drugs in I type incision operation. Methods 142 cases patients with I type Incision operation in department of general surgery from January 2011 to January 2013 were regarded as control group(before the intervention). 165 cases patients with I type incision operation from February 2013 to February 2015 were regarded as observation group(after the intervention). To situation of using antibacterial drugs were compared between two groups. Results The usage rates of antibacterial drugs of observation group was lower than that of control group,there was significant difference between two groups(P<0.01). The time for the first time to use the drugs of observation group was more reasonable than that of control group,the difference was significant(P<0.05). The choice of antibacterial drugs in observation group was more reasonable than that of control group,the difference was significant(P<0.05). Conclusion The intervention of clinical pharmacists on prophylactic uses of antibacterial drugs in type incision operation can make a reasonable choice of the time to use and varieties of antibacterial drugs. The intervention of clinical pharmacists can reduce the usage rate of antibacterial drug and help the clinician to know how to reasonable preventive use of antibiotics. The method is conductive to use the antibiotics more standardized.%目的:评价分析临床药师干预对普外科I类切口手术预防性使用抗生素的影响。方法将我院普外科2011年1月~2013年1月I类切口手术患者142例作为对照组(干预前),将2013年2月~2015年2月I类切口手术患者165例作为观察组(干预后),对两组患者抗生素的应用合理情况进行比较。结果观察组抗生素的使用率低于对照组抗生素的使用率,两组比较具有显著统计学差异(P<0.01);观察组首次用药时间合理

  12. Physician-Pharmacist Collaborative Care for Dyslipidemia Patients: Knowledge and Skills of Community Pharmacists

    Science.gov (United States)

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

    2009-01-01

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

  13. Compliance with treatment: related-issues and insights for pharmacist intervention

    Directory of Open Access Journals (Sweden)

    Nilcéia Lopes da Silva

    2011-03-01

    Full Text Available Low patient compliance with pharmacotherapy remains one of the greatest challenges for success of treatments, especially in chronic diseases, since it can negatively influence treatment effectiveness and patient quality of life, increase health expenses and decrease productivity of the patient. Compliance is an important but complex issue in clinical practice. Its complexity begins with the difficulty in adopting terminology that can express its exact meaning. Moreover, many methods to evaluate compliance have been established but no consensus exists on which method should be considered the gold standard. Additionally, socioeconomic, disease and therapy-related factors, healthcare team and system related-factors and patient-related factors can simultaneously influence compliance levels. In this highly complex scenario, pharmacist interventions have been identified as an effective strategy to enhance patient compliance with treatment. The objectives of this paper were: (1 to provide useful information for pharmacists about issues related to compliance such as terminology and definitions; methods for measuring compliance and persistence; influencing factors and the impact of low compliance; and (2 to offer insight into how these healthcare professionals can effectively contribute toward improved compliance levels.A baixa adesão dos pacientes ao tratamento medicamentoso de doenças crônicas continua sendo um dos maiores desafios da medicina, por comprometer a efetividade do tratamento, repercutindo na qualidade de vida, aumentando os gastos com saúde e diminuindo a produtividade do indivíduo doente. O tema adesão é tão relevante para a prática clínica quanto complexo, a começar pelas tentativas de adoção de uma terminologia que expresse com exatidão o seu significado. Além disso, vários métodos para sua determinação foram estabelecidos sem, contudo, se chegar a um consenso sobre qual seria o "ótimo". Adicionalmente, as condi

  14. 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

  15. 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

  16. 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

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

  17. Pharmaceutical Intervention for 1 Case of Severely Infected Patient by Clinical Pharmacist and The PDCA of Pharmaceutical Care%由1例经临床药师会诊的重症感染病例谈临床药学服务的持续改进

    Institute of Scientific and Technical Information of China (English)

    白红; 李亚骞; 陈龙; 官真水

    2012-01-01

      Objective To discuss the role the clinical pharmacist plays in the anti-microbial treatment designing and modifying process. Methods Analyse one particular severe septicaemia's treatment course consulted and assisted by a clinical pharmacist. Results The clinical pharmacist through monitoring the whole process of patient's treatment, could discern the ADR and alter the dosing regimen timely, therefore helping the clinician greatly. The patient was cured and eventually healed. Conclusion This successful case, is a good demonstration of the PDCA--"Plan, Do, Check, Action". And the execution of The PDCA standard will lead to a higher requirement for the clinical pharmacist, and a new level of the clinical pharmacist expertise.%  目的讨论临床药师在参与制定和调整特殊管理抗菌药物的治疗方案中发挥的作用。方法回顾性分析1例由临床药师会诊并持续监护的重症感染患者的药物治疗过程。结果临床药师通过全程监护患者的治疗过程,能及时协助医师调整方案,发现药物不良反应,为临床医师提供极大的帮助,患者最终病情好转。结论在监护患者的过程中发现问题并解决,同时提高自己,体现了临床药师工作的持续改进。

  18. 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.

  19. An Investigation of Job Stress and Job Burnout in Iranian Clinical Pharmacist

    Directory of Open Access Journals (Sweden)

    Armaghan Eslami

    2016-05-01

    Full Text Available Background: Stress is an important element of organization ineffectiveness and since it leads to sickness, eventually it reduces quality and quantity of health care, lead to expansion of it costs and low job satisfaction. Stress comes along with consequences, one of this reactions which comes along with horrible effects is job burnout. Health care are more exposed for job burnout. We examined the relationship between job stress and job burnout in Iranian clinical pharmacist.Methods: Sample was 50 of men and women of clinical pharmacist. Parker and De cotiis  scale (1983 and Maslach Burnout Inventory (MBI, 1981 were used to asses clinical pharmacist stress and burnout. Data were analyzed by applying regression method.Results: Results indicated that there is strong relationship between stress and burnout and its three dimensions. The result also indicated that stress have the highest impact on emotional exhaustion and the least on the depersonalization.Conclusion: Burnout is a result of stress in human services career. Human service needs are vary from other professions since in these jobs in order to fulfill the clients’ needs, employees should use themselves as the required technology, and in return they do not receive gratitude or appreciation.

  20. 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

  1. Selecting a clinical intervention documentation system for an academic setting.

    Science.gov (United States)

    Fox, Brent I; Andrus, Miranda; Hester, E Kelly; Byrd, Debbie C

    2011-03-10

    Pharmacists' clinical interventions have been the subject of a substantial body of literature that focuses on the process and outcomes of establishing an intervention documentation program within the acute care setting. Few reports describe intervention documentation as a component of doctor of pharmacy (PharmD) programs; none describe the process of selecting an intervention documentation application to support the complete array of pharmacy practice and experiential sites. The process that a school of pharmacy followed to select and implement a school-wide intervention system to document the clinical and financial impact of an experiential program is described. Goals included finding a tool that allowed documentation from all experiential sites and the ability to assign dollar savings (hard and soft) to all documented interventions. The paper provides guidance for other colleges and schools of pharmacy in selecting a clinical intervention documentation system for program-wide use.

  2. [Advanced curriculum for clinical assessment and skill in new age pharmacist education].

    Science.gov (United States)

    Kiuchi, Yuji; Masuda, Yutaka; Kamei, Daisuke; Kogo, Mari; Nakamura, Akihiro

    2013-01-01

    In Showa University School of pharmacy, 7 competencies for outcome-based education were set up in 2011. We are now creating sequential curriculum in order to achieve these competencies. As a member of team medical treatment, pharmacist must share a patient's information with other members, assess each patient's condition, propose the best medication with evidence, and also check the effect of medication. Therefore, many active practices in a hospital and community and problem-based learning (PBL) tutorials are carried out in curriculum in School of Pharmacy. As a training for the future pharmacists who positively perform primary care with responsibility in community pharmacy, students study the method of clinical assessment (assessment of condition of disease from the patient's complain, and choice of appropriate proposal). Furthermore, the exercise and training of parenteral medication, physical assessment, and first aid, etc. are also taken in the curriculums as new clinical skill. The systematic and gradual interprofessional education curriculum for the team medical education has been carried out aiming at training of active members in medical team in a hospital and community. At this symposium, I will introduce these systematic advanced curriculums for the pharmacist of a new age, and to show the usefulness and learning effect.

  3. A Computerized Clinical Information System for Physicians, Pharmacists and Nurses

    OpenAIRE

    Honigman, Benjamin; Rumack, Barry H.; Pons, Peter T.; Conner, Christopher S.; Prince, Jan; Rann, Leonard; Kemp, Marten

    1984-01-01

    MICROMEDEX Clinical Information System (MCIS) is a complete evaluated clinical data base available in a variety of computer formats: mainframe, personal computers with hard disc or laser disc, and local area networks. The data bases contain up-to-date information that is revised quarterly, concerning medical, surgical, toxicologic and traumatic entities as well as drug evaluations and therapeutics. It also includes a section of abstracts of the world's literature in acute care medicine. The o...

  4. Influence of medication-education-oriented pharmaceutical intervention by clinical pharmacist on cancer pain and chemotherapy of patients%临床药师以用药教育为核心的药学干预对癌痛和化疗的影响

    Institute of Scientific and Technical Information of China (English)

    刘丽华; 王卫星

    2016-01-01

    目的:探讨临床药师以用药教育为核心的药学干预在癌症患者癌痛和化疗中的作用。方法选择2013年5月至2015年5月我院肿瘤内科收治的癌痛患者70例,采用随机数字法分为观察组和对照组各35例。对照组患者仅给予常规化疗,观察组患者在此基础上,由临床药师以用药教育为核心进行药学干预。干预后1个月,比较两组患者的治疗效果、使用止痛药以及对癌痛和止痛知识的了解情况,并评价两组患者的疼痛强度,记录两组患者的生活质量疼痛影响评分。结果观察组患者化疗的总有效率为88.6%(31/35),明显高于对照组的68.6%(24/35),差异有统计学意义(P<0.05);观察组使用止痛药患者占42.9%(15/35),明显低于对照组的71.4%(25/35),差异有统计学意义(P<0.05);观察组患者对癌痛知识和止痛知识的了解评分分别为(8.2±1.5)分和(8.0±1.1)分,明显高于对照组的(5.3±2.4)分和(5.8±1.8)分,差异均具有统计学意义(P<0.05);与对照组第2次比较,观察组在最严重疼痛强度、当前疼痛强度、活动时疼痛强度方面评分均显著降低,差异均具有统计学意义(P<0.05)。此外,观察组疼痛影响生活质量的各项评分亦均显著低于对照组差异均具有统计学意义(P<0.05)。结论临床药师对癌痛患者实施以用药教育为核心的药学干预,在化疗效果、癌症疼痛强度以及生活质量方面均有积极的意义。%Objective To investigate the influence of medication-education-oriented pharmaceutical interven-tion by clinical pharmacist on cancer pain and chemotherapy of patients. Methods A total of 70 patients with cancer pain, who admitted to Department of Medical Oncology in our hospital from May 2013 to May 2015, were enrolled and randomly divided into the observation group (n=35) and the control group (n=35) according to random number ta-ble. The control group was given

  5. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

    Science.gov (United States)

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

    2015-10-25

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

  6. Exploration into the Clinic Pharmacists%开展药师门诊的探讨

    Institute of Scientific and Technical Information of China (English)

    李必君

    2014-01-01

    Many patients in the clinic, looking at the hands of drugs, half would not know how to use, consult pharmacists in dispensing window became a common phenomenon. Outpatient pharmacists are required to carry out the requirements for pharmacists, medical services are also extended. Patient Counseling most problems have drug usage, dosage, drug interactions, adverse drug reactions, drug validity preservation and so on. Outpatient pharmacy pharmacists have a solid knowledge and understanding of al hospital drug information, and master the basic situation of the patient, for the patient's problems and provide the best solution to help patients establish medication record card, to avoid forget ing and repeated administration even the occurrence of medication errors.%很多患者在就诊后,看着手里的药品,一时半会不知道怎么使用,在发药窗口咨询药师成了常见的现象。开展药师门诊是对药师的要求,也是医疗服务延伸的要求。患者咨询最多的问题有药物的用法、用量、药物的相互作用、药物的不良反应、药物的保存与有效期等。门诊药师要有扎实的药学专业知识,了解本院所有药品信息,并掌握患者的基本情况,针对患者的问题,提供最佳的解决方法,帮助患者建立用药记录卡,可避免遗忘及重复给药甚至错误用药的发生。

  7. 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...

  8. 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

  9. [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 level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students).

  10. 临床药师参与胎盘植入合并感染会诊的分析与体会%Analysis and Experience of Clinical Pharmacist Participating in the Consultation for Placenta Implantation Complicationg with Infection

    Institute of Scientific and Technical Information of China (English)

    许银燕; 黄新艳; 谢娟; 陈燕妮; 王俐

    2012-01-01

    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,找到在临床工作中的切入点,成为临床治疗团队中不可或缺的一员.方法:回顾临床药师在会诊中参与胎盘植入合并感染治疗典型病例1例,分析临床药师在药物治疗过程中干预的内容和结果.结果:临床药师在病情分析、合理选择药物、指导药物治疗方面发挥了重要作用.结论:临床药师利用专业特长,协助临床医师调整用药方案,使患者的药物治疗更为安全、有效、经济,提高了药物治疗水平.%OBJECTIVE: To summarize and analyze case of clinical pharmacist participating in clinical consultation, cultivate the thinking of clinical pharmacist gradually and discover the breakthrough point of clinical practice, so as to become one member of therapy team. METHODS: A case of clinical pharmacists participating in consultation for placenta implantation complicating with infection was reviewed, and the content and result of intervention by clinical pharmacists during drug treatment were analyzed. RESULTS: Clinical pharmacists had played an important role in analysis of condition, reasonable selection of drugs and drug therapy guidance. CONCLUSION: With the professional speciality, clinical pharmacists assist clinicians to adjust regimen and guarantee safe, effective and economical drug treatment so as to improve the level of drug therapy.

  11. A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors.

    Science.gov (United States)

    Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José

    2012-02-01

    Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare.

  12. 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......, categories and seriousness of medication problems discovered by clinical pharmacists in an ED and to evaluate if it is possible for pharmacists to identify those groups of patients who are most at risk of medication problems....

  13. The contribution of a clinical pharmacist to the improvement of medication at a geriatric hospital unit in Norway.

    Directory of Open Access Journals (Sweden)

    Veggeland T

    2008-03-01

    Full Text Available The aim of the study was to use a clinical pharmacist in order to improve the medication of patients in a geriatric hospital unit. The hospital had no experience of using a clinical pharmacist before.Methods: A clinical pharmacist participated in the therapeutic team for 27 days during a 4-year period. Drug-related problems were recorded prospectively and discussed before and at the ward round. The results of the physician’s decisions on the current day about potential changes in medication proposed by the pharmacist were continuously recorded.Results: The pharmacist evaluated the medication of 250 patients. At least one drug- related problem was found in 188 (75% of the patients. For these patients, the physician made 606 decisions concerning potential changes in the medication (3.2 per patient. Thirty percent (184/606 of the decisions were connected to further measurements and to the follow-up of laboratory results, mainly (82%, 151/184 for cardiovascular drugs. Forty-two percent (255/606 of the decisions resulted in the discontinuation of drugs, dosage reduction or a decision to revise the assessment at a later stage during hospitalisation. Medicines with anticholinergic adverse effects were to a great extent withdrawn. Twenty-one percent (129/606 of the decisions were made on drugs with an addiction potential: hypnotics, anxiolytics, as well as analgesics containing tramadol and codeine. The result was often (71%, 91/129 dosage reduction, a change from fixed medication to medication on demand or to discontinuation. Conclusion: Even with a modest participation of once a month, the evaluation of a patient’s medication by a clinical pharmacist led to improved changes and the follow-up of the medication of the elderly.

  14. 临床药师参与老年房颤患者难治性痛风药物治疗病例分析与干预%Case analysis and intervention of clinical pharmacists for an elderly atrial fibrillation patient with refractory gout

    Institute of Scientific and Technical Information of China (English)

    舒冰; 郑萍

    2013-01-01

    Objective To explore the role of the clinical pharmacists in the clinical treatment of elderly atrial fibrillation patients with gout. Methods We participated in drug treatment of an elderly atrial fibrillation patient with refractory gout and implemented pharma -ceutical care,and then analyzed and intervened the case . Results When acute gout attacks happened ,traditional high -dose colchicine therapy was not suitable for patients over 70 years old. A small dose therapy or the dose recommended by the FDA can be used . In addition to avoiding predisposing factors , clinical pharmacists should also use small doses of colchicine or NSAID maintenance therapy to pre -vent acute attack again in recurrent gout patients . Conclusions For recurrent gout patients , clinical pharmacists should learn more about the patient's diet,lifestyle and medication history ,pay attention to drug use precautions of special populations ,and work with doctors to develop individualized treatment plan and make targeted medication education for patients .%目的 探讨临床药师在老年房颤患者合并痛风的临床治疗中的作用.方法 参与1例老年房颤患者难治性痛风的药物治疗和实施药学监护,并对该病例进行分析和干预.结果 痛风急性发作时,秋水仙碱传统大剂量疗法不太适用于70岁以上患者,可采用小剂量疗法或FDA推荐的冲击疗法.对反复发作的痛风患者,除了要避免诱发因素,还应使用小剂量秋水仙碱或非甾体抗炎药维持治疗以预防再次急性发作.结论 对于痛风反复发作的患者,临床药师应详尽了解患者的饮食、生活及用药史,重视特殊人群的药物使用注意事项,和医生一起为患者制定个体化治疗方案,并有针对性的进行用药教育.

  15. Title: A Study of Role of Clinical Pharmacist in Medication Review and Patient Education

    Directory of Open Access Journals (Sweden)

    Shah Jainam V

    2016-03-01

    Full Text Available Purpose: Identifying, preventing, and resolving the Drug Related Problems (DRPs is an important issue in healthcare process. Factors leading to DRPs are social pressure to prescribers, inadequate patients’ knowledge regarding therapy, structure of health system and pharmaceutical marketing. Method: Fifty adult patients including both genders were recruited for this study. DRPs were assessed using PCNE classification Version 5.01 and patient knowledge was assessed before and after providing education. DRP occurrence was correlated with age, gender, number of drugs prescribed and co-morbid conditions. The patient’s knowledge regarding disease, therapy and life-style were assessed. For this, the medication related points were more focused such as name, strength, dose, schedule, possible ADRs, etc. Results: The maximum positive correlation was found between DRPs and number of drugs (0.42. Drug interaction is a major factor leading to DRPs in case of polypharmacy. Out of all the classes included in PCNE classification, drug choice was a major problem. The highest number of DRPs was found in the age group of 51 to 60 years i.e. 25 DRPs. Among both the genders, relatively more DRPs were found in females. After education, there was a considerable increase in patients’ knowledge by 156.73%. Conclusion: Thus it is concluded from study that if clinical pharmacist proclaims a role in the assessment of DRPs it seems better to focus on the identification, evaluation and prevention of patient- and prescriber- related problems. Clinical pharmacist can also increase patient’s knowledge and awareness by providing counselling leading to reduction in DRPs to a greater extent.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  18. Medication Safety in Clinical Trials: Role of the Pharmacist in Optimizing Practice, Collaboration, and Education to Reduce Errors

    Science.gov (United States)

    Brown, Jamie N.; Britnell, Sara R.; Stivers, Andrew P.; Cruz, Jennifer L.

    2017-01-01

    Standardized safety practices for investigational drugs in clinical research protocols are limited and the vast majority of research pharmacists have concerns regarding its safety. Identified areas for medication safety risks include protocol complexity, medication ordering, and the processes for packaging, storage, and dispensing investigational medications. Inclusion of a pharmacist creates multiple mechanisms to promote safety and improve the quality of clinical research. This is accomplished through collaborating in the development of a research protocol, reviewing as a member of an advisory committee, developing mechanisms that contribute to safety, and assuring compliance with local and national regulations and standards. Ultimately, the profession of pharmacy has foundational responsibility for assuring the safe and effective use of medications, including investigational drugs in clinical research. It is through multidisciplinary collaboration that a research study will attain the highest standards for safety and maximize the quality and effectiveness of the data obtained in the clinical trial. PMID:28356900

  19. Medication Safety in Clinical Trials: Role of the Pharmacist in Optimizing Practice, Collaboration, and Education to Reduce Errors.

    Science.gov (United States)

    Brown, Jamie N; Britnell, Sara R; Stivers, Andrew P; Cruz, Jennifer L

    2017-03-01

    Standardized safety practices for investigational drugs in clinical research protocols are limited and the vast majority of research pharmacists have concerns regarding its safety. Identified areas for medication safety risks include protocol complexity, medication ordering, and the processes for packaging, storage, and dispensing investigational medications. Inclusion of a pharmacist creates multiple mechanisms to promote safety and improve the quality of clinical research. This is accomplished through collaborating in the development of a research protocol, reviewing as a member of an advisory committee, developing mechanisms that contribute to safety, and assuring compliance with local and national regulations and standards. Ultimately, the profession of pharmacy has foundational responsibility for assuring the safe and effective use of medications, including investigational drugs in clinical research. It is through multidisciplinary collaboration that a research study will attain the highest standards for safety and maximize the quality and effectiveness of the data obtained in the clinical trial.

  20. 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...

  1. Review and development of referral criteria used to identify patients with diabetes who would benefit from attending a pharmacist-led cardiovascular out-patient clinic

    OpenAIRE

    Westerhus, Ingvild Risan

    2012-01-01

    Abstract Development and validation of new referral criteria: a triangulation study at the Pharmacist-led Diabetes Cardiovascular risk Reduction Clinic, Edinburgh. The Pharmacist-led Diabetes Cardiovascular risk Reduction (DCVR) clinic has been running at the Western General Hospital (WGH), Edinburgh, for 8 years. It was decided to review the referral process of patients and the referral criteria. Semi-structured interviews were performed with nine clinicians at the diabetes clini...

  2. Assessment of pharmacist-led patient counseling in randomized controlled trials: a systematic review.

    Science.gov (United States)

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

    2014-10-01

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

  3. Motivating pharmacists.

    Science.gov (United States)

    Donehew, G R

    1979-01-01

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

  4. 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.

  5. Problems grasped by clinical pharmacists in clinic%临床药师工作中应把握的几个问题

    Institute of Scientific and Technical Information of China (English)

    刘尚军; 陈宜鸿

    2011-01-01

    结合国内外临床药学开展的实际情况,探讨临床药师常规工作中应把握的重点问题,为临床药师的实践工作提供参考.在临床实践前期,临床药师应做好知识和技能准备工作,重点弥补临床专业知识的欠缺;在实践中应注重用药细节,实时为医护患提供用药咨询,针对特殊患者提供药学监护,重点把握药品不良反应、药物相互作用等问题.同时,在参与临床工作时,应注重沟通、准确定位,提高医疗风险防范意识,保障临床合理用药.%Combined with the practice of clinical pharmacy at home and abroad, we investigate the key issues that clinical pharmacists should take in clinical practice. Before the clinical practice, clinical pharmacists should prepare knowledge and skills especially for making up for clinical expertise; in the clinical practice, clinical pharmacists should focus on the details of medication, offer drug-counseling service for health care workers and patients, provide pharmaceutical care for specific patients, pay attention to adverse drug reactions, drug interactions, etc. Simultaneously, clinical pharmacists should enhance the skills of communication, accurate positioning and awareness of medical risk for the safe, effective, economical and reasonable use of clinical medication.

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

    Science.gov (United States)

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

    2016-01-01

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

  7. 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.

  8. 临床药师的职业风险与合理用药%Occupational Risks of Clinical Pharmacists and Rational Drug Use

    Institute of Scientific and Technical Information of China (English)

    李正翔

    2013-01-01

    目的:探讨我国临床药师面临的职业风险与合理用药的关系.方法:分析目前我国临床药师在执业过程中所面临的职业风险,探讨临床药师参与患者药物治疗、促进合理用药的专业工作的必然性和总结目前临床药师在合理用药方面所做的工作.结果:我国临床药师在法律法规上存在责、权、利的不确定性及工作内容的不明确性;临床药师在促进合理用药方面已经做了较多工作并取得了一定成效.结论:应建立健全的临床药师工作相关法律法规,促进临床药师在合理用药工作中发挥更大的作用.%OBJECTIVE: To explore the relationship of occupational risk of clinical pharmacists and rational drug use in China. METHODS: The occupational risk faced by clinical pharmacists in China during practice were analyzed, and the necessarity of clinical pharmacists participating in drug therapy and promoting rational drug use and the work they had done were also analyzed. RESULTS: The responsibility, power and interest of clinical pharmacists were indeterminate and the work of them was not clear; clinical pharmacists did a lot of work about the improvement of rational drug use and obtained some achievement. CONCLUSION: It is necessary to establish relevant laws and regulations about the job of clinical pharmacist and play the role of clinical pharmacists in rational drug use.

  9. 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.

  10. Clinical Pharmacists Participating in Clinical Medication of Respiration Department%临床药师参与呼吸内科临床用药的实践

    Institute of Scientific and Technical Information of China (English)

    曹国文; 张全英; 顾培德

    2011-01-01

    OBJECTIVE: To introduce the experience of clinical pharmacists participating in pharmaceutical care, and to discuss the role of clinical pharmacists in respiration department. METHODS: The value of clinical pharmacists in our hospital was represented from practice by means of participating in wards round together with clinicians and drug management of nurse station,resolving medication-related problems, writing drug history, etc. RESULTS: Clinical pharmacists participated in the formulation of drug regimen, disposal of clinical problems and changing previous medication ways of physicians based on experience to improve the pertinence of medication and successful rate of rescue and reduce the occurrence of ADR. CONCLUSION: Because of the participation of clinical pharmacists, more economical and effective drug regimen can be obtained. The professional quality and knowledge of clinical pharmacists remains to be further improved to ensure rational use of drugs in the clinic.%目的:介绍我院临床药师开展药学服务的经验与体会,探讨临床药师在呼吸内科的作用.方法:我院临床药师采用参与医师查房、解决有关用药问题、编写药历、参与护理站药品管理等方式,在实践中体现了自身价值.结果:我院临床药师参与临床制订用药方案,帮助临床解决了一些实际问题,改变了医师凭经验用药的方式,使患者用药针对性加强,提高了救治成功率,减少了药品不良反应的发生.结论:临床药师参与临床可以为患者提供更经济、有效的用药方案.同时临床药师必须全面提高自身综合素质,不断更新知识,使临床合理用药达到一个更高的层次.

  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. Study on work model of clinical pharmacists in chronic disease management%临床药师慢病管理工作模式的探讨

    Institute of Scientific and Technical Information of China (English)

    施楠楠; 甄健存; 谢颖; 胡文兰; 张艳雯

    2015-01-01

    目的:探讨临床药师慢病管理的工作模式。方法:以临床药师为主导的临床医生、护士共同参与的药物治疗团队对96例心内科患者进行慢病管理工作。慢病管理的工作包括住院期间的慢病管理及出院后的随访。入出院时分别对患者进行了用药知识评估,4组评价指标分别为适应证、用法用量、不良反应、注意事项。结果:对比入院时,患者出院时对用药知识的了解明显改善,4组指标P=0.000。疾病越多、年龄越大对药物的了解程度越差,应调整用药教育方式。慢病管理工作可提高药师对医生医嘱的干预比例(比同期重点患者增加90.48%)。结论:临床药师参与慢病管理的模式可明显提高慢病管理效果。%Objective:The purpose of this study was to evaluate the work model of clinical pharmacists' management of chronic disease. Methods:The care team led by clinical pharmacist, including doctors and nurses, conducted chronic disease management of 96 cardiovascular patients. Chronic disease management work was consisted of two parts: chronic disease management during hospitalization and follow-up after discharge. At the admission to hospital and discharging from hospital, pharmacists made assessment of patients' knowledge on the drugs they taken. The 4 indices of assessment included indications, usage and dosage, adverse reactions and precautions.Results:Compared with the time of admission to hospital, patients' knowledge of drugs at the time of discharging was signiifcantly improved, respectively(P=0.000). Elder patients and those with more diagnosed diseases tend to have poorer knowledge of drugs, indicating that the education method should be adjusted for those patients specially. And chronic disease management could improve the acceptance rate of clinical pharmacists' intervention(increased by 90.48% compared with the in-hospital patients in the same period without chronic disease

  13. 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

  14. 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

  15. 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 .

  16. Experiences of Cancer Pain Management by Clinical Pharmacists%临床药师参与癌痛患者管理的体会

    Institute of Scientific and Technical Information of China (English)

    李辉; 陈碧; 周艳琴; 王安发; 徐雨佳; 阳建军

    2015-01-01

    Objective To investigate the service pattern of clinical pharmacists for patients with cancer pain. Methods As a part of the establishment of the caner pain standardized treatment demonstration ward, the clinical pharmacist carried out clinical pharmacy services for patients by participating in the evaluation of cancer pain, planning of drug pain treatment and medication guidance on patients. Results The work of clinical pharmacist in cancer pain management improved the patients’medication adherence and decreased their pain scores. Conclusions It is effective that clinical pharmacists par-ticipate in multidisciplinary management mode for caner pain patients.%目的:探索临床药师开展癌痛患者药学服务的工作模式。方法临床药师以创建癌痛规范化治疗示范病房为切入点,通过参与癌痛评估,制定药物止痛治疗方案,指导患者用药,开展面向患者的药学服务。结果临床药师参与癌痛患者的管理,提高了患者的用药依从性,降低了患者的疼痛评分;结论临床药师参与的癌痛多学科管理模式是行之有效的。

  17. Effect of a network system for providing proper inhalation technique by community pharmacists on clinical outcomes in COPD patients

    Directory of Open Access Journals (Sweden)

    Takemura M

    2013-05-01

    Full Text Available Masaya Takemura,1 Katsumi Mitsui,2 Masako Ido,2 Masataka Matsumoto,1 Misuzu Koyama,3 Daiki Inoue,1 Kazufumi Takamatsu,1 Ryo Itotani,1 Manabu Ishitoko,1 Shinko Suzuki,1 Kensaku Aihara,1 Minoru Sakuramoto,1 Hitoshi Kagioka,1 Motonari Fukui11Respiratory Disease Center, Kitano-Hospital, the Tazuke Kofukai Medical Research Institute, Osaka, Japan; 2Division of Pharmacy, Kitano-Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan; 3Kita-ku Pharmaceutical Association, Osaka, JapanIntroduction: Nonadherence to inhalation therapy is very common in patients with chronic obstructive pulmonary disease (COPD. Few data are available to support the role of community pharmacists in optimizing inhalation therapy in COPD patients. Since 2007, the Kitano Hospital and the Kita-ku Pharmaceutical Association have provided a network system for delivering correct inhalation techniques through certified community pharmacists. The effects of this network system on clinical outcomes in COPD patients were examined.Methods: A total of 88 consecutive outpatients with COPD at baseline and 82 of those 4 years later were recruited from the respiratory clinic of Kitano Hospital Medical Research Institute. Measurements included the frequency of COPD exacerbations, patients’ adherence to inhalation therapy using a five-point Likert scale questionnaire, and patients’ health status both prior to this system and 4 years later.Results: Usable information was obtained from 55 patients with COPD at baseline, and from 51 patients 4 years later. Compared with baseline values, a significant decrease was observed in the frequency of COPD exacerbations (1.5 ± 1.6 versus 0.8 ± 1.4 times/year, P = 0.017. Adherence to the inhalation regimen increased significantly (4.1 ± 0.7 versus 4.4 ± 0.8, P = 0.024, but health status was unchanged. At 4 years, of 51 COPD patients, 39 (76% patients who visited the certified pharmacies showed significantly higher medication adherence

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Dalton K

    2017-01-01

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

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

    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。

  1. Provision of clinical pharmacist services for individuals with chronic hepatitis C viral infection: Joint Opinion of the GI/Liver/Nutrition and Infectious Diseases Practice and Research Networks of the American College of Clinical Pharmacy.

    Science.gov (United States)

    Mohammad, Rima A; Bulloch, Marilyn N; Chan, Juliana; Deming, Paulina; Love, Bryan; Smith, Lisa; Dong, Betty J; GI Liver Nutrition and Infectious Diseases Practice and Research Networks of the American College of Clinical Pharmacy

    2014-12-01

    The objective of this opinion paper was to identify and describe potential clinical pharmacists' services for the prevention and management of patients infected with the hepatitis C virus (HCV). The goals of this paper are to guide the establishment and development of pharmacy services for patients infected with HCV and to highlight HCV research and educational opportunities. Recommendations were based on the following: a review of published data on clinical pharmacist involvement in the treatment and management of HCV-infected patients; a consensus of clinical pharmacists who provide direct patient care to HCV-infected patients and practice in different pharmacy models, including community-based and academic settings; and a review of published guidelines and literature focusing on the treatment and management of HCV infections. The recommendations provided in this opinion paper define the areas of clinical pharmacist involvement and clinical pharmacy practice in the treatment and management of patients with HCV. Clinical pharmacists can promote preventive measures and education about reducing HCV transmission, improve medication adherence, assist in monitoring clinical and adverse effects, recommend treatment strategies to minimize adverse effects and drug interactions, and facilitate medication acquisition and logistics that positively improve patient outcomes and reduce the health care system costs.

  2. Roles and functionality of clinical pharmacists in pharmacy administration%临床药师在药事管理中职能与作用探讨

    Institute of Scientific and Technical Information of China (English)

    江灏; 杨雅; 靳迺诗; 何菊英; 夏培元; 唐敏

    2016-01-01

    介绍了我院临床药师深入临床参与药物治疗工作的模式:①建立住院总药师工作模式,临床药师深入临床参与临床药物治疗工作,参与普通会诊及全院会诊;②合理用药质量控制管理,通过我院特有的“驾照式”用药管理系统督促和监督临床医师规范用药;③建立有效的医师药师沟通渠道,相互促进相互学习。通过以上模式,临床药师积累了药物治疗经验,促进了临床合理用药。%This paper introduced the model of clinical pharmacists involving in pharmacy administration in Southwest Hospital.It features the following :1 .Establishment of the chief resident pharmacists mechanism , with clinical pharmacists involving in clinical drug treatment , therapy consultations and hospital‐wide consultations ;2 .Rational drug use quality control ,to supervise normative drug use of clinicians using the "driver′s license management" system for drug use;3 .Establishment of effective communication channels between physicians and pharmacists ,for mutual learning and supervision .Such model has helped clinical pharmacists to accumulate experiences in drug therapy ,and encouraged rational drug use .

  3. Proposing Chinese Pharmacists Month

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

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

  4. 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 .

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

    Science.gov (United States)

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

    2015-06-01

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

  6. 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.

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

    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。

  8. 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.

  9. 临床药师对肺栓塞患者的药学监护%Pharmaceutical care of clinical pharmacist for patients with pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    王来成; 韩强; 吕冬梅

    2011-01-01

    Objective: To ensure the safety and efficacy in pulmonary embolism patients taking drugs by pharmaceutical care of clinical pharmacists. Methods: The clinical pharmacists carried out the close observation,the revisit and medication proposal to a pulmonary embolism patient with pharmaceutical care measure. Results:Through pharmaceutical care, the efficacy and the safety of the patient taking drugs were obviously enhanced, and events of responding adverse drug reactions were avoided. Conclusion: The pharmaceutical care of clinical pharmacist can coordinate the optimization of medicine plan, and is advantageous for the safety and efficacy in pulmonary embolism patients taking drugs.%目的:通过临床药师对患者实施药学监护,保障肺栓塞患者用药的安全有效.方法:临床药师对1例肺栓塞患者进行密切观察与随访,制订相应的药学监护措施,针对性提出用药建议.结果:通过药学监护,明显提高了肺栓塞患者用药的安全性、有效性,尽量避免了不良反应事件的发生.结论:临床药师积极开展药学监护,协同临床医师优化给药方案,有利于患者的用药安全有效.

  10. 分诊模式下急诊临床药师服务探索%Exploration of the service of clinical pharmacists under emergency triage mode

    Institute of Scientific and Technical Information of China (English)

    王轶; 李群益; 陈海飞; 陈璐; 戚慧洁; 冒山林

    2016-01-01

    目的:探索分诊模式下急诊临床药师服务模式。方法:通过急诊药师协助制定患者分诊制度、参与分诊预检和定期查房、对重点患者提出治疗建议及开通危重患者用药“绿色通道”等措施探索急诊药学服务的切入点和要点。结果与结论:分诊模式下的急诊临床药师服务新模式能更好的提高抢救效率,降低患者的死亡率,提高患者满意度。%Objective:To explore the service of clinical pharmacists under emergency triage mode. Methods: The breakthrough point and the essentials for emergency pharmaceutical services were discussed by taking some measures such as for clinical pharmacists to help making patients triage system, to participate in triage preview and regular rounds, to propose some treatment suggestions for the critically ill patients and establish a“green channel”for their medication. Results&Conclusion:The new emergency triage mode for the service of clinical pharmacists can obviously improve the efifciency of rescue and the patient’s satisfaction and reduce the mortality rate of patients.

  11. Measuring time utilization of pharmacists in the Birmingham Free Clinic dispensary

    OpenAIRE

    Fisher, Arielle M.; Ding, Michael Q.; Hochheiser, Harry; Douglas, Gerald P

    2016-01-01

    Background Free and charitable clinics are a critical part of America’s healthcare safety net. Although informatics tools have the potential to mitigate many of the organizational and service-related challenges facing these clinics, little research attention has been paid to the workflows and potential impact of electronic systems in these settings. In previous work, we performed a qualitative investigation at a free clinic dispensary to identify workflow challenges that may be alleviated thr...

  12. 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

  13. 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

  14. Effect Evaluation of Clinical Pharmacist ’ s Participation in Chronic Disease Management of Diabetes Mellitus in Community%临床药师参与社区糖尿病慢病管理的效果评价

    Institute of Scientific and Technical Information of China (English)

    俞慧群; 王珍珍; 张淑燕; 赵昕; 丁晓晓

    2015-01-01

    目的:评价临床药师开展社区糖尿病慢病管理患者药学干预的效果。方法:选取北仑区新矸街道紫荆社区的所有糖尿病慢病管理患者为研究对象,由临床药师通过建立用药档案,对患者开展药学教育、用药指导及监护等方法,对糖尿病慢病管理患者进行药学干预,将干预前后患者对自身疾病的认知、自我管理、对胰岛素相关知识的知晓情况、血糖控制水平等进行比较。结果:临床药师干预后患者对糖尿病疾病的认知水平明显提高(P <0.01),患者的自我管理水平明显改善(P <0.01),对胰岛素相关知识的了解增加(P <0.05),患者血糖、血压、血脂控制情况好转(P <0 . 05)。结论:临床药师开展社区糖尿病慢病管理患者药学干预,可以为患者提供科学合理的用药保障,使患者血糖控制得更好,延缓并发症的发生。临床药师参与社区糖尿病慢病管理患者药学干预模式值得推广和应用。%ABSTRACTObjective:To evaluate the pharmaceutical intervention effect of chronic disease management of dia-betes by clinical pharmacist in community.Methods:All the patients subjected to chronic disease management of diabetes in Beilun Xingan street of Bauhinia community were selected as the research objects, and pharmaceutical intervention on the patients was given by clinical pharmacists by means of establishing medication archives, provid-ing pharmaceutical education, medication guidance and pharmaceutical care to patients. The patient’s cognition of his own diseases, self management, the knowledge related to insulin and the control level of blood sugar before and after the intervention were statistically analyzed and compared.Results:After the intervention, the patient’s cognition level of diabetic disease improved significantly(P<0.01), the self management improved obviously(P<0.01), the knowledge about insulin increased

  15. 临床药师参与2型糖尿病治疗临床路径的实践%Participation of Clinical Pharmacists in Clinical Pathway of Treatment of Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    单红艳; 付海尔

    2015-01-01

    目的:探讨临床药师在2型糖尿病治疗临床路径中的作用。方法:临床药师在2型糖尿病临床路径实施过程中,以患者为中心,与临床医师、护士协调工作,共同制订个体化治疗方案,为合理用药提供保障。结果与结论:临床药师在临床路径的计划阶段、实施阶段、修正改进阶段体现了自身价值。临床药师参与2型糖尿病治疗临床路径,能提高医疗质量、缩短治疗过程、减少费用,更好地使患者受益。%OBJECTIVE:To probe into the role of clinical pharmacists in clinical pathway of treatment of type 2 diabetes.METHODS:During the implementation process of clinical pathway, the clinical pharmacists took the patients as the center, coordinated work with clinicians and nurses to formulate individualized chemotherapy program, and then provided protection for patients with rational drug use. RESULTS&CONCLUSIONS: The planning stage, implementation stage and modified stage of clinical pathway reflected the value of clinical-pharmacists.The participation of clinical pharmacists in clinical pathway of treatment of type 2 diabetes can improve the medical quality , shorten the course of treatment, reduce the cost, better benefit the patients.

  16. Impact of drugs counselling by an undergraduate pharmacist on cardiac surgical patient’s compliance to medicines

    Directory of Open Access Journals (Sweden)

    Zerafa N

    2011-09-01

    Full Text Available Open heart surgery is a procedure which warrants patient education about the complexity of drug regimens and lifestyle modifications. Patient nonadherence is likely to have a considerable negative impact on the patients’ quality of life post-cardiac surgery.Objective: To evaluate the impact of pharmacist intervention on patients’ adherence to medication and lifestyle changes.Method: This case-controlled study was conducted at the Cardiac Surgical Ward and Outpatients Clinic of Mater Dei Hospital, Malta. Eighty consecutive patients who underwent coronary artery bypass or heart valve surgery were interviewed on their day of discharge using the ‘Past Medical History Questionnaire’. The patients were then randomized to receive pharmacist intervention or usual care. Those who received intervention (40 patients were given a chart with pictorial explanation of the time of day together with a colorful photograph of each tablet prescribed. This group of patients was also counselled to comply to oral analgesia and exercise and also on the avoidance of alcohol and smoking during the recovery period. The control patients received usual care without the pharmacist intervention. All patients were re-interviewed eight weeks after discharge using the ‘Assessing Patient Compliance Questionnaire’. Any differences between the control and experimental groups were analysed using Chi-square, Three-Way Cross tabulation One-Way ANOVA and Two-Way ANOVA tests using the SPSS software version 17.0.Results: A statistically significant difference between the two groups in the mean percentage compliance was registered following pharmacist intervention (p<0.05. Patients in the experimental group had a higher mean percentage compliance score (88% than patients in the control group (66%.Conclusion: The statistically significant difference in the mean percentage compliance between the two groups following pharmacist intervention shows conclusive evidence of the

  17. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

    Science.gov (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia

    2015-01-01

    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  18. 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....

  19. 合理用药驾照式管理赋予临床药师的新职能%New Functions Given by Driver's License Type Management of Rational Drug Use to Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    杨雅; 唐敏; 何菊英; 江灏; 夏培元; 吴昊

    2014-01-01

    Purpose The new functions of clinical pharmacists after the implementation of the driver’s license type management for the rational drug use are discussed about.Methods The traditional drug use method and the prescription review of the driver’s license type management platform based on the rational drug use are compared. The new functions of clinical pharmacists in the operation of the driver’s license type management mode for the rational drug use are relfected.Results The main new functions of clinical pharmacists are as follows. Through the new prescription review, the review of prescription is more timely and convenient. The number of prescription reviewed and its content are more comprehensive and broad. Through text message of mobile phone, doctor workstation communication platform and other communication modes, the point-to-point communication with clinicians is realized, so that the doctors can more easily understand the details of the irrational drug use and related information. Through the organization of physicians’ targeted learning of medicine knowledge, the irrational drug use is reduced.Conclusion The driver’s license type management mode for the rational drug use provides a new method and approach for clinical pharmacists’ technical intervention for rational drug use, and new service functions are given to the clinical pharmacists.%目的:…探讨合理用药实施驾照式管理模式下临床药师的新职能。方法…将传统的用药方式与基于合理用药的驾照式管理平台的处方审核方式进行对比,体现临床药师在合理用药运行驾照式管理模式中的新职能。结果…临床药师的新职能主要体现在:通过新的处方审核方式,使审核处方更及时便捷,审核处方数量和其内容更加全面宽泛;通过手机短信、医师工作站交流平台等新的沟通方式与临床医师进行点对点沟通,使医师能更快捷地了解不合理用药的详情和相

  20. Clinical Pharmacist's Clinical Practice in Treatment of One Patient with Diabetic Nephropathy%临床药师参与一例糖尿病肾病患者治疗的临床实践

    Institute of Scientific and Technical Information of China (English)

    张冬燕; 唐彦

    2015-01-01

    目的:探讨临床药师参与糖尿病肾病患者个体化给药方案设计的临床实践。方法:临床药师在1例糖尿病肾病患者的治疗过程中,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: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,减少了药物的不良反应。结论:临床药师通过药学监护,避免了不良反应的发生,优化了临床治疗方案,取得了良好的效果。%OBJECTIVE:To introduce clinical pharmacists'clinical practice in making individual dosage regimen for patient with diabetic nephropathy.METHODS:Clinical pharmacists formulated the therapeutic regimen together with the clinicians, moitored the whole process of treatment for the patient, and put forward suggestions on rational change of drugs according to patients'condition.RESULTS:The pharmaceutical care provided by clinical pharmacists resulted in improvement in patient's compliance and clinical outcomes and reduction in adverse drug reactions.CONCLUSIONS:Clinical pharmacists'pharmaceutical care for patient with diabetic nephropathy contributed to the avoidance of adverse drug reactiona and optimization of the therapeutic regimen, and achievement of satisfactory outcome.

  1. Detection of magnetic nanoparticles for clinical interventions

    NARCIS (Netherlands)

    Visscher, M.

    2014-01-01

    In this thesis the possibilities of detection of magnetic nanoparticles for clinical interventions are investigated. Detection of these particles in, for example, the sentinel lymph node procedure, is a good alternative for the radionuclide based methods currently in use. The thesis shows that the m

  2. Mapping and assessing clinical handover training interventions

    NARCIS (Netherlands)

    Stoyanov, Slavi; Boshuizen, Els; Groene, Oliver; Van der Klink, Marcel; Kicken, Wendy; Drachsler, Hendrik; Barach, Paul

    2013-01-01

    Stoyanov, S., Boshuizen, H. P. A., Groene, O., Van der Klink, M., Kicken, W., Drachsler, H., & Barach, P. (2012). Mapping and assessing clinical handover training interventions. British Medical Journal Quality & Safety, 21, i50-i57. doi:10.1136/bmjqs-2012-001169

  3. PDCA循环理论用于抗感染临床药师工作模式实践%PDCA Cycle Theory in the Role of Anti-Infective Clinical Pharmacists Working Mode

    Institute of Scientific and Technical Information of China (English)

    王莉; 王娜; 张伟东; 杨文明; 贾俐萍; 马金秋; 董建红; 左明芳; 祖香雨

    2015-01-01

    Objective To explore the role of the plan,do,check and action(PDCA) theory in the establishment of the anti-infective clinical pharmacists work mode. Methods With the PDCA quality cycle management theory as the guidance,the clinical pharmacists work systems and work processes were established for standardizing the clinical pharmacists' works. Results The working systems and workflow formulated by the PDCA mode could effectively enhance the work level and work quality of clinical pharmacists. Conclusion The PDCA cycle theory plays an active role for constructing clinical pharmacists work mode and significantly increases the work level of hospital clinical pharmacists.%目的:探讨戴明环(PDCA)循环理论在建立抗感染临床药师工作模式中的作用。方法以PDCA质量循环管理理论为指导,建立临床药师工作制度和工作流程,使临床药师工作标准化。结果通过PDCA模式制订的工作制度和工作流程能有效提升临床药师的工作水平和工作质量。结论 PDCA循环理论对构建临床药师工作模式起到了积极作用,明显提高了医院临床药师的工作水平。

  4. Description of a practice model for pharmacist medication review in a general practice setting

    DEFF Research Database (Denmark)

    Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk;

    2014-01-01

    BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs...... concerned the reporting of interventions and the considerations of the GPs. 208 interventions were proposed among the 50 patients. The acceptance rate among the GPs was 82%. The most common interventions were lack of clinical or laboratory data (n=57, 27%) and drugs that should be discontinued as they had...

  5. 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.

  6. 临床药师参与肾移植术后肺炎患者抗感染治疗分析%Clinical Pharmacists Involved in Anti-infection Treatment of Pneumonia After Renal Transplantation

    Institute of Scientific and Technical Information of China (English)

    李凌霞; 连玉菲; 王路

    2016-01-01

    Infection is common in patients after renal transplantation complications, if not treated early, even cause death.So, proper anti-infective treatment is particularly important.Based on 1 case of pneumonia after renal transplantation in patients with pharmaceutical care, explore the clinical practice of personalized medicine.Clinical pharmacist intervention by the patient's medication to make the pa-tient medication more safe, effective and reasonable.%感染是肾移植术后患者的常见并发症,若治疗不及时或不彻底,感染甚至会造成患者死亡。因此给予恰当的抗感染治疗尤为重要。本文通过对1例肺炎合并肾移植术后患者的药学监护,探讨临床个体化用药实践。临床药师通过对患者的用药干预,提升用药安全、有效和合理,体现了临床药师在参与药物治疗中的积极作用。

  7. 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.

  8. To investigate the role of clinical pharmacists in the working mode of play therapy in clinical medicine%临床药师在临床药物治疗过程中发挥作用的工作模式探讨

    Institute of Scientific and Technical Information of China (English)

    秦莉伟; 刘素娟

    2014-01-01

    临床药师在临床药物治疗过程中发挥重要作用,分析临床药师的工作模式,对临床药师的职业定位、相关知识掌握、参与到临床实际诊疗工作中等相结合的制度进行探讨,对于提高临床药师工作质量和临床诊疗工作的水平,规范抗生素等药物的使用,合理化用药,避免药物严重不良反应的出现具有重要的临床意义。本文针对我院的临床实际以及诊疗特点,对临床药师工作模式进行探讨,为临床药师制度的完善提供一定的参考,用以推动我国临床药师制度的不断完善。%Clinical pharmacists play an important role in the treatment process of clinical drug, analysis of clinical pharmacists working mode, location, occupation of the clinical pharmacist to participate in the discussion of related knowledge, the actual clinical diagnosis and treatment, combination of system, to improve the quality of clinical pharmacists and clinical diagnosis and treatment level, to regulate the use of antibiotics and other drugs, rational drug use, avoid serious adverse drug reaction has important clinical significance. In this paper, the clinical practice in our hospital and clinic characteristics, discuss the clinical pharmacists working mode, so as to provide reference for perfecting the system of clinical pharmacist, to promote the constant improvement of China’s clinical pharmacist system.

  9. Pharmaceutical care of clinical pharmacists in the treatment of demyelinating encephalopathy%临床药师参与脱髓鞘脑病患者治疗的药学监护

    Institute of Scientific and Technical Information of China (English)

    梁河

    2013-01-01

    目的 探讨临床药师对脱髓鞘脑病患者的药学监护方案.方法 临床药师参与1例脱髓鞘脑病的诊治,在治疗中制定合理的药学监护计划.结果 通过建立合理的用药监护计划,全程协助治疗,避免了潜在的药物治疗风险.结论 临床药师对患者实施药学监护可以提高药物治疗水平,保障患者用药的合理性与安全性.%Objective To analyze the pharmaceutical care provided by clinical pharmacist in the treatment of demyelinating encephalopathy. Methods A reasonable pharmaceutical care plan was provided by clinical pharmacists for a case of demyelinating encephalopathy. Results The pharmacists helped establish reasonable pharmaceutical care plans and improve the medication to avoid the potential medication risks. Conclusion Pharmaceutical care provided by clinical pharmacist helps provide a safe, reasonable, economical medication in clinic.

  10. Practice and Experience of Clinical Pharmacist Participating in Ward Round of Cardiovascular Department%临床药师参与心血管内科查房的实践和体会

    Institute of Scientific and Technical Information of China (English)

    陈秋琴; 王君萍; 杜贯涛

    2012-01-01

    OBJECTIVE: To discuss and summarize the necessary knowledge, focus and experiences when clinical pharmacists take part in the ward round in cardiovascular department of our hospital. METHODS; Several examples on important issues clinical pharmacists concerned were analyzed, such as rational drug use, drug interaction, adverse drug reactions, use of antibiotics. RE-SULTS&CONCLUSION: Clinical pharmacists participating in ward round could improve medical quality. Clinical pharmacists should hold the opportunity and greet the challenge, improve pharmaceutical and medical professional level to provide high quality and brand new pharmaceutical care for medical staffs and patients.%目的:总结我院临床药师参与心内科查房的体会,探讨临床药师查房的必要知识准备及应关注的重点.方法:对临床药师关注的重点如合理用药、药物相互作用、不良反应、抗生素使用等进行举例分析.结果与结论:临床药师参与临床查房能提高医疗质量.临床药师应抓住机遇,迎接挑战,不断提高药学和医学专业水平,为医护人员和患者提供高质量的、全新的药学服务.

  11. Variables Affecting Pharmacy Students' Patient Care Interventions during Advanced Pharmacy Practice Experiences.

    Science.gov (United States)

    Bio, Laura L; Patterson, Brandon J; Sen, Sanchita; Bingham, Angela L; Bowen, Jane F; Ereshefsky, Benjamin; Siemianowski, Laura A

    2016-09-25

    Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE). Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey. Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency. Timing of the APPE, previous specialty elective course completion, and previous hospital experience did not result in any significant difference in self-initiated recommendations. Conclusion. Preceptors should not base practice experience expectations for self-initiated interventions on previous student experience or future intentions. Additionally, factors leading to lower rates of self-initiated interventions on infectious diseases or pediatrics APPEs should be explored.

  12. Pharmaceutical Care for Patients with Diabetic Nephropathy by Clinical Pharmacists%临床药师参与糖尿病肾病患者治疗的药学监护

    Institute of Scientific and Technical Information of China (English)

    贾晓旭; 田利霞; 王建雄

    2016-01-01

    OBJECTIVE:To investigate the pharmaceutical care for patients with diabetic nephropathy by clinical pharmacists .METHODS: The clinical pharmacists participated into the formulation of antihypertensive therapeutic scheme to one patient with diabetic nephropathy , and monitored the whole process of treatment for the patient . RESULTS:After the partner treatment of clinical pharmacists and clinicians , the blood pressure level of the patient were in normal range .Through the pharmaceutical care by clinical pharmacists , medication compliance of the patient were improved , and incidence of adverse drug reactions were induced .CONCLUSIONS: The clinical pharmacists participate into the clinic and keep an eye on the medication of patients and propose optimized therapeutic scheme , all of which play important roles in elevating curative effects and promoting the rational drug use .%目的:探讨临床药师参与糖尿病肾病患者的治疗的药学实践。方法:介绍临床药师参与1例糖尿病肾病患者的降压治疗方案的制订,并监护患者用药过程。结果:该患者经过临床药师与医师的配合治疗,血压控制在理想的范围。临床药师通过药学监护,提高了患者用药的依从性,减少了药品不良反应的发生。结论:临床药师深入临床,关注患者的用药情况,提出优化的治疗方案,对提高治疗成效、促进合理用药具有重要作用。

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

    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

  14. 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.

  15. Optimizing drug therapy in patients with cardiovascular disease: the impact of pharmacist-managed pharmacotherapy clinics in a primary care setting.

    Science.gov (United States)

    Geber, Jean; Parra, David; Beckey, Nick P; Korman, Lisa

    2002-06-01

    We evaluated the effectiveness of pharmacist-managed pharmacotherapy clinics in implementing and maximizing therapy with agents known to reduce the morbidity and mortality associated with cardiovascular disease. This was a retrospective chart review of 150 patients who were treated for coronary artery disease in primary care clinics. Appropriate treatment of hypercholesterolemia occurred in 96% of patients referred to a clinical pharmacy specialist, compared with 68% of those followed by primary care providers alone (p<0.0001). Eighty-five percent and 50%, respectively, achieved goal low-density lipoprotein (LDL) values below 105 mg/dl (p<0.0001). Appropriate therapy with aspirin or other antiplatelet or anticoagulant drugs was prescribed in 97% and 92%, respectively (p=0.146). As appropriate therapy with these agents was high in both groups, the ability to detect a difference between groups was limited. Among patients with an ejection fraction below 40%, appropriate therapy with an angiotensin-converting enzyme inhibitor or acceptable alternative was 89% and 69%, respectively (p<0.05). Twenty-seven cardiac events were documented in the clinical pharmacy group, versus 22 in the primary care group (p=0.475). Despite the relatively high percentage of patients reaching goal LDL in the primary care group, referral to clinical pharmacy specialists resulted in statistically significant increases in the number of patients appropriately treated for hypercholesterolemia and achieving goal LDL.

  16. Multidisciplinary meetings as an effective clinical intervention.

    Science.gov (United States)

    MacCallam, Jackie; Higgins, Lisa

    2014-06-01

    When used well, multidisciplinary meetings can function in the same way as other clinical interventions to improve communication, efficiency and outcomes. They help break down barriers, manage difficult emotions, and benefit service users and staff. But it is imperative that they are well prepared, well attended, and that the purpose and agenda are agreed. It is also vital to have an efficient chair and that meetings take place in an environment where feelings can be shared openly and respected. Services should recognise and address relevant training and support requirements.

  17. 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

  18. 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

  19. 临床药师参与重症肺炎患者抗感染治疗的药学实践%Pharmaceutical Practice for the Severe Pneumonia Patient with Anti-infection Treatment by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    梁秀群; 许明睿; 陆翠林; 唐云峡

    2016-01-01

    To probe into the role of clinical pharmacists in the treatment of patient with severe pneumonia. METHODS:The clinical pharmacists participated in to the ward round and consultation of one patient with severe pneumonia;combined with patient's clinical symptoms and drug susceptibility test result, the clinical pharmacists presented concrete suggestions about the formulation and adjustment of anti-infection treatment scheme:imipenem and cilastatin sodium combined with linezolid, and piperacillin sodium and tazobactam sodium combined with voriconazole. Meanwhile, the clinical pharmacists emphatically monitored the blood routine, liver and kidney function, and pulmonary lesions absorption of the patient.RESULTS: The therapeutic scheme provided by clinical pharmacists obtained a good therapeutic effect.The patient's pulmonary infected symptoms ( cough, expectoration, shortness of breath and hypoxemia, etc.) were controlled.The fungal infection was also gradually improved and discharged. CONCLUSIONS: The clinical pharmacists based on clinical, focus on the patient, assist clinicians to optimize therapeutic scheme and implement pharmaceutical care for patient, which can make the patient get the best therapeutic services.%目的:探讨临床药师在重症肺炎患者救治过程中的作用。方法:临床药师参与1例重症肺炎患者的查房、会诊,结合患者的临床症状和药物敏感性试验结果,对抗感染方案的制订和调整提出具体意见,先后使用亚安培南西司他丁钠联合利奈唑胺、哌拉西林钠他唑巴坦钠联合伏立康唑抗感染治疗,同时重点监测患者的血常规、肝肾功能、肺部病灶吸收情况。结果:临床药师提供的用药方案取得了良好的治疗效果,患者咳嗽、咳痰、气促、低氧血症等肺部感染症状得到了控制,相继出现的真菌感染也逐步好转。结论:临床药师立足临床,以患者为中心,协助医师优化治疗方案,

  20. 药师参与临床会诊及制订用药方案的实践与体会%Practice and Experience of Pharmacist Participating in Clinical Consultation and Medication Scheme Design

    Institute of Scientific and Technical Information of China (English)

    孙为民; 李明; 郑志昌; 杨继红

    2012-01-01

    OBJECTIVE: To investigate the experience of clinical pharmacist participating in clinical consultation and medication scheme design. METHODS: The cases of clinical pharmacists participating in clinical consultation and assisting clinical physicians to make individualized medication scheme were analyzed. RESULTS&CONCLUSION: Clinical pharmacists use their pharmaceutical professional skill, put forward suggestions for treatment, reduce the occurrence of ADR and improve drug therapy by participating in clinical consultation.%目的:探讨药师深入临床参与临床会诊、制订用药方案的经验与体会.方法:对药师参与临床会诊及协助医师进行个体化给药的案例进行分析.结果与结论:药师通过参与临床会诊,发挥药学专长,提出合理的药物治疗建议,减少了药品不良反应的发生,提高了药物治疗水平.

  1. Pharmaceutical Practice for Medication Management of Diabetic Patients with TypeⅠIncision during Perioperative Period by Clinical Pharmacists%临床药师参与糖尿病患者Ⅰ类切口手术围术期用药管理的药学实践

    Institute of Scientific and Technical Information of China (English)

    李明伟

    2016-01-01

    目的:探讨临床药师参与糖尿病患者Ⅰ类切口手术围术期用药管理的药学实践方式及意义。方法:随机选取2012年2月—2016年2月河南省职工医院诊治的糖尿病Ⅰ类切口手术患者200例,其中100例为临床药师参与药学实践的病例(干预组),另外100例为临床药师未参与的病例(非干预组),对2组患者住院期间抗菌药物使用情况(抗菌药物使用率、给药时间合理率、联合用药率、用药疗程合理率、切口甲级愈合率等)进行统计分析。结果:干预组患者抗菌药物使用的各项指标均明显优于非干预组,差异均有统计学意义( P<0.05),临床药师的参与取得了较好的成效。结论:临床药师参与糖尿病患者Ⅰ类切口围术期用药管理的药学实践,方式得当、效果明显,有助于加强Ⅰ类切口手术围术期预防性使用抗菌药物的管理。%OBJECTIVE:To investigate the pharmaceutical practice and significance of medication management of diabetic patients with type Ⅰ incision during perioperative period by clinical pharmacists .METHODS:200 diabetic patients with type Ⅰincision during perioperative period admitted into Henan Provincial Worker's Hospital from Feb . 2012 to Feb.2016 were randomly selected , among which 100 cases with the pharmaceutical practice of clinical pharmacists ( intervention group ) , and 100 cases without the help of clinical pharmacists ( non-intervention group ) . Statistical analysis was conducted on the application status of antibiotics ( application rate of antibiotics , rational rate of administration time , drug combination rate , rational rate of treatment course , healing rate of class A ) of two group of patients while in hospital . RESULTS: Various indicators of intervention group were better than those of non-intervention group , the difference was statistically significant ( P <0.05 ) . Better effects were obtained by the

  2. Bayesian cohort and cross-sectional analyses of the PINCER trial: a pharmacist-led intervention to reduce medication errors in primary care.

    Directory of Open Access Journals (Sweden)

    Karla Hemming

    Full Text Available BACKGROUND: Medication errors are an important source of potentially preventable morbidity and mortality. The PINCER study, a cluster randomised controlled trial, is one of the world's first experimental studies aiming to reduce the risk of such medication related potential for harm in general practice. Bayesian analyses can improve the clinical interpretability of trial findings. METHODS: Experts were asked to complete a questionnaire to elicit opinions of the likely effectiveness of the intervention for the key outcomes of interest--three important primary care medication errors. These were averaged to generate collective prior distributions, which were then combined with trial data to generate bayesian posterior distributions. The trial data were analysed in two ways: firstly replicating the trial reported cohort analysis acknowledging pairing of observations, but excluding non-paired observations; and secondly as cross-sectional data, with no exclusions, but without acknowledgement of the pairing. Frequentist and bayesian analyses were compared. FINDINGS: Bayesian evaluations suggest that the intervention is able to reduce the likelihood of one of the medication errors by about 50 (estimated to be between 20% and 70%. However, for the other two main outcomes considered, the evidence that the intervention is able to reduce the likelihood of prescription errors is less conclusive. CONCLUSIONS: Clinicians are interested in what trial results mean to them, as opposed to what trial results suggest for future experiments. This analysis suggests that the PINCER intervention is strongly effective in reducing the likelihood of one of the important errors; not necessarily effective in reducing the other errors. Depending on the clinical importance of the respective errors, careful consideration should be given before implementation, and refinement targeted at the other errors may be something to consider.

  3. Pharmaceutical Role Expansion and Developments in Pharmacist-Physician Communication.

    Science.gov (United States)

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

    2016-01-01

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

  4. 临床药师参与晚期癌性疼痛患者的药学监护%Pharmaceutical Care for Advanced Cancer Patient with Pain by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    黄凌莉; 魏青; 童本定; 王蕾; 丁选胜

    2016-01-01

    OBJECTIVE:To probe into the role of clinical pharmacists in analgesic treatment of advanced cancer patients with pain .METHODS:By providing pharmaceutical care for one advanced cancer patient with pain during the whole processes of treatment , the clinical pharmacists participated in the design and adjustment of individualized treatment scheme and monitored the adverse reactions , so as to ensure rational medication in clinic .RESULTS:Clinical pharmacists assisted clinicians to adjusted analgesic therapy and nutritional support treatment , and then pain in the patient was controlled and adverse reactions were relieved .CONCLUSIONS: Clinical pharmacists go into clinical work and provide pharmaceutical care for patient can improve the treatment effects and promote the rational drug use in clinic .%探讨临床药师在晚期癌性疼痛患者治疗过程中的作用。方法:对1例晚期癌性疼痛患者治疗全过程实施药学监护,药师参与个体化治疗方案的设计与调整,并监测药物不良反应,以保证临床合理用药。结果:通过临床药师协助临床医师不断调整镇痛治疗方案,并进行相应的营养支持治疗,患者疼痛得到控制,不良反应也得以缓解。结论:临床药师深入临床为患者提供药学服务,可提高患者的治疗效果,促进临床合理用药。

  5. 临床药师参与胃癌化疗过程的药学实践%Participation of Clinical Pharmacist in Chemotherapy Process of Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    刘雪丽; 赵彤; 仇妮; 曾卫强; 周学锋

    2014-01-01

    Objective: To investigate the role of clinical pharmacists in the participation in chemotherapy process of gastric cancer . Methods: Through clinical pharmacists ’ participating in chemotherapy plan making and adjustment , adverse reaction monitoring , patient education , the practical activities of clinical pharmacists in the chemotherapy pro-cess of gastric cancer were introduced . Results: The medication suggestions provided by clinical pharmacists were ac-cepted by physicians , the patients ’ compliance was improved under the instruction of clinical pharmacists and the course of treatment was smooth . Conclusion: In the chemotherapy process of gastric cancer clinical pharmacists should have a good cooperation and communication with physicians in chemotherapy plan making and adjustment , adverse re-action monitoring and patient education , and provide an individual drug treatment for patients .%目的:探讨临床药师在参与胃癌化疗过程中的作用。方法:通过临床药师参与胃癌化疗过程中的方案制定、方案调整、不良反应监测、患者教育等,阐述临床药师在胃癌化疗过程中的药学实践活动。结果:医师接受临床药师提出的用药建议,患者在临床药师指导下改善了用药依从性,治疗过程顺利。结论:临床药师在胃癌患者化疗过程中,应该从方案的制定、调整,药物不良反应的监测、患者的用药教育等方面,与医师形成良好的协作与沟通,为患者提供个体化的临床药物治疗。

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Kourosh Sadeghi

    2015-10-01

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

  8. Supporting the management of type 2 diabetes with pharmacist-led reviews: an observational analysis

    Science.gov (United States)

    Langran, Tim; Nanda, Nithya; Bataveljic, Attia; Gonzalez-Durio, Javier

    2017-01-01

    Objective Describe and assess the impact of a pharmacist-led patient review programme on the management and control of type 2 diabetes (T2D). Design Uncontrolled prospective cohort study with before and after intervention data collection. Setting General practices within NHS Slough Clinical Commissioning Group (CCG). Participants 5910 patients with T2D. Interventions Pharmacists reviewed 5910 patients and worked with general practice teams to schedule any of the 9 key care processes recommended by the National Institute for Health and Care Excellence (NICE) that the patients were lacking, to optimise medication and to make other interventions such as providing lifestyle advice. Main outcome measures The proportion of patients receiving the NICE-recommended 9 key care processes and proportion of patients whose glycated haemoglobin (HbA1c), blood pressure (BP) or total cholesterol (TC) readings were over target before and after the intervention period. Results The proportion of patients receiving all of the NICE-recommended 9 key care processes increased from 46% at project outset in April 2013 to 58% on completion in April 2014 and the percentage of patients achieving HbA1c, BP and TC targets all increased (65% to 70%, 70% to 76%, 78% to 82%, respectively). Quality Outcomes Framework (QOF) data for Slough CCG showed the percentage of diabetic patients achieving target HbA1c, BP and TC readings increased from April 2013 to April 2014, but then diminished in the year after project completion. Conclusions The pharmacist-led review increased the number of key care processes administered and improved diabetic control during the year of programme delivery. The improvement abated during the year after, suggesting that such programmes should be ongoing rather than fixed term. The programme combined the strategic drive and project facilitation skills of Slough CCG, the general practice teams' knowledge of their patients and the clinical and information technology skills of

  9. Talking to the Pharmacist (For Parents)

    Science.gov (United States)

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

  10. Pharmaceutical Care for Children with Bone Infection after Trauma by Clinical Pharmacist%临床药师对创伤后骨感染患儿的药学监护

    Institute of Scientific and Technical Information of China (English)

    毛璐; 李锦; 李静

    2012-01-01

    目的:探讨临床药师参与创伤后骨感染患儿综合治疗的药学监护工作要点.方法:临床药师参与1例创伤后骨感染患儿的治疗,对抗感染药物治疗方案的制订、镇痛药物的选择以及不良反应的处理等方面提出具体意见,为患者制订个体化的给药方案.结果:通过药学监护,临床药师为临床提供了合理用药方案,取得了良好的治疗效果.结论:临床药师与医师护士共同组成治疗团队,有利于提高临床治疗水平,促进合理用药.%OBJECTIVE: To investigate the point of clinical pharmacist participating in pharmaceutical care for children with bone infection after trauma. METHODS: Clinical pharmacists participated in therapy for a child with bone infection and gave advices on the formulation of anti-infection drug therapy scheme, the selection of analgesic drugs, and the disposal of adverse drug reaction. They also developed individualized therapy plan for patients. RESULTS: Through pharmaceutical care, clinical pharmacists provided reasonable drug therapy scheme to obtain therapeutic efficacy. CONCLUSION: Clinical pharmacists, physicians and nurse make up of treatment team to improve clinical therapy and rational drug use.

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

    Directory of Open Access Journals (Sweden)

    Saini B

    2011-04-01

    Full Text Available Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade of coordinated research efforts, in various aspects of asthma care, has culminated in the implementation trial of the Pharmacy Asthma Management Service (PAMS, a comprehensive disease management model. There has been research investigating asthma medication adherence through data mining, ways in which usual asthma care can be improved. Our research has focused on self-management education, inhaler technique interventions, spirometry trials, interprofessional models of care, and regional trials addressing the particular needs of rural communities. We have determined that inhaler technique education is a necessity and should be repeated if correct technique is to be maintained. We have identified this effectiveness of health promotion and health education, conducted within and outside the confines of the pharmacy, in public for a and settings such as schools, and established that this outreach role is particularly well received and increases the opportunity for people with asthma to engage in their asthma management. Our research has identified that asthma patients have needs which pharmacists delivering specialized models of care, can address. There is a lot of evidence for the effectiveness of asthma care by pharmacists, the future must involve integration of this role into primary care.

  12. Pharmacy ethics: evaluation pharmacists' ethical attitude.

    Science.gov (United States)

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

    2011-01-01

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

  13. 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.

  14. Practice of Clinical Pharmacists Participating in Drug Therapy for Pregnant Patients with Asthma%临床药师参与妊娠合并哮喘患者的药物治疗实践

    Institute of Scientific and Technical Information of China (English)

    刘娟; 金梅

    2015-01-01

    OBJECTIVE:To explore the significance of clinical pharmacists providing pharmaceutical care for pregnant patients with asthma in respiratory department. METHODS:Clinical pharmacists participated in the analysis of 2 cases of pregnancy complicating with asthma and applied pharmaceutical suggestion and therapy plan as penicillin anti-infective thera-py,intravenous dripping of magnesium sulfate combined with doxofylline,albuterol aerosol treatment instead. RESULTS:The asthma symptom had been relieved significantly and then the patients were discharged from the hospital after clinical phar-macists disposed the symptom appropriately. CONCLUSIONS:The participation of clinical pharmacists in pharmaceutical care for pregnant patients with asthma in respiratory department. Can improve the prognosis effectively and guarantee the safety of drug use.%目的:探讨临床药师对妊娠合并哮喘患者实施药学监护的作用和意义。方法:临床药师通过参与2例妊娠合并哮喘的案例分析,给予药学建议:换用青霉素类抗感染治疗和硫酸镁联合多索茶碱静脉滴注、沙丁胺醇雾化治疗方案。结果:采纳临床药师建议并予适当处理后患者哮喘症状得到明显缓解出院。结论:临床药师参与妊娠合并哮喘患者的药学监护,能有效改善患者预后,保障患者的用药安全。

  15. 临床药师参与1例肿瘤溶解综合征患者治疗的药学监护%Clinical Pharmacists Participating in Pharmaceutical Care for a Patient with Tumor Lysis Syndrome

    Institute of Scientific and Technical Information of China (English)

    张华锋; 陈璿英; 彭小东; 黎军和

    2011-01-01

    目的:探讨临床药师对肿瘤溶解综合征患者的药学监护.方法:结合l例典型病例分析用药情况,分析肿瘤专业临床药师对肿瘤溶解综合征患者的监护点.结果:对化疗导致肿瘤溶解综合征的高危人群,应及时停用或调整化疗药物,临床药师要及早从血钾、尿酸、肾功能、钙磷等方面密切监护,并及时干预.结论:临床药师应利用与医护人员互补的药学专业知识,及时了解肿瘤溶解综合征发生的高危因素,为患者提供个体化的药学监护.%OBJECTIVE: To explore clinical pharmacists participating in pharmaceutical care for a patient with tumor lysis syndrome. METHODS: According to analysis of drug use in a typical case, pharmaceutical care for a patient with tumor lysis syndrome by clinical pharmacist in oncology department was analyzed. RESULTS: For high-risk patients with chemotherapy-induced tumor lysis syndrome, it was necessary for timely drug withdrawl and adjustment of chemotherapy drugs. Clinical pharmacist should closely monitor and intervene timely in terms of hyperkalemia, hyperuricemia, kidney function and hyperphosphatemia. CONCLUSION: Clinical pharmacist and medical staff should enhance their knowledge of pharmacy, realize the high risk factors of tumor lysis syndrome and offer individualized pharmaceutical care for patients.

  16. 1例顺铂腹腔化学治疗致腹泻药学监护实践体会%Pharmaceutical Practice Experience of Clinical Pharmacists Participating in Treating 1 Case of Diarrhea Caused by Cisplatin Intraperitoneal Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    吴畏

    2015-01-01

    Objective To strengthen the pharmaceutical care for reducing the incidence of adverse reactions induced by antineoplastic drugs. Methods Clinical pharmacists discussed the medical records together with the clinicians, assisted the clinicians to formulate the therapeutic regimen and focused on the implementation process of the therapy scheme. Results The patient's condition was improved after timely symptomatic treatment. The patient was discharged with good physical status. Conclusion Clinical pharmacists participating in the clinical therapy is conducive to play the pharmacist role in the treatment team and can provide the treatment related comprehen-sive data for doctors.%目的:加强药学监护,降低抗肿瘤药不良反应的发生率。方法临床药师与医师共同讨论病历,协助制订治疗方案,关注方案实施过程。结果经过及时、对症治疗,患者病情好转,身体状况良好后出院。结论临床药师参与临床治疗,有利于发挥药师在治疗团队中的作用,协助医师明确诊断、准确用药,并可为医师提供治疗相关的全面资料。

  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 Pharmacists'Practice in Pharmaceutical Care for One Patient with Paroxysmal Atrial Fibrillation%临床药师参与1例阵发性房颤的药学监护

    Institute of Scientific and Technical Information of China (English)

    胡国仕; 祝红; 易晓燕; 胡艳芬

    2016-01-01

    目的:探讨临床药师如何对阵发性房颤患者规范化抗凝治疗实施药学监护。方法:回顾临床药师从疾病及药物相互作用等方面进行分析,同时结合药动学和药效学特点,参与1例阵发性房颤患者的华法林抗凝治疗过程。结果:经临床药师对患者实施个体化抗凝治疗,建议医师在使用华法林治疗期间监护药物相互作用,调整华法林抗凝方案,使国际标准化比值达到了目标抗凝范围,患者在抗凝期间未发生严重的出血或血栓栓塞等不良事件。结论:临床药师对房颤患者抗凝治疗实施药学监护,向临床提供个体化方案,可保障患者用药安全,充分体现临床药师在治疗团队中的重要作用。%OBJECTIVE:To explore the clinical pharmacists'practice in pharmaceutical care for one patient with paroxysmal atrial fibrillation .METHODS: The clinical pharmacists participated in the anticoagulant therapy with warfarin for the patient with paroxysmal atrial fibrillation through the retrospective analysis on diseases and drug interations, combined with the characteristics of pharmacokinetics and pharmacodynamics .RESULTS: After the individualized anticoagulant therapy by the clinical pharmacists , the clinicians were suggested to monitor the drug interations during the treatment process , anticoagulant therapy regimen had been adjusted , the international normalized ratio turned to the normal range .There were no severe bleeding or thromboembolism or any other adverse events in patients during anticoagulant therapy .CONCLUSIONS: The clinical pharmacists provide pharmaceutical care for the patient with paroxysmal atrial fibrillation and give individualized regimen for the clinic , can ensure the medication safety in patients , and fully demonstrate the important role of clinical pharmacists in the treatment group .

  19. Pharmacist credentialing in pain management and palliative care.

    Science.gov (United States)

    Juba, Katherine M

    2012-10-01

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

  20. The pharmacist's role in promoting optimal antimicrobial use.

    Science.gov (United States)

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

    2000-06-01

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

  1. Personality Type and Clinical Supervision Interventions

    Science.gov (United States)

    Bernard, Janine M.; Clingerman, Tamara L.; Gilbride, Dennis D.

    2011-01-01

    In this study, the authors investigated personality type of supervisors and supervisees and interventions chosen by supervisors for 78 supervisory dyads from 9 different counselor education programs. Gender effects were also investigated. Results indicated that interventions were not influenced by supervisor personality type as measured by the…

  2. 哮喘及COPD门诊药师工作模式及实践%Working mode and clinical practice of clinical pharmacists for asthma and COPD outpatient service

    Institute of Scientific and Technical Information of China (English)

    李静姿; 田硕涵; 马凌悦; 周颖; 崔一民

    2016-01-01

    目的:探索临床药师在呼吸科对哮喘及慢性阻塞性肺疾病(COPD)患者开展药学服务工作的切入点。方法:借鉴国内外先进管理模式,结合北京大学第一医院具体情况,在如下方面开展了相关工作:①门诊首次应用吸入剂的患者进行用药指导,协助患者开展症状自评;②院内哮喘及COPD患者的教育管理;③对正在使用且既往用过吸入剂的患者进行吸入剂使用再培训,评估效果。结果:已初步获得临床认可,完成患者教育和吸入剂指导共计900余例,提高了患者吸入剂的使用技巧和治疗效果,改善了患者的用药依从性,为药师参与的哮喘及COPD患者的健康管理提供工作模式参考。结论:临床药师对哮喘和COPD患者诊治过程的全程干预,作为全程化临床药学服务的新模式,为进一步建立慢病管理体系提供了重要依据。%Objective:To explore a working mode of pharmaceutical care for asthma and COPD patients.Methods: Following global advanced management mode and combined with situation of our hospital, relative work has been conducted in the following areas:①Outpatients received individualized counselling and instruction on the techniques related to the use of inhaled medications and self-symptom assessment;②Inpatients inhaled and other medications education management;③Asthma and COPD patients inhalation using re-training and effectiveness evaluation.Results:Asthma and COPD patients’ education has been provided to more than 900 cases till now, and inhaled skill, treatment outcome and compliance has been signiifcantly improved, which has been preliminarily recognized by the clinical physicians and provided references for further establishing integrated pharmaceutical care.Conclusion: The intervention of clinical pharmacist may provide a new mode of integrated clinical pharmaceutical care, according to which we could establish our chronic disease

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

  4. 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

  5. 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.

  6. Music intervention study in abdominal surgery patients: challenges of an intervention study in clinical practice.

    Science.gov (United States)

    Vaajoki, Anne; Pietilä, Anna-Maija; Kankkunen, Päivi; Vehviläinen-Julkunen, Katri

    2013-04-01

    Evidence-based nursing requires carefully designed interventions. This paper discusses methodological issues and explores practical solutions in the use of music intervention in pain management among adults after major abdominal surgery. There is a need to study nursing interventions that develop and test the effects of interventions to advanced clinical nursing knowledge and practice. There are challenges in carrying out intervention studies in clinical settings because of several interacting components and the length and complexity of the causal chains linking intervention with outcome. Intervention study is time-consuming and requires both researchers and participants' commitment to the study. Interdisciplinary and multiprofessional collaboration is also paramount. In this study, patients were allocated into the music group, in which patients listened to music 30 minutes at a time, or the control group, in which patients did not listen to any music during the same period.

  7. Pharmaceutical Practice Conducted by Clinical Pharmacists for a Patient with Erythama Multiforme Drug Eruption%临床药师参与一例多形红斑型药疹的药学实践

    Institute of Scientific and Technical Information of China (English)

    肖桂荣; 徐珽

    2012-01-01

    Objective To share the experience of clinical pharmacists in conducting clinical pharmaceutical practice for a patient with erythama multiforme drug eruption induced by tuberculostatics which also caused the patient to probably have tuberculous pleurisy. Methods After the patient developed skin rashes on October 26th, 2011, clinical pharmacists provided advices, and work together with clinicians as a team to develop clinical treatment measures to cope with the adverse drug reactions. Results It was concluded that the skin rashes were caused by streptomycin. Then, the patient ameliorated after active treatment in time. Conclusion Clinical pharmacists taking part in clinical pharmaceutical practices is beneficial for both doctors and patients in dealing with acute adverse reactions.%目的 报道临床药师参与抗结核药物致结核性胸膜炎待诊患者多形红斑型药疹的临床药学实践的经验.方法 1例结核性胸膜炎待诊患者在201 1年1 1月3日出现皮疹后,临床药师根据患者的用药情况及病情变化,提供咨询意见,与临床医师共同制定不良反应的临床处理措施.结果 推断为链霉素所致的多形红斑型药疹,积极处理后患者病情好转.结论 临床药师参与药学监护,有利于处理药物不良反应.

  8. Pharmaceutical care for the patient with acute organophosphorous insecticides poi-soning by clinical pharmacists%临床药师在急性有机磷中毒患者治疗中的药学监护

    Institute of Scientific and Technical Information of China (English)

    伊佳; 陈万生

    2015-01-01

    目的 探讨临床药师在急性有机磷中毒患者的药学监护点,为急性有机磷中毒患者用药提供参考. 方法 临床药师通过参与急性有机磷中毒患者治疗用药方案的制定,从药物的选择、给药剂量及不良反应预计等方面,提出药学观点. 结果 治疗后,患者逐步恢复正常,未出现进一步的阿托品中毒,肝损害症状得到有效控制. 结论 临床药师参与急性有机磷中毒患者的临床治疗过程,使患者获益,提高了临床治疗水平.%Objective To discuss the pharmaceutical care for a patient with acute organophosphorous insecti-cides poisoning by clinical pharmacists,to provide references for clinical medication. Methods Clinical pharmacists participated in the formulation of medication plan for a patient with acute organophosphorous insecticides poisoning,in respects of drug selection,drug dosage and adverse drug reaction monitoring. Results After treatment,the patient re-covered gradually,and no further atropine poisoning appeared,the hepatic injury was effectively controlled. Conclusion Clinical pharmacists can participate in the treatment of patients with acute organophosphorous insecticides poisoning with obvious benefit,and enhance the level of clinical therapy.

  9. 临床药师对1例原因不明发热患者的药学服务%Clinical Pharmacists Supervised Pharmacy Service for a Patient With the Fever of Undetermined Origin

    Institute of Scientific and Technical Information of China (English)

    杜玉娟; 刘小玲; 刘治军

    2015-01-01

    目的:探讨临床药师在原因不明发热治疗中发挥药学服务的途径和方式方法,以提高疾病治疗效果。方法:以1例原因不明发热患者的诊治过程为例,临床药师与临床医师共同制定治疗方案,对患者实施全程的药学监护。结果:经过与临床医师积极协作,通过优化了治疗方案,患者痊愈出院。结论:临床药师开展以患者为中心的药学服务,对用药过程中出现的问题进行了认真分析,可为临床用药提供合理化的建议,积极促进临床合理用药。%Objective: To investigate the ways and methods of pharmacy clinical pharmacists playing roles in the treatment of the patient with unexplained fever during pharmacy services, and to improve the effects of disease treatment.Methods:Taking diagnosis and treatment of one patient with unexplained fever for example, clinical pharmacists and clinicians worked together to make up the treatment plan and to implement full pharmaceutical care for patients.Results:After active collaboration with clinicians, patients were cured by optimizing the treatment plan.Conclusions: Clinical pharmacists to carry out the pharmaceutical care in patients with the center of the problem, the problem was analyzed, which can provide reasonable suggestions for clinical medication, and actively promote the clinical rational drug use.

  10. Pharmacist's role in an interdisciplinary cardiac rehabilitation team.

    Science.gov (United States)

    Packard, Kathleen; Herink, Megan; Kuhlman, Paulette

    2012-01-01

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

  11. 临床药师参与1例难治性哮喘患儿治疗的药学实践%Pharmacy practice of clinical pharmacist participating in the treatment of 1 child with refractory asthma

    Institute of Scientific and Technical Information of China (English)

    沙美娟

    2014-01-01

    To investigate the pharmaceutical care key points of clinical pharmacist participating in the treatment of child with refractory asthma, in order to guide clinical rational drug use. Clinical pharmacist took part in the treatment process of refractory asthma, so as to analyze pathogenesis of refractory asthma and explore the relation between medicine, dose and curative effect for formulating rational use of drug and dose. Clinical effects and condition changes of disease were needed to be considered for adjusting pharmacy scheme timely, and providing individualized pharmacy service. Through joining the pharmaceutical care for refractory asthma, clinical pharmacist could enhance safety and curative effect of pharmacy for children. The participation of clinical pharmacist in formulation of treating refractory asthma can make the treatment become standard and rational, and provide reference for the control and treatment of refractory asthma.%探讨临床药师参与难治性哮喘患儿治疗药学监护要点,以指导临床合理用药。临床药师参与难治性哮喘的治疗过程,分析产生难治性哮喘原因,寻找疗效与药物、剂量与疗效的关系,制定合理药物及合适剂量,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。临床药师通过对难治性哮喘的药学监护,可提高患儿的用药安全性及治疗效果。临床药师参与难治性哮喘的治疗的制定,使治疗更加规范、合理,为难治性哮喘的控制治疗提供参考。

  12. 临床药师对心肌梗死患者个体化用药方案设计的实践%Individualized dosing regimen for myocardial infarction patients in practice of clinical pharmacists

    Institute of Scientific and Technical Information of China (English)

    韩强

    2012-01-01

    目的:探索临床药师参与制定药物个体化治疗方案设计以及实施有效药学监护的思路.方法:以1例心肌梗死患者为例,从临床药师角度分析患者的病情特征和治疗原则,利用药学理论和循证药学的证据,与临床医师共同商讨和制定药物治疗方案,对患者实施药学监护.结果:临床药师参与对患者个体化治疗方案的制定,同时对患者进行密切的药学监护,提高了患者的药物治疗效果,减少了不良反应,确保患者用药安全,取得了满意的治疗效果.结论:临床药师通过参与个体化用药融入临床药物治疗团队,在对患者的治疗方面发挥越来越重要的作用,为特定患者选用适当的药物、适当的剂量和适当的时间的个体化用药方案将打破传统给药模式,从而进一步促进临床用药更加安全、有效、合理.%Objective: To explore the train of thought of clinical pharmacists to participate in designing of the formulation of individualized drug treatment and earring out effective pharmaceutical care. Methods; Taking one myocardial infarction patient as an example, the disease characteristics and treatment principles in patients were analyzed from a clinical pharmacist perspective. On evidence-based pharmacy and pharmacy theory, the drug treatment programs were discussed in the views of clinicians and pharmaceutical care to the patient. Results: Clinical pharmacists participated in the individualized drug treatment plan, and closely took pharmaceutical care of patients. As a result, the drug treatment was improved, the adverse reactions were reduced, patient safety was ensured, and a satisfactory therapeutic effect was obtained. Conclusion; Clinical pharmacists in clinical team can promote the clinical medication more secure, effective and reasonable.

  13. 临床药师对1例重度癌痛患者的药学监护%Pharmaceutical Care of Clinical Pharmacists on a Cancer Patient with Severe Pain

    Institute of Scientific and Technical Information of China (English)

    张东蕾; 魏青; 童本定; 吴楠; 丁选胜

    2014-01-01

    目的:介绍临床药师对重度癌痛患者的药学监护实践。方法针对具体案例,参与个体化镇痛治疗方案的设计与调整,对药品不良反应及时监测并提出药学干预建议,保证临床合理用药。结果临床药师参与药物治疗,可发挥专业特长,协助医师调整用药方案,提高临床药物治疗水平。结论对重度癌痛患者的药学监护能提高患者用药安全性、合理性,提高治疗效果。%Objective To describe the clinical pharmacists' way in carrying out pharmaceutical care for cancer patients with severe pain. Methods Combining with the clinical experience, make the targeted treatment scheme with the physicians together and adjust the scheme according the condition change. Pay close attentions on the patients and make reasonable suggestions as to the adverse drug reactions to guarantee the rational use of drug. Results Clinical pharmacists can assist clinicians to adjust the therapeutic regimen from the perspective of pharmacists, and improve the level of clinical drug treatment. Conclusion Pharmaceutical care on cancer patients with severe pain is needed, as it can improve the safety and rationality of taking drugs so that improve the efficacy of the treatment scheme.

  14. 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.

  15. Clinical Analysis of Treating 5 Cases of Refractory Pyogenic Osteomyelitis by Clinicians and Clinical Pharmacists%临床医师与临床药师联合治疗5例难治性化脓性骨髓炎病例分析

    Institute of Scientific and Technical Information of China (English)

    康文磊; 牛慧云; 杜志强; 靳瑞娟

    2013-01-01

    Objective To investigate the point of clinical pharmacists working together with clinicians participating in treatment for 5 refractory pyogenic osteomyelitis. Methods Clinical pharmacists and clinicians participated in therapy for 5 refractory pyogenic osteomyelitis , and Clinical pharmacists gave advices on the formulation of anti-infection drug therapy scheme. They also developed individualized therapy plan for patients. Results Through pharmaceutical care, clinical pharmacists provided reasonable drug therapy scheme to obtain therapeutic ef icacy. Conclusion Clinical pharmacists and physicians make up of treament team to improve clinical therapy and rational drug use.%目的:探讨临床药师与临床医师共同治疗难治性化脓性骨髓炎的工作要点。方法临床药师与临床医师共同对5例难治性化脓性骨髓炎患者进行治疗,临床药师对抗感染治疗方案的制订提出具体意见,为患者制订个体化的给药方案。结果通过药学监护,临床药师为临床提供了合理用药方案,取得了良好的治疗效果。结论临床药师与医师共同组成治疗团队,有利于提高临床治疗水平,对难治性化脓性骨髓炎均取得满意结果,促进临床合理用药。

  16. Evaluation of pharmacist utilization of a poison center as a resource for patient care.

    Science.gov (United States)

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

    2013-06-01

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

  17. Pharmaceutical Care for Patients with Coronary Heart Disease and Diabetic Nephropathy by Clinical Pharmacists%临床药师对冠心病合并糖尿病肾病患者的药学服务

    Institute of Scientific and Technical Information of China (English)

    李珂佳; 郑萍; 曹世平; 黄健; 崔岚; 邹顺

    2013-01-01

    目的:通过对治疗方案的优化干预和对患者的药学监护,探讨临床药师在合理用药中的作用.方法:对1例基础疾病为冠心病和糖尿病肾病、合并多器官功能衰竭、存在多种药物的禁忌证、经常规药物治疗效果不佳的患者,临床药师结合该患者病理生理状况、经济状况和药物的特点,提出用药调整、补充,对治疗全过程用药进行干预和优化,并对患者进行必要的患者教育.结果与结论:临床药师参与药物治疗方案设计和患者教育,有利于促进药物使用的安全、有效和经济.%OBJECTIVE: To explore the roles of clinical pharmacist in rational drug use by intervening and optimizing therapeutic regimen and providing pharmaceutical care. METHODS: Due to primary disease, i.e. coronary heart disease and diabetic nephropathy, complicating with multiple organ failure, drug contraindication and unsatisfactory curative efficacy, according to pathological state, economic level of the patient and characteristics of drugs, the therapeutic regimen was adjusted and supplemented, medication was optimized and patient education was provided by clinical pharmacists. RESULTS&CONCLUSION: The participation of clinical pharmacist in therapeutic scheme design and patient education contributes to safe, effective and economical drug use.

  18. Clinical Practice of Pharmacists through Participating in the Treatment of a Patient with Guillain Barré Syndrome%药师参与吉兰巴雷综合征治疗实践1例

    Institute of Scientific and Technical Information of China (English)

    闫成; 薛洪源; 刘建芳

    2015-01-01

    Objective:To explore the value of clinical pharmacists in the clinical treatment of a patient with Guillain Barré syn-drome through pharmaceutical care. Methods:Clinical pharmacists participated in the entire treatment process and gave rational sug-gestions about the selection,dosage and course of the drugs,such as glucocorticoid,immunoglobulin and antibiotics. Meanwhile,clini-cal pharmacists focused on the adverse drug reactions. Results:The patient′s condition was controlled and improved gradually. During the hospitalization,the patient developed skin rash and abnormal liver function,while the symptom was improved after the anti allergy and liver protection treatment,and no obvious effect on the primary disease was shown. Conclusion:Clinical pharmacists can help to optimize treatment regimen in order to ensure the safety and effectiveness of patients’medication.%目的:通过临床药师参与1例吉兰巴雷综合征患者的治疗实践,探讨药师在临床发挥的作用。方法:临床药师参与该患者的整个治疗过程,围绕激素、免疫球蛋白及抗菌药物的使用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,关注药品不良反应。结果:患者病情逐步得到控制并好转,住院期间患者出现了皮疹及肝功能异常,经抗敏、保肝治疗后好转,未对原患疾病造成明显影响。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. The role of the pharmacist in home health care.

    Science.gov (United States)

    McAllister, J C

    1985-04-01

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

  20. The clinical pharmacy service ways conducted by pharmacists and its significance%药师开展临床药学服务的途径与意义探讨

    Institute of Scientific and Technical Information of China (English)

    侯书屏

    2014-01-01

    Objective to explore the ways of clinical pharmacist conducting pharmacy services and its significance in order to promote clinical pharmacists conducting work better. Methods With literature reviewed and practical investigation studied, we systemized the data and summarized clinical pharmacy services ways for clinical pharmacists carrying out and its significance.Results clinical pharmacists can participate in physician ward rounds, consultation, providing pharmacy consulting, developing individualized dosing regimens, monitoring adverse reactions of drugs, and processing adverse reactions of drugs, writing medical history and regular pharmacy knowledge training and other ways to provide appropriate clinical pharmacy services. Conclusion after pharmacists positive, proactive and professional participating in many ways, they can provide more accurate and more efficient clinical medical services, thereby reducing the possibility of adverse drug events, and promoting the improvement of the reasonableness of medication. therefore, patients compliance were enhanced and waste of resources were avoided. thus can provide a reference for continuous improvement of clinical medicine.%目的:对药师开展临床药学服务的途径、意义进行探讨,更好的推进临床药师工作的开展。方法通过查阅文献资料、实际调查研究等措施,对有关资料进行整理,对临床药师开展临床药学服务的途径及意义进行总结。结果临床药师可以通过参与医师的查房、会诊、提供药学咨询、制定个性化的给药方案、监测患者所用药物的不良反应、参与药物不良反应的处理、撰写药历、定期的药学知识培训等途径为临床提供相应的药学服务。结论通过药师的积极、主动、专业化、多途径的参与,可以更为准确的、高效的为临床提供更多的医学服务,从而减少药物不良事件发生的可能性,促进用药合理性的提高,增强

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

    OpenAIRE

    Sheakley, Maria L.; Gilbert, Gregory E.; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    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 d...

  2. [Specialist pharmacist training from the viewpoint of sports pharmacology].

    Science.gov (United States)

    Kasashi, Kumiko

    2012-01-01

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

  3. Pharmacist's impact on acute pain management during trauma resuscitation.

    Science.gov (United States)

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

    2015-01-01

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

  4. 临床药师参与1例肺结核合并甲状腺功能减退患者的会诊案例分析%Case Analysis of Clinical Pharmacists Participating in the Consultation for a Patient with Pulmonary Tuberculosis Complicating with Hypothyriodism

    Institute of Scientific and Technical Information of China (English)

    曹国文; 曹斌; 施爱明; 沈珠; 杨文斌; 张全英

    2012-01-01

    OBJECTIVE: To discuss the methods and effect of clinical pharmacist participating in clinical treatment by clinical consultation. METHODS: Pharmacists participated in the clinical consultation for a patient with pulmonary tuberculosis complicating with hypothyroidism, and the methods and effect of clinical pharmacist were analyzed comprehensively in terms of antibiotics adjustment according to disease condition, concerning about antitubercular agent and analysis of drug interaction. RESULTS: Clinical pharmacists did have some actions to assist doctors in rational drug use of clinical treatment, and the suggestions of clinical consultation received clinical recognition. CONCLUSION: Clinical pharmacists participating in the clinical round and consultation could promote clinical treatment and has great improvement for guaranteeing safe, effective, economical and reasonable drug use.%目的:探讨临床药师通过临床会诊参与临床治疗的方法和作用.方法:药师参与1例肺结核合并甲状腺功能减退患者的会诊,从针对病情调整抗生素、关注抗结核药、分析药物相互作用等方面进行综合分析.结果:临床药师在临床疾病治疗进程中,对协助医师合理用药发挥了一定作用,提出的会诊意见和建议得到了临床认可.结论:临床药师参与临床查房和会诊,对提高临床诊疗水平及保障患者用药安全、有效、经济、合理具有极大的帮助和促进作用.

  5. Management Effect of Clinical Pharmacist on Antibiotics Use during Perioperative Period of Great Saphe-nous Varicose Veins Surgery%临床药师参与大隐静脉曲张手术围术期抗菌药物管理的效果评价

    Institute of Scientific and Technical Information of China (English)

    朱亚兰; 包云光; 郭佳奕; 吕世文; 仝淑花; 徐媛青

    2016-01-01

    目的::评价临床药师参与大隐静脉曲张手术围术期预防应用抗菌药物管理的效果。方法:选取2010年6~9月(干预前)、2011年6~9月(干预后)和2014年6~9月(巩固期)出院的大隐静脉单纯剥脱术、大隐静脉高位结扎加剥脱术及大隐静脉高位结扎加静脉内激光治疗的所有病例,针对预防应用抗菌药物的合理性进行评价。结果:临床药师参与管理后,大隐静脉曲张手术围术期预防应用抗菌药物在用药指征、药物品种选择、用法用量、给药途径、溶媒及溶媒量、给药时机、用药疗程、联合用药方面改善明显;抗菌药物使用率、平均住院日、抗菌药物比例、药品比例及输液率均明显降低,并得以巩固。结论:临床药师对大隐静脉曲张手术围术期预防应用抗菌药物的干预,提高了抗菌药物合理使用率,对降低患者费用,规范医院管理有一定意义。%Objective:To evaluate the management effect of clinical pharmacist on antibiotics use during perioperative period of great saphenous varicose veins surgery. Methods:The medical records of all the patients undergoing simple great saphenous vein strip-ping, great saphenous vein high ligation plus simple stripping and saphenous vein ligation plus endovenous laser treatment between June and September in 2010 ( before the intervention) , 2011 ( after the intervention) and 2014 ( consolidation period) were selected, and the rationality of prophylactic use of antibiotics during perioperative period was evaluated. Results: After the management of clinical pharmacists, the preventive application of antibiotics during perioperative period was markedly improved in the indication, medicine va-riety choice,application and dosage, administration route, solvent and solvent dose, administration time, course of treatment and drug combination when compared with that before the intervention. Antibiotics use ratio, average

  6. Study on the Effects of Clinical Pharmacists on Formulation of Prophylactic Antibiotics in Clinical Pathway Diseases%临床药师参与制订临床路径病种预防用抗菌药物作用探讨

    Institute of Scientific and Technical Information of China (English)

    郑高峰; 李彩华; 刁利华

    2011-01-01

    目的:探讨临床药师在临床路径执行中的作用.方法:对本院临床药师参与制订临床路径病种预防用抗菌药物的工作方法及效果进行总结.结果:临床药师通过查阅资料及与临床医师面对面进行沟通,使其推荐的围术期抗菌药物用药方案得到了临床的认可和执行.结论:临床药师在临床路径执行中发挥着重要的作用.%OBJECTIVE: To study the effect of clinical pharmacists on the implementation of clinical pathway. METHODS: The working methods and effects of clinical pharmacists participating in the establishment of the prophylactic antibiotics use of clinical pathway diseases were summarized. RESULTS: By referring to information and communicating with clinicians face to face, the medication scheme of antibiotics during perioperative period was accepted and adopted. CONCLUSION: clinical pharmacists play an important role in implementing clinical pathways.

  7. Pharmaceutical Care of Ciclosporine for Patient with Bullous Pemphigoid by Clinical Pharmacists%临床药师参与环孢素治疗大疱性类天疱疮患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    费龙; 郭珩; 张耕; 刘杨从

    2016-01-01

    目的:为临床药师融入临床实现个体化用药提供思路。方法:分享临床药师对1例环孢素治疗大疱性类天疱疮患者的药学监护,为患者提供个体化用药方案的成功案例。结果:医师接受建议,调整环孢素用药方案,治疗4日后少见新发红斑水疱,症状改善明显,同时临床药师对合并用药(糖皮质激素、人免疫球蛋白、环孢素等)进行药学监护,未见明显不良反应( adverse drug reaction,ADR),患者好转出院。结论:使用环孢素治疗皮肤系统疾病,监测血药浓度可能具有一定的临床意义,但尚需进一步经过临床实践研究。%OBJECTIVE:To provide ideas for the participation of clinical pharmacists in clinical individualized medication.METHODS: By sharing the pharmaceutical care participated by the clinical pharmacists in the drug therapy of a patient with bullous pemphigoid , the successful example of individualized medication was provided . RESULTS:The clinician accepted the proposal and adjusted the therapeutic regimen .The symptoms of the patient had been improved significantly and new erythema blister were rare after four days of treatment .Meanwhile , the clinical pharmacists provided pharmaceutical care for the drug combination ( corticosteroids , gamma globulin , cyclosporine , etc) , with no significant adverse drug reactions , the patient was discharged with a better health condition . CONCLUSIONS:The application of ciclosporine in treatment of skin diseases and monitor the blood concentration may have clinical significance , yet it still needs to be further researched in clinical practice .

  8. The use of placebo interventions in clinical practice.

    Science.gov (United States)

    Linde, K

    2013-04-01

    Although a considerable number of mostly quantitative surveys have investigated the frequency and circumstances of the use of placebo interventions in clinical practice, it remains rather unclear what role placebo interventions really have outside clinical and laboratory research and why they are used. In this article I discuss two aspects which have to be taken into account when future research aims to provide further insights: (1) the different perspectives of patients, providers and scientists when it comes to decide whether a treatment is a placebo or not and (2) the fact that applying placebos intentionally is not only an ethical but also a professional problem.

  9. Summary and Experience of Clinical Pharmacists Participating in the Consultation of 66 Cases%临床药师参与66例临床会诊案例的总结与体会

    Institute of Scientific and Technical Information of China (English)

    曹斌; 曹国文; 施爱明; 张全英

    2012-01-01

    目的:评价临床药学会诊实践的效果.方法:对2010年1月-2011年5月间临床药师参与本院临床会诊病例资料进行统计分析.结果:会诊目的为制订个体化药物治疗方案25例(37.9%),制订抗感染治疗方案15例(22.7%);会诊科室较多的为泌尿外科10例(15.2%),ICU与内分泌科各7例(10.6%);临床药师会诊意见全部被采纳的18例(27.3%),部分采纳的38例(57.6%);会诊后患者痊愈11例(16.7%),好转43例(65.2%).结论:临床药师积极参与会诊,对促进住院患者的合理用药具有重要意义,并得到临床医师的认可.%OBJECTIVE: To evaluate the effect of clinical pharmacy consultation. METHODS: From Jan. 2010 to May 2011, the data of clinical pharmacist participating in consultation of clinical cases in our hospital were analyzed statistically. RESULTS: The aim of consultation of 25 cases was to formulate individual therapeutic scheme (37.9%), that of 15 cases was to formulate anti-infection therapeutic scheme (22.7%); 10 consultations were from urology department (15.2%), and 7 from ICU and 7 from endocrinology department (10.6%). Clinical pharmacist's consultation opinions were totally accepted in 18 cases (27.3%), and partly accepted in 38 cases (57.6%); 11 patients were cured after our consultation (16.7%), and 43 patients were improved (65.2%). CONCLUSION: Clinical pharmacists actively participate in the consultation which is important to promote the rational drug use in hospitalized patients and obtain the recognition of clinicians.

  10. 临床药师参与抗凝治疗的实践及工作模式探讨%Introduction and Discussion of Clinical Practice and Working Pattern of Clinical Pharmacist in Anticoagula-tion Treatment

    Institute of Scientific and Technical Information of China (English)

    刘俊; 徐航

    2014-01-01

    Close monitoring and medication education are very important in the treatment of anticoagulation . Through clinical pharmacists ’ participation in formulating and adjusting anticoagulant therapy scheme and providing a full range of pharmaceutical service to the patients during hospitalization and before and after discharge from hospital , the treatment compliance of patients was increased , the success rate of anticoagulant therapy was improved and the risk of medication was reduced .%在抗凝治疗过程中,密切的监护和系统的用药教育非常重要。临床药师通过参与患者抗凝方案的制定和调整,并为患者在住院期间、出院前和出院后提供全方位药学服务,可增加患者治疗依从性,提高抗凝治疗成功率,减少患者用药风险。

  11. Development of an expert professional curriculum for antimicrobial pharmacists in the UK.

    Science.gov (United States)

    Sneddon, Jacqueline; Gilchrist, Mark; Wickens, Hayley

    2015-05-01

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

  12. Deviant Adolescent Subcultures: Assessment Strategies and Clinical Interventions.

    Science.gov (United States)

    Clark, Cynthia M.

    1992-01-01

    Presents assessment strategies, preventive methods, and clinical interventions to assist clinicians working with teenagers involved with deviant subcultures: Satanism, the neo-Nazi skinhead movement, and violent street gangs. Considers role of alienation as contributing factor in adolescents' participation in these subcultures. Advises therapists…

  13. 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.

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

    Science.gov (United States)

    Sheakley, Maria L.; Gilbert, Gregory E.; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    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 (nl=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. PMID:27060102

  15. 药师参与1例重症肺炎患者的治疗实践%Participation of Clinical Pharmacists in Treatment of One Patient with Severe Pneumonia

    Institute of Scientific and Technical Information of China (English)

    陈洁; 范璟蓉; 方忠宏

    2015-01-01

    OBJECTIVE:To probe into the participation of clinical pharmacists in treatment of one patient with severe pneumonia .METHODS:The clinical pharmacists participated in the medication treatment process of one patient with severe pneumonia , analyzed the change of disease , summarized the program with different kinds of antibiotics and the efficacy , and provided pharmaceutical services for the patient .RESULTS:The efficacy of cefoxitin , as one of cephamycin , in primary treatment of respiratory tract infection was poorer than the basic drugs———high dose of penicillin.CONCLUSIONS:It is necessary to conduct the pharmacodynamics evaluation on the antibiotics of cephamycin , and take effective management measures and medication education , so as to improve the medical quality . The clinical pharmacists go into the clinic and provide pharmaceutical services can assist the clinicians to formulate the safe and effective medication treatment program and promote ration drug use .%目的:探讨药师参与重症肺炎患者的治疗实践。方法:药师参与1例重症肺炎患者的药物治疗过程,分析患者病情变化,总结不同抗菌药物治疗方案及其疗效,并提供药学服务。结果:首诊用头霉素类抗菌药物头孢西丁对呼吸道感染的疗效较差,而大剂量的青霉素等基本药物却发挥了很好的疗效。结论:有必要对头霉素类抗菌药物等进行药效学评价,并采取有效管理措施与用药教育,以提高医疗质量。临床药师深入临床,提供药学服务,可协助临床医师制订安全、有效的药物治疗方案,促进合理用药。

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

    Science.gov (United States)

    Wilbur, Kerry; Kur, Jason

    2015-01-01

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

  17. The role of clinical pharmacists in the diagnosis and treatment of mercury poisoning caused by the topical use of cinnabar%临床药师在朱砂外用致汞中毒诊治中的作用

    Institute of Scientific and Technical Information of China (English)

    于丽; 轩姣; 李晋宝

    2016-01-01

    Objective:To explore the role of clinical pharmacists in the diagnosis and treatment of drug poisoning. Methods:According to the symptoms and medication history of the patient with mercury poisoning caused by topical use of cinnabar, clinical pharmacists provided some vermilion composition information for physicians and the basis for early diagnosis, and recommended to check the urinary mercury concentration and participated in the design of the treatment plan and carry out medication supervision after the clear diagnosis. Results:The concentration of acute urinary mercury in the patient exceeded the standard, however, it decreased to the normal level after the treatment of eliminating mercury and protecting liver and the condition was significantly improved. Conclusion: Clinical pharmacists can provide drug information for physicians in the treatment of drug poisoning, participate in making drug treatment plan and carry out pharmaceutical care.%目的:探讨临床药师在药物致中毒诊治中的作用。方法:在外用朱砂致汞中毒患者救治中,临床药师结合患者症状和用药史,为医师提供朱砂成分信息,并提出检查尿汞浓度的建议,为及早诊断提供依据,诊断明确后参与治疗方案的设计并开展用药监护。结果:急查患者尿汞浓度超标,经驱汞、保肝等治疗后,尿汞浓度降至正常,病情明显好转。结论:临床药师能够在药物中毒救治中提供药品信息、参与制定药物治疗方案和开展药学监护。

  18. Pharmaceutical Care for a Patient with Vancomycin-resistant Enterococcus Infection by Clinical Pharmacists%临床药师对1例耐万古霉素肠球菌感染患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    赵媛媛; 朱立勤; 许国良; 王超男; 章袁

    2013-01-01

    OBJECTIVE: To investigate the methods of clinical pharmaceutical care and promote rational use of drug. METHODS: Taking diagnosis and treatment for a case of vancomycin-resistant enterococcus infection as example, pharmacists provided whole pharmaceutical care in respects of selection of drug type, dosage adjustment, route of administration, individualized dosing regimen for special population, including observation of curative effect, ADR monitoring and patient education. Therapeutic efficacy was evaluted. RESULTS: Clinical pharmacists and clinicians developed treatment regimens for patient, and provide whole pharmaceutical care for patient to achieve good effect. The patient was cured and discharged. CONCLUSIONS: Clinical pharmacists provide the entire course of pharmaceutical care for patient with vancomycin-resistant Enterococcus infection to reduce drug abuse effectively and play a good role in safe and rational use of drugs.%目的:探讨临床药学监护方法,促进药物合理应用.方法:以1例耐万古霉素肠球菌感染患者的诊治过程为例,药师针对药物品种选择、剂量调整、服用方法、针对特殊人群制订个体化给药方案等实行全程药学监护,包括疗效观察、不良反应监测和患者用药教育等,并进行效果评价.结果:临床药师与临床医师共同制订治疗方案,并对患者实施全程的药学监护,效果良好,患者治愈后出院.结论:临床药师对耐万古霉素肠球菌感染患者实行全程药学监护,有效地减少了药物的滥用,对合理、安全地使用药物起到了良好作用.

  19. 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.

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

    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

    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。%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.

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

    OpenAIRE

    Wilbur, Kerry; Kur, Jason

    2015-01-01

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

  2. 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.

  3. 临床药师在危重病人个体化肠外营养支持中的作用%Effectiveness and Efficacy of the Clinical Pharmacist in the Critically Ⅲ Patients' Individual Parenteral Nutrition

    Institute of Scientific and Technical Information of China (English)

    卞晓洁; 葛卫红

    2011-01-01

    我院临床药师在病人个体化肠外营养支持的工作中,从2008年9月至今,共制订个体化肠外营养支持方案31例,其中7例为危重病人,3例为药师会诊危重病人,患者经营养支持后,病情均有所恢复并获准出院.危重病人肠外营养支持成功的关键不仅在于根据病人身高、体重、具体病情等综合评价分析后给予个体化肠外营养组方,更重要的在于:严密监测病人临床状况,分析因为,及时调整组方,保证病人肠外营养支持的安全性和有效性.%In the work of individual parenteral nutrition. the clinical pharmacist in our hospital has formulated 31 parenteral nutrition support programs, including 7 programs of critically ill patients and 3 programs of the critically ill patients of pharmacist consultation from September 2008. With the nutrition support, all the patients recovered and discharged. The key of parenteral nutrition in critically ill patients is not only to formulate the individual parenteral nutrition support program according to the patients’' height, weight, illness condition. but also to monitor the clinical status of patients closely, and to analyze the reason, to adjust the parenteral nutrition support program, in order to ensure safety and effectiveness of patients.

  4. 临床药师对1例吸入性肺炎患者的药学监护%Pharmaceutical Care for a Patient with Aspiration Pneumonia by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    龙锐; 陈庆宪; 朱深银

    2013-01-01

    目的:探讨临床药师开展对吸入性肺炎患者进行药学监护的方法.方法:从对1例因溺淡污水造成吸入性肺炎患者的初始及后续抗感染、神经精神症状的改善、营养支持方案的制订等方面,进行药物治疗监护,总结经验.结果:临床药师评估患者状况、建立用药监护计划、采取合适措施并跟踪治疗,避免了潜在药物治疗风险,解决了药物治疗存在的问题.结论:建立并完善用药监护要点,及时与医师沟通,充分发挥药学专业技能,有利于开展药学监护.%OBJECTIVE: To discuss the way to develop pharmaceutical care for a patient with aspiration pneumonia by clinical pharmacists. METHODS: The pharmaceutical care was given to a patient with aspiration pneumonia induced by drowning, in the aspects of the formulation of anti-infective regimen, improvement of mental and nervous symptom and the development of nutrition support plan. The process and experiences were recorded. RESULTS: Clinical pharmacist evaluated the patient's condition, prepared the plan of pharmaceutical care, selected appropriate measure and followed the treatment. The potential risk of drug therapy was avoided and the problem of drug therapy was solved. CONCLUSIONS: For carrying out pharmaceutical care, it is useful to set up key points of pharmaceutical care, communicate with physician in time and full use professional pharmaceutical skill.

  5. Large scale implementation of clinical medication reviews in Dutch community pharmacies: Drug-related problems and interventions

    NARCIS (Netherlands)

    Kempen, Thomas G. H.; Van De Steeg-Van Gompel, Caroline H. P. A.; Hoogland, Petra; Liu, Yuqian; Bouvy, Marcel L.

    2014-01-01

    Background: Research on the benefits of clinical medication reviews (CMRs) performed by pharmacists has been conducted mostly in controlled settings and has been widely published. Less is known of the effects after large scale implementation in community pharmacies. An online CMR tool enabled the sy

  6. 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

  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. Talking to the Pharmacist (For Parents)

    Science.gov (United States)

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

  9. The palliative care interdisciplinary team: where is the community pharmacist?

    Science.gov (United States)

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

    2011-01-01

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

  10. Pharmacist-Patient Interaction and Patient Expectations

    Science.gov (United States)

    DeSimone, Edward M.; And Others

    1977-01-01

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

  11. Ethical clinical translation of stem cell interventions for neurologic disease

    DEFF Research Database (Denmark)

    Cote, David J; Bredenoord, Annelien L; Smith, Timothy R

    2017-01-01

    The application of stem cell transplants in clinical practice has increased in frequency in recent years. Many of the stem cell transplants in neurologic diseases, including stroke, Parkinson disease, spinal cord injury, and demyelinating diseases, are unproven-they have not been tested...... in prospective, controlled clinical trials and have not become accepted therapies. Stem cell transplant procedures currently being carried out have therapeutic aims, but are frequently experimental and unregulated, and could potentially put patients at risk. In some cases, patients undergoing such operations...... are not included in a clinical trial, and do not provide genuinely informed consent. For these reasons and others, some current stem cell interventions for neurologic diseases are ethically dubious and could jeopardize progress in the field. We provide discussion points for the evaluation of new stem cell...

  12. Clinical practice of an endocrinology clinical pharmacists participating in the treatment of a patient with diabetes and hyperprolactinemia%内分泌科临床药师参与1例糖尿病合并高催乳素血症患者的治疗实践

    Institute of Scientific and Technical Information of China (English)

    王涛; 邓昂

    2015-01-01

    目的:探讨内分泌科临床药师参与临床药物治疗的工作模式。方法临床药师通过参与1例糖尿病合并高催乳素血症患者的治疗,分析患者血糖控制不佳及高催乳素血症的原因,提出治疗方案。结果长期服用抗精神病药物可能是患者血糖控制不佳的原因之一。高催乳素血症可能与患者长期服用抗精神病药帕潘立酮缓释片有关,建议患者转诊精神科,选用无升高催乳素作用的抗精神病药物治疗。结论临床药师积极参与临床治疗,能有效提高患者用药的合理性和依从性。%Objective To explore the working pattern for endocrinology clinical pharmacists participating in clinical drug treatment .Methods By participating in the treatment for a patient with diabetes and hyperprolactinemia and analyzing the cau‐ses of poor glycemic control and hyperprolactinemia ,clinical pharmacists proposed therapeutic regimen .Results The long‐term psychotropic medication may be one of the reasons why blood glucose of the patient was unsatisfactorily controlled .The patient with hyperprolactinemia may be associated with her longstanding use of paliperidone .The patient was recommended to consult a psychiatrist and switch to an alternative medication which does not cause hyperprolactinemia .Conclusion The active partici‐pation of clinical pharmacists during clinical drug therapy could improve the medication rationality and compliance of patients with drugs .

  13. 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.

  14. New roles for pharmacists in community mental health care: a narrative review.

    Science.gov (United States)

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

    2014-10-21

    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. Doctor and pharmacist - back to the apothecary!

    Science.gov (United States)

    Liaw, Siaw-Teng; Peterson, Gregory

    2009-05-01

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

  16. Pharmaceutical Care for One Brain Metastasis Patient with Lung Cancer in Individualized Anti Epilepsy Treatment by clinical Pharmacists%临床药师参与肺癌脑转移患者抗癫痫个体化治疗的药学监护

    Institute of Scientific and Technical Information of China (English)

    杨磊; 王林海; 林意菊; 赵启邹; 聂彩霞; 邹治木; 尹思敏

    2016-01-01

    OBJECTIVE:To probe into the role of clinical pharmacists in individualized anti epilepsy treatment . METHODS:The clinical pharmacists participated into the process of individualized anti epilepsy treatment , adjusted the treatment scheme of anti epilepsy and analyzed the rationality of clinical medication .RESULTS&CONCLUSIONS:The clinical pharmacists go into the clinic , assist the clinicians to formulate individualized anti epilepsy treatment scheme, and develop medication education for patients , so as to promote the rational drug use and improve the treatment level of clinical medication .%目的:探讨临床药师在患者个体化药物治疗中的作用。方法:临床药师参与1例肺癌脑转移患者抗癫痫个体化治疗治疗过程,参与患者抗癫痫治疗方案的调整,分析临床用药的合理性。结果与结论:临床药师通过深入临床,根据患者具体情况协助医师制定个体化用药方案,并对患者开展用药教育,促进了合理用药,提高了临床药物治疗水平。

  17. Analysis on the Communication Effect of Clinical Pharmacists and Clinicians Based on the Driver's License Type Management%基于驾照式管理临床药师与临床医师的沟通效果分析

    Institute of Scientific and Technical Information of China (English)

    胡晓蕾; 唐敏; 何菊英; 夏培元

    2014-01-01

    阐述了驾照式管理中临床药师依托“合理用药信息系统”平台与临床医师进行点对点沟通,拓展并优化了临床药师与临床医师的沟通途径,有利于临床合理用药工作的开展,在促进临床合理用药方面起到了重要作用。%In the driver’s license type management, clinical pharmacists rely on the information system for the rational drug use for the point-to-point communication with clinicians, which expands and optimizes the communication approaches of pharmacists and clinicians, helps with the work of clinical rational drug use, and plays an important role in promoting clinical rational drug use.

  18. Clinical interventions for late-life anxious depression.

    Science.gov (United States)

    Diefenbach, Gretchen J; Goethe, John

    2006-01-01

    Anxiety symptoms are frequently present in patients with late-life depression. The designation "anxious depression" has been used to describe major depressive disorder (MDD) accompanied by clinically significant but subsyndromal anxiety symptoms. MDD may also present comorbid with diagnosable anxiety disorders, although this presentation is less common in late life. Diagnosis of anxious depression in the elderly is complicated by several factors (eg, their tendency to experience and report psychiatric symptoms as somatic illness) and is associated with a more severe clinical presentation, increased risk for suicidal ideation, increased disability, and poorer prognosis. Standard pharmacotherapy for depression may be sufficient but for many patients must be modified or augmented. Psychosocial interventions may also be an important component in the treatment of these patients, although no specific psychosocial treatments have been developed for late-life anxious depression.

  19. 临床药师对1例肺癌骨转合并粒缺性发热患者的药学监护%Pharmaceutical care for a Patient with Bone Metastasis Complicating with Febrile Neutropenia in Lung Cancer by Clinical Pharmacist

    Institute of Scientific and Technical Information of China (English)

    朱智云; 王爱英

    2016-01-01

    目的:通过对化疗患者提供药学监护,促进临床合理用药,保障患者用药安全。方法:临床药师对1例肺癌骨转移患者用药过程进行全程药学监护。结果:通过全程药学监护,患者化疗过程中出现的并发症得到合理解决。结论:临床药师为肿瘤患者提供全程药学监护,对促进患者用药合理化具有重要意义。%Objective: Clinical pharmacist provided a Whole-course pharmaceutical to a tumor patient so as to promote clinical rational use of drugs and to ensure the safety of patient.Methods: Clinical pharmacist provided whole-course pharmaceutical care for one patient with bone metastasis of lung Cancer.Results: Through the whole process of pharmaceutical care, the complications of chemotherapy had been effectively performed. Conclusion: Clinical pharmacists provide clinical pharmaceutical services for tumor patients, and promote rational drug use.

  20. 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.

  1. Role of Clinical Pharmacists in Tumor Pain Management of Palliative Radiotherapy%临床药师在姑息性放疗患者癌痛管理中的作用

    Institute of Scientific and Technical Information of China (English)

    苏颖杰; 刘晓琰; 崔敏; 钟晗

    2015-01-01

    OBJECTIVE:To explore the role of clinical pharmacists in tumor pain management for patients receiving tumor pain palliative radiotherapy. METHODS:In prospective randomized controlled study, 60 patients with tumor pain who received palliative radiotherapy in radiotherapy department of our hospital from June 1,2013 to May 31,2014,according with the selection criteria,were randomized into observation group(30 cases)and control group(30 cases). Clinical pharmacists participated in the treatment of observation group;provided pharmaceutical care for doctors;and recorded drug treatment,pain evaluation,medica-tion compliance,Karnofsky Performance Status(KPS)and quality of life(QOL)of 2 groups. RESULTS:On the 5th day,the pain remission rate of observation group reached 63.3%,and was significantly higher than that(36.7%)of control group(P0.05). At the same time,KPS, QOL and medication adherence were all improved significantly,compared with before treatment(P<0.01 or P<0.05),and medi-cation adherence of observation group was obviously better than that of control group(P<0.01). CONCLUSIONS:The participa-tion of clinical pharmacists in the pain management can obviously improve medication compliance,relieve pain more effectively, and promote rational drug use.%目的:探讨临床药师在姑息性放疗患者癌痛管理中的作用。方法:采用前瞻性随机对照研究,将我院放疗科进行姑息性放疗、符合病例入组条件的癌痛患者随机分为观察组和对照组,各30例。临床药师参与观察组患者的用药治疗,为医师提供药学服务,记录两组患者药物治疗情况、疼痛评分、服药依从性、卡氏(KPS)评分及生存质量评分。结果:综合治疗第5天,观察组患者疼痛缓解率为63.3%,高于对照组的缓解率36.7%(P<0.05)。治疗1个月,两组患者的疼痛缓解率为70%、80%(P>0.05);KPS评分、生存质量评分及服药依从性均较

  2. 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.

  3. Improving patient access to an interventional US clinic.

    Science.gov (United States)

    Steele, Joseph R; Clarke, Ryan K; Terrell, John A; Brightmon, Tonya R

    2014-01-01

    A continuous quality improvement project was conducted to increase patient access to a neurointerventional ultrasonography (US) clinic. The clinic was experiencing major scheduling delays because of an increasing patient volume. A multidisciplinary team was formed that included schedulers, medical assistants, nurses, technologists, and physicians. The team created an Ishikawa diagram of the possible causes of the long wait time to the next available appointment and developed a flowchart of the steps involved in scheduling and completing a diagnostic US examination and biopsy. The team then implemented a staged intervention that included adjustments to staffing and room use (stage 1); new procedures for scheduling same-day add-on appointments (stage 2); and a lead technician rotation to optimize patient flow, staffing, and workflow (stage 3). Six months after initiation of the intervention, the mean time to the next available appointment had decreased from 25 days at baseline to 1 day, and the number of available daily appointments had increased from 38 to 55. These improvements resulted from a coordinated provider effort and had a net present value of more than $275,000. This project demonstrates that structural changes in staffing, workflow, and room use can substantially reduce scheduling delays for critical imaging procedures.

  4. [The Pharmacist as Gatekeeper of Prescription Drug Abuse: Return to "Community Scientists"].

    Science.gov (United States)

    Shimane, Takuya

    2016-01-01

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

  5. 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.

  6. 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

  7. Clinical Pharmacists Participating in Drug Therapy for Pulmonary Infection in a Patient after Renal Transplantation%临床药师参与1例肾移植术后肺部感染患者的药物治疗实践

    Institute of Scientific and Technical Information of China (English)

    李峰; 安琪; 张晓坚

    2012-01-01

    OBJECTIVE: To discuss the role of clinical pharmacists in drug treatment for pulmonary infection in a patient after renal transplantation. METHODS: Clinical pharmacists assisted the doctors to make drug therapy for pulmonary infection in a patient after renal transplantation, formulated reasonable therapeutic scheme and put forward reasonable pharmaceutical care measure and health education. RESULTS&CONCLUSION: Clinical pharmacists participating in clinical treatment for patients can find out adverse drug reaction timely, improve therapeutic scheme and promote therapeutic efficacy.%目的:探讨临床药师在肾移植术后肺部感染患者临床治疗中发挥的作用.方法:通过临床药师参与1例肾移植术后肺部感染患者的药物治疗过程,与临床医师共同制订治疗方案,并对患者提出合理的药学监护措施及健康教育.结果与结论:临床药师参与患者药物治疗过程,可及时发现、解决治疗过程中的药品不良反应与相互作用,完善临床治疗方案,提高药物治疗效果.

  8. A web-based training program to support chronic kidney disease screening by community pharmacists.

    Science.gov (United States)

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

    2016-10-01

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

  9. Analysis of Clinical Pharmacists Participating in Diagnosis and Treatment for a Case of Gemella morbillorum Induced Pulmonary Infection%临床药师参与诊治1例麻疹孪生球菌致肺部感染病例分析

    Institute of Scientific and Technical Information of China (English)

    秦广东; 安琪; 刘红

    2013-01-01

    目的:探讨临床药师在麻疹孪生球菌致肺部感染患者临床治疗中发挥的作用.方法:临床药师参与1例麻疹孪生球菌致肺部感染患者的诊治过程,通过认真分析患者的病情,根据诊疗指南及药敏试验结果,在抗菌药物的选择、药效学、药动学、药品不良反应和注意事项等方面为临床医师提供参考,为患者制订抗感染治疗方案提供合理化建议.结果:临床药师提出的合理化治疗方案被医师采纳,取得了很好的疗效.结论:临床药师参加临床治疗团队,参与药物治疗过程,协助临床医师制订合理化治疗方案,减少了不良反应,提高了药物治疗效果,体现了临床药师的价值.%OBJECTIVE: To study the role of clinical pharmacists in clinical treatment for Gemella morbillorum induced pulmonary infection. METHODS: Clinical pharmacists participated in the diagnosis and treatment for a case of Gemella morbillorum induced pulmonary infection, provided reference for clinical physicians in terms of antibiotics selection, pharmacodynamics, pharma-cokinetics, ADR, cations, and offered reasonable suggestions for anti-infective treatment by analyzing the disease condition of patients according to guidline and drug sensitivity test. RESULTS: Reasonable treatment regimen of clinical pharmacists was adopted by doctors, and achieved good results. CONCLUSIONS: Clinical pharmacists participate in clinical treatment team and drug treatment process and assist clinicians in making rational treatment scheme to reduce adverse drug reaction, improve therapeutic efficacy , and reflect the value of clinical pharmacists.

  10. Practice of Participation of Clinical Pharmacists in Adjustment of Anti-infection Therapeutic Scheme in One Case of Flavobacterium Breve Infection%临床药师参与短黄杆菌感染患者抗感染治疗的实践

    Institute of Scientific and Technical Information of China (English)

    鲁晓燕; 孟静

    2016-01-01

    OBJECTIVE:To probe into the pharmaceutical practice of participation of clinical pharmacists in adjustment of anti-infection therapeutic scheme in one case of flavobacterium breve infection.METHODS:The clinical pharmacists participated into the drug treatment process of one case of flavobacterium breve infection by consultation and continuous monitoring, analyzed the medication status, put forward suggestions for the clinicians to formulate rational therapeutic regimen and monitored the patient’s medication process.RESULTS: The clinical pharmacists assisted the clinicians to adjust therapeutic regimen and promoted the improvement of the disease condition.CONCLUSIONS: The clinical pharmacists participate into the individualized treatment process, bring their pharmaceutical speciality into full play and assist the clinicians with safety and effective medication, which fully reflect their own value.%目的:探讨临床药师参与短黄杆菌感染患者抗感染治疗的药学实践。方法:临床药师参加会诊并持续性监护1例短黄杆菌感染患者的药物治疗过程,分析用药情况,为医师制订合理的用药方案提出建议,并对药品不良反应进行监护。结果:临床药师协助医师调整用药方案,促进患者病情好转。结论:临床药师参与个体化治疗过程,发挥药学专长,协助医师安全、有效地用药,体现了自身的价值。

  11. 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

  12. 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.

  13. 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.

  14. Practice of Pharmaceutical Care in Chemotherapy for One Patient with Advanced Breast Cancer by Clini-cal Pharmacists%临床药师在晚期乳腺癌患者化疗中的药学监护实践

    Institute of Scientific and Technical Information of China (English)

    陈岷; 童荣生; 翁秀华

    2015-01-01

    Objective:To explore the pharmaceutical care for special tumor patients performed by clinical pharmacists. Methods:Using one patient with breast cancer and hepatitis B virus infection as the example, clinical pharmacists participated in the clinical medicine therapy. Cooperating with the clinical physician, clinical pharmacists made an overall therapy regimen for the patient. On the basis of chemotherapy regimen and combining with the actual conditions of the patient, clinical pharmacists comprehensively considered the relevant therapeutic factors, such as antiviral, anti-nausea, hepatoprotective and increasing white cells therapy, and performed the corresponding regimen. In the treatment process, clinical pharmacists provided the real-time pharmaceutical care and tracking evalua-tion for the patient as well. Results: With close collaboration with clinical pharmacists and physicians, the patient obtalned perfect medicine therapy and pharmaceutical care, which made the biochemical indices ( liver enzymes, blood, hepatitis B virus load etc) tend to normal in the whole course of chemotherapy and help the patient complete the chemotherapy. Conclusion:Clinical pharmacists in-volved in clinical medicine treatment especially for special and complex diseases can make clinical medication more rational, which helps achieve the goal of treatment and reduce adverse drug reactions at the same time, and is benefit to the improvement of patient compliance and clinical medication level.%目的::探讨临床药师如何对特殊肿瘤患者实施药学监护。方法:以1例乳腺癌伴乙肝病毒感染患者为例,临床药师介入临床,协助临床医师根据患者实际情况综合考虑与治疗相关的抗病毒、止吐、保肝和升白等多重因素并制定相应的治疗方案;在治疗过程中对该患者进行了实时药学监护与跟踪评价。结果:在临床药师与医师的密切配合下,患者获得了较为完

  15. A network approach to clinical intervention in neurodegenerative diseases.

    Science.gov (United States)

    Santiago, Jose A; Potashkin, Judith A

    2014-12-01

    Network biology has become a powerful tool to dissect the molecular mechanisms triggering neurodegeneration. Recent developments in network biology have led to the discovery of disease-causing genes, diagnostic biomarkers, and therapeutic targets for several neurodegenerative diseases including Alzheimer's, Parkinson's, and Huntington's diseases. Network-based approaches have provided the molecular rationale for the relationship among cancer, diabetes, and neurodegenerative diseases, and have uncovered unexpected links between apparently unrelated diseases. Here, we summarize the recent advances in network biology to untangle the molecular underpinnings giving rise to the most prevalent neurodegenerative diseases. We propose that network analysis provides a feasible and practical tool for identifying biologically meaningful biomarkers and potential therapeutic targets for clinical intervention in neurodegenerative diseases.

  16. Role of Clinical Pharmacists in Drug Treatment of A Prostate Cancer Patient%临床药师在1例前列腺癌患者药物治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    方英立; 周文; 王秀问

    2013-01-01

      临床药师全程参与1例前列腺癌患者药物治疗,在癌痛控制、治疗方案的选择、患者安全用药等方面提供药学服务。患者顺利完成8周期治疗,仅出现轻度恶心,未出现呕吐、骨髓抑制、肝肾损伤等不良反应。同时患者经综合治疗,2周后疼痛得到有效缓解;2周期治疗后排尿困难等不适症状明显减轻,疗效评价为部分缓解(PR)。%Clinical pharmacists participated in the drug treatment of a prostate cancer patient, and provided pharmaceutical care in controlling pain, choosing optimal chemotherapy and safety in drug treatment. The patient completed 8 courses of chemotherapy successfully. During the period, he only felt mild nausea and never appeared vomiting, bone marrow depression, liver or kidney function injury. By comprehensive treatment, the patient got palliation from the pain after two weeks, and extenuation from the symptom of dysuria after 2 courses. Therapeutic effect was assessed as partial response(PR).

  17. Role of Clinical Pharmacists in the Diagnosis of 1 Case of Penicillin Drug-induced Disease%临床药师在1例青霉素引起的药源性疾病诊断中发挥的作用

    Institute of Scientific and Technical Information of China (English)

    运乃茹; 段金菊

    2011-01-01

    OBJECTIVE: To prove the proper role of clinical pharmacists in treatment team. METHODS: Using highly professional sensitivity, pharmaceutical professional knowledge, asking medical history and reviewing literatures, clinical pharmacist found the basis of evidence-based medicine in the diagnosis process of 1 case of drug-induced diseases. RESULTS: It helped treatment team to diagnose 1 case of drug-induced disease. CONCLUSION: Clinical pharmacist can become a real member of the treatment team and play its proper role.%目的:证实临床药师在治疗团队中能够发挥应有的作用.方法:在1例青霉素引起药源性疾病的发现诊断过程中,临床药师利用高度的职业敏感性和药学专业知识,通过询问病史特别是用药情况,查阅相关文献,寻找循证医学证据.结果:最终帮助团队诊断1例药源性疾病.结论:临床药师能成为治疗团队中真正的一员,发挥应有的作用.

  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. Involving staff pharmacists in management decisions.

    Science.gov (United States)

    Robinson, L A; Vanderveen, T W

    1977-03-01

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

  20. 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

  1. The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy

    Directory of Open Access Journals (Sweden)

    Duncan I

    2012-04-01

    Full Text Available Michael Taitel1, Jenny Jiang1, Kristi Rudkin2, Susan Ewing2, Ian Duncan 1Clinical Outcomes and Analytics, Walgreens, 2Corporate Innovation Team, Walgreens, Deerfield, Illinois, USAPurpose: To evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT for statin medications.Patients and methods: This retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR, categorical MPR, and medication persistency.Results: After adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2% and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%; this 4.9% difference is significant (P < 0.01. The 12 month categorical MPR also showed significant differences between groups (χ2 = 6.12, P < 0.05; 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.Conclusion: Patients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the

  2. 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.

  3. 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.

  4. 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.

  5. 利用药物基因检测指导氯吡格雷个体化用药案例分析%Analysis of Individualized Drug Use of Clopidogrel through Drug Genetic Testing by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    惠红岩; 周祥; 陈明

    2016-01-01

    目的:探讨如何根据药物基因检测结果指导氯吡格雷的个体化给药。方法:临床药师在参与抗血小板药物治疗中,通过基因分型,结合药物代谢、药物相互作用,对氯吡格雷慢代谢型、中间代谢型和超快代谢型的3例患者综合判断是否需要继续使用氯吡格雷及合适的使用剂量。结果:冠状动脉支架植入术后半月发生亚急性支架内血栓的氯吡格雷慢代谢型患者,建议改用替格瑞洛口服;抗血小板治疗反复发生皮下出血的超快代谢型患者,建议降低氯吡格雷给药剂量,暂时停用脉血康胶囊并常规口服维生素 C 片;联合使用兰索拉唑发生晚期支架内血栓的氯吡格雷中间代谢型患者,建议增加氯吡格雷给药剂量或换用替格瑞洛,必要时可考虑选择泮托拉唑或雷贝拉唑甚或换用其他抑酸药如雷尼替丁等。结论:临床药师利用药物基因检测工具,结合药物相互作用等,可以指导氯吡格雷的临床使用,优化抗血小板的治疗方案,实现药物的个体化治疗目标。%Objective:To study how to guide the individual dose of clopidogrel in line with the genetic testing results. Methods:Clinical pharmacists decided how to optimize the prescription of clopidogrel according to the genotype combined with the drug metabolism and drug interactions for three patients respectively with slow clopidogrel metabolism,intermediary metabolism and super fast metabolism. Results:The slow clopidogrel metabolism patient with subacute stent thrombosis after half a month of coronary stenting was switched to orally administrate with ticagrelor. The super fast metabolism patient suffered from repeatedly subcutaneous hemorrhage with antiplatelet therapy was suggested to lower the dose of clopidogrel,temporarily withdraw Maixuekang capsules and conventionally administrate with vitamin C tablets orally. The intermediary metabolism patient with late

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Hoan Linh Banh

    2016-02-01

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

  8. A triadic neurocognitive approach to addiction for clinical interventions.

    Science.gov (United States)

    Noël, Xavier; Brevers, Damien; Bechara, Antoine

    2013-12-27

    According to the triadic neurocognitive model of addiction to drugs (e.g., cocaine) and non-drugs (e.g., gambling), weakened "willpower" associated with these behaviors is the product of an abnormal functioning in one or more of three key neural and cognitive systems: (1) an amygdala-striatum dependent system mediating automatic, habitual, and salient behaviors; (2) a prefrontal cortex dependent system important for self-regulation and forecasting the future consequences of a behavior; and (3) an insula dependent system for the reception of interoceptive signals and their translation into feeling states (such as urge and craving), which in turn plays a strong influential role in decision-making and impulse control processes related to uncertainty, risk, and reward. The described three-systems account for poor decision-making (i.e., prioritizing short-term consequences of a decisional option) and stimulus-driven actions, thus leading to a more elevated risk for relapse. Finally, this article elaborates on the need for "personalized" clinical model-based interventions targeting interactions between implicit processes, interoceptive signaling, and supervisory function aimed at helping individuals become less governed by immediate situations and automatic pre-potent responses, and more influenced by systems involved in the pursuit of future valued goals.

  9. A triadic approach to addiction for clinical interventions

    Directory of Open Access Journals (Sweden)

    Xavier eNoel

    2013-12-01

    Full Text Available According to the triadic neurocognitive model of addiction to drugs (e.g., cocaine and non-drugs (e.g., gambling, weakened willpower associated with these behaviours is the product of an abnormal functioning in one or more of three key neural and cognitive systems: (1 an amygdala-striatum dependent system mediating automatic, habitual, and salient behaviours; (2 a prefrontal cortex dependent system important for self-regulation and forecasting the future consequences of a behaviour and (3 an insula dependent system for the reception of interoceptive signals and their translation into feeling states (such as urge and craving, which in turn plays a strong influential role in decision-making and impulse control processes related to uncertainty, risk, and reward. The described three-systems account for poor decision-making (i.e., prioritizing short-term consequences of a decisional option and stimulus-driven actions, thus leading to a more elevated risk for relapse. Finally, this article elaborates on the need for personalized clinical model-based interventions targeting interactions between implicit processes, interoceptive signalling, and supervisory function aimed at helping individuals become less governed by immediate situations and automatic prepotent responses, and more influenced by systems involved in the pursuit of future valued goals.

  10. 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

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

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    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.

  12. Pharmacovigilance in Qatar: a survey of pharmacists.

    Science.gov (United States)

    Wilbur, K

    2013-11-01

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

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

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    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

  14. Clinical Pharmacists'Practice in Pharmaceutical Care for One Nephrotic Syndrome Patient with Gastrointestinal Infection%临床药师参与1例肾病综合征并发胃肠道感染患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    唐景财; 阎敏

    2016-01-01

    OBJECTIVE:To explore the role of clinical pharmacists in clinical rational drug use for nephrotic syndrome patients . METHODS: To introduce the treatment process of one nephrotic syndrome patient with gastrointestinal infection participated by the clinical pharmacists .RESULTS & CONCLUSIONS: Proper drugs were selected through the discussion of clinical pharmacists and clinicians , the medication scheme was adjusted according to the patient's conditions and clinical efficacy of drugs , and necessary pharmaceutical care was provided for the patient . Meanwhile , the patient's urinary protein decreased without any complications like thrombus , and the gastrointestinal tract infection had been cured .Therefore , clinical pharmacists‘ participation in the formulation of the related treatment regimen can improve patient's compliance and clinical treatment efficacy and also promote medical quality .The clinical pharmacists play an important role in the rational drug use for nephrotic syndrome patients .%目的:探讨临床药师在肾病综合征患者合理用药中的作用。方法:介绍临床药师参与1例肾病综合征并发胃肠道感染患者的治疗过程。结果与结论:经临床药师与医师讨论并选择合适的药物,根据患者病情变化及药物疗效及时调整用药方案,可为患者提供必要的药学服务。结果,该患者尿蛋白减少,未出现血栓等并发症,胃肠道感染治愈。由此表明,临床药师参与患者有关治疗方案的制订,可提高患者的用药依从性和临床治疗效果,医疗质量提升,临床药师在肾病综合征患者合理用药中发挥了重要作用。

  15. Empowered diabetes management: life coaching and pharmacist counseling for employed adults with diabetes.

    Science.gov (United States)

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

    2013-10-01

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

  16. 临床药师参与救治1例鲍曼不动杆菌所致颅内感染的用药分析%Analysis of Drug Use of Clinical Pharmacist Participating in the Treatment of Intracranial Infection Caused by Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    李明; 隋建美; 杨继红; 郑志昌

    2012-01-01

    目的:临床药师通过参与鲍曼不动杆菌导致颅内感染患者的救治过程,探索最佳的药物治疗方案.方法:临床药师参加临床治疗团队,参与患者治疗全过程,为危重患者的抢救制订药物治疗方案提供合理化建议.结果:临床药师通过认真分析患者的病情,提出了合理化建议,被临床医师采纳,取得了很好的疗效.结论:临床药学服务对患者的治疗是有帮助的,对于鲍曼不动杆菌所致的颅内感染,头孢哌酮/舒巴坦钠可作为首选药物.%OBJECTIVE: To explore optimal drug therapy scheme through clinical pharmacists participating in treatment process of intracranial infarction caused by Acinetobacter baumannii. METHODS: Clinical pharmacists joined clinical treatment team and participated in whole treatment process to establish drug therapy scheme for critical patients rescue and provide rational suggestion. RESULTS: Clinical pharmacists seriously analyzed patient's condition and put forward rational suggestions, which were adopted by the clinicians, all the things obtained good effect. CONCLUSION: Clinical pharmaceutical care is helpful to patient's treatment. As for A. Baumannii-caused intracranial infection, Cefoperazone/sulbactam sodium is the first chioce.

  17. Participation of Clinical Pharmacists in the Treatment of One Case of Adverse Reaction Induced by Trastu-zumab%临床药师参与1例曲妥珠单抗致不良反应治疗方案的制定

    Institute of Scientific and Technical Information of China (English)

    董利森; 刘璐

    2015-01-01

    Objective:To explore the participation of clinical pharmacists in drug treatment. Methods:Clinical pharmacists car-ried out pharmaceutical ward round, and understood the medication history of one breast cancer patient with postoperative pneumonia. They thought the induction possibility of trastuzumab likely to be non infectious pulmonary infiltration. Combined with the drug instruc-tions, relevant literatures and case report, they put forward suggestions for the medication, and participated in the formulation of drug therapy. Results:The suggestions of clinical pharmacists were adopted, and on the second day of methylprednisolone sodium succinate treatment, the symptoms of the patient were improved, and the results of the imaging examination also tended to be improved without recurrence. Conclusion:The participation of clinical pharmacists in the formulation of clinical medication has important significance for improving the level of clinical treatment.%目的:探索临床药师参与药物治疗方案的制定. 方法:临床药师开展药学查房,通过对1名乳腺癌术后化疗继发肺炎患者询问用药史,考虑由曲妥珠单抗引起的非感染性肺浸润可能性大,结合药品说明书、相关文献及个案报道,及时向医师提出用药建议,参与患者药物治疗方案的制定. 结果:医师采纳临床药师意见,患者在使用甲泼尼龙琥珀酸钠后第2日,症状好转,影像学检查也趋于好转,未再复发. 结论:临床药师参与临床用药方案的制定,对于提高临床治疗水平具有重要意义.

  18. 临床药师参与高警示药品不良事件救治及风险控制的实践体会%Experience of clinical pharmacists participating in the treatment of adverse events and risk control of high alert drugs

    Institute of Scientific and Technical Information of China (English)

    刘淑梅; 李媛; 谢博

    2016-01-01

    目的:介绍我院临床药师参与高警示药品不良事件的救治与风险控制的实践体会。方法:对我院临床药师工作中遇到的高警示药品典型病例进行叙述及分析。结果:临床药师对高警示药品不良事件的诊断、用药分析和救治提出了见解和建议,并且获得较好的效果。结论:临床药师以专业化优势积极参与临床高警示药品不良事件的救治,保证了药物不良事件处置的即时性,纠正错误的、不合理的用药,降低药源性疾病和药物不良事件的危害。同时也对高警示药品临床应用及风险控制起到了关键作用。%Objective:To introduce the practice of the treatment and risk control of the clinical pharmacists participating in the adverse event of high alert drugs in our hospital.Methods:We described and analyzed the typical cases of high alert drugs encountered in the work of clinical pharmacists in our hospital.Results:The clinical pharmacists put forward opinions and suggestions on the diagnosis,treatment and treatment of adverse events of high alert drugs,and got good results.Conclusion:Clinical pharmacists' professional advantages actively participate in the treatment of adverse drug events in the clinical warning,ensure the timely treatment of adverse drug events,correct the wrong and irrational drug use,reduce the risk of drug-induced disease and adverse drug events.At the same time,it also plays a key role in the clinical application and risk control of high alert drugs.

  19. Clinical Pharmacists Participating in the Adjustment of Treatment Programs for 1 Case of Severe Pulmonary Infection%临床药师参与1例肺部重症感染患者治疗方案的调整

    Institute of Scientific and Technical Information of China (English)

    胡晓蕾; 詹世鹏; 王渝; 何菊英

    2013-01-01

    目的:探讨临床药师在重症感染患者救治中的作用.方法:临床药师参与神经外科1例颅脑术后并发肺部重症感染患者的会诊工作,结合本院肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌的细菌耐药情况和药敏结果,为患者制订最佳的个体化治疗方案,先后使用了头孢哌酮/舒巴坦、替考拉宁、阿米卡星抗感染治疗.结果:患者肺部感染情况逐渐好转,得到了有效的控制.结论:临床药师利用自己的专业知识参与到重症感染患者的临床治疗过程,不但可提高临床治疗水平使患者得到最大的收益,而且可以使临床药师逐步得到临床医师的认可.%OBJECTIVE:To investigate the role of clinical pharmacist in the treatment of patients with severe infections diseases.METHODS:Clinical pharmacist involved in the consultations of a neurosurgical patient with severe pulmonary infection after craniocerebral surgery,and developed the best individualized treatment plan for the patient,combining with drug resistance and susceptibility results of Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli.Cefoperazone/sulbactam,teicoplanin and amikacin were used for anti-infective treatment,respectively.RESULTS:The pulmonary infection of patient was improved gradually and controlled effectively.CONCLUSIONS:Clinical pharmacists use their professional knowledge to participate in the clinical course of treatment,so that severe infection patient can get the maximum benefit.It will not only enhance the level of clinical treatment,and also make clinical pharmacists gradually be recognized by clinicians.

  20. Evaluation of pharmacy students’ clinical interventions on a general medicine practice experience

    Directory of Open Access Journals (Sweden)

    Jones JD

    2011-03-01

    Full Text Available As colleges of pharmacy prepare a new generation of practitioners, it is important that during practice experiences students learn the impact of clinical interventions. For over ten years, pharmacy students have been a vital part of the multidisciplinary team at the military treatment facility. The overall impact of the student interventions on patient care has not been evaluated. To evaluate the impact, the students began documenting their clinical interventions in Medkeeper RxInterventions™, an online database. The program is used to document faculty and fourth year pharmacy students’ pharmaceutical interventions.Objective: The objective of this study was to analyze the interventions completed by fourth year pharmacy students during a general medicine advanced pharmacy practice experience at a military treatment facility.Methods: The students completing their general medicine advanced pharmacy practice experience at the military treatment facility are responsible for self reporting all interventions made during clinical rounds into the Medkeeper RxIntervention™ database. The researchers retrospectively collected and analyzed interventions made from June 2008 to June 2009.Results: The total number of interventions recorded by 8 fourth year pharmacy students was 114. Students averaged a number of 14.3 interventions during an eight week practice experience. Students spent an average of 5 minutes per intervention. Ninety- five percent of the interventions were accepted.Conclusion: Fourth year pharmacy students’ recommendations were accepted at a high rate by resident physicians. The high acceptance rate may have the ability to positively impact patient care.

  1. 临床药师对1例病毒性脑炎伴血小板减少患者的个体化药学监护%Individualized Pharmaceutical Care for a Case of Viral Encephalitis Complicating with Thrombocytopenia by Clinical Pharmacist

    Institute of Scientific and Technical Information of China (English)

    杨李华; 段金菊

    2012-01-01

    OBJECTIVE: To explore the role of clinical pharmacist in clinical treatment. METHODS: Clinical pharmacist provided pharmaceutical care for a case of viral encephalitis complicating with thrombocytopenia, paid attention to antiviral treatment, pain treatment, antibacterial drug use and acute gastric mucosal lesion prevention, assisted physicians to develop effective and individualized treatment plan, put forward reasonable pharmaceutical care measures. RESULTS&CONCLUSION: Pharmaceutical care provided by clinical pharmacist can improve compliance, safety and effectiveness of drug use, reduce medical costs for patients, and help clinicians to select drugs.%目的:探讨药师在临床治疗实践中发挥的作用.方法:通过临床药师对1例病毒性脑炎伴血小板减少的患者实施药学监护,关注患者用药方案中抗病毒治疗、疼痛治疗、抗菌药物选用和急性胃黏膜病变预防几个方面,协助医师为患者制订有效、个体化的治疗方案,为患者提供合理的药学监护措施.结果与结论:临床药师对患者实施药学监护可以提高患者用药的依从性、安全性、有效性,为患者节省医疗开支,为临床医师选药开阔思路.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sarah Shrader

    2010-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Moran Lazaryan

    2016-08-01

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

  5. Pharmaceutical care for an elderly patient with primary hypothyroidism complicat-ed with heart failure by clinical pharmacists%临床药师对一例原发性甲减合并心衰老年患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    荆莉; 石卫峰

    2015-01-01

    Objective To explore the processe,method and role of pharmaceutical care for an elderly patient with primary hypothyroidism complicated with heart failure by clinical pharmacists. Methods Pharmaceutical care was given to the elderly patient with primary hypothyroidism complicated with heart failure by clinical pharmacists during the hospitalization period. Monitoring points of pharmaceutical care included the thyroid function, BNP, cardiac en-zyme,ventricular rate,blood pressure,liquid intake and output,electrolyte,etc. Clinical pharmacists gave recommenda-tions about drugs selection and dose according to the results of drug monitoring and provided medication education for the patient to guarantee the safety and effectiveness of drug use. Results The patient′s condition was improved,and the compliance in drug use was raised. Conclusion Clinical pharmacists help physician to provide reasonable medica-tion to improve clinical symptoms significantly from the aspects of drug pharmacodynamics,pharmacokinetics,interac-tion monitoring,adverse drugs action and patient education.%目的:通过对1例原发性甲减合并心衰老年患者的药学监护,探讨实施药学监护的过程、方法及作用。方法临床药师对原发性甲减伴心衰老年患者在住院期间进行药学监护,主要包括:甲状腺功能、BNP、心肌酶、心室率、血压、液体出入量、电解质等指标的监测,并根据监测结果提出药物剂量调整及药物选择使用建议;同时对患者进行用药教育,保障患者用药安全有效。结果患者病情得到缓解,用药依从性提高。结论临床药师从药物药效学及药动学、药物相互作用、药品不良反应和患者教育方面,积极配合医师,为患者提供合理的用药方案,使患者的临床症状得到改善。

  6. 临床药师参与癌痛伴肾功能不全患者止痛方案的实践与经验%Practice and experience in the participant of the clinical pharmacist in the treatment of cancer pain with renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    伊佳; 侯幸赟; 黄立峰; 陈万生

    2016-01-01

    Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs .Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection ,dosage and adverse reaction monitoring .Results Physicians accepted suggestions from clinical pharmacists .The first day ,the morphine hydrochloride tablets were used for rapid titration . The next day doxycodone were used ,adding the morphine hydrochloride tablets when required .After the pain was controlled stability ,the transdermal fentanyl was used to alleviate the damage of kidney .Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treat-ment .%目的:探讨临床药师在止痛治疗中的作用,促进镇痛药更加规范的使用。方法临床药师通过参与癌痛伴肾功能不全患者止痛方案的制定,从药物的选择、给药剂量以及不良反应预计等方面,提出药学观点。结果医师采用了临床药师的建议,首日使用盐酸吗啡片进行快速滴定,次日起使用羟考酮缓释片控制背景疼痛,小剂量盐酸吗啡片控制爆发痛,在疼痛控制稳定后,改用芬太尼贴剂以减轻肾功能损害。结论临床药师参与到重度癌痛患者的治疗方案制定中,能提高患者用药安全性、合理性,提高临床治疗效果。

  7. 临床药师参与1例老年肺癌患者疼痛治疗的用药调整与分析%Adjustment and Analysis of Drugs in Treatment of One Elderly Patient with Lung Cancer Pain Participated by Clinical Pharmacists

    Institute of Scientific and Technical Information of China (English)

    严虹霞; 屠文莲; 曹玮

    2015-01-01

    目的:为临床药师在肿瘤内科参与混合性疼痛的治疗提供参考。方法:针对1例老年肺癌伴疼痛的患者,临床药师参与疼痛治疗方案分析,协助医师从药物剂量、不良反应等方面制订个体化给药方案,密切观察患者疼痛的治疗效果及并发的不良反应,建议医师调整相关治疗药物。结果:临床药师结合患者特点,全程参与该患者治疗,对药物治疗起到了积极的作用,同时协助医师调整了患者的治疗用药,使药品的临床应用更加合理。经过治疗,患者的疼痛得以控制,不良反应也得到缓解。结论:抗肿瘤专业临床药师参与临床实践,可从药学的角度发挥优势,优化治疗方案,预防不良反应的发生。%OBJECTIVE:To provide reference for the treatment of mixed pain in the department of tumors internal medicine participated by the clinical pharmacists .METHODS:An elderly patient with lung cancer pain was selected as the research object , the clinical pharmacists participated in the analysis of therapeutic scheme , assisted the clinician to formulate individualized administration regimen with fully consideration of the dosage of drugs and adverse reactions , closely observed the treatment efficacy of the patient's pain and the subsequent adverse reactions , and suggested the clinician to adjust the related drugs .RESULTS: The clinical pharmacists took the patient's characteristics into consideration , totally participated in the whole treatment process and assisted the clinician to adjust the therapeutic medication of the patient , which played an effective role in the therapeutic treatment and contributed to the clinical rational use of drugs.Also, the pain in the patient was controlled and adverse reactions were relieved after treatment . CONCLUSIONS: The participation of clinical pharmacists in tumor department can take full advantage from the perspective of pharmacy and play an unique

  8. 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-

  9. Clinical Reasoning in School Psychology: From Assessment to Intervention

    Science.gov (United States)

    Andrews, Jac J. W.; Syeda, Maisha M.

    2017-01-01

    School psychologists typically conduct psychological and psychoeducational assessments, provide prevention and intervention services, and consult and collaborate with allied professionals (e.g., teachers, physicians, psychiatrists, physiotherapists, occupational therapists, social workers, and nurses) and parents toward better understanding and…

  10. 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

  11. 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

  12. Pharmaceutical Care for a Case with Fluconazole-induced Acute Liver Injury by Clinical Pharmacists%临床药师对1例伏立康唑致肝损害的脑血管病患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    阎维维; 张永莉

    2012-01-01

    目的:通过干预药物治疗方案,探讨临床药师在药物治疗中的作用.方法:就发生的1例药源性肝损害的诊治及用药方案,排查可能引起急性肝损害的药物,向医师建议停用伏立康唑并给予保肝药.结果:医师采纳临床药师建议,患者停用该药并进行保肝治疗后,肝酶恢复正常.结论:临床药师参与临床药学工作,及时对患者进行药学监护,能有效减少药品不良反应的发生,促进疾病转归.%OBJECTIVE: To intervene in drag therapy scheme, and to explore the role of clinic pharmacists in drag therapy. METHODS: The diagnosis and medication scheme for a case with drug-induced liver injury was analyzed to inspect liver injury-inducing drugs and suggest physicians to stop using fluconazole and provide hepatoprotective. RESULTS: Physicians accepted the suggestion of clinical pharmacists and patients stopped taking fluconazole and received hepatoprotective therapy, then liver enzymes re-tuned to normal. CONCLUSION: The participation of clinical pharmacists and timely pharmaceutical care can reduce the occurrence of ADR and promote the prognosis of disease.

  13. Review and Analysis of Clinical Pharmacist Participating in Drug Therapy for 55 Infection Cases after Internal Fixation for Limb Fracture%临床药师参与55例四肢骨折内固定术后感染的药物治疗回顾与分析

    Institute of Scientific and Technical Information of China (English)

    刘滔滔; 万瑞融; 钟小斌

    2012-01-01

    目的:总结临床药师参与四肢骨折内固定术后感染患者的药物治疗实践,探讨治疗骨折内固定术后感染的有效方法.方法:对55例骨折内固定术后感染患者行抗感染、内固定拆除、局部抗生素骨水泥应用、扩创及持续冲洗引流等处理.临床药师根据患者的病情变化,提供咨询意见,与临床医师协商,制订针对性的治疗方案,并随时调整.结果:术后随访平均2年(10个月~4年2个月),2例截肢,4例不愈合,49例患者愈合.结论:临床药师参与药物治疗实践,对患者的药物治疗有帮助.%OBJECTIVE: To summarize the experience of clinical pharmacist participating in drug therapy for infection case after internal fixation for limbs fracture, and to discuss effective treatment methods for postoperative infection of internal fixation for bone fractures. METHODS: 55 cases of postoperative infection of internal fixation for limbs fracture were given anti-infection administration, internal fixator removal, local bone cement administration, local irrigation and continuous drainage. Clinical pharmacists provided advice and consulted with clinicians to develop and adjust targeted treatment programs, according to patient's condition. RESULTS: Following up for average 2 year (10 months—4 years and 2 months), 49 cases were healed, 4 cases were ineffective and 2 cases were amputated. CONCLUSION: The participation of clinical pharmacists in drug therapy contributes to drug treatment.

  14. Pharmaceutical care for two cases of antimony resistance in Kala-azar by clinical pharmacists%临床药师参与2例锑剂耐药黑热病患者治疗的药学监护

    Institute of Scientific and Technical Information of China (English)

    张建萍; 陈琳; 王晓锋; 袁宏

    2016-01-01

    Objective To explore the effect of drug treatment for two cases of antimony resistance in Kala -azar by clinical pharmacists. Methods The clinical pharmacists participated in therapy of two cases of antimony resistance in Kala-azar, consulted therapeutic regimen with the clinician according to the patient’ s condition and clinical guidelines to disease, analyzed the reasons of adverse drug reactions, provided the pharmaceutical suggestion, and formulated the appropriate therapeutic regimen.Results and Conclusion The two patients were recovered and discharged from hospital.Using drug usage, medication education and adverse reaction monitoring as breakthrough points, pharmacists provided pharmaceutical care for patients, which was helpful to more safe, effec-tive and reasonable medication.%目的:探讨临床药师参与锑剂耐药黑热病患者药物治疗的作用。方法临床药师参与2例锑剂耐药黑热病患者的治疗,结合患者病情及诊疗指南,临床药师与临床医师共同协商治疗方案,分析不良反应发生原因,提出药学建议,制订适宜的治疗方案。结果与结论2例患者均痊愈出院。临床药师从药物使用方法、用药教育及不良反应监测为切入点,为患者提供药学监护,有利于患者安全、有效和合理地使用药物。

  15. Clinical Pharmacists' Experience about the Practice of Anticoagulation Management of the Patients Who Had Been Discharged from Hospital after Undergoing Mechanical Heart Valve Replacement%临床药师参与心脏机械瓣膜置换术患者出院后抗凝管理的实践与体会

    Institute of Scientific and Technical Information of China (English)

    张海燕; 罗万慰; 马守梅

    2009-01-01

    To explore the function and approach of clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement. METHODS: The experiences of clinical pharmacists obtained through first-hand practice in the anticoagulation management and pharmaceutical care of the patients who had been discharged from hospital after undergoing mechanical heart valve replacement were introduced by illustrating examples. RESULTS & CONCLUSION: Clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement provide physicians and patients with pharmaceutical information and pharmaceutical care and enhance the effectiveness and safety of anticoagulative therapy accordingly.%目的:探讨临床药师参与心脏机械瓣膜置换术患者出院后抗凝治疗管理的作用和方法.方法:通过亲身实践,介绍我院临床药师参与抗凝管理工作及开展药学服务的体会,并结合典型实例分析说明.结果与结论:临床药师通过参与心脏机械瓣膜置换术患者出院后的抗凝管理工作,为医师及患者提供药学信息和药学服务,可提高抗凝治疗的安全性和有效性.

  16. 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.

  17. Evaluation of clinical pharmacy services offered for palliative care patients in Qatar.

    Science.gov (United States)

    Wilby, Kyle John; Mohamad, Alaa Adil; AlYafei, Sumaya AlSaadi

    2014-09-01

    Palliative care is an emerging concept in the countries of the Gulf Cooperation Council, a political and economic union of Arab states bordering the Persian Gulf, namely Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Clinical pharmacy services have not yet been evaluated in this region. The objectives of this study were to create a baseline inventory of clinical pharmacy interventions in palliative care and to assess the perceived importance of interventions made. This was a prospective, single-center characterization study. Interventions were documented from September 30 to December 1, 2013. They were characterized into predetermined categories and analyzed using descriptive statistics. Physician acceptance rate and intervention rate per patient were calculated. Classification categories were sent to 10 practicing pharmacists in each of Qatar and Canada, who ranked the categories on the basis of perceived importance. A total of 96 interventions were documented, giving 3 interventions per patient and an acceptance rate of 81%. Discontinuing therapy (29%), initiating therapy (25%), and provision of education/counseling (13.5%) were most common. No differences were found between rankings from pharmacists in Qatar or Canada. Clinical pharmacy interventions are frequent, and those relating to alterations in drug therapy are most common. Interventions align with the perceived importance from pharmacists in both Qatar and Canada.

  18. Anticoagulant Therapy for Patients with Acute Renal Failure After Cardiac Valve Replacement by Clinical Pharmacists%临床药师参与心脏瓣膜置换术后并发急性肾衰竭患者的抗凝治疗

    Institute of Scientific and Technical Information of China (English)

    成云兰; 夏宗玲

    2016-01-01

    目的:探讨临床药师参与心脏瓣膜置换术后并发急性肾衰竭患者的抗凝治疗、协助医师制订连续肾脏替代疗法(continuous renal replacement therapy ,CRRT)用药方案的实践。方法:临床药师参与3例典型心脏瓣膜置换术后并发急性肾衰竭患者的药物治疗过程,阐明心脏瓣膜置换术后并发急性肾衰竭的三大常见原因及其CRRT抗凝治疗方案,根据不同病因制订个体化的CRRT抗凝方案,并跟进治疗效果,提供药学服务,调整治疗方案。结果:医师接受了临床药师的治疗建议,患者治疗过程顺利,病情好转出院。结论:临床药师根据自身掌握的疾病病理生理特点和药学知识,可以有效地协助医师确立更适当的个体化治疗方案。%OBJECTIVE:To probe into the participation of clinical pharmacists in anticoagulant therapy for patients with acute renal failure after cardiac valve replacement , and the assist for clinicians in formulation of medication scheme of continuous renal replacement therapy (CRRT).METHODS: The clinical pharmacists participated into the whole therapeutic process of three patients with acute renal failure after typical cardiac valve replacement , explained three common causes of acute renal failure after typical cardiac valve replacement and the CRRT anticoagulant therapy scheme and formulated the individualized scheme according to different causes , so as to provide pharmaceutical care for patients and adjust the therapeutic scheme .RESULTS: The clinicians received the suggestions provided by the clinical pharmacists .The patients got better and discharged from hospital .CONCLUSIONS: The clinical pharmacists can effectively assist the clinicians to establish more appropriate individualized therapeutic scheme according to their own mastery of disease pathology physiology characteristics and the medicine knowledge .

  19. 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

  20. Minimal intervention dentistry - a new frontier in clinical dentistry.

    Science.gov (United States)

    Mm, Jingarwar; Nk, Bajwa; A, Pathak

    2014-07-01

    Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.

  1. 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.

  2. The evaluation of pharmacist-technician teams applied to a satellite pharmacy.

    Science.gov (United States)

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

    1989-01-01

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

  3. Clinical Reasoning in the Assessment and Intervention Planning for Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Climie, Emma A.; Mah, Janet W. T.; Chase, Cheryl Y.

    2017-01-01

    The purpose of this article is to provide the reader with insight into the clinical reasoning involved in the assessment and intervention planning for a child with Attention-Deficit/Hyperactivity Disorder. The reader will be guided through the authors' conceptualization of this case, and suggestions for intervention in the classroom will be…

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

    OpenAIRE

    Ruygrok, Peter; Webster, Mark; de Valk, Vincent; Es, Gerrit Anne; Ormiston, John; Morel, Marie-Angèle; 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 RESULTS: All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariat...

  5. 临床药师参与治疗老年产β-内酰胺酶大肠埃希菌尿路感染5例%Five cases of clinical pharmacists participating in treatment of senile pa-tients urinary tract infection by Escherichia coli producing ESBLs

    Institute of Scientific and Technical Information of China (English)

    赖静; 夏爱军; 陈龙英; 梁园

    2014-01-01

    通过介绍临床药师参与5例老年患者尿路感染产β-内酰胺酶(ESBLs)大肠埃希菌的临床会诊,探讨临床药师在临床中需结合患者情况、药敏试验结果、尿路感染常见病原菌、辅助用药与药学监护,为产ESBLs大肠埃希菌的老年人尿路感染选药,协助临床医师在抗感染治疗中提高用药的有效性、经济性、合理性,从而制订有效的个体化给药方案。%Through intruducing that clinical pharmacists participate in clinical consultation in 5 senile patients with urinary tract infection by Escherichia coli producing ESBLs, to explore the clinical pharmacists should combine with the situations of the patients, drugs sensitivity test of common pathogenic bacterias, adjuvant drugs and pharmaceutical cares, for the drugs selection of senile patients with urinary tract infection by Escherichia coli producing ESBLs, so as to help clinicians improve drugs effectiveness, economy, rationality, and develop effective individualized dosage regi-mens.

  6. Pharmaceutical practice of clinical pharmacists participating in the treatment of a patient with pneumonia caused by multi-drug resistant Pseudomonas aeruginosa after operation%临床药师参与1例术后由多重耐药铜绿假单胞菌引起的肺炎治疗的药学实践

    Institute of Scientific and Technical Information of China (English)

    张晨; 陈燕

    2014-01-01

    1例高龄患者在因发生急性胃穿孔和急性腹膜炎而施行剖腹探查和乙结肠近端造瘘术后出现由多重耐药铜绿假单胞菌引起的肺炎,临床药师协助临床医师制定治疗方案并选择合理、有效的抗感染药物,挽救了患者的生命。临床药师及时提供临床药学服务可获得良好的效果。%An elderly patient suffered from the pneumonia caused by multi-drug resistant Pseudomonas aeruginosa after performing exploratory laparotomy and sigmoid colostomy due to acute gastric perforation and acute peritonitis. The clinical pharmacists collaborated with clinicians to develop a therapeutic program and select reasonable and effective anti-infective agents, resulting in saving the life of this patient. A good clinical outcome should be received in case clinical pharmacists can provide pharmaceutical care for patients in time.

  7. 临床药师参与1例慢性肾功能不全伴尿路感染的治疗实践%A treatment practice of a clinical pharmacist participating in 1 case of chronic renal insufficiency with urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    刘俊; 安益国; 杨冬梅; 周光树; 张圣雨

    2013-01-01

    目的 通过临床药师参与1例慢性肾功能不全伴尿路感染的治疗实践,探讨药师在合理用药中发挥的作用.方法 临床药师积极参与了该患者的抗感染,控制高血压,纠正贫血,抗凝的治疗实践,针对患者的治疗方案,药品的选择、剂量、相互作用、不良反应、注意事项等提出了一些合理化的建议,同时对患者实施了药学监护,健康教育和用药教育.结果 临床药师参与治疗实践,提高了临床治疗效果.患者住院用药期间无相关不良反应发生,出院时尿路感染已经控制,血压平稳,无电解质紊乱,病情控制尚可.结论 临床药师参与临床药物治疗,为病人提供个体化药学服务,可使用药更合理、有效和经济;临床药师只有参与临床实践与临床医师密切配合,才能有助于更好地开展临床药学服务工作,更好地为病人服务.%Objective To investigate the role of a pharmacist in rational drug use by participating in 1 case of chronic renal insufficiency with urinary tract infection treatment practice. Methods The clinical pharmacist actively participated in the patient' s treatment practice of anti-infection,high blood pressure controlling,anemia correction,and anticoagulation,and also proposed reasonable suggestions according to the patient s treatment practice on drug selection, dosage, interactions, adverse reactions and points for attention, meanwhile implement pharmaceutical care, health education and drug education for the patient at the same time. Results The clinical pharmacist s participating in the treatment practice helped improve the clinical treatment effect. There was no relevant adverse reaction during the patient s hospitalization. And his urinary tract infection had been controlled, with smooth blood pressure, and normal electrolyte after his hospital discharge. Conclusion The clinical pharmacist s participation in clinical drug therapy for patients provides individualized service

  8. 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.

  9. 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

  10. 临床药师参与1例肿瘤患者中心静脉置管感染合并深静脉血栓治疗的实践与体会%Practice and Experience of Clinical Pharmacists Participating in One Case of Cancer Patients with Infection Induced by Peripherally Inserted Central Catheter Complicated with Deep Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    闫秀娟; 李进峰; 张媛

    2016-01-01

    Objective:To explore the methods for drug therapy regimen formulation and pharmaceutical service of clinical pharma-cists for the infection induced by peripherally inserted central catheter ( PICC) complicated with deep venous thrombosis in cancer pa-tients. Methods:Referring to the related guide, clinical pharmacists put forward concrete opinions on how to choose anti-infective drugs and anti-thrombotic drugs for a cancer patient with PICC infection complicated with deep venous thrombosis. Clinical pharmacists sug-gested that vancomycin be used for the infection and low molecular weight heparin sodium for prophylactic anticoagulation. Meanwhile, pharmaceutical care for blood clotting function should be strengthened. Results:The proposals of clinical pharmacist were partly adopt-ed by clinicians. After the therapy, the temperature of the patient returned to normal, and the deep venous thrombosis was well con-trolled. The patient was out of hospital smoothly. Conclusion:Through the participation in clinical practice, clinical pharmacists can assist physicians in optimizing treatment plan and summarize the pharmaceutical care mode for the PICC infection and deep venous thrombosis in cancer patients, which can provide instructions for pharmaceutical care in the future.%目的::探讨临床药师参与肿瘤患者中心静脉置管( PICC)感染合并血栓的药物治疗方案的制定以及提供药学服务的方法。方法:对1例出现PICC感染合并血栓的肿瘤患者,临床药师结合相关指南对抗感染药物及抗血栓药物治疗方案的选择提出了具体意见,建议选用万古霉素治疗导管相关性感染,选用低分子肝素钠预防性抗凝治疗,治疗同时加强凝血功能的药学监护。结果:临床药师的建议被临床医生部分采纳,经治疗后患者的体温恢复正常,深静脉血栓得到良好控制,顺利出院。结论:临床药师通过参与临床实践,可协助医师优化治疗方

  11. Safe in the city: developing an effective video-based intervention for STD clinic waiting rooms.

    Science.gov (United States)

    Myint-U, Athi; Bull, Sheana; Greenwood, Gregory L; Patterson, Jocelyn; Rietmeijer, Cornelis A; Vrungos, Shelley; Warner, Lee; Moss, Jesse; O'Donnell, Lydia N

    2010-05-01

    There is a strong need for inexpensive, easily administered HIV and STD prevention interventions that are highly replicable and appealing to diverse clinic audiences. This article describes the four-step iterative and collaborative process used by the Safe City Study Group to design and develop a brief video-based intervention: Safe in the City. Step 1 involves identification of an appropriate intervention medium, a theoretical framework, and key messages; Step 2, collaboration with a film company to integrate the framework and key messages into an entertaining product; Step 3, facilitation of a multistep participatory process involving input from members of the priority audience (clinic patients), clinic staff, and community reviewers; and Step 4, pilot-testing to determine structural barriers to patients' viewing the video in clinic waiting rooms. Safe in the City has been demonstrated to reduce incident STDs among clinic patients in three cities in the United States.

  12. 临床药师在治疗狼疮肾炎患者个体化给药方案设计的实践与分析%Practice and analysis of clinical pharmacists personalized medicine scheme design in treatment of lupus nephritis patients

    Institute of Scientific and Technical Information of China (English)

    张圣雨; 姜玲; 史天陆; 杨昭毅; 舒冰; 傅昌芳

    2012-01-01

    Objective To explore how renal medicine clinical pharmacists participate in making clinical drug treatment tailored to the individual, and how they carry out effective pharmaceutical care. Methods From the perspective of clinical pharmacists 1 case of 19-years-old systemic lupus erythematosus with lupus nephritis women was analyzed of the patient characteristics, treatment principle, the use of pharmacy theory and evidence-based medicine of the evidence. Together with clinical physicians pharmacists discussed and made sugar cortical hormone and immunosuppressive drugs scheme and conducted implementation of drug monitoring. Results SLEDAI ratings the clinical pharmacists was 22 points, which indicated lupus severe activities and renal biopsy results diffused with lupus nephritis with thickened basement membrane, IV -G (A) + V type. According to patients' individual characteristics clinical pharmacists suggested a nylon formulated on 0.5g,static drop once a day,three days and,at the same time,conducted pharmaceutical care. Five days after the interval and the basic things right,pharmacists gave patients a spilled nylon0.5 g again,static drop once a day,continuous for 3 days. Because for the patients with lupus nephritis the treatment effect was not satisfactory, pharmacists chose choose it for mycophenolate ester 0. 75 g,oral, twice a day. After January, patients achieved satisfactory effect. Conclusions Clinical pharmacists and pharmaceutical care staff team in the treatment of patient, play a more and more important role, and further promote more secure, effective and rational clinical medication.%目的 探索肾内科临床药师如何参与制定临床药物个体化治疗方案,如何实施有效药学监护的思路.方法 从临床药师角度分析1例19岁系统性红斑狼疮伴狼疮肾炎女性患者的病情特征、治疗原则,利用药学理论和循证药学的证据,与临床医师共同讨论、制定糖皮质激素和免疫抑制

  13. 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.

  14. Analysis of a Case of Unknown Floss in Intravenous Drug Infusion by Clinical Pharmacists%临床药师对1例静脉输液中不明絮状物的分析

    Institute of Scientific and Technical Information of China (English)

    韩毓博; 程指民; 刘艳; 李湘晖

    2013-01-01

    OBJECTIVE: To provide new strategy for clinical pharmacists participating in clinic medication practice to deal with medication dispute caused by unknown floss in infusion of cinepazide maleate. METHODS: The unknown floss was isolated during infusion of cinepazide maleate under sterile condition, and then cultured in agar medium under low temperature. The unknown floss was observed under inverted microscope, and the components were determined by infrared spectroscopy scanning after low temperature drying. The components of unknown floss were determined, and its reasons were analyzed. RESULTS: Infrared spectroscopy scanning showed that the floss displayed classic structural characteristics of saccharide, protein, fatty acid and nucleic acid. Clustering filamentous fungi were seen in the agar culture. Both the floss and the floss culture showed black cross-linked hy-pha with torous spores under the microscope. The morphology observation assisted to prove that fungi contamination existed in the cinepazide maleate infusion. The unknown floss was fungi. CONCLUSIONS: In order to avoid infusion accident, precision filter infusion set should be used and the infusion tube should be rinsed routinely in the interval of two infusions.%目的:通过分析1例马来酸桂哌齐特输液中不明絮状物进而解决用药纠纷,为临床药师参与临床用药实践提供新思路.方法:将马来酸桂哌齐特输液过程中出现的不明絮状物在无菌条件下分离,分别利用营养琼脂低温培养,倒置显微镜下形态观察,以及低温干燥后进行红外光谱扫描等手段,确定絮状物成分,并分析原因.结果:红外光谱分析显示该絮状物具有糖类、蛋白质、脂肪酸和核酸的典型结构特征.琼脂培养基也培养出了成簇的丝状真菌,倒置显微镜下可见该培养物与不明絮状物性状相同,均现黑色交错丝状菌丝,其上还有膨出的孢子,进而从形态学上进行了辅

  15. Participation of Clinical Pharmacist in the Individualized Drug Treatment for One Case of Overweight Children with Osteosarcoma%临床药师参与1例骨肉瘤超重患儿个体化药物治疗方案的制定

    Institute of Scientific and Technical Information of China (English)

    关尚为; 吴东媛; 董梅

    2016-01-01

    Objective:To explore the role of clinical pharmacists in the development of individualized drug treatment regimens for the osteosarcoma children with irregular body weight .Methods:Clinical pharmacists involved in the calculation of body weight surface area increased to that of adult for one case of osteosarcoma child during the chemotherapy , comparatively analyzed the suitable calcula-tion formula of surface area for the children in our country and helped clinicians make accurate dose of chemotherapy drugs .Mean-while, according to the pathological and physiological characteristics of the child , clinical pharmacist also provided advice on adjuvant drug use such as antiemetic regimen etc .Results:Physicians adopted the suggestions of clinical pharmacists and the chemotherapy was successfully completed .Overdose adverse reactions were avoided without the use of foreign general calculation formula of body surface area for the overweight child , and inadequate dose was also avoided for the conservative treatment , which could lower the risk of re-duced potential anticancer efficacy .Conclusion:Clinical pharmacists can help doctors perform safer and more effective drug treatment program and reduce adverse drug reactions in the treatment of special patients through participation in the development of individualized medication for cancer children to obtain maximum profit .%目的:探讨临床药师在不规则体重骨肉瘤患儿个体化药物治疗方案制定中发挥的作用。方法:临床药师参与1例骨肉瘤患儿在化疗期间体质量增长至成人体质量时体表面积的计算,对比分析适用于我国儿童体表面积的计算公式,辅助临床医生制定精确的化疗药物剂量,同时结合该患儿的病理生理特点,在化疗辅助用药预防止吐方案的选择上,为临床提供用药建议。结果:医师采纳临床药师建议,患儿顺利完成化疗,避免了根据国外通用体表面积计算公式用

  16. 临床药师参与1例肺癌患者发生肺炎合并脓胸的抗感染降阶梯治疗%Clinical Pharmacist s Experience with Treatment of One Patient with Lung Cancer Complicating Pneumonia and Empyema Receiving Anti-infective De-escalation Therapy

    Institute of Scientific and Technical Information of China (English)

    刘爽; 吴东媛; 关尚为; 董梅

    2014-01-01

    目的:探讨临床药师在肺癌患者发生肺炎合并脓胸的降阶梯治疗中开展药学监护的方法,为合理用药提供参考。方法:剖析1例肺癌患者发生肺炎合并脓胸的抗感染降阶梯治疗过程,探讨临床药师如何在患者复杂的病情变化中,在正确的时机提出合理的用药建议。结果:临床药师协助医师制订最佳用药方案,使患者得到了及时、有效的治疗。结论:临床药师应发挥自身优势,与临床医师密切合作,为患者提供个体化药学服务,促进临床合理用药。%OBJECTIVE:To explore the approaches for clinic pharmacist to carry out pharmaceutical care for patient with lung cancer complicating pneumonia and empyema receiving anti⁃infective de⁃escalation therapy for references of rational use of drug. METHODS: Clinic pharmacist� experience with the treatment of one patient with lung cancer complicating pneumonia and empyema receiving anti⁃infective de⁃escalation therapy was analyzed, and the approaches for clinical pharmacist to offer rational medication advices based on patient�s complicated state of illness. RESULTS:Clinical pharmacist�s cooperation with physicians to work out the best therapeutic regimen resulted in timely and effective treatment for patient. CONCLUSIONS:Clinical pharmacist should bring his advantages into full play and cooperate well with clinicians to provide patients with individualized pharmaceutical care and promote clinical rational use of drugs.

  17. Yoga & Cancer Interventions: A Review of the Clinical Significance of Patient Reported Outcomes for Cancer Survivors

    Directory of Open Access Journals (Sweden)

    S. Nicole Culos-Reed

    2012-01-01

    Full Text Available Limited research suggests yoga may be a viable gentle physical activity option with a variety of health-related quality of life, psychosocial and symptom management benefits. The purpose of this review was to determine the clinical significance of patient-reported outcomes from yoga interventions conducted with cancer survivors. A total of 25 published yoga intervention studies for cancer survivors from 2004–2011 had patient-reported outcomes, including quality of life, psychosocial or symptom measures. Thirteen of these studies met the necessary criteria to assess clinical significance. Clinical significance for each of the outcomes of interest was examined based on 1 standard error of the measurement, 0.5 standard deviation, and relative comparative effect sizes and their respective confidence intervals. This review describes in detail these patient-reported outcomes, how they were obtained, their relative clinical significance and implications for both clinical and research settings. Overall, clinically significant changes in patient-reported outcomes suggest that yoga interventions hold promise for improving cancer survivors' well-being. This research overview provides new directions for examining how clinical significance can provide a unique context for describing changes in patient-reported outcomes from yoga interventions. Researchers are encouraged to employ indices of clinical significance in the interpretation and discussion of results from yoga studies.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    H Sharma

    2009-01-01

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

  20. Current status and perspectives of interventional clinical trials for glioblastoma - analysis of ClinicalTrials.gov.

    Science.gov (United States)

    Cihoric, Nikola; Tsikkinis, Alexandros; Minniti, Giuseppe; Lagerwaard, Frank J; Herrlinger, Ulrich; Mathier, Etienne; Soldatovic, Ivan; Jeremic, Branislav; Ghadjar, Pirus; Elicin, Olgun; Lössl, Kristina; Aebersold, Daniel M; Belka, Claus; Herrmann, Evelyn; Niyazi, Maximilian

    2017-01-03

    The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

  1. 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.

  2. The pharmacy supervisor and the employee pharmacist's job satisfaction.

    Science.gov (United States)

    North, M A; Kirk, K W

    1990-05-01

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

  3. Active Interventions in Clinical Practice: Contributions of Gestalt Therapy.

    Science.gov (United States)

    Lammert, Marilyn; Dolan, Mary M.

    1983-01-01

    Describes two dimensions of Gestalt therapy that can enhance clinical practice--orientation to the present and active-experimental style--and examines them in relation to some traditional principles of practice. Gestalt theory offers a method of discovery that is a combination of phenomenology and behaviorism. (JAC)

  4. 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

  5. THE ROLE OF PHARMACISTS IN PREVENTING FALLS AMONG AMERICA’S OLDER ADULTS

    Directory of Open Access Journals (Sweden)

    Mamta V Karani

    2016-11-01

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

  6. Minnesota Pharmacists and Medical Cannabis: A Survey of Knowledge, Concerns, and Interest Prior to Program Launch

    Science.gov (United States)

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

    2016-01-01

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

  7. Sports pharmacy: Pharmacists role in doping in sport

    OpenAIRE

    Ivanović, Darko; Stojanović, Biljana

    2013-01-01

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

  8. [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

  9. 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…

  10. Clinical Features That Predict the Need for Operative Intervention in Gluteus Medius Tears

    OpenAIRE

    Chandrasekaran, Sivashankar; Vemula, S. Pavan; Gui, Chengcheng; Suarez-Ahedo, Carlos; Lodhia, Parth; Domb, Benjamin G.

    2015-01-01

    Background: Gluteus medius tears are a common cause of lateral hip pain. Operative intervention is usually prescribed for patients with pain despite physical therapy and/or peritrochanteric injections. Purpose: To identify clinical features that predict operative intervention in gluteus medius tears. Study Design: Case control study; Level of evidence, 3. Methods: A matched-pair controlled study was conducted on patients who underwent endoscopic gluteus medius repairs from June 2008 to August...

  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. 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…

  14. 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...

  15. 临床药师与药物中毒:镇静催眠和抗精神病药物%Clinical Pharmacists in the Management of Drug Overdose:Sedative-Hypnotic and Antipsychotic Drugs

    Institute of Scientific and Technical Information of China (English)

    孙树森; 赵志刚

    2016-01-01

    The trend of drug overdose and poisoning has been rising steadily over the past several decades, and the related rate of mortality has also increased. Pharmacists are an integral part of the healthcare team, playing a vital role in the management of overdose patients. The objectives of this series of articles are to update pharmacists with the latest trends on drug overdose and drug overdose management, including the appropriate use of antidotes. This third paper discusses patient management with sedative-hypnotic and antipsychotic drug overdose.%世界范围包括药物在内的有毒物质中毒情形近几十年来每年呈上升趋势,死亡人数不断增加。药师作为医疗团队成员应当积极参与对药物中毒患者的救治。药师应当熟悉和掌握药物中毒和患者管理相关知识,本系列文章为临床药师提供这方面必备的资讯。本文阐述镇静催眠和抗精神病药物中毒患者管理。

  16. 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…

  17. 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…

  18. National Ambulatory Medical Care Survey: tobacco intervention practices in outpatient clinics.

    Science.gov (United States)

    Payne, Thomas J; Chen, Chieh-I; Baker, Christine L; Shah, Sonali N; Pashos, Chris L; Boulanger, Luke

    2012-09-01

    Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use.

  19. 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.

  20. [The role of the pharmacist in dispensing medication in Adult Psychosocial Care Centers in the city of São Paulo, Capital of the State of São Paulo, Brazil].

    Science.gov (United States)

    Zanella, Carolina Gomes; Aguiar, Patricia Melo; Storpirtis, Sílvia

    2015-02-01

    The objective of this study was to evaluate the role of the pharmacist in dispensing medication by conducting cross-sectional exploratory-descriptive research in eight Adult Psychosocial Care Centers (CAPS) in São Paulo. The pharmacists responsible for each of the dispensing units studied filled out a semi-structured questionnaire about the service provided. Two Adult CAPS units were selected from each of the North, South, Eastand West regions of São Paulo. The central region has no Adult CAPS, and was therefore not included in the study. Most of the respondents were aged between 35 and 40 years and were predominantly female. It was found that half of the respondents performed only 25% of dispensations and few conducted an analysis of all prescriptions before dispensing medication. All respondents contacted the prescriber if any medication-related problems a rose. However, few pharmaceutical interventions were commonly performed. Furthermore, one respondent indicated that all his/her functions in the pharmacy could be delegated to another professional. These findings reveal the pressing need for actions that ensure the ongoing training of pharmacists to enable them to be clinically prepared to deal with patients with mental disorders.

  1. Development of clinically meaningful complex interventions - the contribution of qualitative research.

    Science.gov (United States)

    Ludvigsen, Mette Spliid; Meyer, Gabriele; Hall, Elisabeth; Fegran, Liv; Aagaard, Hanne; Uhrenfeldt, Lisbeth

    2013-06-01

    The debate about the "right" methods and designs for nursing research is on-going. According to international surveys, studies on the effectiveness and safety of nursing interventions are rare. Since nursing practice deals daily with interventions, nurses ostensibly expose hospital patients and nursing home residents frequently to unproven therapeutic and preventive nursing interventions. Nursing interventions are predominately of a complex nature, consisting of several components depending on and interacting with each other and their complex contextual factors. Thus, evaluation studies are often challenging and need especially careful development, ambitious designs and systematic evaluations. The UK Medical Research Council (MRC) has proposed a framework, where qualitative and quantitative research rely on each other in order to develop theory-based complex interventions, prepare and conduct their optimal delivery, explain how the interventions work and which conditions contributed in case they did not work. The present essay outlines the points where qualitative research contributes towards the development and evaluation of complex interventions. First, the UK MRC framework is introduced, and secondly it is illustrated where qualitative research should necessarily be located using examples from a handful of qualitative studies. Future clinically meaningful and implementable nursing interventions should best be developed by research groups with both excellent qualitative and quantitative research skills.

  2. [Role of pharmacists in disaster medicine: required knowledge and skills].

    Science.gov (United States)

    Nakura, Hironori

    2014-01-01

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

  3. 临床药师参与1例颅内感染伴肺部感染患者的药学监护%Pharmaceutical care for a patient who acquired intracranial infection and pulmona-ry infection provided by clinical pharmacist

    Institute of Scientific and Technical Information of China (English)

    王仙; 陈世洁

    2015-01-01

    Objective To investigate the importance of pharmaceutical care provided by clinical pharmacist to patients who acquired nosocomial infection after surgery. Methods Clinical pharmacists provided pharmaceutical care for a patient with intracranial infection and pulmonary infection after the surgery"removing hematoma and deboning for decompression" in respects of drug selection,correlation index,adverse reaction monitoring,etc. Results The intracra-nial infection and pulmonary infection of the patient was controlled effectively by intravenous and intrathecal vancomy-cin,the levels of leukocytes and ADA reduced gradually, no nerve root irritation, epilepsy and renal dysfunction oc-curred during the treatment process. Conclusion Clinical pharmacist participates in formulating the individualized treatment schedule and providing pharmaceutical care,which plays an important role in promoting the effective treat-ment,reducing the adverse drug reactions.%目的 探讨临床药师对术后院内感染患者的抗感染治疗进行药学监护的重要性. 方法 从药物选择、相关实验室指标监测、不良反应等方面,临床药师对1例"开颅血肿清除术+去骨瓣减压术"术后合并颅内感染、肺部感染患者的治疗过程实施药学监护. 结果 通过联合使用万古霉素静脉及鞘内注射,患者颅内感染、肺部感染得到有效控制,在治疗过程中脑脊液白细胞逐渐下降,腺苷脱氨酶( ADA)逐渐正常,且在治疗过程中无神经根刺激症状、癫疒间、肾功能损害等不良反应的发生. 结论 临床药师参与患者抗感染治疗过程中个体化治疗方案的制订、开展药学监护,对促进药物治疗的有效性、减少药物不良反应的发生具有重要作用.

  4. Pharmaceutical Care for Elderly Patient with Chronic Obstructive Pulmonary Disease in Anti-infection and Immunoregulation Therapy by Clinical Pharmacists%临床药师参与慢性阻塞性肺疾病老年患者抗感染及免疫调节治疗的药学监护

    Institute of Scientific and Technical Information of China (English)

    张志清; 屠文莲; 曹玮

    2016-01-01

    OBJECTIVE:To provide reference for the anti-infection and immunoregulation therapy participated by the clinical pharmacists in respiration medicine .METHODS: By introducing the adjustments of anti-infection and immunoregulation therapy scheme for one elderly patient with chronic obstructive pulmonary disease with acute attack participated by the clinical pharmacists , the clinical characteristics of antibiotics were fully considered , the clinicians were suggested to select the related treatment drugs and increase the immunomodulator .RESULTS:Combined with the characteristics of the elderly patient , the clinical pharmacists cooperated with the clinicians from the aspect of anti-infection and immunoregulation therapy on chronic obstructive pulmonary disease with acute attack , so as to provide rational medication scheme for the patient .After treatment , the patient showed good infection control , and the acute attacking symptoms of chronic obstructive pulmonary disease were improved .CONCLUSIONS: The participation of clinical pharmacists in the clinical practice of anti-infection can took advantage in the perspective of pharmacy , optimize the treatment scheme , reduce the incidence of chronic obstructive pulmonary disease with acute attack and improve the life quality of patients .%目的:为临床药师在呼吸内科参与抗感染及免疫调节治疗提供参考。方法:介绍临床药师参与1例老年慢性阻塞性肺疾病急性发作患者抗感染及免疫调节治疗方案的调整,充分考虑抗菌药物的临床特点,建议医师选用相关治疗药物,增加免疫调节剂的过程。结果:临床药师结合老年患者的特点,从慢性阻塞性肺疾病急性发作抗感染及免疫调节方面积极配合医师,为患者提供了合理的用药方案。经治疗后,患者的感染控制良好,慢性阻塞性肺疾病急性发作症状得以缓解。结论:临床药师参与抗感染临床实践,可从药学的角

  5. Clinically Relevant Physical Benefits of Exercise Interventions in Breast Cancer Survivors.

    Science.gov (United States)

    Kirkham, Amy A; Bland, Kelcey A; Sayyari, Sarah; Campbell, Kristin L; Davis, Margot K

    2016-02-01

    Evidence is currently limited for the effect of exercise on breast cancer clinical outcomes. However, several of the reported physical benefits of exercise, including peak oxygen consumption, functional capacity, muscle strength and lean mass, cardiovascular risk factors, and bone health, have established associations with disability, cardiovascular disease risk, morbidity, and mortality. This review will summarize the clinically relevant physical benefits of exercise interventions in breast cancer survivors and discuss recommendations for achieving these benefits. It will also describe potential differences in intervention delivery that may impact outcomes and, lastly, describe current physical activity guidelines for cancer survivors.

  6. Extracellular vesicles: masters of intercellular communication and potential clinical interventions.

    Science.gov (United States)

    Pitt, Jonathan M; Kroemer, Guido; Zitvogel, Laurence

    2016-04-01

    Intercellular signaling via extracellular vesicles (EVs) is an underappreciated modality of cell-cell crosstalk that enables cells to convey packages of complex instructions to specific recipient cells. EVs transmit these instructions through their cargoes of multiple proteins, nucleic acids, and specialized lipids, which are derived from their cells of origin and allow for combinatorial effects upon recipient cells. This Review series brings together the recent progress in our understanding of EV signaling in physiological and pathophysiological conditions, highlighting how certain EVs, particularly exosomes, can promote or regulate infections, host immune responses, development, and various diseases - notably cancer. Given the diverse nature of EVs and their abilities to profoundly modulate host cells, this series puts particular emphasis on the clinical applications of EVs as therapeutics and as diagnostic biomarkers.

  7. 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

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

    Directory of Open Access Journals (Sweden)

    France Légaré

    Full Text Available 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.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.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.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.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.

  9. Fifty reasons to love your palliative care pharmacist.

    Science.gov (United States)

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

    2010-12-01

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

  10. Phytotherapic compounds: the consumer-pharmacist relationship.

    Science.gov (United States)

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

    2008-01-01

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

  11. 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.

  12. Adjudicating rights or analyzing interests: ethicists' role in the debate over conscience in clinical practice.

    Science.gov (United States)

    Antommaria, Armand H Matheny

    2008-01-01

    The analysis of a dispute can focus on either interests, rights, or power. Commentators often frame the conflict over conscience in clinical practice as a dispute between a patient's right to legally available medical treatment and a clinician's right to refuse to provide interventions the clinician finds morally objectionable. Multiple sources of unresolvable moral disagreement make resolution in these terms unlikely. One should instead focus on the parties' interests and the different ways in which the health care delivery system can accommodate them. In the specific case of pharmacists refusing to dispense emergency contraception, alternative systems such as advanced prescription, pharmacist provision, and over-the-counter sales may better reconcile the client's interest in preventing unintended pregnancy and the pharmacist's interest in not contravening his or her conscience. Within such an analysis, the ethicist's role becomes identifying and clarifying the parties' morally relevant interests.

  13. 临床药师参与1例慢性肾衰竭患者药物治疗的实践与分析%Practice and Analysis of Clinical Pharmacists Participating in the Treatment for A Patient with Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    王靖; 宁重博; 张翠娥; 王彬; 张凤云; 马晓霞

    2016-01-01

    目的:探讨临床药师在慢性肾衰竭患者药物治疗中的作用。方法:临床药师参与1例慢性肾功能衰竭尿毒症期患者的药物治疗过程,协助医师从纠正贫血、控制血压、改善心功能和调整离子紊乱等方面对药物治疗方案进行优化和完善,先后建议增加非洛地平缓释片、酒石酸美托洛尔片和参芎葡萄糖注射液的给药频次,加用盐酸贝那普利片和单硝酸异山梨酯缓释片;调整重组人促红素的剂量和铁剂的剂型,增加骨化三醇胶丸和碳酸钙片的剂量,减少5%葡萄糖注射液+注射用左卡尼汀的给药频次,加用维生素B12片;治疗过程中密切观察药物治疗效果和药品不良反应,并对患者进行用药教育。结果:医师采纳临床药师建议,患者病情好转,28 d后带药出院。结论:临床药师参与慢性肾衰竭患者的个体化治疗,可协助医师优化用药方案,有助于提高临床药物治疗的有效性与安全性。%OBJECTIVE:To investigate the role of clinical pharmacists in the treatment for patients with chronic renal failure. METHODS:Clinical pharmacists participated in the treatment process for a patient with chronic renal failure during uremia period;assisted physicians to optimize and improve therapy plan from correcting anemia,controlling blood pressure,improving heart func-tion and regulating ion disorder,etc.;suggested adding dosing frequence of Felodipine sustained-release tablet,Metoprolol tartrate tablet and Shenqiong glucose injection,and giving Benazepril hydrochloride tablet and Isosorbide 5-mononitrate sustained-release tablet. They also suggested adjusting the dosage of rhEPO and the dosage form of ferralia,increasing the dosage of Calcitriol cap-sule and Calcium carbonate tablet,decreasing dosing frequence of 5% Glucose injection and Levocarnitine for injection,and giv-ing Vitamine B12 tablet. Therapeutic efficacy and ADR should be observed

  14. 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

  15. Role of the Pharmacist within the Heart Failure Team.

    Science.gov (United States)

    Terasaki, Nobuyuki

    2016-01-01

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

  16. 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

  17. 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

  18. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study

    Directory of Open Access Journals (Sweden)

    Osman A

    2012-06-01

    Full Text Available Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists’ ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden.Objective: To evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan.Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI (n=105, MDI with Spacer (n=83, Turbuhaler (n=61, and Diskus (n=51. Investigator (a pharmacist acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know.Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an “optimal technique”. The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus either did not know proper technique or were totally unfamiliar with the devices.Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge

  19. Endoscopic vs. Surgical Interventions for Painful Chronic Pancreatitis: What is Needed for Future Clinical Trials

    Science.gov (United States)

    Windsor, John A; Reddy, Nageshwar D

    2017-01-01

    The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques. Consideration should be given to the need of a control arm and the optimal timing of intervention. Pending better designed studies, the practical way forward is to identify subgroups of patients who clearly warrant endotherapy or surgery first, and to design the future clinical trials for the remainder. PMID:28079861

  20. Early intervention surveillance strategies (EISS) in dental student clinical performance: a mathematical approach.

    Science.gov (United States)

    Tennant, Marc; Kruger, Estie

    2005-12-01

    Graduating dental practitioners requires the mastery of a number of skills and a significant body of basic information. Dental education is a complex combination of didactic and physical skill learning processes. It is necessary to develop appropriate tools to measure student clinical performance to allow the provision of interventional strategies at the right time targeted at the right individuals. In this study, an approach to early intervention surveillance strategies was developed that is cost-effective, transparent, and robust based on mathematical predictions of student clinical achievements. Using a cohort of students' clinical activity profile, a polynomial pair was developed that represents the predictive function of low and high achieving students. This polynomial pair can then be applied to students to predict their final achievement based on their current status. The polynomial methodology is adaptable to local variation such as access to clinical facilities. The early intervention surveillance strategy developed in this study provides a simple, cost-effective, predictive risk assessment system that relies on data sets already collected in most dental schools and can be completed without the need for significant human intervention. The mathematical approach allows the focusing of educational support towards students that require the assistance, thus augmenting the better use of resources.

  1. Children and Youth with Fetal Alcohol Spectrum Disorders: Summary of Intervention Recommendations after Clinical Diagnosis

    Science.gov (United States)

    Jirikowic, Tracy; Gelo, Julie; Astley, Susan

    2010-01-01

    Children with fetal alcohol spectrum disorders (FASDs) present with a wide range of developmental disabilities; however, clinical standards of care after a diagnosis are not well established. This retrospective review summarizes the types of intervention recommendations generated by an interdisciplinary FASD diagnostic team for 120 children ages…

  2. The impact of IPTi and IPTc interventions on malaria clinical burden - in silico perspectives.

    Directory of Open Access Journals (Sweden)

    Ricardo Aguas

    Full Text Available BACKGROUND: Clinical management of malaria is a major health issue in sub-Saharan Africa. New strategies based on intermittent preventive treatment (IPT can tackle disease burden by simultaneously reducing frequency of infections and life-threatening illness in infants (IPTi and children (IPTc, while allowing for immunity to build up. However, concerns as to whether immunity develops efficiently in treated individuals, and whether there is a rebound effect after treatment is halted, have made it imperative to define the effects that IPTi and IPTc exert on the clinical malaria scenario. METHODS AND FINDINGS: Here, we simulate several schemes of intervention under different transmission settings, while varying immunity build up assumptions. Our model predicts that infection risk and effectiveness of acquisition of clinical immunity under prophylactic effect are associated to intervention impact during treatment and follow-up periods. These effects vary across regions of different endemicity and are highly correlated with the interplay between the timing of interventions in age and the age dependent risk of acquiring an infection. However, even when significant rebound effects are predicted to occur, the overall intervention impact is positive. CONCLUSIONS: IPTi is predicted to have minimal impact on the acquisition of clinical immunity, since it does not interfere with the occurrence of mild infections, thus failing to reduce the underlying force of infection. On the contrary, IPTc has a significant potential to reduce transmission, specifically in areas where it is already low to moderate.

  3. Clinical Reasoning in the Assessment and Intervention Planning for Writing Disorder

    Science.gov (United States)

    Harrison, Gina L.; McManus, Kelly L.

    2017-01-01

    The incidence of writing disorder is as common as reading disorder, but it is frequently under-identified and rarely targeted for intervention. Increasing clinical understanding on various subtypes of writing disorder through assessment guided by data-driven decision making may alleviate this disparity for students with writing disorders. The…

  4. Patient preference regarding assessment of clinical follow-up after percutaneous coronary intervention: the PAPAYA study

    NARCIS (Netherlands)

    Kok, M.; Birgelen, von C.; Lam, M.K.; Lowik, M.; Houwelingen, van G.; Stoel, M.; Louwerenburg, H.; Man, de F.H.; Hartmann, M.; Doggen, C.J.; Til, van J.A.; IJzerman, M.J.

    2015-01-01

    Aims: To keep patients in long-term clinical follow-up programmes after percutaneous coronary intervention (PCI), knowledge of the patient-preferred mode for follow-up assessment is crucial. We systematically assessed patient preference, and explored potential relationships with age and gender.Metho

  5. Patient preference regarding assessment of clinical follow-up after percutaneous coronary intervention: the PAPAYA study

    NARCIS (Netherlands)

    Kok, Marlies M.; Birgelen, von Clemens; Lam, Ming Kai; Löwik, Marije M.; Houwelingen, van K. Gert; Stoel, Martin G.; Louwerenburg, J. (Hans) W.; Man, de Frits H.A.F.; Hartmann, Marc; Doggen, Carine J.M.; Til, van Janine A.; IJzerman, Maarten J.

    2016-01-01

    Aims: To keep patients in long-term clinical follow-up programmes after percutaneous coronary intervention (PCI), knowledge of the patient-preferred mode for follow-up assessment is crucial. We systematically assessed patient preference, and explored potential relationships with age and gender.Metho

  6. Effectiveness of a Therapeutic Summer Camp for Children with ADHD: Phase I Clinical Intervention Trial

    Science.gov (United States)

    Hantson, Julie; Wang, Pan Pan; Grizenko-Vida, Michael; Ter-Stepanian, Marina; Harvey, William; Joober, Ridha; Grizenko, Natalie

    2012-01-01

    Objective: The objective of this study was to evaluate the effectiveness of a 2-week therapeutic summer day camp for children with ADHD, which included a social skills training program and parent psychoeducation and training program. This was an open-label, nonrandomized Phase I Clinical Intervention Trial. Method: Parents completed the Weiss…

  7. EPA guidance on the early intervention in clinical high risk states of psychoses

    DEFF Research Database (Denmark)

    Schmidt, S J; Schultze-Lutter, F; Schimmelmann, B G

    2015-01-01

    This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysi...

  8. Clinical correlates of weight loss and attrition during a 10-week dietary intervention study

    DEFF Research Database (Denmark)

    Handjieva-Darlenska, Teodora; Holst, Claus; Grau, Katrine

    2012-01-01

    clinical centres in 7 European countries, who underwent a 10-week dietary intervention study comparing two hypo-energetic (-600 kcal/day) diets varying in fat content. Results: The multiple regression model showed that weight loss at week 10 was predicted by: 6.55 + 1.27 × early weight loss (kg) at week 1...

  9. European clinical guidelines for Tourette Syndrome and other tic disorders. Part III : behavioural and psychosocial interventions

    NARCIS (Netherlands)

    Verdellen, Cara; van de Griendt, Jolande; Hartmann, Andreas; Murphy, Tara

    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 obt

  10. 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…

  11. 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.

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

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq

    2012-01-01

    , 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 scenario......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...... 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...

  13. Implementation of a pharmacist-led antimicrobial management team in a community teaching hospital: use of pharmacy residents and pharmacy students in a prospective audit and feedback approach.

    Science.gov (United States)

    Laible, Brad R; Nazir, Jawad; Assimacopoulos, Aris P; Schut, Jennifer

    2010-12-01

    Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist. Due to limited resources, our institution chose to implement a pharmacist-led antimicrobial stewardship service on 1 medical/surgical ward, with the existing clinical pharmacist and 3 infectious disease physicians as core members. This clinical pharmacist was not trained in infectious disease specialty, and stewardship activities were only one part of his daily activities. Pharmacy residents and students were extensively utilized to assist in the stewardship process. Approximately two thirds of stewardship recommendations were accepted using primarily a prospective audit and feedback approach.

  14. Electronic prescriptions and disruptions to the jurisdiction of community pharmacists.

    Science.gov (United States)

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

    2011-07-01

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

  15. Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases.

    Directory of Open Access Journals (Sweden)

    Kenichi W Okamoto

    2016-03-01

    Full Text Available Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted. We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences-consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even

  16. Clinical significance of serum alanine aminotransferase and lifestyle intervention in children with nonalcoholic fatty liver disease

    Science.gov (United States)

    Kwon, Kyoung Ah; Chun, Peter

    2016-01-01

    Purpose This study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD. Methods The clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of patients with NAFLD were also compared based on the status of ALT levels after lifestyle intervention. Results Patients with elevated ALT had significantly higher body mass index (BMI) scores than those with normal ALT (P<0.05). Of all the patients with elevated ALT, 89% exhibited moderate or severe degree of fatty change in the liver on ultrasonographic examination, whereas most patients with normal ALT exhibited mild or moderate degree changes. Liver biopsy was performed in 15 children with elevated ALT and all showed mild histological changes. Of all patients with elevated ALT, 49% achieved normal ALT levels after lifestyle intervention. Those with more severe histological changes tended to have continuously increasing ALT levels. There was no correlation between the normalization of posttreatment ALT level and BMI, as well as ultrasonographic findings at diagnosis. Conclusion ALT elevation in NAFLD is highly associated with higher BMI scores and more severe degree of fatty changes on ultrasonographic examination. Lifestyle intervention can significantly improve ALT in children with NAFLD. The degree of histologic changes appears to be a predictor of the treatment response to NAFLD.

  17. 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

  18. 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...... 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...

  19. International trends in lifelong learning for pharmacists.

    Science.gov (United States)

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

    2007-06-15

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

  20. Original research paper. Public health care system, a quasi-experimental study: Acceptance and attitude to implicate clinical services

    Directory of Open Access Journals (Sweden)

    Gillani Syed Wasif

    2017-03-01

    Full Text Available A six-month longitudinal intervention arm study with a pre-post cross-sectional questionnaire-based survey was performed. A 3-phase objective structured clinical examination (OSCE design was utilized for evaluation of acceptance and attitude of pharmacy students towards clinical pharmacy services. The pre-OSCE survey showed increased disagreement with the role of clinical pharmacists, compared to a significant positive shift in attitude towards their services in the healthcare team after 6 months of the trial. Responses improved for awareness (the current healthcare system could be improved by involving pharmacists, p < 0.02 and positive attitude categories (doctors and nurses would be happy to welcome the services of competent clinical pharmacists as part of their team, p < 0.01 in addition to competency (pharmacists have sufficient clinical training to advise doctors and nurses, p < 0.01. The predictive model suggested a strong positive effect on patient interaction, medical information tasks, clinical decisions on drug-related problems (DRPs, and communication with healthcare professionals (R2 = 0.41, F = 1.51, p < 0.001.

  1. Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study

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    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.

  2. Virtual Pharmacist: A Platform for Pharmacogenomics.

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    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.

  3. Family Commitment and Work Characteristics among Pharmacists

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    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.

  4. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review

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    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

  5. Development and evaluation of a pharmacogenomics educational program for pharmacists.

    Science.gov (United States)

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

    2013-02-12

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

  6. Development, Implementation, and Evaluation of a Pilot Parenting Educational Intervention in a Pregnancy Buprenorphine Clinic.

    Science.gov (United States)

    Giles, Averie C; Ren, Dianxu; Founds, Sandra

    2016-01-01

    We developed a pilot evidence-based prenatal educational intervention to increase knowledge of neonatal abstinence syndrome (NAS) and early parenting skills for women with opiate dependency who enrolled in a pregnancy buprenorphine clinic. We developed, implemented, and tested modules regarding expectations during newborn hospitalization for observation or treatment of NAS and regarding evidence-based parenting skills in response to NAS behaviors. Testing evaluated baseline knowledge of early parenting skills with newborns at risk for NAS and change from baseline after the educational intervention. No statistically significant difference in composite knowledge scores was observed. A brief survey completed by the participants postpartum affirmed the perception of women that the educational intervention effectively prepared them for the early postpartum period while their newborns were hospitalized.

  7. 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.

  8. 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

    to systematically identify and analyse studies of matching quality in drug trials. Our primary objective was to assess the proportion of studies that concluded that the matching was inadequate; our secondary objective was to describe mechanisms for inadequate matching. Methods: Systematic review. We searched Pub......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......Med, Google Scholar and Web of Science Citation Index for studies that assessed whether supposedly indistinguishable interventions (experimental and control) in randomized clinical drug trials could be distinguished based on physical properties (e.g. appearance or smell). Two persons decided on study...

  9. Initial clinical experience using the Echo Navigator~-system during structural heart disease interventions

    Institute of Scientific and Technical Information of China (English)

    Jan; Balzer; Tobias; Zeus; Katharina; Hellhammer; Verena; Veulemans; Silke; Eschenhagen; Eva; Kehmeier; Christian; Meyer; Tienush; Rassaf; Malte; Kelm

    2015-01-01

    AIM: To present our initial clinical experience using this innovative software solution for guidance of percutaneous structural heart disease interventions.METHODS: Left atrial appendage, atrial septal defect and paravalvular leak closure, transaortic valve repair and Mitra Clip procedures were performed in the catheter laboratory under fluoroscopic and echocardiographic guidance. The two-dimensional and three-dimensional images generated by the transesophageal echocardiography probe were interfaced with the fluoroscopic images in real-time using the Echo Navigator-system.RESULTS:The application of the novel image fusion technology was safe and led to a better appreciation of multimodality imaging guidance due to improved visualization of the complex relationship between catheter devices and anatomical structures.CONCLUSION:The Echo Navigator-system is a feasible and safe tool for guidance of interventional procedures in structural heart disease.This innovative technology may improve confidence of interventional cardiologists in targeting and positioning interventional devices in order to increase safety,accuracy,and efficacy of percutaneous interventions in the catheter laboratory.

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

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    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.

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

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    Jorgenson Derek

    2012-08-01

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

  12. 临床药师干预前后中药注射剂溶媒选择的合理性分析%Analysis of solvent selection in traditional Chinese medicine injections before and after clinical pharmacists′intervention

    Institute of Scientific and Technical Information of China (English)

    潘京京; 王娟; 王惠川

    2014-01-01

    目的:了解临床药师干预前后,我院中药注射剂溶媒选择的合理性。方法对我院心内科、神经内科自2012年11月至2013年4月使用中药注射剂的病例每月随机抽取40份,对中药注射剂溶媒的选择进行回顾性调查与分析。临床药师将调查结果反馈给临床医生并对其进行中药注射剂溶媒如何选择的培训。结果11月至次年2月,心内科、神经内科中药注射剂溶媒选择不当的病历份数分别高达10%~30%和37.5%~47.5%,临床药师干预后,3月和4月未再出现溶媒选择不当的问题。结论临床药师在规范中药注射剂溶媒的选择中起到了积极的作用,在一定程度上提高了我院合理用药水平。%Objective To probe the rationality of solvent selection in traditional Chinese medicine injections before and after clinical pharmacists′intervention .Methods 40 cases were randomly collected from November 2012 to April 2013 in the department of cardiology and neurology ,respectively .The rationality in solvent selection in traditional Chinese medicine injections was investiga-ted and analyzed retrospectively .Clinical pharmacists feedbacked the results to the clinicians and trained them how to choose the solvent selection rationally .Results The irrational cases about solvent selection in the department of cardiology and neurology were 10%-30% and 37 .5%-47 .5% from November to February ,respectively .The irrationality of solvent selection in traditional Chinese medicine injections was a universal problem in our hospital . Through the clinical pharmacists′efforts , the situation was improved .Conclusion Clinical pharmacists has played a positive role in the choice of the traditional Chinese medicine injection solvent .

  13. Scientific Principles and Rigorous Processes Should Be Followed in Developing Clinical Guidelines for Therapeutic Interventions of Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    LAI Shi-long; WU Da-rong; LAO Ying-rong

    2008-01-01

    @@ A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(1-4).

  14. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis.

    Science.gov (United States)

    Fitzgerald, G K; Hinman, R S; Zeni, J; Risberg, M A; Snyder-Mackler, L; Bennell, K L

    2015-05-01

    A Task Force of the Osteoarthritis Research Society International (OARSI) has previously published a set of guidelines for the conduct of clinical trials in osteoarthritis (OA) of the hip and knee. Limited material available on clinical trials of rehabilitation in people with OA has prompted OARSI to establish a separate Task Force to elaborate guidelines encompassing special issues relating to rehabilitation of OA. The Task Force identified three main categories of rehabilitation clinical trials. The categories included non-operative rehabilitation trials, post-operative rehabilitation trials, and trials examining the effectiveness of devices (e.g., assistive devices, bracing, physical agents, electrical stimulation, etc.) that are used in rehabilitation of people with OA. In addition, the Task Force identified two main categories of outcomes in rehabilitation clinical trials, which include outcomes related to symptoms and function, and outcomes related to disease modification. The guidelines for rehabilitation clinical trials provided in this report encompass these main categories. The report provides guidelines for conducting and reporting on randomized clinical trials. The topics include considerations for entering patients into trials, issues related to conducting trials, considerations for selecting outcome measures, and recommendations for statistical analyses and reporting of results. The focus of the report is on rehabilitation trials for hip, knee and hand OA, however, we believe the content is broad enough that it could be applied to rehabilitation trials for other regions as well.

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

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    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.

  16. [Clinical and preventive intervention in eating behaviour: a dialogue between psychology and nutritional sciences].

    Science.gov (United States)

    Tinoco, Rui; Paiva, Isabel

    2011-12-01

    The eating habits modification is a clinical challenge, both on therapeutic and preventive levels, which requires tools from various areas of health, such as psychology and nutrition. In the structured work in these areas, that includes the referral to specialist consultants, there is a need of a first intervention in Primary Health Care, in clinical and community levels. In this paper, we attempt to systematize useful information for intervention. We will start by reviewing some important interviewing skills, some models of motivational interviewing, and we will make a brief reflection about the client. Then we will analyse an individual case structured in two complementary levels of interpretation: a closer look in general factors and another that reflect the antecedents, consequences and the description of the behaviour problem. We will also tackle issues related to the context in which the individual moves. We will analyse some group intervention programs within a clinical and preventive perspectives. Finally, we will discuss some concepts related to therapeutic adherence.

  17. Relation of metformin treatment to clinical events in diabetic patients undergoing percutaneous intervention.

    Science.gov (United States)

    Kao, John; Tobis, Jonathan; McClelland, Robyn L; Heaton, Melissa R; Davis, Barry R; Holmes, David R; Currier, Jesse W

    2004-06-01

    Diabetic patients undergoing coronary interventions have worse clinical and angiographic outcomes than do patients without diabetes. Metformin, an insulin sensitizer, may decrease the occurrence of these outcomes. Diabetic patients in the Prevention of Restenosis with Tranilast and its Outcomes Trial were identified through their medical records (n = 2,772). In this trial, 1,110 diabetic patients received nonsensitizer therapy (insulin and/or sulfonylureas) and 887 received sensitizer therapy (metformin with or without additional therapy). Logistic regression was used to obtain odds ratios (ORs) (sensitizer vs nonsensitizer therapy) of any clinical event (death, myocardial infarction, or ischemia-driven target vessel revascularization) and adjusted for multiple risk factors. Multivariate analysis showed no effect of lesion characteristics on clinical outcomes. Compared with patients on nonsensitizer therapy, those on sensitizer therapy showed an adjusted OR of 0.72 (95% confidence interval [CI] 0.57 to 0.91, p = 0.005) for any clinical event. The differences between the nonsensitizer therapy group and the sensitizer group were attributable mainly to decreased rates of death (OR 0.39, 95% CI 0.19 to 0.77, p = 0.007) and myocardial infarction (OR 0.31, 95% CI 0.15 to 0.66, p = 0.002). In our retrospective analysis, use of metformin in diabetics undergoing coronary interventions appeared to decrease adverse clinical events, especially death and myocardial infarction, compared with diabetic patients treated with nonsensitizer therapy.

  18. POSITIVE CLINICAL INTERVENTIONS: WHY ARE THEY IMPORTANT AND HOW DO THEY WORK?

    Directory of Open Access Journals (Sweden)

    E.T. Bohlmeijer

    2017-01-01

    Full Text Available In this paper we discuss positive clinical psychology as an emerging field within clinical psychology. Positive clinical psychology is based on research demonstrating that mental health is more than the absence of mental illness, on research showing that wellbeing has buffering effects on the incidence of psychopathology and mental illnesses and on studies demonstrating that positive characteristics, such as positive emotions and gratitude, can predict pathology beyond the predictive power of negative characteristics. In this paper we present three distinct forms of well-being: emotional, psychological and social. In addition we review three types of positive clinical interventions: well-being therapy, positive psychotherapy and acceptance and commitment therapy. The paper ends with a call for a transformation of mental health care in which illness oriented treatments are complemented with well-being oriented treatments.

  19. 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.

  20. 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

  1. 临床药师参与麻醉用药监管对麻醉质量及效率的影响%The Effect of Clinical Pharmacist Participating in the Administration of Anesthetics on the Anesthetic Quality and Efficiency

    Institute of Scientific and Technical Information of China (English)

    蔡蕤; 谢悦旭; 王本军

    2015-01-01

    Objective To study the effect of clinical pharmacist participating in the administration of anesthetics on the anesthetic quality and efficiency. Methods 200 patients who received operation with anesthesia in the hospital during February 2012 to February 2014 were selected and were randomly divided into the control group and the observation group with 100 cases in each group. Operation with anesthesia was performed in the control group, strictly following the procedure of anesthetics. In the observation group, operation with anesthesia was performed with clinical pharmacist participating in the administration of drugs, based on referring to the standard of useage of anesthetics. The anesthetic quality assessment score and the excellent and good rate of patient self evaluation in the two groups were observed. Results The anesthetic quality assessment score in the observation group were(90.6±3.7)points which were higher than(84.4±7.2)ponts in the con-trol group, which was statistically(P<0.05). The excellent and good rate of anesthesia self evaluation in the observation group was 95.0%which was higher than 86.0%in the control group, which was statistically significant(P<0.05). Conclusion Clin-ical pharmacist participating in the administration of anesthetics can effectively improve the tedious procedure management, standardize the use of anesthetics and improve the efficiency. It is of important clinical value in reducing the risk of anes-thesia and operative pain.%目的 研究临床药师参与麻醉用药监管对麻醉质量及效率的影响. 方法 选取该院2012年2月—2014年2月200例进行麻醉手术患者,抽签随机分为对照组和观察组,每组各100例. 对照组严格遵循麻醉药品的用药程序进行麻醉手术,观察组在参考麻醉药品用药标准的基础上由临床药师参与用药监管行麻醉手术. 观察两组麻醉质量考核评价得分和患者自我评价麻醉优良率.结果 观察组麻醉质量评分(90.6±3

  2. Pattern of drug therapy problems and interventions in ambulatory patients receiving antiretroviral therapy in Nigeria

    Directory of Open Access Journals (Sweden)

    Ojeh VB

    2015-06-01

    Full Text Available Objectives: We describe the frequency and types of drug therapy problems (DTPs, and interventions carried out to resolve them, among a cohort of HIV- infected patients on ART in Jos, Nigeria. Methods: A prospective pharmacists’ intervention study was conducted between January and August 2012 at the outpatient HIV clinic of the Jos University Teaching Hospital (JUTH. Pharmacists identified DTPs and made recommendations to resolve them. The main outcome measures were number of DTPs encountered, interventions proposed and acceptance rate of recommendations. Results: A total of 42,416 prescriptions were dispensed to 9339 patients during the eight months study. A total of 420 interventions (Intervention rate of 1 per 100 prescriptions were made to resolve DTPs in 401 (4.3% patients with a mean age of 41 (SD=10 years, and made up of 73% females. DTPs encountered were drug omission (n=89, 21.2%, unnecessary drug (n=55, 13.1% and wrong drug indication (n=55, 13.1%. Recommendations offered included; Addition of another drug to the therapy (n=87, 20.7%, rectification of incomplete prescriptions (n=85, 20.2%, change of drug or dosage (n=67, 16.0%, and discontinuation of the offending drug (n=59, 14.0%. A total of 389 (93% out of 420 of the recommendations were accepted. In all, 50.4% (212 of the problematic prescriptions were changed and dispensed, 22.2% (89 were clarified and dispensed, while wrong identities were corrected in 11.7% (49. However, 7.5% (30 prescriptions were dispensed as prescribed, 5.2% (21 were not dispensed, and 3% (12 were unresolved. Conclusion: Our findings suggest that pharmacists-initiated interventions can ameliorate DTPs in patients receiving ART given the high intervention acceptance rate recorded. The implication of this finding is that pharmacists with requisite training in HIV pharmacotherapy are an excellent resource in detecting and minimizing the effect of antiretroviral drug-related errors.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. Childhood exposure to violence and lifelong health: Clinical intervention science and stress biology research join forces

    Science.gov (United States)

    Moffitt, Terrie E.

    2013-01-01

    Many young people who are mistreated by an adult, victimized by bullies, criminally assaulted, or who witness domestic violence react to this violence exposure by developing behavioral, emotional, or learning problems. What is less well known is that adverse experiences like violence exposure can lead to hidden physical alterations inside a child’s body, alterations which may have adverse effects on life-long health. We discuss why this is important for the field of developmental psychopathology and for society, and we recommend that stress-biology research and intervention science join forces to tackle the problem. We examine the evidence base in relation to stress-sensitive measures for the body (inflammatory reactions, telomere erosion, epigenetic methylation, and gene expression) and brain (mental disorders, neuroimaging, and neuropsychological testing). We also review promising interventions for families, couples, and children that have been designed to reduce the effects of childhood violence exposure. We invite intervention scientists and stress-biology researchers to collaborate in adding stress-biology measures to randomized clinical trials of interventions intended to reduce effects of violence exposure and other traumas on young people. PMID:24342859

  8. Moving from theory to research to practice. Implementing an effective dyadic intervention to improve antiretroviral adherence for clinic patients.

    Science.gov (United States)

    Remien, Robert H; Stirratt, Michael J; Dognin, Joanna; Day, Emily; El-Bassel, Nabila; Warne, Patricia

    2006-12-01

    There is a dearth of evidence on the relative efficacy of intervention modalities to improve and maintain patient adherence to antiretroviral medications. Although empiric findings from research on HIV/AIDS, other diseases, and chronic medical conditions consistently demonstrate that social support plays an important role in facilitating adherence, few HIV/AIDS interventions have directly targeted this factor. Ewart's social action theory emphasizes the role of social relationships in behavior change and provides a comprehensive and useful guide to the development of interventions for adherence. We describe the development, content, and testing of SMART Couples, an effective antiretroviral adherence intervention that is grounded in social action theory and designed to enhance social support for ART adherence. Finally, we discuss some of the challenges of translating findings from the randomized clinical trial of this intervention into clinical practice and offer recommendations for integration of lessons learned into ongoing clinical care.

  9. Efficacy of brief interventions in clinical care settings for persons living with HIV.

    Science.gov (United States)

    Lightfoot, Marguerita; Rotheram-Borus, Mary Jane; Comulada, W Scott; Reddy, Vanessa S; Duan, Naihua

    2010-03-01

    Prevention of HIV transmission from patients living with HIV (PLH) is a high national priority and strategies that are easy to implement and sustain to eliminate sexual transmission acts among PLH are needed. We evaluated a brief intervention that focused primarily on the enhancing motivations and encouraging PLH to act in accordance with their values without providing the intensity of the existing evidence-based programs for PLH. Using a quasiexperimental design, six medical clinics in Los Angeles County, CA, were evaluated across three intervention conditions: 1) computerized delivery; 2) provider delivery; or 3) standard care. We examined longitudinal changes in patients' reports of the number of HIV-negative (HIV-) or serostatus-unknown sexual partners and the number of unprotected vaginal and anal sex acts. Among 566 PLH, PLH in the computerized delivery condition reported a significant decrease in the number of HIV-/unknown sexual partners compared with the provider delivery and standard care conditions and a significant decrease in the number of unprotected sex acts in comparison to the standard care condition. Computerized motivational interventions delivered in waiting rooms at medical clinics may be an efficient strategy to reduce unprotected sex acts among PLH.

  10. 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 ...

  11. Pharmacist or Physician: Age Differences in Satisfaction with Medical Advice

    Science.gov (United States)

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

    2006-01-01

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

  12. Community Pharmacists' Preferences for Continuing Education Delivery in Australia

    Science.gov (United States)

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

    2009-01-01

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

  13. Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health

    DEFF Research Database (Denmark)

    Jørgensen, Sune Dandanell; Skovborg, Camilla; Præst, Charlotte Boslev

    2016-01-01

    maintenance (>10% weight loss), moderate maintenance (1-10%), and weight regain based on weight loss at follow-up (5.3±0.4years). Weight loss during the ILI was achieved by increased physical activity and hypo-caloric diet. Dual X-ray Absorptiometry, blood sample, skeletal muscle biopsy and VO2max test were......OBJECTIVE: Intensive lifestyle interventions (ILI) are criticised for ineffective obesity treatment because weight loss over time is modest and thus of limited clinical relevance. However, a subgroup (5-30%) maintains a clinical weight loss >10%, but it is not clear if cardiometabolic health...... follows this pattern. The aim was to study the effect of different magnitudes of weight loss maintenance after ILI on cardiometabolic health. METHODS: Eighty out of 2420 former participants (age: 36±1, BMI: 38±1, (means ±SE)) in an 11-12-week ILI were recruited into 3 groups; clinical weight loss...

  14. 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

  15. 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

  16. Psychological interventions for terroristic trauma: prevention, crisis management, and clinical treatment strategies.

    Science.gov (United States)

    Miller, Laurence

    2011-01-01

    Terrorist attacks combine features of a criminal assault, a mass casualty disaster and an act of war Accordingly, this article presents a model for prevention, response and recovery from the psychological impact of a terror attack. The nature of terrorism is delineated and the various psychological effects are described, including diagnostic clinical syndromes, as well as individual reactions. Interventions in the immediate aftermath of a terrorist attack include on-scene crisis intervention, short-term psychological stabilization, and longer-term psychotherapeutic approaches. Special techniques are described for individuals, families, children, and large groups of survivors and responders. Finally, the ways that mental health clinicians can serve as valuable consultants to community recovery efforts are discussed.

  17. Pharmacists belong in accountable care organizations and integrated care teams.

    Science.gov (United States)

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

    2013-11-01

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

  18. Interaction between community pharmacists and community nurses in dementia care.

    Science.gov (United States)

    Smith, Veronica M

    2016-04-01

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

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. Screening, Brief Intervention, and Referral to Treatment in a rural Ryan White Part C HIV clinic.

    Science.gov (United States)

    Graham, Lucy J; Davis, Amy L; Cook, Paul F; Weber, Mary

    2016-01-01

    About 24% of people living with HIV nationally are identified as needing treatment for alcohol or illicit drug use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) has evolved as a strategy to assess and intervene with substance abuse behaviors in various clinical settings. However, less is known about the processes and outcomes of using the SBIRT intervention in outpatient HIV clinics. This paper presents a descriptive analysis of de-identified existing SBIRT results data from an outpatient HIV clinic located in western Colorado. From 2008 to 2013, a total of 1616 SBIRT evaluations were done, which included duplicate patients because some individual patients were screened more than once in a given year. Over this time period, 37-49% of encounters per year were notable for tobacco use, 8-21% for alcohol use, 6-16% for marijuana use, 3-9% for amphetamine use, and 0-2% for illicit opioid use. Unique, unduplicated patient data from 2013 revealed 40% of patients used tobacco, 16% used alcohol, and 11% used methamphetamine. Analyses highlighted that the majority of our patient population (58% in 2013) used and/or abused tobacco, alcohol, and/or illicit substances. An alarming finding was the increase in methamphetamine use over time with more than 50-fold prevalence of use in our population compared to national rates.

  4. Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

    Science.gov (United States)

    Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette

    2017-03-20

    In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr(-1). The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

  5. 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

  6. 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.

  7. 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.

  8. Original research paper. Public health care system, a quasi-experimental study: Acceptance and attitude to implicate clinical services.

    Science.gov (United States)

    Gillani, Syed Wasif; Abdul, Mohi Iqbal Mohammad

    2017-03-01

    A six-month longitudinal intervention arm study with a pre-post cross-sectional questionnaire-based survey was performed. A 3-phase objective structured clinical examination (OSCE) design was utilized for evaluation of acceptance and attitude of pharmacy students towards clinical pharmacy services. The pre-OSCE survey showed increased disagreement with the role of clinical pharmacists, compared to a significant positive shift in attitude towards their services in the healthcare team after 6 months of the trial. Responses improved for awareness (the current healthcare system could be improved by involving pharmacists, p model suggested a strong positive effect on patient interaction, medical information tasks, clinical decisions on drug-related problems (DRPs), and communication with healthcare professionals (R2 = 0.41, F = 1.51, p < 0.001).

  9. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring.

    Science.gov (United States)

    Omboni, Stefano; Sala, Elisa

    2015-02-01

    Randomized controlled trials have documented that a team of health care professionals which includes a physician, a nurse and a community pharmacist may improve the benefit and adherence of anti-hypertensive therapy. If such a health care model relies on blood pressure telemonitoring, it can promote a stronger relationship between health care professionals and patients, and further improve BP control of hypertension. The major benefit of this collaborative approach is to center the patient's management in a tailored way, providing comprehensive and preventive care based on health information technologies. In this review, the authors summarize recent clinical studies that evaluate the role of the community pharmacist in BP measurements, and in hypertension screening and control. The authors also describe the advantages of using blood pressure telemonitoring in home and ambulatory settings to evaluate potential alternatives to primary care in hypertension management.

  10. 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.)

  11. Clinical analysis of the early comprehensive intervention on hypoxic ischemic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    Xu-E Li; Yi-MinDu; Yan-JuGuo; Zhi-QingWu; Su-GeHao

    2015-01-01

    Objective:To explore the clinical efficacy of the early comprehensive intervention on hypoxic ischemic encephalopathy (HIE).Methods:HIE children who were admitted in our department from March, 2014 to May, 2015 were included in the study and randomized into the observation group and the control group. The patients in the control group were given routine fluid infusion, electrolyte disturbance correcting, blood sugar maintaining, convulsion controlling, intracranial pressure reducing, hormone, mannitol, vitamins, infection preventing, and other treatments. Based on the treatments given in the control group, the patients in the observation group were given the comprehensive intervention. After treatment, the serum related indicators, NBNA, and DQ in the two groups were observed.Results:The levels of serum AST, LDH, CK, and CK-MB in the observation group were significantly lower than those in the control group (P0.05). NBNA score in the observation group was significantly superior to that in the control group (P<0.05). DQ values at 3, 6, 12, 18, and 24 months in the observation group were significantly higher than those in the control group (P<0.05).Conclusions:Early comprehensive intervention on HIE patients can effectively reduce the serum cardiac enzyme levels, increase the therapeutic effect, improve the intelligence and motor development levels and DQ in order to enhance the living qualities.

  12. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic

    DEFF Research Database (Denmark)

    Rask, Mette Trøllund; Jensen, Mette Lund; Andersen, Jørn

    2009-01-01

    In an ever more burdened healthcare system, there is an urgent need to investigate whether patients benefit from the resources allocated to nurses' communication skills training in terms of improved patient outcomes. This study aimed to evaluate a standardized two 2-day (33 hours) communication...... skills training program in nursing cancer care. Twenty-four nurses in an oncology outpatient clinic participated and were randomly assigned to the intervention program or a control group. A total of 413 patients treated in the clinic during 2 recruitment periods (before and after the communication skills...... training) completed a questionnaire package assessing the nurse-patient relationship, psychological well-being, and cancer-related self-efficacy. Nurse group differences in change scores between time points (baseline, 1 week, and 3 months after the communication skills training) on measures related...

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

    Directory of Open Access Journals (Sweden)

    Kreshnik Hoti

    2011-04-01

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

  14. ADVERSE DRUG REACTION: COMMUNITY PHARMACISTS KNOWLEDGE, ATTITUDE AND BEHAVIOR

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    Ravi Katti Venkappa

    2012-01-01

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

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

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    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

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

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    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.

  17. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

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    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.

  18. Interventional multispectral photoacoustic imaging with a clinical linear array ultrasound probe for guiding nerve blocks

    Science.gov (United States)

    Xia, Wenfeng; West, Simeon J.; Nikitichev, Daniil I.; Ourselin, Sebastien; Beard, Paul C.; Desjardins, Adrien E.

    2016-03-01

    Accurate identification of tissue structures such as nerves and blood vessels is critically important for interventional procedures such as nerve blocks. Ultrasound imaging is widely used as a guidance modality to visualize anatomical structures in real-time. However, identification of nerves and small blood vessels can be very challenging, and accidental intra-neural or intra-vascular injections can result in significant complications. Multi-spectral photoacoustic imaging can provide high sensitivity and specificity for discriminating hemoglobin- and lipid-rich tissues. However, conventional surface-illumination-based photoacoustic systems suffer from limited sensitivity at large depths. In this study, for the first time, an interventional multispectral photoacoustic imaging (IMPA) system was used to image nerves in a swine model in vivo. Pulsed excitation light with wavelengths in the ranges of 750 - 900 nm and 1150 - 1300 nm was delivered inside the body through an optical fiber positioned within the cannula of an injection needle. Ultrasound waves were received at the tissue surface using a clinical linear array imaging probe. Co-registered B-mode ultrasound images were acquired using the same imaging probe. Nerve identification was performed using a combination of B-mode ultrasound imaging and electrical stimulation. Using a linear model, spectral-unmixing of the photoacoustic data was performed to provide image contrast for oxygenated and de-oxygenated hemoglobin, water and lipids. Good correspondence between a known nerve location and a lipid-rich region in the photoacoustic images was observed. The results indicate that IMPA is a promising modality for guiding nerve blocks and other interventional procedures. Challenges involved with clinical translation are discussed.

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

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

    2016-01-01

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

  20. Telehealth: Acceptability, clinical interventions and quality of life in peritoneal dialysis

    Science.gov (United States)

    Dey, Vishal; Jones, Audrey; Spalding, Elaine M

    2016-01-01

    Introduction: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis. Methods: Peritoneal dialysis patients were provided with computer tablets (PODs). PODs contained a knowledge database with treatment- and symptom-based questionnaires that generated alerts for the clinical team. Alerts were reviewed daily and followed up by a telephone call or clinic visit. Interventions were at the discretion of clinicians. Data were recorded prospectively and quality of life and Quebec User Evaluation of Satisfaction with assistive Technology questionnaires evaluated at the start and end of the programme. Results: In all, 22 patients have participated over 15 months. The mean age was 61.6 years and PODs were utilised for an average of 341.9 days with 59.1% choosing to continue beyond the study period. We received a total of 1195 alerts with an average of 2.6 alerts per day. A total of 36 admissions were avoided and patients supported to self-manage on 154 occasions. Quebec User Evaluation of Satisfaction with assistive Technology scores remained high throughout the programme although no improvement in quality of life was seen. Discussion: Telehealth is useful to monitor patients with renal failure on peritoneal dialysis. It is acceptable across age groups and provides an additional resource for patients to self-manage. Satisfaction scores and retention rates suggest a high level of acceptability.

  1. [Current situation of suicide in Japan, and what pharmacists contribute to suicide prevention].

    Science.gov (United States)

    Matsumoto, Toshihiko

    2013-01-01

      In Japan, a national countermeasure has been forwarded since the enactment of the Basic Act on Suicide Countermeasures in 2006 and the Comprehensive Suicide Prevention Initiative in 2007. The distinctive policy of the Japanese countermeasure is expressed as the word, "comprehensive," which means that suicide prevention may not only be carried out only by mental health measures but also by comprehensive measures including chance of administrative practices. This policy is proper, although mental health measures appear to be too simple inclining to psychiatric treatments for the classic type of "depression" by a pharmacotherapy. The authors have insisted that mental health measures including psychiatric treatments are also required to be more comprehensive. This paper describes that benzodiazepine (BZ)-abuse problems including overdosing by suicidal intents have got worse recently as psychiatric clinics have increased and most of BZ abusers obtain the abused drugs form psychiatrists. This current situation indicates that pharmacists need to monitor psychiatrists' prescribing behavior and qualities of psychiatric treatment is required to be refined, suggesting pharmacists may be one of the "Gate Keeper," as supporting resources for suicide prevention. Additionally, this paper explained that basic attitudes and responses acquired by pharmacists as a supporter for suicide prevention.

  2. Pharmacist conscience clauses and access to oral contraceptives.

    Science.gov (United States)

    Flynn, D P

    2008-07-01

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

  3. [The conscientious objection among pharmacists in the Slovak Republic].

    Science.gov (United States)

    Ambrus, Tünde; Kolář, Jozef; Krempaská, Radka

    2016-01-01

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

  4. Evaluation of an Intervention among Adolescents to Reduce Preventive Misconception in HIV Vaccine Clinical Trials

    Science.gov (United States)

    Lally, Michelle; Goldsworthy, Richard; Sarr, Moussa; Kahn, Jessica; Brown, Larry; Peralta, Ligia; Zimet, Greg

    2014-01-01

    Purpose Placebo and randomization are important concepts that must be understood before youth can safely participate in HIV vaccine studies or other biomedical trials for HIV prevention. These concepts are central to the phenomenon of preventive misconception which may be associated with an increase in risk behavior among study participants related to mistaken beliefs. Persuasive messaging, traditionally used in the field of marketing, could enhance educational efforts associated with randomized clinical trials. Methods Two educational brochures were designed to increase knowledge about HIV vaccine clinical trials via 1 and 2-sided persuasive messaging. Through the Adolescent Medicine Trials Network, 120 youth were enrolled, administered a mock HIV vaccine trial consent, and then randomized to receive either no supplemental information or one of the two brochures. Results The 2-sided brochure group in which common clinical trial misconceptions were acknowledgedand then refuted had significantly higher scores on knowledge of randomization and interpretation of side effects than the consent-only control group, and willingness to participate in an HIV vaccine trial was not decreased with the use of this brochure. Conclusion Two sided persuasive messaging improves understanding of the concepts of randomization and placebo among youth who would consider participating in an HIV vaccine trial. Further evaluation of this approach should be considered for at-risk youth participating in an actual trial of a biomedical intervention for HIV prevention. PMID:24613097

  5. 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.

  6. Efficacy of a brief multifactorial adherence-based intervention in reducing blood pressure: a randomized clinical trial

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    Leiva A

    2014-12-01

    (usual care or a multifactorial adherence-based intervention including nurse-led motivational interviews, pill reminders, family support, BP self-recording, and simplification of the dosing regimen by a pharmacist.Main outcome measures: The primary outcome was 12-month blinded measure of systolic BP (mean of three measurements. The secondary outcomes were 12-month diastolic BP and proportion of patients with adequately controlled BP.Results: One hundred and fourteen patients were allocated to the intervention group and 109 to the control group. At 12 months, 212 (89% participants completed the study. The systolic BP in the intervention group was 151.3 versus 153.7 in the control group (P=0.294. The diastolic BP did not differ between groups (83.4 versus 83.6. Of the patients in the control group, 9.2% achieved BP control versus a 15.8% in the intervention group. The relative risk for achieving BP control was 1.72 (95% confidence interval: 0.83–3.56.Conclusion: A multifactorial intervention based on improving adherence in patients with uncontrolled hypertension failed to find evidence of effectiveness in lowering systolic BP.Trial registration: ISRCTN21229328.Keywords: hypertension, medication adherence, blood pressure, intervention studies

  7. Key articles and guidelines for the emergency medicine pharmacist.

    Science.gov (United States)

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

    2011-12-01

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

  8. [Pharmacy and pharmacists in the novels of Orhan Pamuk].

    Science.gov (United States)

    Tekiner, Halil

    2012-05-01

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

  9. Distance magnetic nanoparticle detection using a magnetoelectric sensor for clinical interventions

    Science.gov (United States)

    Huong Giang, D. T.; Dang, D. X.; Toan, N. X.; Tuan, N. V.; Phung, A. T.; Duc, N. H.

    2017-01-01

    Distance magnetic nanoparticle detections were investigated by using a magnetoelectric based magnetic sensor with a long type bilayer Metglas/PZT laminate composite. In homogeneous magnetic fields, the sensor exhibits a sensitivity of 307.4 mV/Oe, which is possible for a detection limit of 2.7 × 10-7 emu. This sensor can detect an amount of 0.31 μg of the superparamagnetic Fe3O4-chitosan fluid at 2 mm height above the sensor surface. To detect a spot with magnetic nanoparticles at a distance of about 7.6 mm, it should contain at least 50 μg of iron oxide. This approach can develop the local detection of magnetic nanoparticles at a depth of centimeters in the body during clinical interventions.

  10. Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment

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    Nilson Abrão Szylit

    Full Text Available CONTEXT: Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determining the most appropriate course of action in these situations. CASE REPORT: In a patient with an ultrasound diagnosis of interstitial pregnancy, clinical treatment using methotrexate was chosen. However, after one week, there was a marked decline in the serum level of the β subunit of chorionic gonadotropin hormone, although an ultrasound examination revealed embryonic cardiac activity. A second dose of the chemotherapy was administered. Embryonic cardiac activity persisted 48 hours later. Video laparoscopy was performed to achieve right-side cornual resection, which resulted in satisfactory resolution of the case.

  11. Distance magnetic nanoparticle detection using a magnetoelectric sensor for clinical interventions.

    Science.gov (United States)

    Huong Giang, D T; Dang, D X; Toan, N X; Tuan, N V; Phung, A T; Duc, N H

    2017-01-01

    Distance magnetic nanoparticle detections were investigated by using a magnetoelectric based magnetic sensor with a long type bilayer Metglas/PZT laminate composite. In homogeneous magnetic fields, the sensor exhibits a sensitivity of 307.4 mV/Oe, which is possible for a detection limit of 2.7 × 10(-7) emu. This sensor can detect an amount of 0.31 μg of the superparamagnetic Fe3O4-chitosan fluid at 2 mm height above the sensor surface. To detect a spot with magnetic nanoparticles at a distance of about 7.6 mm, it should contain at least 50 μg of iron oxide. This approach can develop the local detection of magnetic nanoparticles at a depth of centimeters in the body during clinical interventions.

  12. Hypertension Education Intervention with Ugandan Nurses Working in Hospital Outpatient Clinic: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Godfrey Katende

    2014-01-01

    Full Text Available Noncommunicable diseases (NCDs pose a significant global burden in both developed and developing countries. It is estimated that, by 2025, 41.7% of males and 38.7% of females in Sub-Saharan Africa will develop high blood pressure (HBP. This is particularly true in Uganda with hypertensive prevalence rates estimated to range from 22.5% to 30.5%. Coupled with low levels of detection, treatment, and control, hypertension represents a Ugandan public health crisis. An innovative WHO-ISH education program culturally was adapted in a pilot study and focused on knowledge, skills, and attitudes (KSA of nurses caring for hypertensive patients in an outpatient clinic. Pre-post intervention data was collected and analyzed in which significant improvements were noted on all the three outcome measures. This pilot study demonstrated that nurses’ knowledge, skills, and attitudes could be significantly improved with a multimodal education program implemented in a low resource environment.

  13. [Ageism and its clinical consequences in oncogeriatry: a review of existing data and intervention leads].

    Science.gov (United States)

    Schroyen, S; Adam, S; Jerusalem, G; Missotten, P

    2014-01-01

    Aging is a risk factor in oncology. Indeed, it is estimated that, in 2030, 70% of diagnosed cancers in the United States will concern subjects older than 65 years. Paradoxically, elderly are often excluded from clinical trials and are undertreated compared to younger patients. An important explanatory factor (and yet still not considered!) for these observations is the age stigma (in other words our stereotypes linked to age, and so ageism), age being actually the main motive for discrimination. In this perspective, our aim is to present ageism manifestations in oncogeriatry and their direct consequences for patients, interlocutors (that is to say health professionals) and interactions between them. Throughout this article, we will enhance our remarks by data from researches in "normal" aging. Before ending, we will give some intervention leads potentially applicable in oncogeriatry, to reduce ageism deleterious effect.

  14. Nursing Education Interventions for Managing Acute Pain in Hospital Settings: A Systematic Review of Clinical Outcomes and Teaching Methods.

    Science.gov (United States)

    Drake, Gareth; de C Williams, Amanda C

    2017-02-01

    The objective of this review was to examine the effects of nursing education interventions on clinical outcomes for acute pain management in hospital settings, relating interventions to health care behavior change theory. Three databases were searched for nursing education interventions from 2002 to 2015 in acute hospital settings with clinical outcomes reported. Methodological quality was rated as strong, moderate, or weak using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies. The 12 eligible studies used varied didactic and interactive teaching methods. Several studies had weaknesses attributable to selection biases, uncontrolled confounders, and lack of blinding of outcome assessors. No studies made reference to behavior change theory in their design. Eight of the 12 studies investigated nursing documentation of pain assessment as the main outcome, with the majority reporting positive effects of education interventions on nursing pain assessment. Of the remaining studies, two reported mixed findings on patient self-report of pain scores as the key measure, one reported improvements in patient satisfaction with pain management after a nursing intervention, and one study found an increase in nurses' delivery of a relaxation treatment following an intervention. Improvements in design and evaluation of nursing education interventions are suggested, drawing on behavior change theory and emphasizing the relational, contextual, and emotionally demanding nature of nursing pain management in hospital settings.

  15. Using Interactive Web-Based Screening, Brief Intervention and Referral to Treatment in an Urban, Safety-Net HIV Clinic.

    Science.gov (United States)

    Dawson Rose, Carol; Cuca, Yvette P; Kamitani, Emiko; Eng, Shannon; Zepf, Roland; Draughon, Jessica; Lum, Paula

    2015-06-01

    Substance use among people living with HIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined whether patients would participate in a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic's web-based patient portal linked to their personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n = 39; 41 %). Participants who completed the web-based intervention had significantly higher amphetamine SSIS scores than those who did not complete the intervention. Participants whose substance use is more harmful may be more motivated to seek help from a variety of sources. In addition, it is important that technology-based approaches to behavioral interventions in clinics take into consideration feasibility, client knowledge, and comfort using technology.

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

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    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.

  17. Health-related restrictions of choices and choosing: implications for quality of life and clinical interventions

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    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

  18. Maslach Burnout Inventory: factor structures for pharmacists in health maintenance organizations and comparison with normative data for USA pharmacists.

    Science.gov (United States)

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

    1994-06-01

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

  19. Costing nursing care: using the clinical care classification system to value nursing intervention in an acute-care setting.

    Science.gov (United States)

    Moss, Jacqueline; Saba, Virginia

    2011-08-01

    The purpose of this study was to combine an established methodology for coding nursing interventions and action types using the Clinical Care Classification System with a reliable formula (relative value units) to cost nursing services. Using a flat per-diem rate to cost nursing care greatly understates the actual costs and fails to address the high levels of variability within and across units. We observed nurses performing commonly executed nursing interventions and recorded these into an electronic database with corresponding Clinical Care Classification System codes. The duration of these observations was used to calculate intervention costs using relative value unit calculation formulas. The costs of the five most commonly executed interventions were nursing care coordination/manage-refer ($2.43), nursing status report/assess-monitor ($4.22), medication treatment/perform-direct ($6.33), physical examination/assess-monitor ($3.20), and universal precautions/perform-direct ($1.96). Future studies across a variety of nursing specialties and units are needed to validate the relative value unit for Clinical Care Classification System action types developed for use with the Clinical Care Classification System nursing interventions as a method to cost nursing care.

  20. Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

    Directory of Open Access Journals (Sweden)

    Tommasello Anthony C

    2004-04-01

    Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use

  1. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting

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    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.

  2. Self-reported low self-esteem. Intervention and follow-up in a clinical setting.

    Science.gov (United States)

    Ventegodt, Søren; Thegler, Suzett; Andreasen, Tove; Struve, Flemming; Enevoldsen, Lars; Bassaine, Laila; Torp, Margrethe; Merrick, Joav

    2007-02-09

    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 self-esteem (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 improving self-esteem can be the key to a new life for patients presenting with low quality of life, poor health (physical and/or mental), 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.

  3. Kyphoplasty interventions using a navigation system and C-arm CT data: first clinical results

    Science.gov (United States)

    Hoheisel, Martin; Skalej, Martin; Beuing, Oliver; Bill, Ulrich; Klingenbeck-Regn, Klaus; Petzold, Ralf; Nagel, Markus H.

    2009-02-01

    This study evaluates new applications using a novel navigation system with electromagnetic (EM) tracking in clinical routine. The navigation system (iGuide CAPPA, CAS innovations, Erlangen, Germany) consists of a PC with dedicated navigation software, the AURORA tracking system (NDI, Waterloo Ontario, Canada; needles equipped with small coils in their tips for EM navigation. After patient positioning a 3D C-arm data set of the spine region of interest is acquired. The images are reconstructed and the 3D data set is directly transferred to the navigation system. Image loading and image to patient registration are performed automatically by the navigation system. For image acquisition a C-arm system with DynaCT option (AXIOM Artis, Siemens Healthcare, Forchheim, Germany) was used. As new clinical applications we performed kyphoplasty for reconstruction of collapsed vertebrae. All interventions were carried out without any complication. After a single planning scan the radiologists were able to place the needle in the designated vertebra. During needle driving 2D imaging was performed just in a few cases for control reasons. The time between planning and final needle positioning was reduced in all cases compared to conventional methods. Moreover, the number of control scans could be markedly reduced. The deviation of the needle to the planned target was less than 2 mm. The use of DynaCT images in combination with electromagnetic tracking-based navigation systems allows a precise needle positioning for kyphoplasty.

  4. THE ROLES OF CLINICAL PHARMACY IN REDUCING MEDICATION ERRORS

    OpenAIRE

    Alsaraf Khulood Majid

    2012-01-01

    Potential activation of clinical pharmacist role is of great importance in reducing the medication errors which are a well- known problem in hospital. The medication errors could be prescribing errors, dispensing errors, and administering errors. In this study medication errors randomly were collected by clinical pharmacist and inpatient pharmacist from different wards at a Hospital in Dubai, UAE, from July to October 2011. The results showed that the highest percentage of medication errors w...

  5. Survey of community pharmacists' perception of electronic cigarettes in London

    Science.gov (United States)

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

    2016-01-01

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

  6. Student pharmacist initiated medication reconciliation in the outpatient setting

    Directory of Open Access Journals (Sweden)

    Andrus MR

    2012-06-01

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

  7. Mentalizing Makes Parenting Work: A Review about Parental Reflective Functioning and Clinical Interventions to Improve It.

    Science.gov (United States)

    Camoirano, Andrea

    2017-01-01

    In the last decade several studies have investigated the role of parental reflective functioning (RF), defined as the parental ability to understand his/her child's mental states, on the child's development. Herein, a narrative review on parental RF is presented aimed at (1) presenting an overview of the existing empirical studies, (2) pinpointing unrequited questions, and (3) identifying future research directions. Specifically, the current review focused on (a) the impact of parental RF on the quality of caregiving and the child's attachment security, (b) the effect of parental RF on the child's emotion regulation and the child's RF, (c) maternal RF in women with a history of neglect and abuse, (d) the efficacy of mentalization-based clinical interventions, and (e) the recently developed Parental Reflective Questionnaire. The following terms "maternal RF," "paternal RF," "parental RF," "parental mentalization," "maternal mentalization," and "paternal mentalization" were searched in titles, abstracts, and main texts using Medline, Web of Science, and Scopus databases. Next, a search in Mendeley was also conducted. Inclusion criteria comprised original articles if they refer to the RF Scale (Fonagy et al., 1998) and were published in an English language, peer-reviewed journal before July, 2016. According to exclusion criteria, dissertations, qualitative or theoretical papers, and chapters in books were not taken into account. The review includes 47 studies that, taken together, supported the notion that higher parental RF was associated with adequate caregiving and the child's attachment security, whereas low maternal RF was found in mothers whose children suffered from anxiety disorders, impairment in emotion regulation, and externalizing behaviors. In addition, higher parental RF was associated with better mentalizing abilities in children. However, unexpected findings have emerged from the most recent randomized controlled trials that tested the efficacy of

  8. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Science.gov (United States)

    Forbes, Lindsay J. L.; Forster, Alice S.; Dodd, Rachael H.; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J.

    2012-01-01

    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. PMID:23213334